Rudra Dahal
Many people think high cholesterol is a big health problem. It is partly true. Cholesterol is an integral part of our body and we need it. However, it can be a dangerous foe when we are not able to keep a good balance between ‘good ‘and ‘bad’ cholesterol. Lack of knowledge about how we can control our cholesterol with some simple life style modifications prevents us from enjoying our lives in healthy way. Cholesterol is a white, odourless fat-like substance that constitutes a group of substance known as lipid. Every cell in our body is covered by protective membrane composed partly of cholesterol. Cholesterol is essential for our health and well-being. It is used to produce steroid hormones such as testosterone, estrogen and progesterone, cortisol, aldosterone required for our normal functioning and development. Vitamin D which is responsible for strong bone also uses cholesterol. Cholesterol is used to make bile, which is needed to digest food that contain fat and absorb fat soluble vitamins A, D, E and K. Cholesterol is found in many foods we eat daily, although we cannot see it on our plate. All the animals have potential to produce cholesterol, so, all animal sources foods like milk, egg, meat, cheese, butter contain cholesterol. Plants on the other hand do not have capacity to produce cholesterol, so, plant sources of food like grains, cereals, nuts, fruits, vegetables, and even vegetable oils do not have cholesterol. They, however, can have fat which is unsaturated. Our body can manufacture the cholesterol it needs for its various functions. We also get cholesterol from food containing animal products. To balance these two sources of cholesterol, our body adjusts the amount it produces each day. When most of the food we eat comes from animal sources that contain a substantial amount of dietary cholesterol, our body slows down its own production of cholesterol automatically. Our body can also eliminate some excess cholesterol by converting it to bile acids.
Cholesterol exists in the body in different forms. Low density lipid (LDL) cholesterol is a ‘bad’ cholesterol and is harmful in excess amount as it accumulates in the blood vessels making them narrow. Chest pain and heart attack result from narrowing of the arteries that supply blood to the heart. Paralysis or stroke occurs when the blood vessels supplying the brain get blocked. These serious consequences occur years after such ‘bad’ cholesterol continues to increase higher than the normal range. Blood test is the only way to know if we have high cholesterol level before serious effects are seen, so that we can try ways to prevent or postpone such grave consequences. High density lipid (HDL) cholesterol is ‘good’ cholesterol. It helps reduce the effects of ‘bad’ cholesterol by sending low density lipid cholesterol to liver for other use rather than letting it get deposited in the wall of blood vessels. It is best to have such cholesterol in ideal range. When the blood test is done to check total cholesterol, level of HDL or LDL cholesterols or triglycerides, which constitute total cholesterol, can be measured. There are different risk factors for having high cholesterol level in blood, which is medically known as hyperlipidemia. Poor diet is the biggest risk factor which is under our control. Consuming saturated fat and trans fats can raise cholesterol level in the body. Saturated fat is found in all animal products and trans fat is found in commercially prepared junks foods. Red meat and full fat dairy products can greatly increase cholesterol level in blood which gets deposited in blood vessels. Lack of physical exercise increases the risk of high cholesterol. Physical exercise helps to increase HDL or “good” cholesterol and limits LDL or “bad” cholesterol in the body. Smoking is a dangerous thing to have, particularly in people who already have other risk factors for heart disease or high cholesterol. The chemicals in cigarette damage the wall of arteries and increase the risk of heart attack and stroke. Diabetes is another big evil in people who have high cholesterol, as high blood sugar also damages the wall of arteries. Some people have genetic risk of having high cholesterol that run in family, known as familial hypercholesterolemia. They cannot change their genetic risk but can reduce the chances of having serious consequences by paying more attention in controlling other risk factors. Those who are obese or have large waist circumference have more risk of having high cholesterol. There are some simple ways to combat the ill effect of ‘bad’ cholesterol and prevent the risk of dying early or suffering from its serious health consequences. We can choose to live healthy by eating healthy food and choosing healthy lifestyle. The food we eat daily determines the amount and type of fats that goes to our body. We should minimize fatty food from animal sources and junk food as they contain saturated and trans fat that increase ‘bad’
cholesterol. Lipids or fats are also necessary nutrients for our body. There are better sources of fat that contain unsaturated fatty acids and HDL cholesterol. Plant sources of fat, fish, curd etc. are some examples of sources of ‘good’ fats needed for our body. It is better to consult dietician or doctor to get better advice on the type of food that best suits your health condition. It is always good to eat more fruits and vegetables and take plenty of high fibre diet and water as a part of our daily meal. If you have diabetes, you should keep blood sugar under control using medicine and lifestyle modification as advised by your doctor. If you smoke, you should consider quitting it completely. Alcohol is also bad and should be avoided. Do regular physical exercise, at least thirty minutes in a day. You should also reduce your weight and decrease sedentary activities such as watching television for a long time. Doctors recommend medicine based on level of cholesterol in blood and presence of any additional risk factors such as diabetes, smoking, family history etc. Medicines have side effects and are generally used when dietary and lifestyle changes are not able to reduce cholesterol level adequately. But, when needed, medicines decrease the risk of early death or complications, so medicine should be used regularly when recommended by doctor.
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