Monday 29 July 2013

All about Cholesterols - Good and Bad

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A number of facts and myths about cholesterol are widely circulated. I recently received a comprehensive PPT presentation on this topic. It appears to be from a reliable source. Important points in that  document are presented in this post.

Our liver produces 75% of the cholesterol that circulates in our blood. The other 25% comes from food. At normal levels, cholesterol actually plays an important role in helping cells do their jobs.

High cholesterol itself does not cause any symptoms. But it does cause damage deep within the body. Over time, too much cholesterol may lead to a buildup of plaque inside the arteries. Known as atherosclerosis, this condition narrows the space available for blood flow and can trigger heart disease.

Cholesterol Testing is done with a simple blood test known as a fasting lipoprotein (or Lipid) profile. It measures the different forms of cholesterol that are circulating in your blood after you avoid eating for 9 to 12 hours. The results show your levels of "bad" cholesterol, "good" cholesterol, and triglycerides

Most of the cholesterol in the blood is carried by proteins called low density lipoproteins or LDL. This is known as the 'Bad cholesterol' because it combines with other substances to clog the arteries. A diet high in saturated fats and trans fats tends to raise the level of LDL cholesterol. For most people, an LDL score below 100 is healthy, but people with heart disease may need to aim even lower.

Up to a third of blood cholesterol is carried by high-density lipoproteins or HDL. This is called Good cholesterol because it helps remove bad cholesterol, preventing it from building up inside the arteries. The higher the level of HDL cholesterol, the better. People with too little are more likely to develop heart disease.

The body converts excess calories, sugar, and alcohol into Triglycerides, a type of fat that is carried in the blood and stored in fat cells throughout the body. People who are overweight, inactive, smokers, or heavy drinkers tend to have high triglycerides, as do those who eat a very high-carb diet. A triglycerides score of 150 or higher puts you at risk for metabolic syndrome,  which is linked to heart disease and diabetes.

Total cholesterol measures the combination of LDL, HDL, and VLDL (very low density lipoprotein) in your bloodstream. VLDL is a precursor of LDL, the bad cholesterol. A total cholesterol score of under 200 is considered healthy in most cases. People who score in the "high" range have an increased risk of developing heart disease compared to those who score below 200

To calculate your cholesterol ratio, divide your total cholesterol by your HDL cholesterol. For example, a total score of 200 divided by an HDL score of 50 equals a cholesterol ratio of 4 to 1. Doctors recommend maintaining a ratio of 4 to 1 or lower. The smaller the ratio, the better.

Research shows that the cholesterol we eat has only a small effect on blood cholesterol levels for most people. A few people are "responders," whose blood levels spike up after eating eggs.  But for most, saturated fat and trans fats are bigger concerns.  Daily cholesterol limits are 300 mg for healthy people and 200 mg for those at higher risk. One egg has 186 mg of cholesterol.

Cholesterol comes from two sources: the body and food : and either one can contribute to high cholesterol. Some people inherit genes that trigger too much cholesterol production. For others, diet is the main culprit. Saturated fat and cholesterol occur in animal-based foods, including meat, eggs, and dairy products made with milk.  In many cases, high cholesterol stems from a combination of diet and genetics

Several factors can make you more likely to develop high cholesterol:
A diet high in saturated fats and cholesterol
A family history of high cholesterol
Being overweight or obese
Getting older

Until menopause, women typically have lower total cholesterol levels than men of the same age. They also have higher levels of HDL cholesterol, the good kind.  After age 55, a woman's risk of developing high cholesterol begins to climb. Cholesterol can begin clogging the arteries during childhood, leading to atherosclerosis and heart disease later in life.  Ideally, total cholesterol should be below 170 in people ages 2 to 19.

High cholesterol leads to a buildup of plaque that narrows the arteries. It can restrict blood flow and is one of the major risk factors for coronary artery disease, heart attacks, and strokes. It also appears to boost the risk of Alzheimer's disease.  If the blood supply to a part of the heart or brain is completely cut off, the result is a heart attack or stroke

Cholesterol Busters:
Eat More Fiber :The soluble fiber found in many foods helps reduce LDL, the bad cholesterol. Good sources of soluble fiber include whole-grain breads and cereals, oatmeal, fruits, dried fruits, vegetables, and legumes such as kidney beans.
Know Your Fats: No more than 35% of your daily calories should come from fat.  Saturated fats  from animal products and tropical oils  raise LDL or bad cholesterol, while lowering the good kind. These two bad fats are found in many baked goods, fried foods , stick margarine, and cookies. Unsaturated fats may lower LDL when combined with other healthy diet changes. They're found in avocados, olive oil, and peanut oil
Smart Protein : Meat and full-fat milk offer plenty of protein, but they are also major sources of cholesterol. You may be able to reduce LDL cholesterol by switching to soy protein, such as tofu, at some meals. Fish is another great choice. It's rich in omega-3 fatty acids, which can improve cholesterol levels.
 Low-Carb Diet :Low-carb diets may be better than low-fat diets for improving cholesterol levels.
Lose Weight: If you're overweight, losing weight can help you reduce your levels of triglycerides, LDL, and total cholesterol.
 Quit Smoking :When you stop smoking, your good cholesterol is likely to improve by as much as 10%.
 Exercise :An aerobic exercise program could increase your good cholesterol and lower bad cholesterol. Choose an activity that boosts your heart rate, such as running, swimming, or walking briskly, and aim for at least 30 minutes on most days of the week; two 15-minute walks works just as well. However, you must cosult your doctor before starting exercise.

Treatment: Medications can give your cholesterol levels an extra nudge. Statins  block the production of cholesterol in the liver. Other options include cholesterol absorption inhibitors, bile acid resins and fibrates. Your doctor may recommend a combination of these medications.
Certain dietary supplements may also improve cholesterol levels.
Herbal Remedies :Some studies suggest garlic can knock a few percentage points off total cholesterol. But garlic pills can have side effects.

Many people are able to lower cholesterol levels through a combination of medication and lifestyle changes. But how low is low enough? For people with diabetes or a high risk of developing heart disease, an LDL score of less than 100 is desirable. If you already have heart disease or coronary artery disease, some doctors recommend reducing LDL to 70 or lower

Can the Damage Be Undone? It takes years for high cholesterol to clog the arteries with plaque. But there is evidence that atherosclerosis can be reversed, at least to some degree. A low-fat vegetarian diet, stress management, and moderate exercise can chip away at the build-up inside the coronary arteries.

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