Cholesterol level management and you- how to do it for best heart health

Having discussed the ‘Good’,’Bad’, and ‘Ugly’ cholesterol in my last article, today we will learn the ways for cholesterol level management for a hale and hearty life.

An increase in cholesterol levels, especially the ‘bad’ and ‘ugly’ ones, above normal level induces deposition of fats in the arteries of our circulatory system by a process termed atherogenesis. This, in turn, leads to a rise in blood pressure and the formation of blocks in the coronary[heart] arteries.

In laboratory blood tests called the Lipid Profile, we lookout for all of the above-mentioned cholesterol levels. Broadly speaking, I would look out for these results:-

  1]Total cholesterol=HDL+LDL+VLDL     

 2]  Non-HDL cholesterol=Total cholesterol -HDL cholesterol. 

 3]Triglycerides   

 4] Total cholesterol/HDL Ratio   

 5]LDL/HDL ratio.

In one of my earlier posts[see Diabetes+Hypertension-a deadly duo-how to prevent effects of both-Part 2] on 20th December 2018, I have mentioned what levels of cholesterol we have to watch out for. In today’s article, I will focus on simple day-to-day remedies other than medicines, for abnormal test findings. As far as medication is concerned, you should consult your family physician if your cholesterol levels are very high. I will also provide a list of commonly prescribed medicines at the end of this discussion.

How is cholesterol formed in our body?

By the way, did you know how cholesterol is formed in our body? I came across one very interesting article written by Dr. Joel Yong who has explained in a very concise manner. Read it here to understand how it is formed so that you may be able to control it without medications–Dr.Joel Yong

How do you manage the different types of cholesterols-

You can manage your cholesterol levels by-

1. Regular exercise
2. Proper diet

Having said this, I will now focus on how to increase the ‘Good’ cholesterol HDL and how to decrease ‘Bad’ cholesterol LDL, VLDL, and TGL.

A] How to increase HDL:- Normally, HDL level ranges from 40 to 65 mg/dl in a person with optimal total cholesterol level and higher the HDL level, better the chances for protection from premature heart attacks. However, with an increase in other non-HDL cholesterols, there is a substantial decrease in HDL. Consider these options for increasing  HDL:-

1. Have a diet rich in carbohydrates with high levels of fibers in it{oats, quinoa, etc.,} and low in fats.
2. Diet rich in mono-saturated fats such as lean meat, avocado, olive oil, canola oil, rice bran oil, etc. increase HDL.
3. Niacin- a B-complex vitamin, also known as vitamin B3-is known to increase HDL. Foods rich in niacin or vitamin B3 are chicken liver and breast, tuna fish, salmon, mushrooms, peanuts, green peas, brown rice, etc.
4. Daily exercise for weight loss—HDL levels increase by 1-2 mg/dl for every 3.5 to 5.00 kg weight loss. A crash diet causes weight loss through loss of water from the body and is not a true weight loss and therefore does not increase HDL. Here, walking briskly for 30 to 45 minutes daily followed by a high-intensity exercise for 5 to 10 minutes, come handy as it tends to burn fats in form of calories thereby reducing weight as well as total cholesterol. Of course, a prudent diet is also a must along with walk and exercise. 

B] How to decrease LDL and VLDL:- 

Raised LDL  cholesterol levels [LDL above 120 mg/dl ] and VLDL levels[above 20 mg/dl] can be brought under control by the following these simple steps:-

• Bodyweight reduction by 5 kg is known to bring down LDL cholesterol by 5%. Brisk walking, jogging, cycling, etc. helps in reducing weight in 4 to 5 months.
• Having about 25 to 50 g of nuts like almonds, walnuts, hazelnuts, etc. daily can reduce LDL by 8-12 %.

  

• Having 5 to 10 g soy proteins [tofu, soy chunks] on a regular basis, first-class proteins like egg whites only [yolk{yellow part} in 1 egg contains 280 mg cholesterol] can reduce LDL by 5%.
• Sat-isabgol [psyllium husk]-a soluble fiber, about 5 to 10 g per day can reduce LDL by 5%.
• Avoid butter and ghee[clarified butter]-instead have Nutralite butter spread, Amul Lite bread spread about 1 to 3 g/day—this can reduce LDL by 5%.

If you follow all the above instructions, your total LDL reduction will be about 25 to 30%.

Having said this, your risk of having a heart attack reduces by 10% on reducing LDL and VLDL by 10%  and 90 % on reducing LDL by 30%.

C] How to decrease Triglycerides [TGL]:- 

Now we come to the topic of Triglycerides-TGL-the ugly cholesterol. Triglycerides are fats consisting of 3 molecules of fatty acids [we will come to this in my next article] combined with 1 molecule of alcohol glycerol. Calories that are consumed during meals but not needed by the body for immediate use, are stored in the form of triglycerides and are stored in fat cells and released when the body needs it in between meals. A high level of TGL, also called hypertriglyceridemia, can lead to inflammation of the pancreas, referred to as pancreatitis, which in the future can lead to diabetes. So it is essential that this ‘ugly’ cholesterol be controlled effectively to avoid complications. Normal TGL level range is 100 to 150 mg/dl where 100 mg/dl is more desirable than 150 mg/dl. So, how do we control it? Consider these points:-

• TGL rises by having foods with a high glycemic index such as refined flour, white bread, alcohol, pastries, soft drinks, etc.—avoid these foods especially in your dinner. People tend to avoid regular breakfast and lunch in the hope that it will bring down weight and have a heavy meal at night—this should be reversed. Having a heavy breakfast, a moderate lunch and a light dinner are highly recommended.
• TGL is high in overweight and obese people. A weight reduction of 5% can bring down your TGL level by 50%. Even without weight loss, TGL will reduce substantially by regular exercise and that includes brisk walking for 40 to 45 minutes, high-intensity training for 5 to 10 minutes, jogging,

  

  weight training in a gym, swimming, cycling for 30 to 40 minutes daily.
•  Food rich in Omega-3 polyunsaturated fats {like fish oil} and alpha-linolenic acid {like oils of flaxseed, canola, mustard, soybean; nuts like almonds, walnuts, peanuts; tofu- a soy product} also helps in reducing TGL.

Having said this and understanding how to reduce cholesterol levels without medicines, we will now discuss the medicines used to bring down cholesterol. One should remember that these are prescription medicines and are to be used only under the supervision of your family physician as they have side effects.

Medications for Cholesterol level Management

They are broadly classified as:-

1. Statins like atorvastatin[eg. Atocor, Atorvas] rosuvastatin[eg. Rosufit, Rosuvas];
2. Fibrates such as fenofibrate[eg. Fenolip];
3. Niacin[eg. Nialip];
4. Fish oil capsules[eg. Seven Seas Capsules].

These medications are used by physicians all over the world in patients who are at risk of heart diseases like hypertension, angina, diabetes, recent heart attack and obesity.

Finally, one should understand that:-

a] High HDL levels are anti-atherogenic;

b] High LDL and TGL levels are atherogenic.

It is very important to keep them at normal levels for a “healthy heart” and “healthy life” and you should consult your family physician if they are abnormal.

 To know about some foods that you can have which help in reducing your cholesterol,  Click here

In my next article, I will discuss the `good’ and the bad’ fats in our diet with some interesting and nourishing recipes using these fats judiciously and which will help manage your cholesterol levels.