Cholesterol & Lipid Profile Advice
Numark Pharmacy information on Cholesterol
Twenty years ago cholesterol was an unfamiliar term outside the medical profession. Today, most health-conscious people know that a high blood cholesterol level is unhealthy but there are complex issues and questions concerning its role in causing heart disease. Hopefully the information that follows is in easily understandable terms that will shed some light on the relationship between cholesterol and health.
What is Cholesterol?
Cholesterol is an essential component of certain hormones, body structures and digestive acids. The amount of cholesterol needed to perform these bodily functions is manufactured internally in the liver.
Saturated fats tend to increase blood cholesterol. Foods high in saturated fat include
- Fatty Meats
- Whole-milk products
- Hydrogenated vegetable oil
- Coconut oil
- Palm kernel oil
- Palm oil
- Cocoa
- Butter
They are commonly found in commercial baked goods, processed foods, and non-dairy creamers. Though products made with such ingredients may be labelled "Cholesterol Free" or "made with 100% Vegetable Oil" consumers should be aware that the presence of saturated fat may adversely affect blood cholesterol.
Cholesterol is also found naturally in certain foods such as
- Red meat (particularly liver and other organ meats)
- Whole-milk products
- Egg yolks
- Egg yolks (the whites are cholesterol-free), pack the highest concentration of cholesterol of any food. The yolk from one GradeA egg contains 71% of a persons recommended daily cholesterol intake, which is 300mg per day. Some shellfish-lobster, crab and shrimp -are also high in cholesterol: however, they are also very low in saturated fat.
Cholesterol -conscious shoppers should read product labels and and purchase items that are made with polyunsaturated oil(safflower,sunflower,corn,soybeen and cottonseed) or mono-unsaturated oil(olive,peanut and canola oils). Both polyunsaturated and monounsaturated fats tend to lower blood cholesterol.
Saturated fat should account for no more than 10% of total fat intake. Total fat intake should account for no more than 30% of total caloric intake. Currently, the average person person gets 37% of calories from fat, of which 13% are saturated.
Why do I need to be concerned about cholesterol?
If the cells are given more cholesterol than they can use they have no way to get rid of the excess. The unused cholesterol can form deposits in the coronary arteries, restricting blood flow to the heart. This condition known as arteriosclerosis, is the leading cause of coronary heart disease.
Reducing a high level cholesterol can reduce the chance of dying of a heart attack in people who have coronary disease as well as in individuals who have no evidence of heart disease. Therefore evidence indicates that monitoring whole cholesterol is in the interest of everyone.
What's the difference between "Good" and "Bad" Cholesterol?
These terms are sometimes used to describe high-density lipoprotein (HDL) and low density lipoprotein and low density lipoprotein (LDL), which are types of protein molecules that carry cholesterol throughout the body. LDL is called "bad" because it deposits cholesterol in the coronary arteries( causes hardening of the arteries called Atherosclerosis) thereby increasing the risk of coronary heart disease. HDL is deemed "good" because it remove cholesterol from blood circulation, actually decreasing the risk
A diet high in saturated fat and cholesterol is believed to reduce the clearance of LDL from the blood, while obesity and excess calories stimulate the over production of LDL. The ratio of HDL to LDL is important. The ratio should be less than 4. This can be achieved by increasing the level of HDL or by lowering the level of LDL. Dietary measures may reduce LDL, however they may also reduce HDL. In order to prevent this it is important to exercise. Exercise not only reduces the levels of LDL but also increases HDL.
The most effective and beneficial way of improving your lipid profile is a combination of exercise and diet.
What are Triglycerides?
Triglycerides, a type of fat that is transported throughout the body by very low-density lipoproteins(LDL cholesterol), are used by the body as energy. The liver manufactures Triglycerides and converts some into cholesterol. Saturated ,polyunsaturated and monounsaturated fats are all types of Triglycerides.
How Can Triglycerides Affect Health?
A persistently high concentration of Triglycerides in the blood may add to the risk of coronary heart disease, especially if the cholesterol is elevated or other coronary heart disease factors are present.
How Are Levels Of Cholesterol And Triglycerides Determined?
Cholesterol level is determined by testing a small sample of blood .The analysis can be done using a small desktop analyser.
Interpretation Of Results
In general 5.0 mmol (millimoles) of cholesterol per litre of blood (mmol/l) or lower is considered a desirable result
Total Cholesterol 3.0 -5.0 mmol/l
HDL 0.8 -2.2mmol/l
LDL 3.37-2.2mmol/l or under
Triglycerides 0.2-1.7mmol/l
Glucose 3.3 -11mmol/l
Ratio Less than 4
Lipoprotein analysis may also be performed. This test breaks down total cholesterol level into proportions of HDL and LDL providing a more accurate indicator of coronary heart disease risk. Total cholesterol divided by HDL should be under 4. The ideal ratio is under 3.5. At a ratio of between 3.5 and 4.5 Atherosclerosis is slowly progressing according to leading heart disease experts. With LDL a level of 3.37mmol/l is desirable:3.37-4.12 mmol/l is borderline-high and 4.14 mmol/l and above is considered high risk.
An even more detailed analysis of blood cholesterol considers Triglycerides. There is a wide range of normal Triglyceride levels depending on age and sex. As a rule a Triglyceride level of between 0.45 and 1.81 mmol/l or less can be considered normal. Above this may be cause for concern.
Approximately 5 to 10 percent of individuals have mildly elevated Triglycerides. There is no widely accepted schedule for frequency of Triglyceride testing.
How Often Should I Get My Cholesterol Tested?
There are conflicting opinions as to how often cholesterol should be tested. Your doctor can give you more information. It is usually recommended that cholesterol testing should be performed on all adults age 20 years and older. If the level is less than 5.0mmol/l the next test should be in 12 months. If the person tests between 5.18 and 6.19mmol/l and is without coronary heart disease or two risk factors of the disease dietary counselling and annual cholesterol testing is advised. If the person tests 6.22mmol/l or greater and has coronary heart disease or two risk factors of the disease, a lipoprotein analysis a full lipid profile is advised.
If My Cholesterol Is High How Can I Lower It ?
If your doctor recommends that you lower your cholesterol level, initially he may give you dietary and exercise guidelines, which may or may not be aimed at weight loss. If after following the guidelines carefully your cholesterol level has not reached the desired goal, your doctor may prescribe medication.
Lowering the blood cholesterol level
Heart disease remains the commonest form of death and disability in the UK it is mainly due to social factors such as excessive cigarette smoking, physical inactivity and eating habits which elevate the cholesterol level in the blood. Outlined below are the dietary principals, which will reduce the blood cholesterol levels. They form the basis of a healthy diet for the whole family but should be followed more carefully if you have a raised blood cholesterol.
Meat, fish, Poultry, eggs
Have up to 6oz (cooked) a day of lean meat, chicken or turkey (without skin), veal, fish, scallops, oystes, mussells, crab or lobster. Limit egg yolks to two a week, Soy protein meat substitute and egg whites may be used as desired. Grilling or frying in recommended oil are preferable. When roasting, place meat on a rack to allow the fat to drain. Avoid fatty meat, sausage, goose and duck ( which are high in saturated fat), and liver kidney, heart brains, sweetbreads, shrimp, prawns and fish roe (which are rich in cholesterol). A 2oz serving of liver may be substituted for one egg yolk. Also avoid commercially fried food and canned or frozen meat products containing gravy or sauces.
Dairy Products
Use skimmed milk:low fat yogurt, skimmed milk cheese and cottage cheese as desired. Restrict other cheeses to 1oz a week. Avoid whole milk, condensed milk, cream, butter, non-dairy coffee creamers, commercial whipped topping and ice cream.
Fats and Oils
Choose margarine rich in polyunsaturated fat. Sunflower oil, corn oil and soybean oil for cooking and salad dressings. Avoid hard cooking fats and regular margarines.
Vegetables and Fruits
All vegetables and fruits are allowed. Limit avocado to one per week.
Breads, cakes, cereals
Whole wheat, white, brown and rye bread are low in fat; also rye or wheat crispbread and matzo. All cereals are permitted, including grain products such as rice, macaroni, semolina and flour. Bake at home using skimmed milk, egg white and allowed fat. Avoid commercial cakes, biscuits other than those above), buns and pastries.
Sweets
Sugar, jam, honey, syrup, boiled sweets, marshmallow, and hard peppermints are permitted. Chose sorbet or meringues for desert. Avoid all other sweets such as chocolate, toffee and fudge.
Miscellaneous
Olives, pickles and most nuts are acceptable
Dining Out
Chinese and fish restaurants are ideal, but avoid deep-fried food and creamy sauces, and ask for fish to be prepared without butter.Elswhere, regard all fat-containing items as likely to be rich in saturated fat. Select clear soup or salad; follow with grilled fish, poultry or lean meat and vegetables prepared without fat. End with a sorbet or fruit. Balance an enforced dietary lapse with extra care for the next day or so, and enjoy your wine-its harmless in moderation.
In this book Dr Tom Smith describes in his easily accessible style the causes of high cholesterol, the associated problems, the complications and the risks involved if your high cholesterol goes untreated.
