It?s unsettling but true. Cardiovascular disease is the world?s leading killer. And one of the biggest reasons for this is high blood cholestrol. According to statistics, from 2000 to 2005, coronary heart disease has gone up from 4 to 11% in urban areas.
Says Dr Sameer Shrivastava, principal consultant cardiologist at Escorts Heart Institute and Research Centre, ?South Asians and especially Indians are very prone to developing heart attacks and blockages in the heart arteries. Compared to the West, we are four times more prone to these.? According to WHO estimates, by 2010, 60% of the world?s cardiac patients will be Indians. These are alarming figures.
The other major risk factors for coronary heart disease are said to be high blood pressure, cigarette smoking, diabetes, a sedentary lifestyle and stress. But let?s take a closer look at cholestrol.
What exactly is cholesterol?
Cholesterol is a type of lipid found in the cell membranes. It comes from two origins: food intake and production by the liver. The liver produces approximately 1000 milligrams of cholesterol everyday. Triglycerides are another form of fat that circulates in the blood.
What are LDL and HDL?
Cholesterol and triglycerides cannot dissolve in blood, so they have to be transported by molecules called lipoproteins. About a quarter of the blood cholesterol is carried away by HDL, or High Density Lipoproteins away from the arteries and back to the liver, where most of it is got rid of. On the other hand, LDL (low density lipoproteins) and VLDL (very low density lipoproteins) carry the cholesterol to the cells, and this ultimately forms plaque lining the arteries. That?s why LDL and VLDL are known as bad cholesterol.
Why is it dangerous?
A blood cholesterol level of 240 mg/dl or more is considered high and needs medical attention. However, a level more than 200 is considered borderline and can increase the risk of heart disease. High blood cholesterol is said to lead to atherosclerosis, a condition under which there is a deposition of fat in the arteries of the heart, brain or kidney. This leads to a thickening of the blood vessels, leading to reduced flow of blood. The plaque that deposits in the walls of the arteries can further rupture, throwing into the bloodstream dead cells, crystals and fat molecules that deter the flow of blood, causing clots.
This could be due to a number of factors: high blood pressure, force of the blood damaging the artery. And also stress. A rise in stress levels leads to a rise in fat and cholesterol in the bloodstream. Wherever there is damage, blood platelets stick to the lining and speed up fibrous plaque formation.
Strokes are also associated with cholesterol. A small clot could break away from cholesterol debris in the carotid arteries in the neck. The clot could wedge its way into a part of the brain causing cerebral embolism. An embolism that gets lodged in an artery supplying blood to the brain results in stroke. And if it lodges itself in a coronary artery, then it is a heart attack.
Why we need cholesterol?
Cholesterol plays an important part in preventing cell membranes from becoming too fluid or too rigid. Lipid rafts (of which cholesterol is a vital part) help secure proteins which are needed as important neuro- transmitters. It is used by the liver to synthesise bile acids. These mix fat with water-soluble enzymes and help in digestion. Mental health, a strong immune system, prevention of cancer and blood sugar regulation, all need vitamin D. For this the body needs seven-dehydrocholesterol. It helps control blood pressure, blood sugar, mineral balance and libido. Last, but not least, it protects the body against infection. When an arterial cell is damaged by infection, cholesterol is dispatched to repair the damage.
Nutritionist Dr Shikha Sharma feels that cholesterol-reducing drugs like statins do not solve the problem, but offer only temporary solutions. 99.9% of cases of high blood cholesterol can be cured by the right diet and regular exercise.
Recommended lifestyle
Recommended diets take into account the age, gender and lifestyle of a person. A balanced diet is important. Studies have shown a connection between stress and elevated levels of cholesterol. Clearly, then, diet is not the only factor that can bring down the level of cholesterol. A healthy lifestyle would involve, apart from a healthy diet, regular exercise, meditation, and relaxation techniques. For some people, medication to bring down cholesterol may be necessary.
Physical exercise is very important as it affects blood lipid and cholesterol levels. It raises the level of HDL and lowers LDL and triglycerides and changes the fraction of blood fat converted into LDL by the liver. Exercise, if done regularly, could bring about a dissolving of fat in plaques in the arteries.
Says Anil Tandon, an engineer in his early 40s who works for a private company, ?After an annual medical check up I found that my cholesterol levels were alarmingly high. Now I am on cholesterol reducing drugs. I have changed my eating habits and cut down on fried foods and red meat. I also go for morning walks and practice yoga every day. I also decided to spend one day with the family to relax and shut my mind off all work. Playing golf also helps me to relax. Now my cholesterol levels are down to normal.?
Suniti Chauhan, a physical instructor at a private school followed a similar routine. ?Rotis made with soya flour mixed with wheat atta and plenty of sprouts, salads and fresh fruits make up her family?s diet. Dr Shrivastava recommends mustard or canola oil. Soya, sesame and olive oils are also preferred to other fats. A mix of these, used in rotation is advised by him. He recommends two to three teaspoonfuls of oil in a day for a healthy adult.
