Dr Tilak Suvarna, senior cardiologist at Asian Heart Institute
This fat molecule/lipid is a necessary component in the cell membrane, and it helps in the synthesis of steroid hormones, bile acids & many other important functions. There are two major types of cholesterol, bad cholesterol ( VLDL & LDL ) & good cholesterol ( HDL ).But like everything else, you don’t want too much of it–especially the bad types–very low-density lipoprotein (VLDL) and low-density lipoprotein (LDL). These carry cholesterol from the liver to the peripheral tissues and blood vessels. High levels of bad cholesterol leads to atherosclerosis–the accumulation of cholesterol-rich fatty deposits in important arteries, coronary (leading to the heart) and carotid (leading to the brain).
This can cause arteries to narrow or get blocked, slowing or stopping the flow of blood to these two vital organs. Good cholesterol or High-density lipoprotein (HDL), on the other hand, protects against heart attacks and strokes by removing cholesterol from the arteries and bringing it back to the liver. Here are five facts about cholesterol you need to know.
- Your body makes most of the cholesterol you need. The liver and intestine help to synthesise it (about 1g daily or 85% of your cholesterol). You need only a small amount of fat in your diet (approx 300 mg) to help you stay healthy. Diabetics need about 200 mg fat from food sources. To give you an idea, the yolk of an egg has about 180 mg cholesterol. Animal products (red meats, full-fat dairy products, etc.) are loaded with cholesterol, and having too much of them may increase the amount of cholesterol in your body. A high-fiber diet can reduce the effect by cutting cholesterol absorption in the gut. Try to get most of your calories from plant sources-vegetables, fruits, whole grains, beans, nuts, and seeds. Non-vegetarians should eat fish at least twice a week. Canola, rice bran, olive, groundnut, and mustard oils are all good cooking mediums. However, don’t go overboard with them as they are high in calories.
- Cholesterol numbers by themselves do not indicate a high risk. Cholesterol is part of the larger equation ( what we call as risk factors ) that includes age, sex, race, other health conditions such as diabetes, blood pressure, smoking or tobacco habit and sedentary lifestyle. This determines the 10-year risk of cardiovascular disease and then a treatment strategy is planned. (Try tools.cardiosource.org/ ASCVD-Risk-Estimator/ to calculate your 10-year risk.) People with elevated LDL are usually put on medicines called statins to bring it down.
- Triglycerides count too. Triglycerides are also fat molecules like cholesterol. They store unused calories and provide your body with energy. When you eat, your body converts excess calories into triglycerides, which are stored in your fat cells. Later, hormones release triglycerides for energy between meals. Eating more calories than your body needs, particularly the easy ones like carbohydrates and fats, leads to high triglyceride levels. Excess triglycerides also lead to fatty deposits and blockages in the artery increases the risk of vascular disease. Some health conditions such as diabetes and hypothyroidism can lead to hypertriglyceridemia. Also, high triglycerides along with low HDL and high LDL, known as atherogenic dyslipidemia, are particularly common among Indians. Researchers think it is due to our genetic predisposition and characteristic body pattern with central obesity
- Age and sex play a role. Cholesterol levels naturally go up with age, especially in women. At the same age, pre-menopausal women have lower LDL and higher HDL than men. But things Change drastically after menopause. Scientists believe that oestrogen plays a role in it. However, both men and women need to take more precaution as they age.
- Exercise helps. Regular exercise helps in clearing the bad cholesterol and increases good cholesterol. Studies show that exercising 20 minutes a day may increase your HDL by 2.5 points. For every additional 10 minutes per day, you could add an extra 1.4 points to your HDL.