Cholesterol is a fat-like substance, which is found in all cells of the body. It is naturally made in the body as well as found in some foods. Cholesterol is attached to proteins called lipoprotein and carried throughout the bloodstream. Lipoproteins are conjugated protein, which contains a lipid component. They are small packages, which are made out of fat on the inside and protein on the outside. These are required for transporting fat molecules in the blood. There are two important kinds of cholesterol.
- Low-density lipoprotein (LDL-cholesterol)
- High density cholesterol (HDL-cholesterol)
In simple terms, LDL cholesterol is known as bad cholesterol because it leads to build-up of cholesterol in your arteries. Whereas HDL cholesterol is known as good cholesterol because it carries cholesterol from other parts of the body to the liver and liver further removes it from the body. High total cholesterol levels surely have devastating effects on the body.
Diagnosis of high blood cholesterol
A blood test is done to check the cholesterol levels. The patient is not allowed to eat or drink anything except water for 10-12 hours before this test.
|Total cholesterol levels||Interpretation|
|Less than 200 mg/dL||Desirable/Normal/Healthy|
|200-239 mg/dL||Borderline high/ Slightly unhealthy|
|240 mg/dL or higher||High/ Unhealthy|
|LDL cholesterol levels||Interpretation|
|Less than 100 mg/dL||Desirable/optimal/normal|
|100-129 mg/dL||Near optimal|
|130-159 mg/dL||Borderline high|
|190 mg/dL and higher||Very high|
|HDL cholesterol levels||Outcome|
|Less than 40 mg/dL||A major risk factor for heart disease|
|40-59 mg/dL||Usually considered healthy but the higher, the better|
|60 mg/dL and above||Provides protection against heart disease|
Role of cholesterol in the body
Cholesterol can be your body’s friend if maintained within desirable range, but if the levels are on the higher side, it can be your body’s worst enemy. Cholesterol plays various important roles in the body. Therefore it is not possible to complete avoid cholesterol. Some of the functions include.
- Cholesterol is found in all the cells and integral part of cell membranes.
- Cholesterol plays an important role in the production of hormones such as aldosterone, testosterone, estrogen, progesterone and testosterone.
- It also helps in the production of bile acids, which aid digestion, and absorption of certain vitamins (fat-soluble vitamins such as vitamin A, D, E and K).
- Cholesterol is an important precursor for the production of vitamin D.
- Cholesterol is also required for a healthy skin.
- It is also required for brain development, intracellular transport, and cell signaling and nerve conduction.
Risk factors: What are causes of high cholesterol?
- Obesity: Body mass index (BMI) of more than 30 increases the risk of high cholesterol.
- Smoking: It damages the blood vessels and causes accumulation of fatty deposits in them. It also reduces the level of HDL (good) cholesterol, which provides protection to the heart.
- Large waist circumference or abdominal obesity: The risk of having high cholesterol levels increases if your waist circumference is around 40 inches (for males) and 35 inches (for females).
- Sedentary lifestyle or lack of exercise: Sedentary lifestyle lowers the level of HDL (good) cholesterol, which in turn increases the risk of high cholesterol levels and heart disease. A regular exercise for at least 30 minutes daily helps to improve HDL cholesterol levels and reduces the level of LDL cholesterol.
- Poor diet: A diet high in cholesterol such as organ meat, red meat, bakery products and fried foods can raise your cholesterol levels.
Food Restriction in high Cholesterol
Patient with high cholesterol should avoid following foods.
- Egg yolk
- Liver and other organ meat
- Fried foods
- Fast foods such as burger, pizza, French fries etc
- Full fat milk, cream and yogurt
- Vegetable (Vanaspati) Ghee
- Bakery products such as cookies, biscuits, puffs, cakes, pastries and pie
Nutritional management of high cholesterol levels
Here are some nutritional and dietary management tips for lowering the cholesterol levels.
SELECTION OF FAT
Reduce intake of trans-fat and saturated fat
Less than 7% of total calories should come from saturated fat and less than 1% should come from trans-fat. Saturated fat raises the level of LDL cholesterol, which in turn increases the risk of developing cardiovascular diseases.
Foods high in saturated fat include.
- Full fat dairy products
- Palm oil
- Chicken skin
- Fried foods or foods with high fat content
- Processed meats such as salami and sausages
Trans-fat also known as ‘partially hydrogenated oils’ is produced during an industrial process when hydrogen is added to liquid vegetable oil to make it solid.
Trans-fat is usually present in foods such as
- Bakery products- Biscuits, crackers, pastries, pizza dough and pie crust.
- Processed foods
Increase intake of unsaturated fat
There are two main types of unsaturated fat: monounsaturated fat (MUFA) and polyunsaturated fat (PUFA). Around 20% of total calories should come from MUFA and less than 10% from PUFA. Studies have shown that both MUFA and PUFA lower LDL cholesterol, but MUFA provides extra health benefits. It raises HDL cholesterol.
Sources of MUFA include:
- Olive oil
- Peanut oil
- Peanut butter
- Mustard oil
- Rice bran oil
- Canola oil
Sources of PUFA include
- Sunflower oil
- Safflower oil
- Corn oil
- Cottonseed oil
- Soybean oil
It is very well known that a higher BMI (more than 30) and abdominal obesity increases the risk of hypercholesterolemia or high blood cholesterol levels. Losing body weight by 10% will help reducing the risk of hypercholesterolemia and cardiovascular diseases. Following a healthy diet and regular exercise will surely enhance weight loss.
Dietary fibers are plant substances that escape digestion by human gastrointestinal enzymes. There are two main types of dietary fiber.
- Soluble Fiber
- Insoluble Fiber
Studies suggest that soluble fiber helps to lower LDL cholesterol levels and further reduces the risk of coronary artery diseases. When a fiber rich diet is consumed, soluble fiber from the diet binds bile acid and cholesterol and reduces the cholesterol content of liver cells. This leads to up-regulation of LDL receptors and increases the clearance of LDL cholesterol. 30 to 35 grams of dietary fiber should be consumed daily to bring about significant reduction in the cholesterol levels.
Foods with high fiber content include.
- Fruits such as apple, pear, banana, orange, peaches, figs and berries
- Vegetables especially green leafy vegetables such as spinach, collard greens, mustard greens, beet greens, turnip greens and Swiss chard. Cruciferous vegetables are also good sources of dietary fiber
- Oat bran
- Wheat bran
- Whole grains such as barley, oats, sorghum, pearl millet, finger millet, whole wheat, brown rice, buckwheat, quinoa, amaranth (grain)
- Pulses, legumes and beans such as lima beans, kidney beans, black beans, navy beans, mug beans and pinto beans
- Nuts and oilseeds such as almonds, walnuts, flaxseeds, pumpkin seeds and sunflower seeds
STRICTLY RESTRICT RED MEAT
Red meat such as beef, pork and lamb has higher cholesterol and saturated fat content as compared to chicken and fish. If you want to eat meat, select lean cuts of meat. Check on the package for words such as sirloin, loin and round before purchasing lean meat. Also before cooking, trim off as much as fat, as you can.
HEALTHIER COOKING METHODS
Instead of frying, use healthier cooking methods such as baking, broiling, stewing and grilling. In addition, one should not add cashew paste, cream and other full fat dairy products to gravies and soups for thickening.
Sample Diet Plan
|On rising||2 teaspoons roasted flaxseeds with 1 glass of water.|
|Breakfast||1 cup green tea + 1 bowl fiber rich cereal grain with vegetables + 1 glass low-fat milk OR 1 bowl porridge with skimmed milk (porridge can be made out of oats, barley, quinoa, broken wheat) OR 2 egg whites with 2 slices of wholegrain or multigrain bread.|
|Mid-morning||1 fruit/ 1 cucumber/1 carrot or 4 soaked almonds.|
|Lunch||1 bowl salad with pumpkin seeds + 2 serving whole grain cereals + 1 serving whole pulses/sprouts/2-3 pieces grilled chicken/2 pieces fish/ 2-3 egg whites + 1 bowl low-fat yogurt.|
|Mid-morning||1 cup green tea + 1 serving of fiber rich cereal grain|
|Evening-||1 glass unstrained vegetable juice/ 1 bowl unstrained soup with 2 spoons sprouts.|
|Dinner||1 bowl salad with pumpkin seeds + 2 serving whole grain cereals + 1 serving whole pulses/sprouts/2-3 pieces grilled chicken/2 pieces fish/ 2-3 egg whites + 1 bowl low-fat yogurt.|
|Bed-time||1 glass low-fat milk|
Quick Tips for Lowering High Cholesterol Levels
- Eat at least 3-4 servings of vegetables and 2 servings of fresh fruits daily.
- Eat at least 5-6 servings of whole grain cereals daily.
- Eat 4 soaked almonds or 1 walnut daily.
- Replace full fat dairy products with low fat dairy products.
- Limit intake of fried snacks and food with high fat content such as crisps, wafers, chips, cakes and cookies.
- Use PUFA and MUFA oils for cooking (select from the list above).
- Trim visible fat from meat before cooking.
- Fish is a great source of omega-3 fatty acid, which helps to lower total cholesterol. Eat 100 grams of fish twice a week.
- Select soft margarines over harder stick forms.
- Read the food label carefully. Look at the total fat, cholesterol, saturated fat and trans-fat content of foods before purchasing.