Elevated blood lipids can affect anyone and needs to be addressed early on. It is important that the Lipid Profile is checked on a regular basis especially above the age of 30. High levels of cholesterol and Triglycerides can increase the risk of heart disease. Taking action early on is crucial in bringing the levels into a normal range to protect your health. Therapeutic Lifestyle Changes include having a healthy diet, being physically active and fit to keep body weight at an optimum level.
Types of Cholesterol
Cholesterol is important to maintain the motility of the cell wall and helps in hormonal and Vitamin D production. There are 2 main types of cholesterol- Low Density Lipoproteins (LDL) and High Density Lipoproteins (HDL)
LDL- Is also known as ‘bad' cholesterol because higher the level of LDL in the blood, greater the risk for heart disease. This is carried to the arteries of the heart where it forms plaque leading to a condition called arthrosclerosis(hardening of the arteries)
HDL- Is also known as ‘good' cholesterol because it removes cholesterol from tissues to the liver, from where it is eventually removed by the body. If HDL levels decrease, this puts you at a greater risk for heart disease.
Factors affecting cholesterol levels:
Age and sex: Cholesterol rises from the age of 20 to the age of 60-65 years. Women generally have protection against cholesterol until menopause due to the presence of oestrogen.
Heredity: High cholesterol is partly determined by genes. But this is not the only reason for elevated levels and steps can be taken to lower it.
Diet: A diet rich in trans-fat, saturated fat and cholesterol on a regular basis increases risk
Weight and Physical inactivity: Extra pounds raise the levels of Triglycerides, while lowering HDL.
Diabetes:Diabetes lowers HDL levels and raises LDL and serum triglycerides which increases the risk for heart disease and stroke. This common condition is called diabetic dyslipidaemia
Blood pressure:Increase in blood cholesterol increases your risk of coronary heart disease. Other risk factor such as high blood pressure causes an increased risk.
Smoking:Cigarette smoking lowers HDL and increases the risk of coronary artery disease.
Cholesterol values and Ranges:
Total Cholesterol |
|
|---|---|
Less than 200 mg/ dL |
Desirable |
200-239 mg/ dL |
Borderline High |
Above 240 mg/ dL |
High |
LDL Cholesterol |
Optimal |
Less than 100 mg/dL |
Near optimal |
100–129 mg/dL |
Borderline high |
130–159 mg/dL |
High |
160–189 mg/dL |
Very High |
190 mg/dL and above |
Very High |
HDL Cholesterol |
|
Less than 40 mg/dL |
Major heart disease risk factor |
60 mg/dL and above |
Gives some protection against heart disease |
Source: https://www.nhlbi.nih.gov/files/docs/public/heart/chol_tlc.pdf
Necessary Changes
| Component | Change needed | % of LDL reduction |
|---|---|---|
| Saturated Fat | Decrease to less than 7% of calories | 8–10% |
| Dietary Cholesterol | Decrease to less than 200 mg/ day | 3-5% |
| Weight | Lose 5 kgs if overweight | 5-8% |
| Soluble Fiber | Add 10 g/ day | 3-5% |
| Plant sterols | Add 2g/ day | 5-15% |
| Total | 20-30% |
Source: https://www.nhlbi.nih.gov/files/docs/public/heart/chol_tlc.pdf
If your BMI is above 35, this puts you in the obesity category. A weight loss of at least 15-20% of your total body weight is important to show significant changes in your Lipid Profile and other health benefits. (http://patient.info/health/obesity-and-overweight-in-adults)
Triglycerides
Triglycerides are another kind of fat found in the blood; in excess these are associated with coronary heart disease, diabetes and fatty liver disease which are all indicative of metabolic health. Elevated Triglycerides along with low HDL and high levels of LDL is associated with heart disease and stroke. They are formed directly from the fats in the food or the body can make them by turning refined and simple carbohydrates into new fats (primarily in the liver), known as lipogenesis.
| Serum Triglycerides | |
|---|---|
| Less than 150 milligrams per deciliter (mg/dL). | Normal |
| 150 to 199 mg/dL | Borderline high |
| 200 to 499 mg/dL. | High |
| 500 mg/dL or higher | Very high |
Source: https://www.nhlbi.nih.gov/files/docs/public/heart/chol_tlc.pdf
Necessary Changes
| Component | Change needed | % of STg reduction |
|---|---|---|
| Weight loss | Loss of 5-10% of excess body weight | 20% |
| Brisk Walking ( 150 minutes per week) | Over a period of 3 months | 20-30% |
| Diet and exercise | Up to 50% |
Source: https://www.nhlbi.nih.gov/files/docs/public/heart/chol_tlc.pdf
Guidelines for a healthy lipid profile
• Adopt a heart healthy eating plan that is low in unhealthy fats like trans- fat, saturated fat and cholesterol. If you are overweight you can take help from a qualified Dietitian to plan your meals so that you have enough calories to reach a healthy weight. Along with a healthy diet, you need to engage in 45-60 minutes of some exercise of moderate intensity for at least 5 days/ week,exercise should be done on the recommendation of your Doctor or Physiotherapist. Studies have shown that a 5-10% weight loss results in a 20 % decrease in triglycerides, the weight lost is directly proportional to decrease in triglyceride levels.
• A healthy balanced meal plan is not some restrictive ‘diet' plan. You need to approach it as a new way of eating healthy on a regular basis. This can involve healthier cooking methods, right food choices and inclusion of more fruit and vegetables in your meals.
• Fiber is also important as part of the healthy heart diet, both soluble and insoluble fiber reduce LDL cholesterol. These fibres differ in how they go through the digestive tract. Insoluble fiber is undissolved and is found in whole grains, fruits with skin, vegetables, beans and peas. Soluble fiber dissolves in the digestive tract and is absorbed into the blood stream helping to lower LDL cholesterol further. Fiber should be added to the diet gradually as a sudden increase can cause abdominal discomfort and bloating especially if it is not chewed properly. Add bran, oats, and fruits with skin, sprouts, vegetables, beans and lentils to your diet.
• Plant sterols are found in small amounts in foods like soybean, these help in blocking the absorption of cholesterol from the digestive tract. These help to lower LDL levels in a matter of weeks.
• Omega 3 fatty acids are found in fatty fish, walnuts, canola, soybean and flaxseed. These fatty acids are protective in nature as they prevent the formation of blood clots and inflammation of the artery walls. Try and include fatty fish prepared in a healthy way like grilling/ poaching/ baking or steaming in your diet twice a week.
• Sodium is found in table salt, reducing the amount of sodium help lower blood pressure which is again protective against heart disease. The Consensus Action on Salt and Health states- ‘It has been estimated that a reduction in salt intake from 10g a day to 6g will reduce blood pressure and could lead to a 16% reduction in deaths from strokes and a 12% reduction in deaths from coronary heart disease.'
• Avoid simple sugars and refined carbs, for those with elevated triglyceride levels, even fructose from fruits needs to be regulated as part of the diet. Fructose in processed and naturally occurring foods should be less than 50 to 100 grams per day. All carbs should be limited to 60% of the total calories in a day.
Making lifestyle changes can be a challenge but in the long run it is worth it. It will help you live longer and healthier by lowering unhealthy levels of cholesterol. Keep in touch with your Doctor and Dietitian on a regular basis. These health changes are not a one-time activity and needs regular follow up so that you can achieve good health. Their guidance is essential to learn how to eat healthy and exercise right.