Reducing your Cholesterol level

Cholesterol is a lipid that is essentially made by the liver and also obtained in our diet. The body needs cholesterol to make some hormones, maintain cell structure, digest lipids in food and so on.

Good cholesterol is cholesterol carried by High Density Lipoprotein (HDL-Cholesterol) because it mops up cholesterol from the blood and carries it to the liver for removal from the body. Bad cholesterol refers to that carried by Low Density Lipoprotein (LDL-Cholesterol) because it is made by the liver and sent to different parts of the body and hence increases the amount of cholesterol in the blood.

Ultimately high levels of bad cholesterol leads to the formation of plaques in the blood vessels that cause narrowing and blockage of blood vessel and causing heart attacks, strokes, kidney diseases and death.

The major factors that enhance the damaging effect of high blood cholesterol include; having diabetes, being a smoker, having hypertension or high blood pressure, not being physically active enough, being overweight or obese, and having a family history of high blood cholesterol or premature coronary heart disease.

It is therefore important for everyone to know his/her blood cholesterol level especially if you are over 35 for males and over 45 for females.

Measuring blood cholesterol involves a simple blood test called the serum fasting lipid profile. This test tells the levels of all lipids in the blood as well as the total cholesterol. You will be required to fast overnight before the test.

For normal readings one must obtain a total cholesterol level under 4 mmol/l, LDL cholesterol level under 2 mmol/l and an HDL cholesterol level above 1 mmol/l. Another lipid measured includes triglyceride whose level must be under 1.7 mmol/l. Of these the level of LDL is the most important.

The blood cholesterol level rises if we eat too much fat or saturated oils. Some people have high cholesterol levels as a result of an underactive thyroid gland, long-term kidney problems, or having too much alcohol. Also, about 1 in 500 people have high cholesterol levels because of the inherited condition known as familial hyperlipidaemia or hypercholesterolaemia in which the liver makes excessive amount of cholesterol.

The liver is able to make cholesterol from fats and saturated oil found in food items such as butter, hard cheese, fatty meat, meat products, biscuits, cakes, cream, lard, dripping, suet, ghee, coconut oil and palm oil. Cholesterol can also be made from oils obtained from pastries, cakes, biscuits, crackers, hard margarines and food that have hydrogenated oils. Excessive alcohol drinking also raises the cholesterol levels in the blood.

Appropriate diet can significantly reduce blood cholesterol level. Eating foods that are high in 'soluble fibre' such as porridge, beans, pulses, lentils, nuts, fruits and vegetables can help lower cholesterol by preventing it absorption in the gut. A high-fibre diet also helps to fill you up, making you less likely to snack on fattening foods.

Saturated oils and fats are bad because the liver makes bad cholesterol from them. On the contrary unsaturated oils are good because the body makes good cholesterol out of them and essentially reduce the blood cholesterol levels. Food containing unsaturated oils and fats include corn oil, sunflower oil, soya oil, nuts and seeds. Others include walnuts, pine, cashew, avocado and sesame seeds. Another very important source is oil from fishes. Oils from oily fish such as herring, mackerel, pilchards, sardines, salmon, trout and fresh tuna help reduce blood cholesterol.

There is evidence that substances called 'plant sterols' and 'stanols' – which are added to certain foods including margarines, spreads, soft cheeses and yogurts – may reduce blood cholesterol levels.

Exercise reduces blood cholesterol because being active increases the level of HDL cholesterol (the 'good' cholesterol). Exercise also helps lower blood pressure, helps maintain a healthy weight and reduces the risk of getting diabetes. To get the most benefit, you need to be active enough (for at least 30 minutes) to make you feel warm and slightly puffed but still able to have a conversation. It's important to build up gradually the amount of activity that you do.

Drinking alcohol in moderation also reduces blood cholesterol. Keep within the sensible limits. Men should drink no more than 3-4 units (where 1 unit = 10mls of 100% alcohol) each day and women no more than 2-3 units each day. The number of units of alcohol in a drink can be determined by multiplying the volume of the drink (in millilitres) by its percentage, and dividing by 1000.

Keep to a healthy weight for your height. Here, body mass index (BMI) is used. This involves dividing one's weight (in Kg) by the square of one's height (in m) a result over25 is considered over weight. Where the blood cholesterol is too high or the above mentioned interventions do not help, doctors may recommend drugs to help lower the blood cholesterol levels. These drugs include statins, fibrates, and nicotinic acid drugs. The doctor will always do well to monitor the blood level of cholesterol as one is put on these drugs.

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