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The big FAT truth

MOUSHMI KISHORE
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HEALTH Reduce LDL, the bad cholesterol, and increase HDL, the good cholesterol, in your diet

JUNK FOOD CRAZEAs pizzas and burgers are within easy reach, people have less time and lesser inclination to hit the gym
JUNK FOOD CRAZEAs pizzas and burgers are within easy reach, people have less time and lesser inclination to hit the gym

The major cause of high cholesterol is eating items rich in fat, especially saturated fat. High cholesterol is a major risk factor for heart disease. It isn’t something which should cause concern only to overweight, middle-aged people. It’s something we should all be aware of. Heart disease is the biggest killer, and cholesterol is a major risk factor. If you think that the normal reading you got a few years ago signifies that you’re in the clear, think again. Levels of artery clogging often rise with age, and cardiologists say that everyone age 20 or older should be screened for high cholesterol at least once every five years, with more frequent screening for anyone deemed to be at a high risk for heart disease. If it’s been a while since your last cholesterol screening, now is a good time to ask your doctor if you’re due for one.

India is the global heart disease capital. “There are many things that put us at risk — sedentary lifestyle, unhealthy diet, stress, diabetes, hypertension and narrow arteries. Indians have narrower arteries compared to their western counterparts, putting them at a greater risk for heart disease,” says Dr. Pavan Kumar, cardiac surgeon in Mumbai. Clogging and formation of deposits which cause blocks occur easily in smaller arteries. Even bypass surgery and grafting becomes challenging.

“India has witnessed an increase in the number of bypass surgeries, and multiple bypass surgeries; what was earlier in the 60s age group has come down to the 50s,” he says. While the incidence of heart disease among women is alarming, the risk goes up post menopause; what was earlier in the 40-45 age group, is presently the 36-38 age group, due to the increase in the incidence of early menopause. Around one in 500 people in India have familial hypercholesterolaemia, which implies that they have inherited high cholesterol levels. If there’s a history of heart disease in your family, it’s especially important to keep your cholesterol in check.

Cholesterol is a fatty substance manufactured in the liver and it can also be found in various edible items. It is necessary to build cells, manufacture steroid hormones and Vitamin D, and produce bile acids, which help in the absorption of fats. It is carried around the body in the blood. When it exceeds the normal range, it is deposited on the walls of the arteries, increasing the risk of heart disease.

How much is too much?

Ideal cholesterol levels are less than 200mg/dl; the borderline is between 200-225mg/dl, and a high cholesterol level is 250mg/dl or more,” says Dr. Pavan Kumar. “Those already at risk of developing heart problems, diabetes or high blood pressure should bring their cholesterol levels down to 200gm/dl,” advises Monica Sinha, consulting dietician and nutritionist in Mumbai. There are two types of cholesterol — LDL, the ‘bad’ kind, and HDL, the ‘good’ kind, which carries the bad type to the liver for elimination. “A healthy level for LDL should be less than 100, and HDL should be 45 mg/dl or more,” says Dr. Pavan Kumar.

What causes high cholesterol?

Apart from family history, eating too much fat, especially saturated fats and trans-fats, the kind which is solid at room temperature, such as butter, is the main cause. “One of the first things to do when you are lowering your cholesterol level is to take saturated fat down by a few notches,” says Monica Sinha. “The second thing to do is to start eating more smart fats.” Saturated fats are present in meat, dairy products and baked products. Trans-fats are present in fried and processed foods, most baked foods and tiffin items.

If you include items which are high in saturated fats, trans-fats and cholesterol in your diet, then they can lead to an increase in your LDL or ‘bad’ cholesterol. People who take too much alcohol and don’t exercise have more LDL cholesterol. Being overweight can also lead to high levels. We reach for cars all the time, and it’s only the miniscule population that hits the gym. With items such as burgers and pizzas within easy reach, we have less time and lesser inclination for a traditional low-fat, low-cholesterol, high-fibre diet. Today, we are more into a carbohydrate-centric diet. If you have a family history of high cholesterol, chances are you might also have it. Cholesterol levels also increase with age. For women, LDL levels tend to increase after menopause.

What are the risks if the cholesterol level is too high?

“The main risk is an increased chance of developing coronary heart disease,” says Dr. Pavan Kumar. When the blood vessels to the heart (the coronary arteries) become lined with fatty material, such as cholesterol, your blood is unable to flow freely. As the arteries narrow, insufficient blood reaches the heart, which can result in chest pain, known as angina. If a clot forms in the artery wall, the result is a heart attack.

Easy ways to lower your cholesterol

“Bringing it down to a safer level could be easier than you think. In fact, with simple lifestyle modification and, if necessary, medication, people see a significant reduction in their cholesterol levels. According to Sinha, exercise plays an important role in managing cholesterol. It is important to do cardiovascular exercises three to four times in a week; walking or running is an excellent choice. It will help keep cholesterol under check. It also raises the level of ‘good’ or HDL cholesterol, which has a protective effect. Certain dietary changes will also help reduce bad cholesterol. Studies have shown that fibre reduces cholesterol. Add to it by eating a lot of fresh vegetables and whole grain cereals. Try to consume raw vegetables and salads every day. Choose a diet low in saturated fats and trans-fats. Avoid animal fats, dairy products, ghee, butter, ice-cream, and fried items.

“You may use olive oil or rice bran oil as your cooking medium. Traditional oils such as sunflower oil, groundnut oil and mustard oil, when used in moderation is good. Coconut oil may be used once in a month. It is important to keep changing your oil and use it in alteration. This not only helps lower consumption, but also helps you get all types of good fats, which lower the cholesterol level,” says Sinha.

Include sources of omega-3 fatty acids, such as walnuts, flaxseeds, salmon and sardines in your diet. Replace full-fat dairy products with a low-fat equivalent — skimmed milk, half-fat cheese, low-fat yogurt and spreads. Trim skin off chicken and fat off meat and grill rather than fry it; you should also eat wholemeal bread, pasta and fresh fruits and vegetables. Reduce salt intake, and substitute honey for sugar. Indians tend to put off medical checkups and many visit the doctor only when they have already had a heart attack. A little awareness can go a long way in prevention!

MOUSHMI KISHORE

There are many things that put us at risk — sedentary lifestyle, unhealthy diet, stress, diabetes, hypertension and even narrow arteries

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