Cholesterol Management

We all know that heart health is important and that we should maintain a healthy diet and take regular exercise, but our hectic lifestyles don't always allow for this. However, because heart disease and stroke are the main causes of death in Ireland, it's vital that we understand the risk factors involved and how best to manage them.

Heart disease and stroke account for almost 40% of deaths in Ireland, killing over 10,500 people here in 2004. Narrowing of the coronary arteries makes it difficult for blood to reach the heart muscle and can lead to heart disease. If an artery leading to the heart muscle becomes completely blocked, it is called a heart attack. During a heart attack, cells in the heart muscle may die because they are starved of vital oxygen and nutrients. Like the heart, the brain is also supplied with arteries to feed it with oxygen and nutrients. If an artery leading to the brain is completely blocked, brain cells may die and brain damage may occur - this is known as a stroke.

The good news is that the risk of developing heart disease and stroke can be significantly reduced or even prevented by taking various steps towards better heart health. Taking these steps should help you to feel better and to live a longer, healthier life.

Modifiable Risk Factors

Smoking

Quit Smoking! (See Article of 13th-26th February)

High blood pressure

Hypertension can cause silent damage to the blood vessels and the heart. You should have it checked by your doctor regularly so that he may suggest a treatment plan if required.

Obesity (being overweight)

Your pharmacist or doctor can calculate your Body Mass Index, a good indicator of whether you are overweight or not.
Lack of exercise

Get 30-45 mins. of physical activity 4 to 5 times weekly.

Diabetes

Do you have diabetes? It is important to know this, as untreated diabetes places you at a higher risk of a heart attack or other heart disease.
High Cholesterol...

Cholesterol is a type of fat that is essential for the body in small amounts. It is produced in the liver and obtained from the diet. LDL (low-density lipoprotein) is often called 'bad cholesterol' because high levels of LDL in the blood promote the accumulation of fat in the vessel walls. Over time a plaque can form, which hardens the walls of the arteries and makes it more difficult for blood to get through. LDL levels above 3 mmol/l are associated with an increased risk of heart disease and stroke.
HDL (high-density lipoprotein) is often called 'good cholesterol' because it retrieves cholesterol from the walls of arteries and from body tissues and helps to transfer it to the liver for disposal. HDL cholesterol should be 1 mmol/l or higher.
Total cholesterol should be 5 mmol/l or lower. This is the sum total of all the cholesterol in your blood. The higher a person's total cholesterol, the greater their risk for heart disease.

As having high cholesterol is not something you can just feel or see, many people don't realise that they have unhealthy cholesterol levels which are putting them at risk. This is why it is so important for people who may be at risk of developing heart disease or stroke to have their cholesterol levels checked regularly - at least yearly. This can be done easily by a GP or hospital clinic. If lifestyle changes do not bring your cholesterol or blood pressure to healthier levels then your doctor may decide that you need to take medication.

Tips for Healthier Eating

Diet should be Low In
Animal Foods, especially liver, kidney, pate, egg yolks (three per week recommended). Animal foods are the only direct source of cholesterol in the diet. Most blood cholesterol is actually made within the body, from other fatty components in the diet. It is critical, therefore, that a low cholesterol diet be combined with a low-fat diet.
Saturated Fats, including foods such as butter, fatty meats and meat products, dairy products, chips, biscuits, cakes and confectionery.

Diet should be Moderate In
Monounsaturated Fats, which have been shown to have a positive effect in increasing HDL levels. Sources of monounsaturated fats include olive oil, almonds, pecans, peanuts, cashews, avocados and fish. Only moderate intake of these fats is recommended as they are high in calories.
Complex carbohydrates may beneficially decrease LDL cholesterol levels. However they may also lower 'good' HDL levels so should only be eaten in moderation. Sources of complex carbohydrates include potatoes, rice, whole grains and root vegetables.

Diet should be Rich In
High Fibre Foods. These reduce the absorption of cholesterol in the gut. Flaxseed is an ideal source of soluble fibre as it contains a gum-like substance to bind to bile (which contains cholesterol) and dietary cholesterol so that the body excretes it. Furthermore flaxseed is a good source of Omega-3 fatty acids and prostaglandins which control the way cholesterol works in the system, regulating blood pressure and arterial function.
Walnuts can significantly reduce blood cholesterol. Rich in polyunsaturated fatty acids, walnuts also help keep blood vessels healthy and elastic. Almonds appear to have a similar effect. All nuts are high in calories, however, so a handful a day is enough to have a positive effect.
Plant Sterol or Stanol-fortified foods, such as some margarines and spreads, help block the absorption of cholesterol. These foods are only recommended for people who actually have high levels of LDL cholesterol. Yellow and orange fruits and vegetables are recommended to prevent decrease of the important vitamin beta-carotene which may occur with consumption of plant sterols.
Omega-3 Fatty Acids and Fish, such as salmon, mackerel and herring, help reduce the stickiness of blood, protecting it from clotting.

Thus, whether one has a predisposition to heart disease or not, there are still many areas of one's life that may be targeted to help control overall risk. As always, where there is scope, there is hope! Many people have surprised themselves with whole number reductions in their total cholesterol levels, just by modifying their diet and exercising as recommended. See what you can do!