Introduction

Cholesterol is a fat-like substance that is produced by the body or derived from food. It is necessary for the body to function normally and is used to build cell walls, though it takes only a small amount of in the blood to meet those needs. The cholesterol is carried through one’s bloodstream by special proteins called lipoproteins.

There are two types of lipoproteins. One is low-density lipoprotein (LDL) or “bad” cholesterol, which will increase the build-up of fats in the arteries. The other is high-density lipoprotein (HDL) or “good” cholesterol, which removes cholesterol from the cells before they are deposited as plaque in the arteries.

The goal is to keep your total cholesterol level as low as possible. Any excess cholesterol in the blood may be deposited in the arteries, including the coronary arteries. This build-up causes hardening and narrowing of the arteries, causing blood flow to the heart to be reduced or blocked. If there is insufficient blood and oxygen to the heart, one may experience chest pain. If the blood supply to a portion of the heart is completely cut off by a blockage, heart attack may occur.

Check cholesterol levels regularly

Several common factors that can increase your cholesterol levels include heredity, diet, weight, physical inactivity, age, gender, alcohol, and stress.

However, high blood cholesterol itself does not cause symptoms. Therefore, it is important to check your cholesterol level regularly, to reduce your susceptibility to coronary heart disease.

If your total cholesterol level is between 5.2 and 6.1mmol/L, you are at an increased risk for coronary heart disease. If your total cholesterol level registers at 6.2 mmol/L and above, you are having hypercholesterolaemia, which is attributable to genetic factors, diabetes mellitus, obesity, and poor eating habits.

The desirable level of LDL depends on your preexisting risk for coronary heart disease. If you already have coronary artery disease, peripheral vascular disease, or diabetes, you are in the high-risk group and the desirable level is more stringent. Conversely, if you have none or only one risk factor, a higher value of LDL is acceptable before medical intervention.

HDL protects against heart disease, so the higher HDL levels, the better. A level less than 1.0 mmol/L is low and is considered a risk factor. The risk of heart disease is lower when HDL level is 1.0 mmol/L or more. Women usually tend to have higher HDL cholesterol levels than men.

Higher-than-normal levels of triglyceride also put you at a greater risk of cardiovascular disease. Elevated triglyceride levels are more common in people who are obese or those with poorly controlled diabetes. As you get older and more overweight, your trigylceride and cholesterol levels tend to increase.

Keep cholesterol levels down

Our blood cholesterol level is affected by cholesterol and fat intake. While cholesterol is derived from animals, both plants and animals can contribute to dietary fat.

There are two types of dietary fat: saturated and unsaturated fatty acids.

Saturated fatty acids primarily found in animal products such as fatty meat, butter, full-cream dairy products, and tropical oils such as coconut and palm oil. Such fats tend to raise the blood cholesterol level and cause the accumulation of fat deposits on the inside of blood vessels, narrowing or blocking them.

Unsaturated (mono-unsaturated or poly-unsaturated) fatty acids are found mainly in vegetable oils such as soybean, corn, sunflower, olive, canola and peanut as well as fish. Some nuts may have cholesterol-lowering effect. Essential fatty acids such as Omega 3 (found in salmon, canola and soya oil) may also help in lowering triglyceride levels.

Desirable blood lipid profile is not only achieved by reducing your consumption on cholesterol foods, but also the amount of saturated fatty acids.

Therefore, beware of products that are labeled “cholesterol-free”, as these foods may not necessarily help you to achieve desirable blood lipid profile. You should learn to read food labels, and limit your fat intake to less than 30 per cent of your total calorie intake. For people with vascular diseases, your fat intake should be less than 20 per cent of your total calorie intake.

Tips to achieve desirable cholesterol levels

· Limit intake of egg yolks to not more than three times a week
· Limit intake of organ meats to once a month and in small portions
· Limit intake of certain seafood, e.g. squids, prawns or shellfish, to once or twice a week and in small portions
· Trim off fat from meat and skin from poultry before cooking
· Choose cooking oil with a low saturated fat content
· Choose grains and unsaturated fatty acids from fish, vegetables, legumes, and nuts

Tips to increase dietary fibre intake

Soluble dietary fibre has been found to help lower blood cholesterol levels. Moreover, it also has a satiety value and this helps discourage snacking between meals, which is ideal for weight control. Foods high in soluble fibre include oatmeal, oat bran, beans, peas, barley, rice bran and fruits.

Insoluble fibre, on the other hand, provides “roughage” and bulk that help control bowel regularity, thus relieving constipation. Consumption of wholegrains (e.g. oats, wheat, corn, and rice) may improve glycaemic control for those with diabetes.

· Increase intake of fruits and vegetables (two servings each day)
· Eat fruits whole with skin, rather than with skin removed or as fruit juice
· Choose high fibre products, e.g. oats, oat bran, wholemeal bread and biscuits

Classification of Total, LDL and HDL Cholesterol and Triglyceride Levels