Lipids are a collective term
meaning the fat component
in our blood. They comprise
cholesterol and triglycerides.
Lipids are actually made by our own
body from carbohydrate even if we
do not eat them. They are essential
components of cell membranes and
are used to make many steroid
hormones such as vitamin D, sex
hormones and cortisol.
However, excess eating will cause
levels to rise such that they get
accumulated in blood vessel walls, a
process called atherosclerosis. Food
items such as animal fats are extremely
rich in cholesterol. Many Singaporeans
already avoid these and wonder why
their cholesterol levels are still high.
This is because the body makes excess
cholesterol when we eat in excess.
What is cholesterol?
Dietary cholesterol is found only in
foods of animal origin. Plant foods may
contain oils e.g. avocado, coconut,
palm oil, peanuts etc but do not have
cholesterol. Oils can also be used by
the body to manufacture cholesterol.
Some people are also predisposed
with a family history of a tendency to
higher cholesterol levels.
What is a lipid blood test and what
are normal lipid levels?
Lipid blood tests include total
cholesterol which consists of LDL, the
‘bad cholesterol’ that can harm, and
HDL or good cholesterol which can
limit the bad effect of LDL. There is
another item, triglycerides, blood fat
which can also cause atherosclerosis
and needs to be lowered if it is too high.
While total cholesterol is a good
screening test, it is actually a
combination of good and bad
cholesterol together. The LDL level
is what doctors use when ordering
treatment. Total cholesterol should not
exceed 5mmol/L (200mg/dL) and LDL 4 mmol/L for normal people, about 3
mmol/L for those with conditions such
as hypertension and 2.6mmol/L for
those already with heart disease.
HDL should be more than 1mmol/L
and triglyceride not exceeding 2mmol/L.
Lipid tests include the LDL/HDL ratio
which indicates total risk balancing
good and bad. This should be 3.5 or less.
Effects of high cholesterol
Although a high result itself will
not cause symptoms, over time the
cholesterol will cause atherosclerosis
and accumulate in lipid plaque
formation along vessel wall linings
which block up blood vessels.
Blood vessel blockages in the heart
will lead to heart attacks, and in the
brain to strokes. When a lipid laden
plaque bursts or ruptures, this can
lead to a sudden, catastrophic and
devastating event. Controlling lipid
levels is therefore an important
strategy to reduce these diseases.
Limit total fat intake, high cholesterol foods and carbohydrate. Keep total fat intake between 20 to 35 percent of calories for adults. Make choices that are lean, low fat or fat-free. Choose fish, skinless poultry and lean meat. Avoid animal fat.
Certain food items, apart from fat, known to contain higher cholesterol, include shellfish, crabs, lobster, egg yolk, squid and prawns. While it is prudent to consume these in moderation, one need not abstain totally. Total dietary moderation is more effective than omitting one or two items but still overeating overall. For example, it is okay and even good for growing children to eat an egg a day.
Other preventive measures:
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