Cholesterol -- the slow killer


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"Health Watch"

Cholesterol -- the slow killer

Dr. Tej K. Munsh

What is Cholesterol?

Cholesterol is a fat, or lipid, in the body. If you held cholesterol in your hand, you would see a waxy substance that resembles the scrapings of a whitish-yellow candle. Cholesterol flows through your body via your bloodstream , but this is not a simple process. Because lipids are oil-based, they don’t mix. As a fat, cholesterol isn’t water soluble, so it doesn’t dissolve in the blood. To allow it to move around the body, a special carrier molecule known as a lipoprotein attaches to it. Lipoproteins have the capacity to help fats dissolve in water, hence with blood. The fat in these particles is made up of cholesterol and triglycerides. They shuttle cholesterol and triglycerides between the different tissues of the body. Triglycerides are a fat made up of 3 fatty acids and glycerol{glycerine}---hence the name. They compose about 90 % of the fat in the food you eat. The body needs triglycerides for energy, but as with cholesterol, too much is bad for the arteries and the heart. Cholesterol is so much important to the body that it makes it itself. So even if you ate a completely cholesterol-free diet, your body would make the approximately 1,000 mg it needs to function properly. If your diet doesn’t provide adequate amounts, your body has the ability to produce more and regulate it in the blood. The system works much as your thermostat and compressor work to regulate the temperature in your refrigerator. Almost all of the cells of the body can make the cholesterol they need. The liver, however, is an especially efficient cholesterol factory; it creates more than 90 % and the rest comes through food---animal products, such as meat, milk, and eggs. The body uses it to make bile, which it uses to digest fats, as well as to produce vitamin D and hormones, such as estrogen and progesterone {in females}, and testosterone {in males}

Lipoproteins: “Good” Cholesterol versus “Bad” Cholesterol.

There are several different types of lipoprotein /cholesterol packages, and each has its own effect on the body. The major types are called low-density lipoprotein {LDL} and high-density lipoprotein {HDL]. Though the names sound the same, these two particles are as different as night and day. The differences stem from their densities. LDL appears to be the most harmful type and, therefore, is often referred to as “bad” cholesterol. Studies show that higher LDL levels are directly associated with accel- erated atherosclerosis. Conversely HDL is regarded as the “good” cholesterol, because higher levels of it are associated with a lower incidence of atherosclerosis. In most people 60-70 % of cholesterol is carried in LDL particles. LDL particles act as ferries, taking cholesterol to the parts of the body that need it at any given time. Unfortunately, if you have too much LDL in the bloodstream, it deposits the cholesterol into arteries, which can cause blockages and lead to heart attack. The good news is that the amount of LDL in your bloodstream is related to the amount of saturated fat you eat. So, most people can decrease their LDL if they follow a reduced fat diet.

High-Density Lipoproteins {HDL}

HDL is basically the opposite of LDL. Instead of having a lot of fat, HDL has a lot of protein. Instead of ferrying cholesterol around the body, HDL acts as a vacuum cleaner sucking up as much excess cholesterol as it can. It picks up extra cholesterol from the cells and tissues and takes it back to the liver, which either uses it to make bile or recycles it. This action is thought to explain why high levels of HDL are associated with low risk of heart disease. Lifestyle changes affect HDL levels---exercise can increase them, while obesity and smoking lower them. Low fat diet lower both HDL and LDL.

How do you know if you have high cholesterol ?

Your doctor can determine your total blood cholesterol, HDL, and triglyceride levels with a simple blood test called a lipid profile. You need to get your blood drawn in the morning before you have eaten, because a fatty or high cholesterol meal can temporarily raise your cholesterol level over the day. In the West, a goal of total cholesterol below 200 mg/dL is recommended. Total cholesterol levels between 200 and 240 mg/dL are considered to be borderline high; levels above 240 mg/dL are considered high risk. Optimally, LDL {“bad Cholesterol”} should be below 130 mg/dL, and HDL {“good cholesterol”} should be greater than 30 mg/dL. Triglyceride levels should be less than 250 mg/dL, and lipoprotein levels should ideally fall below 20 mg/dL

Atherosclerosis: is a disorder of the arteries in the body that leads to thickening and hardening of the arterial wall, and deposits of a fatty substance known as plaque. Atherosclerosis in the coronary arteries of the heart diminishes the flow of blood to the heart muscle causing a type of pain known as angina. Such blockages of the artery can result in heart attacks and strokes. The higher the blood cholesterol levels, the greater the heart attack rate. Studies have shown that for every 1 % drop in total cholesterol there is a 2 % decrease in the risk of having a heart attack.

Herbal treatment: As per the Ayurveda and the Chinese system of medicine there are several herbs available to fight cholesterol menace. Europeans especially the Germans are the main believers in the herbal treatment. Garlic was regarded as sacred by the Egyptians, who would often keep bulbs of dried garlic inside the Pharaoh’s tombs. Allium called garlic, contains considerable amounts of sulphur. The powerfully aromatic substance called allicin in garlic inhibits enzymes responsible for making cholesterol. Besides sulphur, garlic also contains B vitamins , minerals, flavonoids, aminoacids, proteins, lipids, steroids, and 12 trace elements. ‘Mader Studies, ’conducted in Germany revealed that regular use of garlic can lower cholesterol levels by an average of 12 %.

In India, companies that make herb concoctions, produce ‘odour free’ garlic tablets for users. There’s considerable evidence that garlic can reduce high blood pressure, at least modestly. Its ‘blood thinning’ effects may be the reason for its ability to prevent atherosclerosis.
  • Red Yeast Rice: This product is a traditional Chinese food that is made by fermenting a type of yeast over rice, and used since 800 AD. In a recent Chinese study involving 35 patients, who took 1.2 g daily of red yeast rice formulation, reported a cholesterol reduction by 26 %.
  • Guggul: A traditional Indian herb derived from the bark of the Mukkul Myrrh tree, a small thorny tree native to India and Arabia. This substance has been used since 600 BC to reduce total cholesterol by about 12 %.
  • Pantethine: is related to pantothenic acid, or vitamin B-5. This co-enzyme is involved in many biochemical routes and hence responsible for the transport of fats in cells. According to a small study, pantethine can lower triglyceride levels by 30 % and improve total cholesterol.
  • Vitamin C: Also known as ascorbic acid, is an important antioxidant nutrient. Many foods are high in Vitamin C; not only oranges and lemons, but also green peppers, potatoes and fresh fruits and vegetables.
  • Green Tea: has been shown to lower cholesterol besides being an antoxidant.
  • Palm oil and Rice bran oil: contain Tocotrienols {Vitamin E} which offer benefits in lowering cholesterol.
  • Calcium: A nutritional dose of !000-1200 mg calcium supplements may occasionally lower cholesterol.
  • Niacin: Vitamin B-3 is another vitamin which can bring down cholesterol if taken in regular doses of 1000-1500 mg. It is present in whole grains, wheat germ, peanuts, pinenuts, sunflower seeds, split peas, besides organ meats viz, liver, fish etc.

Other natural treatments: Last but not least, diet and lifestyle can reduce your cholesterol levels, reverse atherosclerosis and protect you from a variety of maladies and health risks. Quitting smoking is the single most important change in your lifestyle.

In the allopathic stream of medicine: “ Statins” are widely used to address the problem of cholesterol. Being beyond the scope of this writ up, cardiologist may be consulted if and when needed

*Dr. Tej K. Munshi, is Ex. Professor, Deptt. of Applied Sciences, NIT (J&K)
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