THE CHOLESTEROL MYTHS  PART --2

In continuation of my first Article on Gholesterol today                                                                                  I am presenting my second Articles 

Dr.V.Jagannathan

 

TOPIC  2

Facts About Cholesterol

Good morning

This is Jagannathan In continuation of my previous  discussion today I would like to bring in more facts about the individual members in this articles on Cholesterol

Most of us  know that fat is bad for us, but most of us are confused about how cholesterol differs from fats. The fat issue is actually the most clearly defined topic in nutrition. Yes, most of should  should cut the fat. They need to do it now and for the rest of our lives, for the sake of our hearts, health and obesity

The Facts about Cholesterol

Can we Burn Off Cholesterol?

Cholesterol is a type of lipid, just as fats are. However, unlike fat, cholesterol can't be exercised off, sweated out or burned for energy. It is found only in animal products, including meat, chicken, fish, eggs, organ meats and high-fat dairy products.

Is Cholesterol Good or Bad?

Our body transports fat and cholesterol by coating them with a water-soluble "bubble" of protein. This protein-fat bubble is called a lipoprotein.

• Low-density lipoproteins (LDLs) carry cholesterol to the tissues. This is "bad" cholesterol, since high LDL levels are linked to increased risk for heart disease.
• High-density lipoproteins (HDLs) carry excess cholesterol back to the liver, which processes and excretes the cholesterol. HDLs are "good" cholesterol; The more HDL you have, the lower your risk for developing heart disease.
• HDLs and LDLs are found only in your blood, not in food.

Test Your Cholesterol

Our  risk for heart disease can be assessed with a blood-cholesterol test. In this test, your total-cholesterol reading should approximate the sum of your LDL, HDL and other lipoproteins. If you have 3.5 mg of total cholesterol, or less, for every 1 mg of HDLs, then your cholesterol ratio is ideal. According to guidelines from the National Cholesterol Education Program:

• Total cholesterol should remain below 200 mg/dl, unless HDL is high.
• LDL should be lower than 130 mg/dl.
• HDL should be 35 mg/dl or higher.
• People under age 30 should aim for an even lower total cholesterol of 180 mg/dl.

The Fats

The fats that supply calories, float in our blood and accumulate in your thighs and hips are called "triglycerides." They can be saturated or unsaturated, and the unsaturated ones can be either monounsaturated or polyunsaturated. For every gram of triglycerides we eat, we add 9 calories to our diet. Only saturated fats increase blood levels of cholesterol and heart-disease risk.

Which Ones Are Saturated?

In general, the harder a fat, the more saturated it is. Beef and dairy fats are mostly saturated fats. Liquid oils are usually unsaturated fats, including monounsaturated fats in olive  oils and polyunsaturated fats in safflower, corn, soybean and fish oils. Coconut, palm and palm kernel oils are exceptions to the rule; these liquid vegetable oils are highly saturated fats.

Fear of Frying

Eating foods with a lot of saturated fat raises your risk for heart disease; this causes the amount of bad LDLs in your blood to increase while good HDLs decrease. Cut the saturated fat, and your blood-cholesterol levels and your risk for heart disease drop. Your risk for cancer also decreases. A diet with more polyunsaturated fats, rather than saturated fats, lowers total blood-cholesterol levels, but unfortunately also drops HDL levels, so you lose both good and bad cholesterol.

Olive oil is another story. This oil lowers total-blood cholesterol and LDL cholesterol without causing HDL levels to drop. By using olive oil, you can decrease your total-cholesterol levels while maintaining your HDL levels, thus decreasing your risk for heart disease. Fish oil also lowers heart-disease risk. Consequently, olive and fish are the oils of choice.

Trans, Schmans

Hydrogenated fats are liquid vegetable oils made creamy when manufacturers convert some of the unsaturated fats into saturated ones through a process called "hydrogenation." This process also rearranges the molecular shape of the remaining unsaturated fats. The resulting shape is an abnormal "trans" shape.

Trans fatty acids constitute up to 60 percent of the fat in processed foods containing hydrogenated fats. TFAs raise blood-cholesterol levels and increase heart-disease risk just like saturated fats.

Knowing your fats gives you an edge when it comes to buying and preparing the right foods to eat. And when you steer away from the saturated fat and trans fatty acids, you can live a heart-healthy life.

The bottom line is:

• Eat less fat, especially saturated fat.
• Limit your intake of fatty meats, fatty dairy products and processed foods that contain hydrogenated vegetable oil.
• Use olive oil, but in moderation if you're watching your weight.
• Fill your plate with fruit, vegetables, whole grains, fish and legumes.

TREATMENT OPTIONS AND THE STATINS

Healthy lifestyle changes

To help you lower your LDL cholesterol level, you must doctor adopt a healthy lifestyle.

· Choose heart-healthy foods. The Therapeutic Lifestyle Changes and DASH eating plans can help you lower your “bad” LDL cholesterol. These plans also encourage limiting saturated fats found in fatty cuts of meets, dairy products, and desserts; and eating whole grains, fruits, and vegetables rather than refined carbohydrates such as sugar.

· Get regular physical activity. Studies have shown that physical activity can lower LDL cholesterol and triglycerides and raise your “good” HDL cholesterol..

· Aim for a healthy weight. Research has shown that adults with overweight and obesity can lower “bad” LDL cholesterol and raise “good” HDL cholesterol by losing only 3% to 5% of their weight.

· Manage stress. Research has shown that chronic stress can sometimes increase LDL cholesterol levels and decrease HDL cholesterol levels.

· Quit smoking. . Cessation of smoking reduces the risk of CAD by reducing LDL and increasing HDL

· Get enough good quality sleep. Sleep helps heal and repair your heart and blood vessels. The recommended amount for adults is 7 to 9 hours of sleep a day.

· Limit alcohol. Visit the National Institute on Alcohol Abuse and Alcoholism for resources on support and treatment to stop drinking.

NOW LET US SEE ABOUT STATINS

Statins are drugs that can lower our cholesterol. They work by blocking a substance our body needs to make cholesterol.

Lowering cholesterol isn't the only benefit associated with statins. These medications have also been linked to a lower risk of heart disease and stroke. These drugs may help stabilize the plaques on blood vessel walls and reduce the risk of certain blood clots.

A number of statins are available for use  They include:

·         Atorvastatin                                                                                                     Lovastatin                                                                                                                    Rosuvastatin                                                                                                                           Simvastatin

Sometimes, a statin is combined with another heart medication. Examples are atorvastatin-amlodipine and ezetimibe-simvastatin

Should you be on a statin?

Whether you need to be on a statin depends on your cholesterol levels and other risk factors for cardiovascular disease.

Knowing your cholesterol numbers is a good place to start.

·         Total cholesterol. Most people should try to keep their total cholesterol below 200 milligrams per deciliter (mg/dL)

·         Low-density lipoprotein (LDL) cholesterol. Aim to keep this "bad" cholesterol under 100 mg/dL,  If you have a history of heart attacks or you're at a very high risk of a heart attack or stroke, you may need to aim even lower (below 70 mg/dL,

·          

The most important thing you will have to  keep in mind when thinking about statin treatment is your long-term risk of a heart attack or stroke. If your risk is very low, you probably won't need a statin, unless your LDL is above 190 mg/dL (4.92 mmol/L).

If your risk is very high — for example, you've had a heart attack in the past — a statin may be helpful even if you don't have high cholesterol.

Besides cholesterol, other risk factors for heart disease and stroke are:

·         Tobacco use

·         Lack of exercise

·         High blood pressure

·         Diabetes

·         Overweight or obesity

·         Narrowed arteries in your neck, arms or legs (peripheral artery disease)

·         Family history of heart disease, especially if it was before the age of 55 in male relatives or before 65 in female relatives

·         Older age

Cholesterol guidelines

Not everyone with a heart condition needs to use a statin. Guidelines from the U.S. Preventive Services Task Force, American College of Cardiology and American Heart Association suggest four main groups of people who may be helped by statins:

·         1 People who don't have heart or blood vessel disease, but have one or more cardiovascular disease risk factors and a higher 10-year risk of a heart attack. This group includes people who have diabetes, high cholesterol or high blood pressure, or who smoke and whose 10-year risk of a heart attack is 10% or higher.

·         2 People who already have cardiovascular disease related to Atherosclerosis of the arteries. This group includes people who have had heart attacks, strokes caused bytransient ischemic attacks, peripheral artery disease, or prior surgery to open or replace coronary arteries.

·         People who have very high LDL ("bad") cholesterol. This group includes adults who have LDL cholesterol levels of 190 mg/dL or higher.

·         People who have diabetes. This group includes adults 40 to 75 who have diabetes and an LDL cholesterol level between 70 and 189 mg/dL especially if they have evidence of blood vessel disease or other risk factors for heart disease such as high blood pressure or smoking.

It isrecommended low- to moderate-dose statins in adults ages 40 to 75 who have one or more risk factors for heart and blood vessel disease and at least a 1 in 10 chance of having a cardiosvascular disease event in the next 10 years.

Consider statins a lifelong commitment

You may think that if your cholesterol goes down, you don't need a statin anymore. But if the drug helped lower your cholesterol, you'll likely need to stay on it long term to keep your cholesterol down.

Side effects of statins

Statins are tolerated well by most people, but they can have side effects. Some side effects go away as the body adjusts to the medication.

Commonly reported side effects of statins include:

·         Headaches

·         Nausea

·         Muscle and joint aches

However, studies comparing statins to a fake pill (placebo) have found a very small difference in the number of people reporting muscle aches between the groups.

Rarely, statins can cause more-serious side effects such as:

·         Increased blood sugar or type 2 diabetes. 

·         Muscle cell damage. 

·         Liver damage. 

·         Memory problems.                                                                                                                        Weighing the risks and benefits of statins

When thinking about whether you should take statins for high cholesterol, ask yourself these questions:

·         Do I have other risk factors for heart and blood vessel disease?

·         Am I willing and able to make lifestyle changes to improve my health?

·         Am I concerned about taking a pill every day, perhaps for the rest of my life?

·         Am I concerned about statins' side effects or interactions with other drugs?

It's important to consider your medical reasons, personal values, lifestyle choices and any concerns when choosing a treatment.

With this I wish to conclude this rather long and very useful topics for our personal u

Untill then Thank you

Jagannathan