Cholesterol! Though a fairly commonly used term, people often see it as an illness. `He can`t eat mutton/ Butter as he has cholesterol, is a classic example.

For those who do not know, cholesterol isn`t all bad; there is good cholesterol (HDL) and bad cholesterol(Total/ LDL). Cholesterol, to put it simply, is a fatty material that is present in all of our cells and has quite a few positive roles, like helping to make your cells and their biochemical reactions.

Sugar is very important for the body but excess sugar can pose problems. Similar lines can be used for cholesterol.

Cholesterol is carried via our bloodstream fastened to proteins. These proteins are known as lipoproteins. You may have heard from your doctor that lowering the total cholesterol level is as important as to raising your High Density Lipoprotein (HDL), which is good cholesterol. Sounds like a disparity? Well, bringing down the Low Density Lipoprotein (LDL) cholesterol and enhancing the HDL is one sound way to keep your heart steered of troubles.

• Low-density lipoproteins (LDL)
These lipoproteins carry cholesterol throughout your body, delivering it to different organs and tissues. But if your body has more LDL cholesterol than it needs, the excess keeps circulating in your blood. Over time, circulating LDL cholesterol can enter your blood vessel walls and start to build up under the vessel lining. Deposits of LDL cholesterol particles within the vessel walls are called plaques, and they begin to narrow your blood vessels. Eventually, plaques can narrow the vessels to the point of blocking blood flow, causing coronary artery disease (Atherosclerosis). This is why LDL cholesterol is often referred to as "bad" cholesterol.

• High-density lipoproteins (HDL)
These lipoproteins are often referred to as HDL, or "good," cholesterol. They act as cholesterol scavengers, picking up excess cholesterol in your blood and taking it back to your liver where it`s broken down. This helps prevent the fat from oxidizing and building upon the walls of your blood vessels. The higher your HDL level, the more protected are your organs from atherosclerosis.

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A blood test which measures these fats (lipids) is known as lipid profile. (Total cholesterol & Triglycerides which are included in the lipid profile, are not discussed here)

HDL levels in lipid profile

Men

At risk- Less than 40 mg/dL

Desirable- 45 mg/dL or above

Women

At risk- Less than 50 mg/dL

Desirable- 55 mg/dL or above

The ratio of LDL/ HDL achieved also carries importance. This ratio of 2.5 to 1 is ideal, the lower the better. (lower LDL, higher HDL!)

Both genetics and your lifestyle play a role in your cholesterol levels. Indians peculiarly have low HDL levels. Some people may be naturally predisposed to low HDL. They may also have a harder time increasing a low number, by diet and exercise alone. And so doctors may prescribe medication such as Fibrates or Niacin. Certain lifestyle habits may push a low number further down. Smoking, taking steroids, eating foods with trans fats, being obese and inactive can all result in lower HDLs. (Taking contraceptive pills high in progesterone can also push your HDL levels downward.)

Tips to improve HDL values

• Lose excess body fat (More to reduce LDL)

Losing weight if you have a body mass index above 25 can help control high cholesterol, especially LDLs. But weight loss from dieting alone can cause the desirable HDLs to drop along with the LDLs. By performing regular aerobic exercise when you diet you can help get over this lowering effect. Aerobic exercise is the only proven way of increasing HDL.

• Exercise (More to improve HDL)

Exercise has a powerful, albeit short-lived effect. Each workout may result in a subtle HDL boost, so that`s why it needs to be done on a consistent basis. Regular exercisers tend to have higher HDLs. Research shows that HDL may be elevated by as much as 20 percent from regular aerobic exercise that expends at least 800 to 1,200 calories per week. Walking at 5km/hour per hour, for example, will use around 300 calories. So a person needs to walk around 12 to 15km in a week, or do some equivalent aerobic activity for at least 30 minutes on five or more days per week. Inactive people may need to do slightly more, burning from 1,500 to 2,200 calories per week through aerobic workouts like walking, swimming, cycling or aerobics. (But any beginner should always start slow and gradually work up to higher intensity and longer workouts.)

• Avoid trans fats

It may be harder to improve your good cholesterol levels with food. But high intakes of trans fats, found in processed foods made with hydrogenated oils, bakery products, reboiled oils have been found to lower HDLs. So, cutting out fast foods and processed foods that contain these fats is wise.

• Go for good fats and plenty of plant foods

Eating more foods high in unsaturated fats such as olive oil and nuts, as well as more fruits, veggies, beans and whole grains may be beneficial, too. One 2004 study in Diabetes Care found that men and women with Type 2 diabetes who included 30 grams of walnuts a day in their diet had improved HDL levels. Food stuffs which are known to increase HDL are Almonds, walnuts, flax seeds, Fenugreek, 2-3 Teaspoonful of ghee, Fish oil, Dark chocolates, Red wine.

• Take home message for increasing HDL.

1) Increase aerobic exercise.

2) Concentrate on HDL increasing food items.

3) Aim at a LDL/ HDL ratio less than 2.5.

 

By Dr Amit Bhushan Sharma