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A Clear and Simple Guide Focusing in Cholesterol

Cholesterol is a term we hear frequently and is often associated with heart health and diet. But what is this waxy, fat-like substance, and why does it matter?

What are the essential compounds found in every cell of your body?

  • It produces hormones, vitamin D
  • Aids digestion

Note: Despite its essential role, an excess of it, particularly the wrong type, can be detrimental to our health.

What Causes Cholesterol?

Our Body: 

The liver and intestines produce approximately 80% of cholesterol in our body. Cholesterol is an essential substance in our bodies which helps to form the structure of cell membranes, producing hormones such as testosterone,oestrogen and cortisol. They also assist in the production of bile acids that aid in fat digestion.

Our Eating Habits: 

The remaining 20% of cholesterol comes from the food we eat. For example: 

(1) Animal-based foods (such as meat and dairy products) – high in cholesterol. 

(2) Foods high in saturated and trans fats can cause our bodies to produce more cholesterol. (3) Processed foods, particularly those containing trans fats or “partially hydrogenated” oils that can raise cholesterol levels in the body as well. Many commercially baked goods such as cookies,crackers and fried foods fall into this category.

Understanding the Good, the Bad, and the Cholesterol

There are two types of cholesterol: 

Low-density lipoprotein (LDL), (Bad’ cholesterol)

LDL cholesterol can build up in the walls of our arteries, leading to atherosclerosis, a condition characterised by artery hardening and narrowing. This, in turn, can increase the risk of heart disease, stroke, and heart attack.

High-density lipoprotein (HDL), (Good’ cholesterol) 

HDL cholesterol, on the other hand, acts as a cleanup crew for our bloodstream, transporting cholesterol back to our liver, where it is removed from our bodies. This procedure aids in the prevention of plaque buildup, which causes heart disease.

A Comprehensive Overview of Our Lipid Profile

Cholesterol levels are typically measured in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L) via a blood test.

The following are general cholesterol guidelines:

Cholesterol TypeIdeal Levels
Total cholesterolLess than 200 mg/dL
LDL (bad) cholesterolLess than 100 mg/dL
HDL (good) cholesterolMen: At least 40 mg/dL Women: At least 50 mg/dL in women
Triglycerides - fat in the bloodLess than 150 mg/dL

It is critical to recognize that maintaining a healthy cholesterol balance (higher HDL, lower LDL) is more important than focusing solely on total cholesterol.

Why Does High Cholesterol Matter?

High cholesterol narrows the blood vessels, which increases the risk of heart attack or stroke. However, not all cholesterol is bad. While HDL (high-density lipoprotein) cholesterol, also called ‘good’ cholesterol, has many benefits.

Good Cholesterol (HDL)Bad Cholesterol (LDL)
BenefitsActs as a scavenger, removes excess cholesterol from the bloodstream and transports it back to the liverEssential for various bodily functions like hormone production and cell membrane formation
Health ImpactHigher levels associated with reduced risk of heart disease and strokeElevated levels associated with increased risk of heart disease, heart attacks, and strokes
RoleRemoves excess cholesterol, has anti-inflammatory and antioxidant properties, maintains healthy blood vesselsTransports cholesterol to cells, necessary for bodily functions
How to Improve LevelsRegular exercise, consuming monounsaturated and polyunsaturated fats, avoiding smoking, and maintaining a healthy weightConsuming a balanced diet, limiting saturated and trans fats, regular exercise, and medication if necessary

High Cholesterol Causes Multifaceted Problem

A combination of dietary, lifestyle, and genetic factors contribute to high cholesterol levels. Let’s take a closer look at each of these components:

  1. Dietary factors:
    • Saturated and trans fats: Diets high in saturated and trans fats can significantly contribute to high cholesterol levels. These fats are commonly found in animal  products (e.g. fatty meats, full-fat dairy products) and processed foods (e.g fried  foods, baked goods). Excessive consumption of these fats raises the production of   LDL cholesterol, also known as “bad” cholesterol.
  2. Lifestyle Factors:
    • Obesity: Being overweight or obese can raise LDL cholesterol while lowering HDL cholesterol, increasing the risk of developing high cholesterol.
    • Physical inactivity is linked to lower levels of high-density lipoprotein (HDL), also       known as “good” cholesterol. Regular physical activity increases HDL cholesterol levels, which aids in the removal of LDL cholesterol from the bloodstream.
    • Cigarette smoking causes blood vessel damage and lowers HDL cholesterol levels. It also increases LDL cholesterol oxidation, making it more likely to contribute to the formation of artery plaque.
    • Certain Medical Conditions: Hypothyroidism, diabetes, kidney disease, and liver disease can all have an impact on cholesterol metabolism, contributing to high cholesterol levels.
  3. Variables of a Genetic Nature:
    • Hypercholesterolemia in Families is an inherited condition that is characterized by high LDL cholesterol levels at birth. Mutations in genes involved in the clearance of LDL cholesterol from the bloodstream causes it. People who have familial hypercholesterolemia have a higher risk of developing heart disease at a young age.
  4. Other Factors:
    • High Coffee Intake (Black coffee/ Instant Coffee): While moderate coffee consumption is generally considered safe and may even have some health benefits, consuming excessive amounts of coffee (more than 4-5 cups per day) has been associated with a slight increase in cholesterol levels. This effect is primarily attributed to the compounds cafestol and kahweol found in coffee oils. These compounds can raise LDL cholesterol levels, but their impact can vary among individuals.
    • Stress: Chronic stress and elevated levels of stress hormones, such as cortisol, can affect cholesterol metabolism. Stress has been linked to higher LDL cholesterol and lower HDL cholesterol levels. It is believed that stress-induced behaviours like overeating, unhealthy food choices, and sedentary lifestyle may contribute to these changes in cholesterol. 
    • Certain Medications: Some medications, such as certain types of birth control pills, corticosteroids, and beta-blockers, can affect cholesterol levels. Corticosteroids can increase LDL cholesterol and decrease HDL cholesterol, while beta-blockers may have a modest impact on lipid levels. It is important to discuss any concerns about medication-related effects on cholesterol with your healthcare provider, who can monitor and manage your cholesterol levels accordingly.
    • Pregnancy: During pregnancy, hormonal changes can influence cholesterol levels. As pregnancy progresses, cholesterol levels tend to increase to support the growth and development of the baby. This increase is primarily seen in LDL cholesterol and triglyceride levels, while HDL cholesterol may remain relatively stable or decrease slightly. These changes are considered normal physiological adaptations during pregnancy and typically return to pre-pregnancy levels after delivery.

Symptoms of High Cholesterol Level

High cholesterol itself usually doesn’t cause any symptoms. It’s often referred to as a “silent” condition because many people don’t know their cholesterol levels are high until they have a heart attack or stroke or have a test that shows high cholesterol levels.

In some cases, extremely high levels of cholesterol can lead to visible signs such as:

  • Xanthomas: These are fatty deposits that can appear as yellow bumps on your skin. They are most common in the hands, elbows, knees, ankles, and around the cornea of the eye.
  • Xanthelasma: These are yellow patches around your eyelids and can be a sign of high levels of cholesterol or lipids in your blood.
  • Corneal arcus: This is a grey or white arc or ring around the cornea of your eye, and it can be a sign of high cholesterol in people under the age of 45.

However, these signs are rare and not a reliable method to diagnose high cholesterol. The most effective way to find out if you have high cholesterol is through a blood test. 

Tips for Managing Your Cholesterol

Tips 1: Choose a healthy and balanced diet.
Reducing intake of saturated and trans fats, and increasing consumption of fruits, vegetables, whole grains, lean proteins, and unsaturated fats.

Types of FatEffect on Blood CholesterolFood Sources
*Consuming too much omega-6 compared to omega-3 fatty acids may promote inflammation
Saturated Fat (SF)↑ LDL-cholesterolAnimal: butter, lard, ghee, fat/ skin on meat, full cream dairy productsPlant: palm kernel oil, non-dairy creamer, coconut oil, coconut milk, cocoa butter
Trans Fat↑ LDL-cholesterol ↓HDL-cholesterolFried food (e.g. French fries, potato chips and donuts) Baked goods (e.g. pastries, biscuits, cookies), shortenings, partially hydrogenated vegetables oil
Unsaturated Fat - Polyunsaturated Fat (PUFA)
Omega-3-reducing inflammation -supporting brain health -promoting heart health ↓LDL-cholesterolAnimal: fatty fish (salmon, mackerel, tuna, sardines)Plant: flaxseeds, chia seeds, and walnuts.
Omega-6normal growth and development ↓LDL-cholesterolsoybean oil, corn oil, safflower oil, and sunflower oil

Tips 2: Limit sugar consumption (eg: glucose, fructose, cane sugar)
Because these substances can contribute to increased levels of LDL cholesterol.

Tips 3: Regular exercise
Not only improves your overall health but can also specifically raise your HDL cholesterol and lower your LDL cholesterol and triglycerides. Combined with maintaining a healthy weight, these lifestyle modifications can significantly impact your cholesterol levels and overall heart health.

Tips 4: Maintain a healthy weight 
Losing excess weight and maintaining a healthy weight can help improve cholesterol levels. Aim for a healthy weight range of Body Mass Index (BMI) from 18.5 to 23 kg/
m2. When you carry extra weight, particularly around your midsection, your body’s chemistry can be altered. This can lead to increased production of LDL cholesterol, decreased production of HDL cholesterol, and increased triglycerides. All of these changes can lead to a higher risk of developing atherosclerosis, a condition where plaque builds up in the arteries, narrowing them and making them less flexible.

Tips 5: Limit alcohol consumption 
Drinking alcohol in moderation may have some cardiovascular benefits. However, excessive alcohol consumption can increase cholesterol levels and contribute to other health problems. Stick to moderate alcohol intake, which means up to one drink per day for women and up to two drinks per day for men.

Tips 6: Regularly monitor your cholesterol levels
Consult with your healthcare provider to determine how frequently you should have your cholesterol levels checked. Regular monitoring helps track your progress and allows you to make necessary adjustments to your lifestyle if needed.

The Role of Traditional Chinese Medicine in Managing Cholesterol

While conventional medical treatments are the cornerstone of managing high cholesterol, complementary approaches such as Traditional Chinese Medicine (TCM) may also provide benefits.

Traditional Chinese Medicine (TCM) takes a holistic approach to health, stressing balance, harmony, and energy flow throughout the body.

TCM emphasizes general health and well-being through a balanced diet, frequent exercise, and stress-reduction measures.

Here are some ways in which TCM may help with High Cholesterol

  1. Acupuncture: Acupuncture is believed to stimulate the nervous system, which can influence various physiological responses.
  2. Dietary Guidance: A balanced diet tailored to an individual’s constitution and the current state of their Qi (energy), Yin, and Yang is being emphasised in the perspective of TCM. TCM physicians’ dietary advice aimed at restoring balance and promoting health, which can help with cholesterol management indirectly.
  3. Lifestyle Advice: Sleep, stress management, and physical activity is part of a balanced lifestyle that can support overall health and contribute to maintaining healthy cholesterol levels.

Take note that, While TCM can supplement modern medical treatments, it is not meant to take the place of them. High cholesterol is a troubling condition that can result in potentially serious complications such as heart disease and stroke. Always seek the advice of a healthcare practitioner when dealing with high cholesterol.

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