Cholesterol (part II)

CHOLESTEROL is a very important substance or material in your body; and we did establish this last week. For instance, your brain is built from cholesterol among other key components that include carbohydrate and protein. Cholesterol is also an important component of your skin, making it (your skin) have a smooth texture and giving it that ability to retain moisture.

Bile, a very key factor in the digestion of food, especially fatty foods, is made from cholesterol. Cholesterol is also used by the body to produce reproductive or sex hormones such as oestrogen, progesterone and testosterone. What’s more, cholesterol is also required in adequate amounts by the body to produce stress hormones. Indeed list of good things that make cholesterol essential to life is really long and we can go on and on talking about the good work that cholesterol is known for in relation to your body and your general health.

Yet even with these vital roles that cholesterol is known for, there is well established and in fact abundant evidence that the same cholesterol is responsible for damaging the many tissues and organs of your body, but especially the cardiovascular system, to the extent that if not controlled early enough and adequately so, it leads to life threatening events and in many cases, sadly, sudden death occurs.

According to the American Heart Association (AHA), cholesterol i.e. the waxy substance in your body (and particularly in your blood circulation) can build up along the inner walls of the arteries that feed blood to the heart and the brain. This can force the heart to pump harder and increase the chance that a blood clot will seal off the vessel and cause a heart attack or a stroke.

As a matter of fact, the risk of developing coronary heart disease rises as your blood cholesterol increases; and in many instances this can cause pain in your chest or arm during stress or physical activity (you probably have heard of the term “angina”).

However, although in many discussions, and to some extent in this article particularly in part 1 last week, the focus of discussion on negative effects of cholesterol has mainly been on the heart and the brain (leading to a heart attack and stroke, respectively), as high cholesterol tends to cause a buildup of fatty deposits or plaques in your arterial walls and reduce blood flow, the disease also known as atherosclerosis can and usually does affect arteries throughout your body; and when it occurs in the arteries supplying blood to your limbs, it causes a condition doctors refer to as peripheral artery disease (PAD).

With this condition, you are likely to experience symptoms such as painful cramping in your hips, thigh or calf muscles after activity, such as walking and climbing stairs (a condition doctors further refer to as intermittent claudication). There may be numbness or weakness of the legs. You may also experience coldness in your lower leg or foot, especially when compared with the other side. There might also be sores on your toes, feet or legs that may take long to heal or won’t heal at all. You might also notice a change in the colour of your legs.

In an event however that peripheral artery disease progresses, pain may even occur when you are at rest or when you are lying down (doctors refer to the later as ischaemic rest pain). Note that the pain may be intense enough to disrupt sleep. Of course there are other causes of PAD, but the presence of high cholesterol in your blood stream, in your circulation, stands high above them all.

The agonizing pain and discomfort from peripheral artery disease and intermittent claudication may sometimes be trivialized as “ni old age chabe” especially in and among the old folks and particularly so when no medical care is sought or no proper assessment or evaluation is done and or when no appropriate tests are done or when the tests are not available (but we know that age ‘aint’ nothin’ but a number – remember the song by Aliyah and friends?) and when such an unfortunate conclusion is settled for, then the patient is unfortunately (for months and or years) subjected to one pain killer after another; today it’s panadol or aspirin (ASA), tomorrow it’s brufen or indomethacin (so called indocid), then weeks later it will be diclofenac and then who knows what next!!. So it’s important that our health care providers have a high index of suspicion of the possibility of high cholesterol and its attendant complications and at the earliest time possible make appropriated evaluation which should enable them make a correct diagnosis and institute appropriate treatment and care.

But also if you are male, you are likely to experience (sadly), erectile dysfunction   (and I want to believe you don’t want to get yourself to this level, do you?).

High cholesterol levels in your body or blood circulation, however, can be attributed mainly to consumption of unhealthy diets. Last week, we showed a picture that had foods that are high in terms of cholesterol content; and today we re-visit these foods and identify them by name. This kind of food, referred to as unhealthy diets, contain high amounts of saturated fats. And saturated fats are notorious for increasing blood levels of low density lipoprotein (LDL), the type of cholesterol we have earlier learnt (in part I of this article last week) that is ‘the bad’ and ‘unfriendly’ cholesterol in the body, especially when in excessive amounts. And you pick up (consume) saturated fat in foods such as full-fat dairy products, fatty meats, biscuits, pies, pastries and fried take-aways. However, LDL cholesterol can be reduced by restricting intake of these foods; this can be achieved by replacing full-fat daily foods with low- or reduced-fat alternatives, replacing fatty meats with lean meats and replacing butter with unsalted margarine, and if you fry foods, a good advice is that you may do so only occasionally and use unsaturated cooking oils such as olive, peanut, cottonseed, sunflower and so on instead of hard fats. But also remember that some oils of plant origin, such as palm oil and coconut oil contain saturated fats and therefore, they are not heart friendly. So you will do well to watch these foods in your diet. Eggs, contrary to previous thoughts about them, are however, relatively OK.

Carbohydrates (otherwise known as carbs), when you consume too much of them, your body will convert the excess in to cholesterol and also triglycerides (this is apart from or in addition to the direct and primary storage form of carbs or glucose called glycogen). And in many cases, these (cholesterol and triglycerides) may just be excess and not needed by the body and this ultimately will expose or predispose you to the risk of a heart attack and or a stroke. It is therefore advised that you watch your carbs intake and in fact consume the correct type (s) of carbs.

And then there are those factors which are generally not good for your healthy and they are often also regarded as anti-longevity factors; these are overweight, obesity and physical inactivity. These factors have been known to contribute to elevated LDL cholesterol levels in your bloodstream or circulation. Therefore, maintaining (or regaining) optical body weight and engaging in moderate to vigorous physical activity will have beneficial effects on blood cholesterol as exercise increases levels of ‘friendly’ or helpful HDL cholesterol and reduces levels of harmful LDL. There is evidence that even losing a little bit of weight can improve the levels of cholesterol in your blood to your advantage. And yes, as is advised in many situations for good health and disease prevention, a variety of vegetables, fruit and whole grain are beneficial to your overall health and longevity.

And then you have this interesting one; if you drink alcohol, a low or moderate intake of alcoholic beverages (particularly wine) apparently reduces the risk of heart disease – and this effect is at least partly attributed to an increase in HDL cholesterol associated with alcohol intake. Here we see alcohol scoring a first, right? (However, note that this is not a reason or recommendation to take up drinking alcohol, but rather constitutes advice for those who already drink to do so only in moderation; advises the Nutritionists Network of Australia).

And of course one of the ‘usual suspect’ and always a problem is smoking; smoking is known to frustrate the good work of high density lipoprotein (HDL) by stopping the latter from transporting cholesterol from the rest of the body tissues to the liver (where it supposed to be re-cycled and eliminated from the body); and when this happens, i.e. when HDL is hindered from doing its good work, the ultimate result is accumulation of fatty plaques in the walls and narrowing of blood vessels, the arteries, causing a condition we have already looked at – atherosclerosis.

There are other factors that are commonly associated with high cholesterol levels in your body and these include medical conditions such as diabetes and high blood pressure. Any wonder that from time to time when you go to see your doctor for your medical attention, among the test done is a check of cholesterol levels or more generally lipid level in your blood? (If you go to ‘good’ doctors and indeed those with the necessary tools and capacity that is…)…Yes your doctor will from time to time do a test called lipid profile or a lipogram. This is essentially to know whether or not you may also have high cholesterol or abnormal lipid levels in addition to the diabetes and or hypertension you may already have; and if such is a situation i.e. if fats in your blood are found to be elevated, then your risk for a heart attack and or stroke are quite high. With this state of affairs, your doctor will advise necessary measures to be taken and observed which should include a good control of your diabetes or blood sugar and your hypertension or BP, exercise, weight control and a healthy diet (adequate fruit, veggie and whole grain). If this doesn’t help much, or sometimes concurrently in addition to this plan, your doctor might (in many cases will) recommend that you also take a cholesterol-lowering drug called a statin. Statins are quite helpful, but note that they do also come with them some side effects and many of these unwanted effects may be really terrible, though.

We also need to note that for some people, their elevated blood cholesterol levels is primarily due to an inherited condition called familial hypercholesterolemia. However, we won’t delve into the details of this condition at this point.

Indeed cholesterol is a friendly commodity to your body but on the other hand it has been found wanting, it can be a dangerous foe. Therefore, develop a habit of regularly checking your blood cholesterol levels (and familiarize yourself with those blood cholesterol measurement numbers in discussion with your doctor) among other tests that you would want to routinely check such as HIV testing, Hepatitis B, BP check, kidney function tests and, according to your gender and age – prostate cancer screening, cervical cancer screening, breast cancer screening etc; and hey, remember the excellent benefits of a healthy diet, adequate exercise, quitting the smoke, taking alcohol only in moderation if you can’t stop completely (stopping completely is best, though), weight control, control of your diabetes or hypertension if you already have one or both of these diseases.

You might just save yourself from that heart attack or stroke or PAD that might have been looming.

Stay healthy.