September 2021

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1. Increased Cholesterol (C) and other fats (LIPIDS) in the blood is known as “Hyperlipidemia”  Cholesterol is the most important lipid and it is a yellow fatty substance in the blood. It is used to produce other substances like sex hormones, bile acids for digesting fat, VIT D, and steroids. It also forms part of the cell covering. Another important Lipid is Triglyceride (TG) which provides energy for the liver, other organs and helps keep us warm. When cholesterol and TG are too much in the blood they can be stored as Fat in the liver.

2. Where do we get Cholesterol(C) from?
C. is produced by the body in the liver and we also get it from what we eat- mainly animal products like meat, chicken, pork, egg yolks, shrimps and dairy products. The lipids are carried together in the blood with a protein in a molecule called a lipoprotein. There are several types of these and the important ones are:
LDL or BAD (Lousy) cholesterol
HDL GOOD (Healthy) cholesterol.
When cells need cholesterol the protein part is removed and cholesterol enters the cells.

3. Diseases associated with High C & TGs
High HDL cholesterol is protective while high LDL cholesterol is destructive. High LDL may be deposited in the blood vessels and can cause hardening and blockage of the vessels. Diseases associated with this and high TG include Cardio-Vascular (heart and blood vessels), Coronary (heart) Artery Disease, Heart Attacks, Stroke, Mini stroke and blocked Blood Vessels in the legs, and in the Penis (erectile problems). It can also affect tendons of muscles causing inflammation. Diseases like Diabetes Mellitus, Chronic kidney disease, liver disease and thyroid disease may result in high C. Chronic use of medicines like steroids and progesterone can also lead to high cholesterol.

4. High Cholesterol and Cancers
Recent studies show High C has been linked to cancers, making it easier for the cancer cells to spread in breast, gynecological and skin cancers.

5. How to lower your Cholesterol
A Know your cholesterol levels by asking your doctor to order a “Lipid Panel”.
B Your total cholesterol level is affected more by what you produce in the body than what you eat in your food. Levels are affected more by fats called “saturated fats” found in meats and tropical oils, and “trans fats” found in foods like margarine, cookies, cakes snacks. Try to decrease these.
C Regular exercise, Weight loss, Eat healthy like more fruits, veggies and fiber in your diet
D Eat fatty rich fish like salmon, mackerel, tuna which contain good fats
E Trim fat from meats and poultry before cooking
F Choose Dairy products low in fat like skim, 1 or 2% milk/yogurt. Cut back on Ice cream
G Choose cooking methods like baking, grilling instead of deep frying
H Use oils like olive, canola, peanut oil avocado, soybean, safflower which contain good fats
I Use cooking sprays to grease baking sheets and spray on foods when baking

Not everyone with high cholesterol goes on medications. You and your Doctor will make that decision based on your risk factors and underlying diseases. Lifestyle changes are important even when on medicines. These include statins, Ezetimibe, Fibrates, niacin,  colestipol, and injectable types.

A. These include Niacin, fish oil (Omega 3), krill oil, and flax seed oil
B. Plant sterols or phytosterols as supplements or added to vegetable spreads
C. Fiber supplements like Psyllium, Metamucil, Fibercon etc.
D. Red Yeast Rice a Chinese medicine has statin like properties but it may be adulterated with statins
E. Soy products e.g. Soy Isoflavones.

Reliable studies have not found Garlic, Chromium, Vit. C to lower cholesterol levels.

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Dr. Barbara Entsuah  MD, MHSc (Family Physician, Philanthropist and Author)