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| Sunday, 24 October 2004 |
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Features |  |
| News Business Features Editorial
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Compiled by Carol Aloysius Do fatty foods cause high cholesterol? Rising cholesterol levels have often been blamed on fatty diets.But not all fats increase cholesterol levels, says Dr. Rani Goonewardene in an interview with Carol Aloysius. Q:What is cholesterol? A: It is a wax like substance Q:What are the sources of cholesterol? A: foods that you eat. It is also produced in the liver Q:Why is cholesterol produced? A: It is needed to form, cell membranes, certain hormones, digest dietary fat, to produce vitamin D, and for other important processes. Q:What happens if there is excess cholesterol? A:It forms plaques causing narrowing of blood vessels resulting in less blood supply and therefore less oxygen to the heart muscle resulting in Angina (chest pain) or rupture of a plaque will cause stroke, heart attack or sudden death. Q:'Low fat low cholesterol diet' is this recommendation far outdated? A:Yes, because what matters is the type of fat in the diet. Some type of bad fats will tend to worsen blood cholesterol levels, and increase the risk for certain diseases like coronary Heart Disease, stroke. Good fats will improve Blood Cholesterol levels, and lower the risk. Q:What is the part played by LDL and HDL? (Low density Lipoproteins, High density lipoproteins) A:LDL carries the cholesterol in the blood from liver to the other parts of the body, and deposits on the walls of the arteries. (BAD) HDL carries the cholesterol from the body back to liver to be eliminated (GOOD) Q:What are the ideal cholesterol levels? A:Total cholesterol less than 200mg/dl HDL 40mg/dl or higher. LDL less than 100mg/dl Q:What is my risk level of CHD? A:Your risk level is relatively low if you do not have other risk factors. Check you lipid profile every five years. Q:If my total cholesterol level is less than 200mg/dl HDL and less than 40mg/dl, what should I do? A:Check your LDL Increase your physical activity reduce your risk factors check lipid profile every two years. HDL less than 35mg/dl increase risk of CHD. Q:If my total cholesterol is more than 200mg/dl, HDL less than 40mg/dl and a high LDL of more than 130mg/dl what are my risks? A:Your chances of getting Coronary Heart Disease (CHD) is twice as much as those people whose cholesterol is less than 200mg/dl Q:If the total cholesterol is higher than 240mg/dl what are my risks? A:You have a high risk of getting CHD, with added risk factors, Diabetes, CHD, High Blood Pressure, and Peripheral Vascular Disease. Q:Ideally, what should be my HDL levels? A:Higher the better. less than 40mg/dl has high risk of heart disease Q:What should be my LDL levels? A:Less than 100mg/dl Lower the LDL lower the risks. More than 190mg/dl carries a very high risk. Q:What are Triglycerides? A:These are the energy supplying fats. Q:What are the normal levels? A:Less than 150mg/dl; More than 200mg/dl is high; More than 500mg/dl is very high. The higher the value of Friglycerides level in the blood the higher the risk of heart disease. Q:What are the dietary measures that will help to increase the good cholesterol and lower the bad cholesterol? A:Avoid consumption of bad fats Q:What are bad fats? A:Saturated Fats and Trans Fats. Q:What foods have saturated fats? A:Whole milk, butter, cheese, ice cream, red meat, chocolates, etc. poultry skin, egg yolks, some plant foods. Q:What effect do they have on cholesterol levels? A:Raise both LDL and HDL Q:What are Trans fats? A:Margerines, vegetable, shortening, partially hydrogenated vegetable oils, or hydrogenated vegetable oils, deep fried chips, fast foods, crackers, snack foods (cutlets, pastries), baked foods, processed foods, Salad dressing Q:What kind of an effect do they have on cholesterol? A:They Raise LDL and Lower HDL Q:What are Trans Fatty Acids? A:It is the end product of heating liquid vegetable oils in the presence of hydrogen. Trans fatty acids are found in the food I mentioned. Q:Why should I worry about Trans fatty acids? A:Because they increase the bad LDH thus increasing the risk of heart disease. Q:How would I know that Trans fatty acids are present in foods? A:If the label shows the presence of partially or fully hydrogenated vegetable oils Q:What are Good Fats? A:There are two types of good fats a) Monounsatured fats like olives, (weralu) olive oil, canola oil, cashews, peanut oil, almonds walnuts, most other nuts, avacados. b) Poly unsaturated like corn, soy bean, sun flower, cotton seed, oil, fish, omega 3 fatty acids found in fatty cold water fish, salmon, sardines, and mackerel (also in lesser amounts in flax seed, soybean, canola oil) these fats lower LDL raises HDL. Q:What effects do they have on cholesterol? A:They lower LDL and Raises HDL Q:What can I do to lower cholesterol levels? A:Change your lifestyle: lose weight. This reduces LDL and raises HDL as well as lowers the total cholesterol levels; avoid diet rich in bad fats; consume good fats; eat cereals, bread pasta, made from whole grains; use skim or non-fat milk in cooking; eat a vegetarian diet less in LDL; reduce cigarette smoking. Smoking lowers HDL, increase LDL, and increases the tendency to clot blood. Regular physical activity increases HDL; reduce excess alcohol consumption Change your cooking habits, take off skin and fat from poultry, meat and fish. Broil bake and grill instead of frying. Stress; although studies have not shown there is a direct link, during stress, people tend to eat more bad fatty foods thus increasing cholesterol levels The following conditions can also cause high cholesterol levels and therefore warrants clinical and laboratory assessment before starting on cholesterol lowering drugs, Diabetes; Hypothyroidism; Obstructive liver disease; Chronic renal failure. Things that you cannot do anything about the high cholesterol levels * High Blood Pressure (140/90 mmHg or higher or on blood pressure medication) * Heredity - Your genes partly determined how much cholesterol your body makes for these people the type of fat in the diet will have little impact on the blood cholesterol. * High cholesterol runs in families. Heart disease in father or brother before age 55; heart disease in mother or sister before age 65 * Age (men 45 years or older; women 55 years or older) After menopause women are more prone to increase LDL levels. ******************* Heart rate determines cardiovascular risk by Dr. D.P. Atukorale It is common knowledge that in normal healthy people's heart rate is same as pulse rate. The normal resting heart rate is usually between 60 and 80 beats per minute and tachycardia is defined as heart rate over 100 beats per minute. People with tachycardia is those with heart rate and pulse rate over 100 per minute are more likely to develop cardiovascular disease (high blood pressure and heart attacks) according to a large number of research studies. People with fast heart rates are more prone to Atherosclerotic Disease such as heart attacks, Hypertension Strokes Peripheral Vascular Disease. Heart rate was found to be a predictor of future development of hypertension (high blood pressure) as far back as 1945. This finding was subsequently confirmed by other studies. A body of evidence indicates that tachycardia is also related to increased cardivocsular mortality. A number of other studies confirmed above finding showing that resting heart rate (and resting pulse rate) was a powerful predictor of death from cardiovascular and non-cardiovascular causes. The relationship between heart rate and cardiovascular mortality persists into old age according to the Framingham study, and Nhanes study which were performed in general population. Two more studies conducted in elderly people show that elderly people with increased heart rate are prone to increased cardiovascular orality. According to a Norwegian study of myocardial infarction total mortality was 14 per cent in subjects with an admission heart rate was less than 60 per minute, 41 per cent in subjects with a heart rate over 90 beats per minute and 48 per cent in those with heart rate over 110 beats per minute. The mean blood pressure has been found to be high in subjects with faster heart rate. As mentioned earlier, heart rate is considered as a marker of abnormal clinical condition. Heart rate was correlated with blood pressure, degree of obesity cholesterol, triglycerides, and fasting insulin level i.e. fast heart rate is a marker of insulin resistance syndrome.The connection between high heart rate and mortality can be explained also by an unrecognised underlying disease and tachycardia can reflect poor physical fitness or loss of cardiac reserve. As mentioned earlier tachycardia can facilitate sudden death. Subjects with tachycardia are more prone to ventricular arrhythmias and tachycardia increases oxygen consumption and ventricular vulnerability. ******************* Breast cancer month : Wear a pink ribbon and show you care A month-long campaign to create awareness on breast cancer and support women affected by it was formally launched in Colombo by the Ceylinco Healthcare Centre (CHC), on October 1. The ceremony also marked the commencement of the Ceylinco 'Pink Ribbon' campaign to disseminate the message that 'Early detection is your best protection'. Some 35 leading business establishments in Colombo and the suburbs are distributing these pink ribbons, supplied by the Ceylinco Healthcare Centre, free of charge to their customers. Wearing one during October, designated universally as the breast cancer awareness month, shows that the wearer honours survivors, remembers those lost to the disease and supports the search for a cure. In Sri Lanka, breast cancer is the commonest form of cancer among females, afflicting one in every 20 or five per cent of the female population. It is the leading cause of death of women in the 40 to 55 age group. This alarming situation can be reversed if more women are made aware that mammography can detect a cancer up to two years before it is large enough to be felt, and that cancers detected early can often be cured for life. |
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