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CHOLESTEROL CONTROL: NAVIGATING THE PATH TO HEART HEALTH


Cardiovascular disease (CVD) continues to pose a significant challenge for many developing countries, including Malaysia. Despite ongoing efforts to prevent and manage CVD, it remains the leading cause of morbidity and mortality. One contributing factor to the increased risk of CVD is a condition known as hyperlipidemia. 


Hyperlipidemia is a health concern caused by a variety of genetic and acquired factors that result in elevated lipid levels in the body. It is common, particularly in the Western world, but it is also seen all over the world. 


In simpler terms, hyperlipidemia is characterized by elevated levels of specific lipids in the body. This includes low-density lipoprotein (LDL), total cholesterol (TC), triglycerides (TG), and lipoproteins that are above normal levels. Conversely, having lower-than-normal levels of high-density lipoprotein (HDL) is considered hyperlipidemia as well.


Another term for lipid disorder is dyslipidemia, which occurs when LDL, TC, TG, or HDL levels are either higher or lower than the recommended level. This condition is a known risk factor for cardiovascular problems. 


WHAT ARE TC, TG, LDL, AND HDL?

Total Cholesterol (TC): is the measure of all the cholesterol in blood, including LDL cholesterol and HDL cholesterol. 


Triglycerides (TG): the most common type of fat in the body, found in fat cells all over. When consumed exceed calories, alcohol, or sugar than your body needs, it transformed into triglycerides and stored as fat. TG consist of glycerol and three fatty acid molecules. High TG was risky for heart health, potentially leading to CVD, especially in women. 


Low-density Lipoprotein (LDL): produced partly in the intestine and partly after breaking down very low-density lipoproteins (VLDL). They are directly linked to coronary heart disease and play a significant role in cholesterol buildup and arterial blockage.


High-density Lipoprotein (HDL): also known as good cholesterol, is formed in the liver. It functions as a cholesterol transporter, moving cholesterol and other fats away from tissues and back to the liver for breakdown. HDL protects against atherosclerosis by removing cholesterol from your arteries. 


HEALTHY LEVEL OF CHOLESTEROL

The following levels are considered "desired" in healthy individuals: 

  • Total Cholesterol (TC): < 5.2 mmol/L

  • Triglycerides (TG): < 1.7 mmol/L

  • Low-density Lipoprotein (LDL): < 2.6 mmol/L

  • High-density Lipoprotein (HDL): > 1.0 mmol/L in men ; > 1.3 mmol/L in women



PREVENTION

Preventing hyperlipidemia involves adopting healthy lifestyle choices:

  • Follow the DASH Eating Plan:

    • Prioritize vegetables, fruits, and whole grains.

    • Include fat-free or low-fat dairy, fish, poultry, legumes, nuts, and vegetable oils. 

    • Limit intake of saturated fat from fatty meats, full-fat dairy products, and tropical oils. 

    • Limit intake of sugary beverages and desserts.

  • Opt Healthy Fats:

    • Restrict total fat to 25-35% of daily calories, with less than 7% coming from saturated fat. 

    • Choose lean meats, nuts, and unsaturated fats such as canola, olive, and safflower oils. 

    • Avoid trans fat found in hydrogenated oils, stick margarine, crackers, and fried foods. 

  • Limit Cholesterol Intake:

    • Try to consume less than 200mg of cholesterol per day from animal-based foods.

    • Reduce consumption of liver organ meats, egg yolks, shrimp, and whole milk products. 

  • Increase Soluble Fiber:

    • Consume whole grains, and fruits such as apples, bananas, oranges, and legumes. 

    • Soluble fibre assists in preventing cholesterol absorption in the digestive tract.

  • Eat Plenty of Fruits and Vegetables:

    • A Diet rich in fruits and vegetables boosts cholesterol-lowering compounds like plant stanols or sterols, helping to reduce some of the cholesterol as waste. 

  • Include Omega-3 Fatty Acids:

    • Incorporate fish high in omega-3 fatty acids like salmon, tuna, and mackerel.

    • Omega-3s may increase HDL levels while also protecting the heart from clots and inflammation. 

  • Moderate Alcohol Consumption:

    • Limit alcohol consumption to one drink per day for women and two drinks per day for men, as excess alcohol consumption can affect cholesterol levels and overall heart health. 

  • Green Tea Consumption:

    • Green tea, rich in antioxidants, can help lower cholesterol and prevent artery plaques. 

  • Regular Physical Exercise:

    • Adults are recommended to carry out 150-300 minutes of moderate-intensity aerobic activity per week, combined with muscle-strengthening exercise. 

    • Reduce sedentary time, as any physical activity, no matter how light, has health benefits. 


To summarise, keep your heart in harmony by adhering to a DASH diet, selecting healthier fats, and reducing cholesterol excess. Add a pinch of soluble fibre, catch the omega-3 wave, and dance your way to heart health with energetic beats and mindful sips. 



REFERENCES

DASH Eating Plan. (2019). Medlineplus.gov; National Library of Medicine. https://medlineplus.gov/dasheatingplan.html


Firus Khan, A. Y., Ramli, A. S., Abdul Razak, S., Mohd Kasim, N. A., Chua, Y.-A., Ul-Saufie, A. Z., Jalaludin, M. A., & Nawawi, H. (2022). The Malaysian HEalth and WellBeing AssessmenT (MyHEBAT) Study Protocol: An Initiation of a National Registry for Extended Cardiovascular Risk Evaluation in the Community. International Journal of Environmental Research and Public Health, 19(18), 11789. https://doi.org/10.3390/ijerph191811789


Hill, M., & Bordoni, B. (2023, August 8). Hyperlipidemia. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559182/


Medline Plus. (2019). How to lower cholesterol with diet. Medlineplus.gov; National Library of Medicine. https://medlineplus.gov/howtolowercholesterolwithdiet.html


Mohamed-Yassin, M.-S., Rosman, N., Kamaruddin, K. N., Miptah, H. N., Baharudin, N., Ramli, A. S., Abdul-Razak, S., & Lai, N. M. (2023). A systematic review and meta-analysis of the prevalence of dyslipidaemia among adults in Malaysia. Scientific Reports, 13, 11036. https://doi.org/10.1038/s41598-023-38275-7


U.S. National Library of Medicine. (2020, October 2). Cholesterol Levels: What You Need to Know. Medlineplus; National Library of Medicine. https://medlineplus.gov/cholesterollevelswhatyouneedtoknow.html


Verma, N. (2016). INTRODUCTION TO HYPERLIPIDEMIA AND ITS TREATMENT: A REVIEW. International Journal of Current Pharmaceutical Research, 9(1), 6. https://doi.org/10.22159/ijcpr.2017v9i1.16616


World Health Organization. (2022, October 5). Physical Activity. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/physical-activity 


@iGLOW SDN BHD

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