Cholesterol

A fat molecule that is white, insoluble and waxy
Essential for many metabolic processes
There are different types of cholesterol:

• HDL is the ‘good’ cholesterol
• LDL is the ‘bad’ cholesterol
• Triglycerides, a type of fat, also form part of the lipid profile
• Eating foods rich in saturated fats will increase the amount of LDL cholesterol in the body, which is a risk factor in coronary heart disease
• High triglycerides may contribute to hardening of the arteries or thickening of the artery walls

High cholesterol, or hypercholesterolaemia, is a condition in which the amount of cholesterol in the blood exceeds normal values
This may be due to genetic or lifestyle factors
If it is genetic, it is referred to as familial hypercholesterolaemia

Cholesterol comes from 2 sources:

• Animal-based foods in our diets
• Production by the liver and cells

We need a small amount of cholesterol because the body uses it to:

Build the structure of cell membranes
Make hormones, like oestrogen and testosterone
Help your metabolism work efficiently
Produce vitamin D
Produce bile acids, which help the body digest fat and absorb important nutrients

• Being overweight
• Incorrect diet, rich in saturated fats
• Family history of high cholesterol
• Excessive alcohol consumption
• Smoking
• Lack of exercise
• Stress
• Lack of fibre in the diet

Finger prick test that will show total cholesterol for screening and follow-up purposes, ranging from total cholesterol only, to a full cholesterol lipogram profile
Lipogram where blood is drawn and evaluated by a laboratory
Health authorities recommend that a lipogram be done at least once a year in high risk individuals

Health authorities recommend that cholesterol levels should be less than 5mmol per litre for total cholesterol and 3 mmol/l for LDL cholesterol if there are no other risk factors present.

The South African Heart Association’s guidelines for lifestyle modifications in this regard is summarised as follows:

• Stop smoking and avoid exposure to smoke
• Increase your physical activity
• Achieve and maintain an ideal body weight
• Reduce your intake of saturated fats,
• Increase your intake of soluble fiber
• Avoid refined carbohydrates and sugars
• Consume alcohol in moderation
• Avoid adding additional salt to food
• Monitor your cholesterol levels on a regular basis

• Fatty or processed meats like salami and sausages
• Snack foods like chips
• Most takeaway foods, especially deep-fried foods
• Cakes, biscuits and pastries

LDL cholesterol can be lowered by the following food types:

• Oats and legumes and chickpeas
• Garlic and onions
• Apple polyphenols found in apples
• Plant sterols (often incorporated into margarine these days)

Is a healthy lifestyle on its own enough to combat high cholesterol?
For some people, diet and lifestyle changes alone are not enough, as High blood cholesterol levels often have a genetic component.

For these individuals, prescription medication such as statins may be required
Treatment of cholesterol should have a multi-approach:
(1) prevention of new formation of new cholesterol on the vessel walls
(2) removal of existing cholesterol
(3) decrease the complications that occur with the cholesterol increase