Doc, what is cholesterol? Where does it come from? What does it do?

These are not uncommon questions. Most adults, who have a regular physical examination, undergo routine blood tests to check for cholesterol level. Some are normal. Others are abnormal. Some have to go on a diet. Some have to take pills. Is this necessary?

Cholesterol is normally present in blood and all animal tissues. It is odourless and tasteless. It is essential to life. It is an important component of the membrane that surrounds each cell. Cholesterol is required when body synthesises substances like bile acids, steroid hormones, and vitamin D.

Where does it come from?

The liver and many other organs synthesize cholesterol. We also consume considerable amount of it in our diet.

How does it do the damage?

Cholesterol is not soluble in the blood. In order for it to be transported to different sites in the body, it has to attach itself to certain type of protein called lipoprotein. This transportation occurs through the bloodstream.

LDL (low density lipoprotein), also known as bad cholesterol, picks up the cholesterol from the liver and transports it to various tissues and body cells. Here the cholesterol gets separated from the lipoprotein and is used by the cells. This includes the deposition of cholesterol and other fatty substances circulating in the blood stream in the interior walls of the blood vessels. These deposits (atherosclerosis) narrow the blood vessels causing heart attacks and strokes. Higher levels of blood cholesterol cause more damage and increased narrowing of the blood vessels.

HDL (high density lipoprotein), also known as good cholesterol, transports excess or unused cholesterol from the tissues back to the liver, where it is broken down to bile acids and then removed from the body.

How can we avoid high cholesterol levels in the blood?

Mainly by improved nutrition (remember March is nutrition month!). Susan White, Clinical Dietician at the Medicine Hat Regional Hospital has a very informative hand out for the Cardiac Rehab Program patients. It is called: Nutrition – For Your Heart. It has five titles: 1.Eat more fibre 2. Meats and Alternatives 3. Choose lower fat Milk Products 4. Reduce all sources of dietary fat 5. Reduce salt, caffeine and alcohol intake.

Avoid lard, butter, cheese, whole milk, red meat, candy and baked goods containing shortening. Egg-yolks and shrimps are high in cholesterol. If you love cheese then eat in small amounts. Pick varieties with less than 20 percent M.F. (milk fat), and products made with skim milk or partly skim milk.

Chips, deep-fried items (who does not love French fries?), and commercially baked goods should be avoided. Same goes for ice cream, whipping or cereal cream, coffee whitener or regular puddings.

So, it is not easy. Careful thinking and strong motivation helps.

Those who fail to control their cholesterol level by diet and exercise end up on pills. There are several in the market and your doctor should be well versed in this area as it is such a common problem. Heart disease is the number one killer.

In the last few days you have had your plate full with items on nutrition. Hopefully, it has not given you indigestion. If you decide to make changes in how and what you eat then do it slowly. Sometimes it is the smallest changes that can pretty well change your life.

Good luck and happy eating!

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