Blood lipids are substances in your blood
stream. They include cholesterol (there are two main types: bad
cholesterol or LDL-cholesterol, and good cholesterol or HDL-cholesterol),
and triglycerides. Too high a level of LDL-cholesterol, or too
low a level of HDL-cholesterol, or high triglycerides can
predispose you to developing heart disease and stroke. Persons
with diabetes often have lipid problems.
eating to lower your cholesterol
It's generally not difficult to lower your
blood cholesterol. You need the correct information, and lots of
will power. You should eat more foods that are low in saturated
fat and cholesterol, and cut down on high-fat ones, especially
those high in saturated fats. Here are some simple daily
1 Watch your caloric intake by eating a
wide variety of foods low in saturated fat and cholesterol.
2 Eat more vegetables and fruits every day.
Persons with diabetes should first find out what fruits may be
too "sweet" for them to take safely. Examples may include
durians and mango and grapes!
3 Eat more servings of cereals, plain
breads, pasta and other whole-grain products.
4 Eat fish, poultry without skin and leaner
cuts of meat instead of fatty ones.
5 Eat nonfat or 1% milk (low fat) dairy
products rather than whole-milk dairy products.
6 Increase exercise.
7 Maintain a healthy weight.
If you need to eat out in restaurants or
entertain a lot, you should think carefully before ordering!
Examples of local foods that are generally "bad" if you have a
lipid problem: char kuay teow, fried rice, mee goreng, curries,
nasi lemak, rendang, lontong, chicken rice, fish head curry,
roti prata, among others.
If your cholesterol is not dangerously
high, you should try to reduce it by altering your lifestyle.
Drug therapy is usually considered for patients who, in spite of
adequate dietary therapy, regular physical activity and weight
loss, still need more treatment to lower their blood cholesterol
levels. The presence of other coronary heart disease risk
factors influences the use of cholesterol-lowering drugs:
Age -- This
includes men 45 years or older, or women 55 years or older.
-- This includes anyone having a father, brother or son with a
history of coronary heart disease before age 55, or a mother,
sister or daughter with coronary heart disease before age 65.
This includes anyone who smokes or who lives or works every day
around people who smoke.
High blood pressure
-- This includes anyone with a blood pressure of 140/90 mm Hg or
higher, measured on two or more occasions.
--This includes anyone whose HDL cholesterol level is less than
--Diabetes is a very strong risk factor for heart disease and
stroke. If you have diabetes and high lipids, you need to pay
attention to keeping your lipids down.
There are a variety of medications
available for lowering blood cholesterol levels. They may be
prescribed individually or in combination with other drugs. Some
of the common types of cholesterol-lowering drugs include
statins, resins and nicotinic acid (niacin), fibrates.
This drug lowers blood triglycerides and raises HDL
derivatives This drug works in the liver by affecting the
production of blood fats. It's used to lower triglycerides,
lower LDL cholesterol and raise HDL ("good") cholesterol. It may
cause flushing and itching.
Resins are also called bile acid-binding drugs. They work in the
intestines by promoting increased disposal of cholesterol. There
are three kinds of medications in this class. Resins include
cholestryamine (Questran, Prevalite, Lo-Cholest), colestipol (Colestid),
coleseveiam (WelChol). Resins often come in a powder that you
mix with water or juice. Side effects may include constipation,
bloating, nausea and gas. To reduce these effects, eat more
fiber and drink more fluids.
Statins have shown themselves to be very effective for lowering
LDL ("bad") cholesterol levels. They are very safe and have very
few side effects. They work by interrupting the formation of
cholesterol from the circulating blood. Commonly prescribed
statins include: atorvastatin (Lipitor), fluvastatin (Lescol),
lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor).
Misconceptions About Cholesterol
1. Using margarine instead of butter
will help lower my cholesterol.
Both margarine and butter are high in fat,
so use both in moderation. From a dietary perspective, the major
factor affecting blood cholesterol is how much fat (particularly
saturated fat) is in the food — not the amount of cholesterol.
Reducing your intake of saturated fat is key to helping control
cholesterol. Most soft margarines have less saturated fat and so
are preferable to the stick forms for a heart-healthy diet.
However, eat all fatty foods in moderation.
2. Thin people don’t have to worry
about high cholesterol.
This is not true. Yes, overweight people
are more likely to have high cholesterol from eating too many
fatty foods, but thin people should also have their cholesterol
checked regularly. Often people who don’t gain weight easily are
less aware of how much fat they eat. Nobody can “eat anything
they want” and stay heart healthy. Have your cholesterol checked
regularly regardless of your weight, exercise habits and diet.
3. My doctor hasn’t said anything
about my cholesterol, so I don’t have to worry.
Unfortunately, not all physicians are as
proactive about healthy lifestyles as they should be. Your
health is your responsibility. Make sure that you have a blood
cholesterol test and learn how to interpret all the numbers,
including HDL (“good”) cholesterol, LDL (“bad”) cholesterol and
triglyceride levels. If you’re in a high or borderline-high
range, discuss options with your physician. You may be able to
control the levels by eating a diet lower in saturated fat and
cholesterol, getting 30–60 minutes of physical activity on most
days and quitting smoking. If lifestyle changes alone don’t
work, your physician may prescribe a cholesterol-lowering
4. Since the nutrition label on my
favorite food says there’s no cholesterol, I can be sure that
it’s a “heart-healthy” choice.
Nutrition labels on food are very helpful
when choosing heart-healthy foods, but you need to know what to
look for. Many “low-cholesterol” foods contain high levels of
saturated fat or trans-fatty acids — both of which contribute to
high blood cholesterol. Even foods that claim to be “low-fat”
may have a higher fat content than expected. Look for the amount
of saturated fat, total fat, cholesterol and total calories in a
serving of the product. Also check how much a serving is. Often,
it’s smaller than you think. The first ingredient listed is the
one used most in the product, so choose products where fats and
oils appear later in the ingredient listing. Currently,
trans-fats aren’t required to be listed, but if the product has
hydrogenated oils, it has a high level of trans-fatty acids,
which can raise your cholesterol level. Know your fats.
5. Since I started taking medication
for my high cholesterol, I don’t have to worry about what I eat.
Modern medications have come a long way in
helping to control blood cholesterol levels, but making
lifestyle changes along with taking medication is the best way
to help prevent heart disease. Reducing the amount of fat and
cholesterol in your diet and getting 30–60 minutes of exercise
on most or all days of the week is recommended, even if you’re
taking cholesterol-lowering medication. It’s also very important
to take your medication exactly as your doctor has instructed so
it can work most efficiently. Most modern medications are very
safe when used with your doctor's instructions.
6. I recently read that eggs aren’t so
bad for your cholesterol after all, so I guess I can go back to
having my two eggs for breakfast every morning.
One egg contains about 213 milligrams of
dietary cholesterol. That’s a lot given that the daily
recommended cholesterol limit is 300 milligrams. An egg a day
can fit within heart-healthy guidelines only if cholesterol from
other sources, such as meats, poultry and dairy products, is
limited. For example, eating one egg for breakfast, drinking 2
cups of coffee with one tablespoon of creamer, lunching on lean
turkey breast without skin and one tablespoon of mayonnaise, and
having a 6-ounce serving of broiled, short loin porterhouse
steak for dinner would account for about 510 mg of dietary
cholesterol that day — nearly twice the recommended limit. If
you love eggs and have to eat an egg every morning, substitute
vegetables for some of the meat, or drink your coffee without
creamer. Learn more about cooking for lower cholesterol.
7. I’m a woman so I don’t have to
worry. High cholesterol is a man’s problem.
Pre-menopausal women are usually protected
from high LDL (“bad”) levels of cholesterol, because the female
hormone estrogen tends to raise HDL (“good”) cholesterol levels.
Postmenopausal women may find that even a heart-healthy diet and
regular exercise aren’t enough to keep their cholesterol from
rising. If you’re approaching menopause, it’s especially
important to have your cholesterol checked and talk with your
doctor about your options. If you are a woman with diabetes,
your risk of heart disease is roughly 4 times higher than a
woman without diabetes.
8. You don’t need to have your
cholesterol checked until you reach middle age.
It’s a good idea to start having your
cholesterol checked at an early age, as even children can have
high cholesterol levels. And evidence exists that these children
are at greater risk for developing heart disease as adults. Lack
of exercise, poor dietary habits and genetics can all affect a
child’s cholesterol levels. You’re never too young to develop a
heart-healthy lifestyle by eating foods low in fats, getting
30–60 minutes of physical activity on most or all days, and
avoiding tobacco products.
How do I know if
my treatment is working?
Your doctor will test your blood
cholesterol level when needed. You should keep track of your
cholesterol level, perhaps using a chart or writing it on your
calendar. Together with your endocrinologist, set a goal and ask
how long it may take to reach that goal. Be sure to follow up
with your doctor after reaching your goal. Don’t stop medication
unless your doctor tells you to. Be wary of folk cures and