High cholesterol increases risk of heart disease; low-fat diet, exercise help keep health in check

Cholesterol is a fat-like substance in the body. It is produced by your body — 75 percent by your liver. The rest comes from the food you eat.

Cholesterol is present in every cell of the body and is important in digesting foods, generating Vitamin D, building cell walls and producing some hormones. While it is needed for good health, too much cholesterol can damage your arteries and increase the risk of heart disease.

Cholesterol in the blood doesn't move through the body on its own. It combines with proteins to travel through the bloodstream.

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Cholesterol and protein traveling together are called lipoproteins. The main types of lipoproteins are high-density lipoprotein (HDL) and low-density lipoprotein (LDL). HDL moves cholesterol out of arteries and back to the liver for disposal. LDL cholesterol is known as “bad” cholesterol because it brings and leaves cholesterol in your arteries.

The extra LDL-cholesterol builds up on the walls of the arteries, forming plaque. Plaque can block arteries, making it harder for the blood to flow through and putting you at a risk of heart disease, attacks and strokes. High cholesterol does not usually produce any symptoms, so you could be in danger even without knowing it. One sign is a grey-white line of fat deposits growing on the outside edge of your cornea. If you're under 40, it could be a sign of dangerously high cholesterol.

Representational image. Reuters

You can inherit a tendency towards high cholesterol. No one in my family has died of a heart attack so far, but I do have small yellowish-white patches on my eyelids which I developed in my 40s—and which are a symptom of extra cholesterol. They are more likely to develop during a person's middle years and are more common in women than men. My mother and grandmother had them too. My cholesterol levels have always been on the higher side even though my lifestyle includes exercise and only non-oily vegetarian food.

The doctors say hypercholesterolaemia may be an inherited condition which occurs because of a mutated gene. This usually results in heart disease before 55 but I am past that now. Around 12 percent of females, who inherit the genetic mutation from a parent, will develop coronary artery disease before they turn 50, and 74 percent by the age of 70 years. About 85 percent of affected male children will have a heart attack before the age of 60. But, this can be kept in check by diet and exercise.

In adults, cholesterol levels of below 200 milligrams per decilitre (mg/dL) are considered healthy. Between 200 and 239 mg/dL is borderline high, while 240 mg/dL and above is high.

LDL cholesterol levels should be less than 100 mg/dL. A reading of 100–129 mg/dL is acceptable for people with no health problems but may be a concern for anyone with heart disease or heart-disease risk factors. While 130—159 mg/dL is borderline high, 160–189 mg/dL is high.

HDL levels should be 60 mg/dL or higher. Less than 40 mg/dL can be a major risk factor for heart disease. Cholesterol only comes from animal foods such as eggs, milk, butter, cheese, meat, fish, poultry and hydrogenated oils like lard, margarine, palm and coconut.

People who eat animal products may have more cholesterol in their bodies, at any given time than those who don't. It is not just from the food they eat — the liver will also increase cholesterol levels when a diet is high in fat and trans fats. Having an increased amount of LDL cholesterol, caused by trans and saturated fats, increases the risk for heart disease and diabetes.

A report from Harvard Health has identified foods that actively decrease cholesterol levels:

Oats, barley and whole grains, beans, eggplant and okra, nuts, vegetable oil (canola, sunflower), fruits (mainly apples, grapes, strawberries, and citrus), soy and soy-based foods, foods rich in fibre (no animal-based foods have fibre.)

Reducing the intake of fat in the diet helps to manage cholesterol levels.

Limit foods that contain:

Saturated fat: This occurs in meats, dairy products, chocolate, baked goods, deep-fried, and processed foods.

Trans fats: These occur in some fried and processed foods.

Excess weight can also lead to higher blood LDL levels.

Other conditions that can lead to high cholesterol include diabetes (another lifestyle disease), liver or kidney disease, polycystic ovary syndrome and steroids.

If your diet is high in fibre and you eat mainly fresh fruit and plants, plant sterols will lower your cholesterol. Physical activity will also make you maintain or lose weight. Exercising for an hour a day raises the heart rate, helps with keeping a healthy weight, and reduces LDL cholesterol levels while increasing HDL cholesterol levels.

Researchers at the department of preventive medicine at the Northwestern University Feinberg School of Medicine, Chicago, and published in Journal for the American Medical Association, examined data from six study groups of more than 29,000 people followed for 17½ years. At the start, participants filled in questionnaires detailing the foods they ate. Over the follow-up period, a total of 5,400 cardiovascular events occurred, including 1,302 fatal and nonfatal strokes, 1,897 incidents of fatal and nonfatal heart failure and 113 other heart-disease deaths. An additional 6,132 participants died of other causes.

When they analysed the data, the researchers found an association between egg consumption as reported at the start of the study and participants’ risk of developing cardiovascular disease. As their egg consumption rose, so did their risk. An egg has 155 calories and 11gms total fat. Each egg has 186 milligrams of cholesterol, which is 124% of what you should be eating per day and sodium 124 mg—more cholesterol than a fast-food double cheeseburger.

Three or more eggs a week was associated with a 3.2 percent higher risk of heart disease and a 4.4 percent higher risk of early death. Each additional half an egg consumed per day was associated with a 6-8% higher risk of cardiovascular disease and higher risk of early death due to any cause.

The researchers factored in every other unhealthy behaviour, such as low physical activity, smoking and an unhealthy diet full of processed food and saturated fats.

Dr Robert H Eckel of the University of Colorado School of Medicine wrote that the new report "is far more comprehensive, with enough data to make a strong statement that eggs and overall dietary cholesterol intake remain important in affecting the risk of cardiovascular disease, and more so the risk of all-cause mortality".

"Considering the negative consequences of egg consumption and dietary cholesterol in the setting of heart-healthy dietary patterns, the importance of limiting intake of cholesterol-rich foods should not be dismissed," he concluded. According to industry data, the world will eat more eggs in 2019 than any time for the past 20 years.

Are eggs eaten alone? The food they are eaten with is as terrible for the body—white bread, butter, salt, and/or processed meats like bacon or sausages.

How many eggs a week is safe? None.

The more eggs a person eats, the more those risks increase. People in the study, who averaged an egg every day, saw their risk of a heart-related event, such as a heart attack or stroke, increase by 12 percent compared to someone who didn’t eat eggs. Those who averaged two eggs every day had a 24 percent increased risk of heart-related events.

Researchers saw similarly increased risks for people who ate processed and unprocessed red meat.

Those associations held even when researchers looked at the overall quality of a person’s diet. Those who included eggs as part of a healthy diet didn’t have lower risks compared to those who ate eggs along with less nutritious foods.

It follows a 2018 study that looked at the evidence collected from 28 studies that had people eat eggs as an experiment and then looked at changes in their blood lipids. The study found eating eggs boosted total cholesterol by about five points compared to people who were on diets that didn’t include eggs. Most of that increase came from an increase in LDL, or “bad” cholesterol.

To join the animal welfare movement contact gandhim@nic.in, www.peopleforanimalsindia.org