Common queries about cholesterol, lipid profile, VLDL, HDL, triglycerides…

You have your latest lipid profile reports in front of you and the doctor says it doesn’t look good. You’re utterly flummoxed by the numbers and the strange terms on the report like cholesterol, LDL, HDL, triglycerides and lipid profile. Don’t worry help is at hand:-
What is cholesterol?
Just like the fat you have in your body, cholesterol is also a fat/ lipid that is produced in the liver and its normal levels are necessary for the proper functioning of the body.
If our own body produces it, why is cholesterol harmful?
When cholesterol levels are in the normal range, in a healthy body, the blood flows freely through the veins and arteries. When the cholesterol levels are high, it starts forming clots (plaques) in the blood vessels causing hypertension (high BP), angina (chest pain), heart attacks, strokes and peripheral vascular diseases.
What do the terms LDL, HDL and VLDL that figure in my lipid profile reports mean?
As cholesterol is a fat that is insoluble in blood, it needs something to carry it or transport it in our body. LDL, HDL, VLDL are small molecules called lipoproteins that help with the same.
I’ve heard there is ‘good’ and ‘bad’ cholesterol. What are they?
‘Good’ cholesterols are good because they help get rid of excess cholesterol by transporting them from the blood vessels to the liver for excretion. HDL (High Density Lipoprotein) is a good cholesterol.
‘Bad’ cholesterols are bad because they deposit more cholesterol in the blood by transporting it from the liver, causing more plaques and dangers of high BP, chest pain, heart problems etc. VLDL (Very Low Density Lipoprotein) which is eventually converted to LDL (Low Density Lipoprotein) is the “bad cholesterol” as it mobilizes the cholesterol from the liver depositing it in your blood vessels.
What are triglycerides?
Triglycerides are another type of fat or lipid that combine with cholesterol to form plasma lipids and gets deposited in the vessels.  When your calorie intake is more than what you need, the excess is converted and stored in the form of triglycerides. In between meals, when the body needs more energy, this triglyceride store is burned to convert into energy.
How do I know I have excess cholesterol and lipoproteins?
 A simple investigation called the Lipid Profile done by drawing your blood is the answer (after an overnight fasting on consuming a diet low in fat for three days) is recommended. It measures the Triglyceride levels, Total cholesterol, LDL, VLDL and HDL levels.
The normal ranges are as given below:

	Desirable	Borderline	High risk
Cholesterol	<200 mg/dl	200-239 mg/dl	240 mg/dl
Triglycerides	<150 mg/dl	150-199 mg/dl	200-499 mg/dl
HDL Cholesterol	60 mg/dl	35-45 mg/dl	<35 mg/dl
LDL Cholesterol	60-130 mg/dl	130-159 mg/dl	160-189 mg/dl
Cholesterol/HDL ratio	4.0	5.0	6.0

If your values are slightly deranged or ‘borderline’, you need to be careful but there’s no cause for alarm. They could also result due to an interplay of genetic and acquired factors. While nothing can be done about one’s genes, efforts to modify our lifestyle can really prove beneficial.  Modify your diet, increase your level of physical activity and keep your weight under watch!
What foods can help me control my cholesterol levels and maintain heart health?
Just a few simple tweaks to your daily diet can help you get your cholesterol levels under control:
 1. Olive oil:  Switch to olive oil for cooking. Research has shown that the Mediterranean people consume olive oil and have very low incidence of cardiovascular diseases and stroke. Olive oil contains a mix of various anti-oxidants which lower your bad cholesterol (LDL). Use it for your tadka or add it as a dressing to salads. Extra virgin olive oils are even more beneficial as they are less-processed and retain more anti-oxidants than the other varieties.
 2. Nuts: Walnuts and almonds are rich in omega three fatty acids and PUFA (poly unsaturated fatty acids) which help reduce LDL cholesterol and keep the blood vessels healthy. A handful of these nuts (unsalted, unfried) should help.
 3. Oats: Being high in soluble fibre, oats reduce the absorption of cholesterol (Total & LDL) in your blood. Eating 1 ½ cups of cooked oats with milk and bananas or apples gives you your daily requirement of soluble fibre.
 4. Fish: High in omega 3 fatty acids, it helps increase the levels of the good (or HDL) cholesterol.
It is recommended that you have atleast two servings of Salmon (rawas fish), herring (bhing) or mackerel (bangda) per week. For restricting calories, they are best eaten grilled, shallow fried with very little oil or baked.
If you do not eat fish or do not have access to good fish, add ground flax seeds (alsi), pumpkin seeds, sesame seeds (til), soyabean oil, canola oil to your diet. Omega 3 fatty acid supplements are also available.
 5. Garlic: Though the cholesterol lowering effects of garlic has been debated in recent times, it has been shown that allicin in the garlic does help.
 What foods need to be avoided?
 Avoid processed foods like biscuits, cookies, cakes and fried stuff. Avoid red meat and egg yolk.
 How much exercise do I require?
 Just a walk daily isn’t enough, as is often recommended. The intensity and the amount of time spent exercising is very important to have significant beneficial effects. If you have been a sedentary person all your life, you can start with a 45 minute walk but should soon increase the intensity by adding jogging and other forms of cardio exercises to your routine. Try and change some of your sedentary habits – walk down the road for shopping, climb those stairs, play football with kids, do your household cleaning yourself.  Every calorie you shed counts!
 Start your fight against cholesterol today and let us know what your next lipid profile reads.