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Coronary heart disease (CHD) is the main cause of death in South Africans following a western lifestyle. High blood cholesterol is one of the major risk factors for coronary heart disease but is one which can be controlled. It is estimated that over 4,5 million South Africans suffer from elevated cholesterol levels, but most only find out when it is too late, i.e when they've suffered from a heart attack.

What is cholesterol?

Cholesterol is a fatty substance produced mostly in the liver but it is also supplied by our diet. Our body needs cholesterol to form cell membranes and hormones. Cholesterol can't dissolve in the blood and therefore is carried in the bloodstream by special carriers. The two main types of carriers are LDL cholesterol and HDL cholesterol.

LDL ('bad') cholestrol

LDL cholesterol brings cholesterol to the body's cells.The cells take the cholesterol they need and the excess cholesterol remains in the blood. This can build up in the walls of the arteries and so increase the risk of heart disease.

HDL ('good') cholestrol

HDL cholesterol takes excess cholesterol the body doesn't need back to the liver where it is eliminated. This type of cholesterol is considered good for keeping your heart healthy.

Why should I care about cholesterol levels?

An unhealthy diet, physical inactivity, smoking, being overweight, age and family history can lead to high cholesterol levels. High blood cholesterol levels can cause blood vessels to narrow or gradually block up. This build-up of cholesterol can happen very slowly. As the blood vessels become narrower, the flow of blood to the heart muscle is reduced. When blood flow is restricted, chest pain (called 'angina') can result. When blood flow to the heart is severely restricted or stops completely, a heart attack can result.

How can I tell if I have high cholesterol levels?

Unfortunately, high total cholesterol levels are very common. 60 - 70% of urban South African adults have moderate to high total cholesterol levels (>5 mmol/L). Recent surveys show that the majority of people do not know their cholesterol levels or what desirable levels are. Because there are usually no symptoms, the best way to tell if you have high cholesterol is to have your cholesterol checked by your doctor or pharmacist.

Recommended cholesterol levels
Total cholesterol < 5 mmol/L*
LDL-cholesterol < 3 mmol/L*
HDL-cholesterol > 1 mmol/L*
* mmol/L measures the amount of cholesterol per millilitre of blood

How can I reduce my cholesterol levels?

Fortunately, you can improve the cholesterol levels in your blood by eating a healthy diet. One important aspect of a healthy diet is a low intake of saturated and trans fats. Polyunsaturated or monounsaturated fats can be used to replace saturated and trans fats. Plant sterol enriched spreads have also been clinically proven to actually lower LDL cholesterol levels.

Other important ways to help lower cholesterol include stop smoking, achieve a healthy weight and take regular physical activity. Read the helpful tips section on how to lower your blood cholesterol levels. Remember - don't try to change everything at once; a few small initial changes will make a big difference!

Familial hypercholesterolaemia

Familial hypercholesterolaemia (FH) is the inheritance of high blood cholesterol levels, leading to a very high risk of heart disease in middle adulthood years, and is one of the most common inherited diseases world-wide. In South Africa FH is particularly prevalent amongst Afrikaans, Indian and Jewish communities. On average 1 in 100 people in these communities will have FH. The good news is that FH is treatable. It is therefore even more important for you and your family to know your cholesterol level if you fall into one of these high risk groups.

Polyunsaturated fats

Can help lower total and LDL cholesterol and help maintain a healthy heart. Vegetable oils and spreads made with sunflower and corn oil, oily fish like herring, mackerel, tuna, sardines and salmon are also a good source.

Monounsaturated fats

Tend to lower total and LDL cholesterol. These fats are present in olive and rapeseed oil and in avocados.

Saturated and trans fats

Increase blood cholesterol.You should avoid animal products such as fatty meat, full fat milk, cheese, butter and many snack and processed snack products.

Plant sterols

Lower the absorption of cholesterol in the body. Spreads enriched with plant sterols reduce your cholesterol levels by more than 10%.

Helpful Tips

  • Eat less saturated and trans fats:
    • Choose soft (vegetable-based) spreads and oils.
    • Choose low-fat or fat-free dairy foods and lean meat.
    • Eat less pre-prepared biscuits, pastries and cakes.
  • Use spreads rich in plant sterols (ensure you use the recommended amount).
  • Try eating fish regularly.You should aim to eat oily fish (e.g. herring, mackerel, salmon, tuna, sardines -including canned fish) at least twice a week.
  • Eat plenty of fruit, vegetables and pulses (like butter beans, red kidney beans and lentils). Choose at least five portions each day.
  • Eat regular meals based on starchy foods like pasta, grains, bread, rice, potatoes and cereals.
  • If you choose to drink alcohol, do so in moderation. That is two drinks a day for women and three drinks a day for men.
  • Stop smoking.
  • Lose weight if you are overweight.
  • Get more physically active. Aim to do at least 30 minutes of moderate-intensive activity on most days (this can be done in ±10 minute sessions).
  • Learn to control your stress and take time to relax.
  • Contact your doctor or dietician for more information and additional advice.

Source: Flora Institute

  Article Date: 9 March 2005


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