Cholesterol! Though a fairly commonly used term, people often see it as an illness. ‘He can’t eat mutton /Butter as he has cholesterol, is a classic example. Other spectrum is news on circulating virtual media that Cholesterol is blindly removed from naughty list and egg, butter, dairy products, nuts, coconut oil and meat are safe. So what is true? Latest article published on NEJM 2017 that according to a study in Denmark where they analysed that parents who had stopped taking statins because of news on virtual media had increased incidence of heart attacks and brain stokes and there for increased mortality. That had put all speculations of Cholesterol being all healthy to rest.

However cholesterol isn’t all bad; there is good cholesterol (HDL) and bad cholesterol (Total/ LDL). Cholesterol is a fatty material that is present in all of our cells and has few positive roles like helping to make your cells and their biochemical reactions.

Low-density lipoproteins (LDL). These lipoproteins carry cholesterol throughout the body, delivering it to different organs and tissues. But if the body has more LDL cholesterol than it requires, the excess keeps circulating in the blood. Over time, this type of cholesterol can enter the blood vessel walls and start to build up under the vessel lining. Deposits of these cholesterol particles within the vessel walls are called plaques, and blood vessels become narrow and can block blood flow causing coronary artery disease (Atherosclerosis). This is the reason that LDL cholesterol is often referred to as “bad” cholesterol.

High-density lipoproteins (HDL). This type is referred to as HDL, or “good, “cholesterol. They act as cholesterol scavengers, picking up excess cholesterol in the blood and taking it back to the liver where it’s broken down. This helps prevent the fat from oxidizing and building up on the walls of the blood vessels. The higher your HDL level, the more protected are the organs. Blood test which measures these fats or lipids is known as lipid profile.

Recent guidelines according to American society endocrinology and cardiology 2017 have stated that level of LDL should be less than 50 on patients with previous heart attacks or stents or prior history of  by-pass.

Both genetics and the lifestyle plays an important role in your cholesterol levels. Indians peculiarly have low HDL levels. Some people may be naturally predisposed to low HDL and they may also have a harder time increasing a low number, by diet and exercise alone. And doctors may prescribe medication such as Fibrates or Niacin. There are certain lifestyle habits like Smoking, taking steroids, eating foods with trans fats, being obese and inactive push a low number further down.

Tips to improve HDL values

Lose excess body fat: Appropriate body mass index (ratio of weight and height) can help control high cholesterol, especially LDLs. But weight loss from dieting alone can cause HDLs to drop along with the LDLs.

Exercise: Exercise has a powerful, albeit short-lived effect. Each workout may result in a subtle HDL boost, so that’s why it needs to be done on a consistent basis. Regular exercisers tend to have higher HDLs. Research shows that HDL may be elevated by as much as 20% from regular aerobic exercise that expends at least 800 to 1,200 calories per week. Walking at 5km/hour, for example, will use around 300 calories. So a person needs to walk around 12 to 15km in a week, or do some equivalent aerobic activity for at least 30 minutes on five per week. Inactive people may need to do slightly more, burning from 1,500 to 2,200 calories per week through aerobic workouts like walking, swimming, cycling or aerobics. (Beginners should always start slow and gradually work up to higher intensity and longer workouts.)

Avoid trans fats: High intakes of trans fats which is found in processed foods made with hydrogenated oils, bakery products, reboiled oils have been found to lower HDLs. So, cutting out fast foods and processed foods that contain these fats is wise.

 Go for good fats and plenty of plant foods.

Dr. Amit Bhushan Sharma, Associate Director & Unit Head, Interventional cardiology, Paras Hospitals, Gurugram