DEFINITION

Cholesterol is a hard, waxy substance and is one of the main fats found in the blood. The two main types are the harmful LDL (low-density lipoprotein) Cholesterol, and the beneficial HDL (high-density lipoprotein) Cholesterol.

DESCRIPTION

A certain amount of Cholesterol is vital for the normal functioning of the body. Cholesterol has several functions:
- Maintains the flexibility of cell membranes.
- Helps make the sex hormones oestrogen, progesterone and testosterone.
- Helps produce the natural steroids aldosterone, which regulates water balance in the kidneys, and cortisone, which promotes the synthesis of glucose for energy.
- Helps the body produce vitamin D, needed for bone growth.
- Helps the body produce bile acids to aid digestion and absorb vitamins and nutrients from food.

High Cholesterol is a major risk factor for heart disease and stroke. High Cholesterol causes atherogenesis. This is when cholesterol is deposited as plaques on the inner walls of arteries, a process called atherosclerosis. Atherosclerosis does not cause any symptoms and occurs over many years. If the plaques tear away from the vessel wall, a clot forms at the site of the rupture. This reduces the width of the artery or may block it completely, decreasing blood flow and reducing oxygen supply to the tissues. The affected tissues die and a heart attack or stroke occurs.

LDL's carry Cholesterol to the cells, increasing the potential for plaque formation. HDL's carry Cholesterol away from the cells and back to the liver where it is changed into bile and excreted in the faeces. A Cholesterol test that shows the total amount of Cholesterol is not sufficient to determine the risk of heart disease, because it combines both "good" and "bad" Cholesterol into the same measurement. A Cholesterol blood test needs to show the ratio of HDL to LDL, as well as the total Cholesterol level. The goal for Cholesterol treatment is to lower the levels of LDL while raising the levels of HDL. The recommended blood level of LDL Cholesterol is less than 3.5 mmol/litre. The recommended blood level of HDL Cholesterol is more than 1 mmol/litre.

Cholesterol is not needed in the diet, because the body makes all the Cholesterol it needs. There is no danger in having little or no Cholesterol in the diet. Cholesterol is found in foods of animal origin. There is no Cholesterol in plant foods. Cholesterol appears in all meat products, dairy foods and eggs. The foods most likely to raise LDL ("bad") cholesterol are those which are also high in saturated fats. These include cheese, butter and the muscle meat of beef, lamb and pork. Chicken (without skin), fish, shellfish and organ meats contain Cholesterol but are lower in saturated fats, making them preferable in the diet.

TREATMENT OPTIONS

- Have your Cholesterol level checked annually by your Doctor.
- Follow the Diet hints to reduce Cholesterol and saturated fat intake.
- Have regular exercise at least twice a week.
- If you are in a high risk category, medications may be prescribed to lower your Cholesterol. These must be taken in conjunction with exercise and dietary modifications.
- Heavy alcohol use may worsen the effects if your Cholesterol level is already high.

PHARMACIST'S ADVICE

Ask your Pharmacist for advice.
1) See your Doctor for a full check-up and Cholesterol test, to determine your risk factors for heart disease.
2) Regular exercise is very helpful because it increases the HDL Cholesterol and also helps to maintain a healthy weight.
3) Your Doctor may prescribe a medication to lower blood cholesterol levels. These medications should be used in conjunction with a lifestyle programme that includes dietary modification and exercise. Ask your Pharmacist for advice.

DIET HINTS

See the Atherosclerosis Diet on the Healthpoint for detailed information.

VITAMINS/MINERALS/HERBS

Vitamin and nutrient deficiencies are closely linked to high Cholesterol and heart disease. Antioxidants protect the blood vessels from the damage caused by high Cholesterol. Supplements that may be beneficial include:
- Essential fatty acids can reduce inflammation in the arteries and lower cholesterol and triglyceride levels.
- Coenzyme Q10. Medication used to lower elevated cholesterol levels (statins) has been shown to lower the body's levels of co-enzyme Q10. This nutrient is involved in energy production and lowered levels may result in fatigue. Taking an adequate dosage of co-enzyme Q10 may help to restore depleted levels of this nutrient
- Vitamin C may reduce total cholesterol and LDL levels.
- Garlic can reduce cholesterol levels and increase HDL choesterol.
- Vitamin E may prevent LDL oxidation which is the first stage in the development of Atherosclerosis.

ORGANISATIONS and SUPPORT GROUPS

See the Heart Foundation of Australia topic on the Healthpoint.

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