High Cholesterol (Hypercholesterolaemia)

A high blood cholesterol level means that you have more cholesterol in your bloodstream than your body can use. The risk of developing coronary heart disease increases proportionally to your blood cholesterol levels.

What is cholesterol?

Cholesterol is a fatty substance present in every cell of the human body and in the animal foods we eat - meat, cream and egg yolk, for example. It performs many important functions, such as constructing cell membranes and helping to produce hormones. Under normal and health circumstances the body produces enough cholesterol to meet its own needs.

Cholesterol travels in the blood in packages called lipoproteins. This has to work this way because cholesterol is a fatty substance and therefor does not mix well with blood. (This is similar to water and oil that does not mix permanently ; it you stir them together they seperate again after some time.) The lipoprotein is a kind of "wrapper" that prevents these mixing problems.

The liver is the primary producer of cholesterol and lipoproteins (cholesterol carriers). High-density lipoproteins (HDL) provide the best transportation, moving cholesterol safely between the liver and tissue cells. These lipoproteins are often referred to as "good/Healthy" cholesterol. HDL also take exess cholesterol back to the liver where it can be disposed of. Low-density cholesterol (LDL) or "bad/Lousy" cholesterol, on the other hand, is more plentiful and carry the most cholesterol. LDL is not as efficient and tends to loose cholesterol in the arteries, where it accumulates and forms fatty deposits. A third type of carrier, very-low-density lipoprotein (VLDL), converts to LDL after depositing energy-giving triglyserides in the muscles.

Any surplus cholesterol can build up on the inside walls of arteries and cause hardening. This is called artherosclerosis. It there is too much bad LDL cholesterol, or not enough good HDL cholesterol, cholesterol may eventually impede the flow of blood to the heart and lead to heart disease.

According to the Heart Foundation of Southern Africa, it is recommended that adults generally limit their dietary cholesterol intake to 300 mg a day. The desirable blood cholesterol level for a male, 40 years of age, should be below 5.0 mmol/L, 5.0. 6.8 mmol/L is considered moderately high while a reading above 6.8 mmol/L is considered high. A reading of 4.0 mmol/L is considered desirable for a male 20 years of age.

What is the function of fat in the body?

Fat stores extra energy in the body aids in absorbing the fat-soluble vitamins A, D, E, and K, helps maintain cell membranes and is used in the production of certain hormones. It is made up primarily of three types of fatty acids: mono-unsaturated, polyunsaturated and saturated fats. Although all fats are a mixture of these three , one type usually predominates. Most vegetable fats are mainly unsaturated and most animal fats are primarily saturated.

What is the difference between saturated and unsaturated fats?

Chemically, the difference between the two is that saturated fatty acids have hydrogen atoms attached to all the carbon chains that they comprise of, whereas unsaturated fats have one or more pairs of carbon that lack the hydrogen bond. As a rule, fats that are primarily saturated remain solid at room temperature as opposed to unsaturated fats that remain liquid. In the body, saturated fats promote the build-up of cholesterol, or plaque, in artery walls, thereby clogging them. Unsaturated fats do not activate this build-up, in fact, some actually help to unclog veins. Mono-unsaturated fats tend to lower LDL, raise HDL and because of this you overall cholesterol can become lower. Mono-unsaturated fats can be found in Avocado, olive oil, canola oil, nuts and peanut butter.

Ways to cut back on fat.

If high-fat foods are among your favourites, eat them less often or look for pleasing substitutes. Example, substitute fruit tart, ice cream, potato crisps, doughnuts, sour cream and mayonnaise with fruit crisp, low fat yoghurt, plain pop corn, bran muffin, yoghurt, low fat salad dressing. To reduce fat intake, grill, roast, steam or poach food instead of frying it. Prepare chicken without the skin. Substitute low-fat dairy products such as yoghurt and skim milk for sour cream and whole milk.

How does saturated fat affect cholesterol levels in the blood stream?

Foods high in saturated fat seem to stimulate the body's own production of cholesterol. Egg yolk, kidneys and liver are examples of such foods. Although foods of plant origin contain no cholesterol, studies have shown that ones high in saturated fat - coconut oil, palm and palm kernel oils and cocoa butter - can also elevate blood cholesterol levels. Commercially baked products and whipped toppings often contain tropical oils.

How do oat bran and other foods high in soluble fibre lower cholesterol?

The exact process by which soluble fibre lowers cholesterol levels is not known, but some researchers believe that it binds with cholesterol and removes it in the process of elimination. Cholesterol-lowering benefits are more pronounced with a high intake of soluble fibre - from legumes, oat bran, pectin's (found in most fruits). Vegetables and guar gum - is part of a diet that contains moderate amounts of fat and cholesterol.

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