Lipid disorders are a group of medical conditions which refer to excessive levels of fatty substances in the bloodstream. These fatty substances include cholesterol and triglycerides. An excess of bad cholesterol increases your risk of heart disease and stroke .

Types of Lipids

Lipoproteins carry cholesterol in the blood.

• High Density Lipoprotein (HDL) Cholesterol - HDL cholesterol is commonly known as good cholesterol. It removes excess cholesterol and may prevent cholesterol build up in the blood vessels and lower your risk of heart disease.
  
• Low Density Lipoprotein (LDL) Cholesterol - LDL cholesterol is often called bad cholesterol. It can build up slowly in the inner walls of the arteries contributing to the formation of cholesterol plaques. Cholesterol plaques can block up arteries resulting in the hardening and narrowing of arteries (atherosclerosis).
  

Triglycerides

Triglycerides are a form of fat from food; they are also made in the body from other sources of energy like carbohydrates. High levels can increase your risk of heart disease.

Causes & risk factors

Apart from genetic causes of lipid disorders, a diet high in saturated and trans fat will also increase cholesterol. All fats and oil contain a mixture of saturated, monounsaturated and polyunsaturated fats in different proportions. Some foods contain more saturated fat than others. It is important to limit your intake of saturated and trans fat.

There are 4 types of fat in your diet.

Saturated fats (SFA)

These are found mainly in animal foods, like butter, ghee, lard, cream, fat on meat, milk fat and cheese. Vegetable fats like palm kernel oil, palm oil and cocoa butter are rich sources. Too much SFA raises total and LDL cholesterol.

Trans fats

These are formed during the hydrogenation of unsaturated oil a commercial process to harden oil for production of fats like shortening and hard margarine. Hydrogenation causes the oil to be more saturated. Too much trans fats raises blood cholesterol.

Polyunsaturated fats (PUFA)

These are found mainly in nuts, grains and seeds such as sunflower, soya bean, corn and sesame. Some oily fish such as sardine, salmon, mackerel and herring also contain high amounts of polyunsaturated fat called omega-3 fatty acids, which makes blood clot less easily and reduces the risk of stroke. PUFA helps to lower blood cholesterol.

Monounsaturated fats (MUFA)

These are present in olive, canola, peanut and sesame oils, almonds and avocados. Studies have shown that MUFA can lower LDL-cholesterol and increase HDL-cholesterol.

Signs & symptoms

Lipid disorders are usually silent. They are usually picked up during screening or during routine blood tests for other medical conditions. Otherwise, they may only be diagnosed when the complications arise e.g. angina, heart attacks, stroke.

Complications

When there is too much bad cholesterol in your blood, the excess cholesterol gets deposited in the walls of your blood vessels. These deposits cause narrowing and hardening of the blood vessels or atherosclerosis. This can lead to slowing down or blockage of the flow of blood, resulting in

• angina (chest pain) and heart attacks
  
• stroke
  
• peripheral artery disease (narrowing of the blood vessels of the limbs).
  

Lowering of abnormal LDL cholesterol level is most important in the prevention of the above diseases.

Screening & diagnosis

If you have no risk factors (e.g. a family history, diabetes ) for lipid disorders, you should start going for a fasting lipid blood test at 40 years of age. If the blood test is normal, you should continue to screen once every 3 years.

If you have risk factors, you should check with your doctor and start screening for lipid disorders earlier.

Treatment

Know your targets

Your doctor will help you work out your personal target for your lipid disorder. Your LDL cholesterol target will vary according to your risk for developing coronary heart disease. Please discuss with your doctor.

Go for regular check-ups

Follow your doctors advice and lead a healthy lifestyle

Be diligent with your medication

If your cholesterol cannot be controlled by diet and physical activity, your doctor may prescribe cholesterol - lowering medication(s).

Remember medication is not meant to replace a healthy lifestyle

So take your medication in addition to making changes in your lifestyle.

Self-care

Control your weight to keep your BMI less than 23kg/m2 but not below 18.5kg/m2. Reducing your excess weight will help to lower your total and LDL-cholesterol and triglyceride level.

• Healthy diet.
  
• Limit your intake of all types of fats. Try to replace saturated with unsaturated fats.
  
• Limit your cholesterol intake. Major sources include organ meats (e.g. liver, brains, kidney, intestines and heart), egg yolk, squid, fish roe, shellfish, prawns, crabs and animal fats.
  
• Increase fibre intake. Fibre is found in oats, oat bran, barley, fruit, vegetables, legumes and whole grains can speed up the removal of cholesterol from your blood.
  
• Exercise for 30 minutes for 5 or more days per week. Lack of exercise is associated with a low HDL-cholesterol level. 
• Limit alcohol intake to no more than 2 standard drinks per day.
  
• 2/3 small can of beer (220 ml)
• 1 glass of wine (100ml)
• 1 nip of spirit (30ml)
• Don't smoke.