Hyperlipidemia which is also known as high blood cholesterol, occurs when there is high cholesterol present in the blood lipids.

Introduction to Hyperlipidemia

Hyperlipidemia (high levels of lipids in the blood) is one of the main risk factors for coronary heart disease and stroke.
Coronary heart disease is second only to cancer as a leading cause of death in Singapore. It is therefore important to understand more about hyperlipidemia and how to control it.

What Are Lipids?

Lipids are fatty substances in our bodies that play an important role in all living cells. These include cholesterol, triglycerides, phospholipids and fatty acids. However, when there is too much cholesterol and/or triglycerides, we will be at risk of certain diseases.

A high level of triglycerides increases our risk of developing coronary heart disease and is associated with diabetes mellitus. Cholesterol also plays a very important role in the development of coronary heart disease and stroke. As cholesterol is a major factor, we will look at what cholesterol is and how we can control the level of cholesterol in our blood.

What Is Cholesterol?

Cholesterol is a waxy, "fat-like" substance that is produced naturally by the liver and also absorbed from the food we eat. We need cholesterol to build our cell membranes, make Vitamin D in our skin and certain hormones like the male and female sex hormones. It also forms bile acids to help the fats in our food get digested and absorbed more easily.

Where Does Cholesterol Come From?

Our liver produces 80% of our body's cholesterol. The other 20% comes from the food that we eat. Cholesterol is found in foods of animal origin (egg yolk, poultry, seafood and whole milk dairy products). Food of plant origin (vegetable, fruits, grains, cereals) contains no cholesterol.

Health Risk of Cholesterol

Too much cholesterol in the blood causes a buildup of fatty deposits on the inside walls of the blood vessels (atherosclerotic plaques).

This results in blockage of the blood vessels, causing the blood flow through these blood vessels to decrease. When this happens in the coronary arteries that supply blood to the heart muscles, the decrease in blood supply (and therefore oxygen and other nutrients) causes the heart muscles to be damaged or die.

This condition is called coronary heart disease, which presents as a heart attack if severe. When this happens in the brain, the person will experience a stroke. The risk increases when other risk factors such as smoking, hypertension, diabetes, obesity, sedentary lifestyle and family history are also present in a person.

Types of Cholesterol

Cholesterol is not very water-soluble and needs to be carried in the bloodstream by liquid-protein complexes called lipoproteins.

These lipoproteins are of various sizes and densities. Two of these types-the low-density lipoprotein and high-density lipoprotein, play important roles in the development of coronary heart disease.

The low-density lipoprotein (LDL) carries cholesterol from the liver to different parts of the body where they are needed. It has the tendency to deposit cholesterol onto the walls of the blood vessels, leading to the formation of atherosclerotic plaques. LDL-cholesterol is known as the "bad" cholesterol. Lowering the level of LDL cholesterol can reduce our risk of coronary heart disease and stroke.

The high-density lipoprotein (HDL) carries excess cholesterol from the different parts of the body to the liver and is known as the "good" cholesterol. High levels of HDL cholesterol may help to reduce our risk of heart disease or stroke.

What Affects Cholesterol Levels?

  • Hereditary Metabolic Disorders
  • Increased dietary intake of cholesterol and fat
  • Certain Illnesses
  • Obesity
  • Lack of physical activity, sedentary lifestyle

How Does Your Diet Affect Your Cholesterol Level?

There are three aspects of our diet that can affect your cholesterol level

The Amount and Type of Fats in Your Diet
Both polyunsaturated and monosaturated fats may help lower your cholesterol level when you use them in place of saturated and trans fat in your diet. However, as all fats are high in calories, take them in moderation only.

The Amount of Cholesterol in Your Diet
Foods with high cholesterol content may also affect your blood cholesterol level if you take too much of these foods.

The Amount of Fibre in Your Diet
Soluble fibre decreases our cholesterol level.

What Should You Do To Control Your Cholesterol Level?

Make changes to your diet. Check with your dietitian if you need a more detailed diet plan.

Eat Less Fat

  • Cut down on the amount of fat in your diet in general.
  • Cut down on the amount of saturated fat. This is found mainly in animal products such as meat, fat, poultry skin, full cream milk, milk products, butter and ghee, and in plant products such as coconut milk, palm oil and certain types of non-dairy creamer.
  • Read food labels to watch out for saturated fat in the ingredients.
  • Eat skinless poultry, fish, lean meats and low-fat dairy products.
  • Choose monounsaturated oils such as olive oil, canola oil, peanut oil or polyunsaturated oils such as corn oil, sunflower oil, soybean oil in cooking.

Eat Less High Cholesterol Food

  • Eat smaller quantities of foods containing cholesterol, which is found in foods of animal origin.
  • Avoid organ meats (liver, kidney, brain and innards) or eat them in small portions as these have high cholesterol content.
  • Replace meat with bean curds, peas and beans on some days.
  • Eat less seafood such as squid.
  • Limit to 3-5 egg yolks a week if your blood cholesterol level is normal. If it is high, you should not take more than 3 egg yolks a week.

Eat More Fibre

  • Eat more fruits, vegetables, grains, cereals, and legumes.
  • Foods containing soluble fibres like oats, barley, beans, peas are good in reducing cholesterol.

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