Exercise, Diet and Cholesterol

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Cholesterol is the main fat that circulates in the blood. Cholesterol is naturally produced by the body and can also be found in the various foods we eat such as meat, eggs and diary. Cholesterol is intimately involved in hormonal production and regulation as well as Vitamin D production.

Excess blood cholesterol leads to a build up of plague in the blood vessels which can clog these areas increasing the risk of cardiovascular disease.

TYPES OF CHOLESTEROL.

Total cholesterol readings are made up of two types of cholesterol – LDL (low density lipoprotein) and HDL (high density lipoprotein).

LDL is made up of more fat than protein and is also known as “bad” cholesterol and it is this form of cholesterol deposits within blood vessels ultimately resulting in angina, heart attack and stroke. Elevated LDL levels are considered to be the main culprit in increasing the incidence of cardiovascular disease (CVD). HDL on the other hand has a greater proportion of protein to fat and appears to carry cholesterol to the liver for excretion. Higher concentrations of HDL is cardio protective due to this function.

TRIGLYCERIDES.

Elevated levels of triglycerides are stronger related to heart disease and is associated to excess alcohol consumption and carbohydrate intake and can occur independent of an elevation in cholesterol levels.

CHECKING YOUR BLOOD LIPIDS.

Cardiovascular disease is an insidious and progressive disease without symptoms often until such time as a life threatening occurrence occurs. It is therefore important for all adults to have their blood lipid profile reviewed regularly:

All adults 20 plus at least once every 5 years.
For men over 45 and women over 55 or if your family has a strong history of elevated cholesterol levels more regularly than at 5 year intervals.
Total cholesterol levels can be tested on the spot via a simple finger prick sample. However a full assessment, after fasting via a pathology lab provides much more comprehensive information including a break down of LDL and HDL cholesterol, a fractional ratio of total to HDL cholesterol (known as the Cardiac Ratio) – important from a predictive perspective - as well as triglyceride concentrations.

KNOW YOUR LEVELS.

Based on recent data from the National Heart Foundation total cholesterol is no longer considered to be the most critical consideration, rather it is the Cardiac Ratio that is considered to have the strongest predictive power. In order to lower the risk of CVD it is recommended that adults maintain the following readings:

Cardiac Ratio < 4

LDL cholesterol < 3mmol/L

HDL cholesterol > 1.1mmol/L

Triglycerides < 1.8mmol/L

In short, the lower the better in relation to cholesterol levels particularly if there is a family history of CVD. Other important risk factors associated with CVD include; smoking, abdominal obesity, diabetes, a lack of physical activity and a family history of CVD.

IMPROVING YOUR LEVELS.

Improve your diet. Specifically:
- Eat more fruit and veg. These are high in anti-oxidants which protect the body against CVD. All societies that have documented improvements in longevity have diets that are largely plant based. All fruit and veg is good but your best options are leafy green vegetables, yellow and orange vegetables, citrus fruits, kiwi fruit and berries.
- Eat less saturated fat such as fatty meat, skin on chicken, full fat diary products, commercially prepared baked goods.
- Eat more good fat (or unsaturated fat) such as that found in oily fish (i.e. Salmon, sardines and mackerel), or plant sources like avocado, olives, nuts and seeds. These fats help lower LDL levels and improve your cardiac ratio.
- Choose high fibre plant options rich in plant sterols as these high to lower cholesterol absorption in the intestine. Foods such as legumes, nuts, seeds, wholegrain breads and cereals are your ideal sources.
- Avoid sugary high GI carbohydrate sources such as soft drinks.
- Reduce your caffeine and alcohol intake. Limit your alcohol intake to no more than two standard drinks per day with 2-3 alcohol free days per week and limit your caffeine intake to less than 4 cups of coffee/tea/cola drinks per day.
Exercise regularly as exercise increases HDL concentrations whilst reducing LDL concentrations. Any form of aerobic exercise is acceptable – walk, jog, swim, cycle, paddle for 30-45 minutes per session on most days of the week.
Give up smoking. Smoking significantly raises the risk of CVD as well as lung cancer.
Lose some weight. Being overweight/obese increases the risk of CVD. If you’re male and have a waist circumference of >94cm or female with a waist circumference of >80cm, you’re at increased risk
See your doctor. In some instance diet and exercise changes aren’t enough. If after a couple of months of changing your diet, giving up smoking and undertaking a graded exercise program your blood lipid profile still hasn’t improve speak to your doctor. Some people may require medication to help improve their blood lipid profile but this should be done only after making the necessary lifestyle changes.