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cholesterol
DrNDTV: What is cholesterol?
Dr. Manchanda:Cholesterol is a fat like substance, which circulates in the blood. It is attached with some protein, which is the reason why it is called lipoprotein also. There are various types of lipoproteins and cholesterol. Bad cholesterol is called LDL. Good cholesterol is called HDL. There are triglycerides also which are important as far as heart disease is concerned.
DrNDTV: What is good and bad cholesterol?
Dr. Manchanda: The high level of bad cholesterol (LDL cholesterol) is responsible for heart disease. The good cholesterol (HDL cholesterol) on the other hand, washes bad cholesterol. So, higher the good cholesterol lesser are the chances of getting heart disease.
DrNDTV: What is the normal range of good cholesterol and bad cholesterol?
Dr. Manchanda: The total cholesterol should be less than 200 mg/dl. Bad cholesterol (LDL) should be less than 100 mg/dl and good cholesterol (HDL) should be higher than 45 mg/dl.
DrNDTV: Are both good and bad cholesterol present in the body or do we acquire them from our diet?
Dr. Manchanda: They are already present in the body and our diet modifies them. If we take unhealthy diet, then LDL cholesterol can increase markedly. Similarly the HDL cholesterol can reduce if we have a sedentary lifestyle.
DrNDTV: What kinds of food contain bad cholesterol?
Dr. Sisodia: All non-vegetarian food contains bad cholesterol, so to reduce cholesterol one should eat vegetarian food and include fibrous food in their diet.
DrNDTV: How does good cholesterol bring down bad cholesterol?
Dr. Manchanda: It is a complicated biochemical process in which HDL does not allow deposition of bad cholesterol. It removes the cholesterol deposition in the arteries and eliminates it from the body.
DrNDTV: How can we increase the good cholesterol (HDL)?
Dr. Manchanda: HDL increases with exercise. There is very little in the diet, which increases HDL. So to increase the good cholesterol, we have to exercise everyday because exercise is known to increase the good cholesterol.
DrNDTV: What amount of exercise is required by a person who does not have bad cholesterol?
Dr. Manchanda: Everybody should do at least 45 minutes to one hour of brisk walking or any other type of dynamic exercise everyday. It can be jogging if a person is young: cycling, swimming or playing games. Regular exercise also brings down the bad cholesterol markedly.
DrNDTV: How bad is junk food? What is the substitute for junk food?
Dr. Sisodia: Junk food increases bad cholesterol because it gets deposited in the arteries. To have a healthy meal one should include one fibrous food in every meal.
DrNDTV: How is the level of cholesterol estimated in the body?
Dr. Manchanda: A blood test called lipid profile is done in which all types of cholesterol are checked. First, we check the total cholesterol, which is a combination of good and bad cholesterol. Then we check the bad cholesterol (LDL), triglycerides, which are also considered as bad cholesterol; we also check the good cholesterol, and very low-density lipoprotein (VLDL), which is similar to triglycerides.
DrNDTV: Is high cholesterol a hereditary problem?
Dr. Manchanda: Yes, it is a hereditary problem. But only 5 per cent is hereditary. Ninety-five per cent of the times, cholesterol increases because of dietary or lifestyle disturbances.
Caller: I am 34 years old. I had operation of the ovary and I am on oestrogen 4 mg for the past four years. Does oestrogen have a direct effect on the cholesterol level?
Dr. Manchanda: Oestrogen has a protective effect as far as the cholesterol is concerned; that is why it is said that ladies before menopause have lesser risk of coronary artery disease. In the older days, we used to give hormone replacement therapy. These days it is considered harmful, but oestrogen does have an effect and therefore, after menopause ladies should be very careful because they can get coronary disease.
DrNDTV: What are the symptoms of high cholesterol?
Dr. Manchanda: There are very few symptoms. If the cholesterol is very high, then you can have deposition around the eyes called xanthoma but otherwise, there are very few symptoms. You have to get it checked by a blood test.
DrNDTV: At what age should one start getting routine cholesterol check-up done?
Dr. Manchanda: After the age of 35 years every Indian should have an executive checkup, which includes lipid profile and a treadmill test.
Caller: I am 51 years old. My cholesterol level is around 270. I am hypertensive, and I have thyroid problem also. Are these problems related to each? Please suggest some specific exercises and diet. I am a non-vegetarian; I want to know what non-vegetarian dishes can I eat?
Dr. Manchanda: Your diseases are not related but it is found that people who are hypertensive, have high cholesterol also. Similarly, if your thyroid is not functioning well, your triglycerides can go up. To reduce hypertension, you can exercise and take fruits, vegetables and low-salt diet. For reducing cholesterol there are two methods – one is without drug, which is called non-pharmacological, and can be done by lifestyle modification. Secondly, drugs can be used to reduce cholesterol.
Dr. Sisodia:I would suggest him, if possible, to be a vegetarian. If it is not possible, then what he can do is whenever he is eating non-vegetarian food he can include some fibrous food. If in breakfast, he wants to have an egg, he should avoid yellow part of the egg and can have egg white along with whole wheat bread or porridge. In lunch and dinner I would suggest to include at least two servings of vegetables, both the time, along with salad which will reduce his cholesterol.
Caller: I weigh 104 kg and my height is 6 feet 3 inches. Do I need to get my cholesterol checked?
Dr. Manchanda: Yes, you are grossly obese and obese people are likely to have high cholesterol; they are also likely to have diabetes and hypertension. Obesity is not a good thing for anybody.
Caller: My LDL is 630; should I start taking tablets?
Dr. Manchanda: Yes, LDL of 630 is very high. It must be hereditary. Lipid-lowering drugs are a must so that the cholesterol level comes down.
Caller: Are mustard oil and corn oil helpful in maintaining cholesterol?
Dr. Manchanda: Mustard and corn oil are rich in non-saturated fat or unsaturated fats. Both these oils have been shown to reduce cholesterol. You can take any oil, which has lot of non-saturated or unsaturated fats, but in limited amount, because calories are same in any oil.
DrNDTV: What kind of diet is advised for people with high cholesterol?
Dr. Sisodia: Diet depends on the person’s age, sex and physical activity; but if someone with high cholesterol wants to eat something, that is forbidden for him, then it can be eaten once in a month or a fortnight.
DrNDTV: Is liposuction beneficial to reduce cholesterol level?
Dr. Manchanda: Liposuction is good to reduce the morbid obesity. If a person is very obese, the weight can reduce, but the cholesterol levels in the blood will not be affected by liposuction.
DrNDTV: Is it true that thin people will never have a cholesterol problem?
Dr. Manchanda: No, this is not true. In India, we have seen that thin people also develop heart disease quite frequently.
DrNDTV: Is smoking and drinking related to high cholesterol?
Dr. Manchanda: Smoking oxidises the cholesterol and makes the cholesterol bad, so that it can deposit in the arteries. So, smoking should be avoided completely. Alcohol increases the triglyceride levels, especially if one takes beer. Other types of alcohol do not affect the triglyceride level.
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