DR SHREERAM VAIDYADR SHREERAM VAIDYA

Health Talk “CHOLESTEROL Health Talk “CHOLESTEROL GOOD OR BAD ?GOOD OR BAD ?

44THTH JULY 2009 JULY 2009

Coronary Heart DiseaseCoronary Heart Disease

• Accidental killing of 2000 people becomes a breaking News

• 2000 Americans die every day ,365 days a year

• From a single cause coronary Heart disease

• No 1 Killer

ATHEROSCEROSISATHEROSCEROSIS

• Atherosclerosis is the condition in which an artery wall thickens as the result of a build-up of fatty materials such as cholesterol

CholesterolCholesterol• Soft fat like waxy substance• Found in blood ,cells and food we eat• Needed for cell membranes• Helps in making hormone and vitamin D• But too much cholesterol leads to heart • Attack and stroke (brain attack)• Cholesterol is manufactured in the liver• Cholesterol Food sources : meats, poultry• Fish ,eggs, butter, whole milk, cheese• No plant source

Bad CholesterolBad Cholesterol

• Foods with trans fats or saturated fats may cause body to produce more cholesterol

• LDL (Bad cholesterol)

• Too much can clog arteries, It has tendency to built up on walls of arteries

• Harmful can cause heart attack or stroke

GOOD CHOLESTEROLGOOD CHOLESTEROL

• HDL Cholesterol (good cholesterol)

• Tends to carry cholesterol away from arteries and back to liver where it is broken and excreted

Saturated FatsSaturated Fats

• Fats are fattening

• Eat fats less than 30% of your daily calories. Saturated Fats <10%

• And Unsaturated Fats <20%

• Saturated Fats Remember ‘S’ for stay away

• Arterial ageing ---- Saturated fats

Cont. Saturated FatsCont. Saturated Fats

• Consumption of saturated fat ,not cholesterol is the biggest dietary factor contributing to elevated levels of cholesterol in the blood

• Excess saturated fats linked to elevated TG levels elevated TG levels linked to arterial ageing

• Saturated fats are found in red meat, whole fat -dairy products, palm or coconut oil

Trans Fat-Trans Fatty AcidsTrans Fat-Trans Fatty Acids

• Fats solid at room temperature

• Eg margarine butter

• Many packaged foods –Cookies, crackers

• And potato chips contain oils to give longer shelf life (hydrogenated)

• It does not matter even if food is cholesterol free if it contains trans fats it will damage your arteries.

Total cholesterol Optimal <200mg%

Borderline high 200-239mg%

High risk

240mg% and above

LDL (Bad cholesterol)

Optimal

<100mg%

Borderline

High130-159mg%

High 160-189mg%

HDL (good cholesterol)

Low <40mg%

In females <50mg%

Triglycerides Normal <150mg%

Border line high 150-199mg%

High > 200mg%

National cholesterol education program National heart lung and blood institute

FraminghamFramingham study 1948 study 1948Gift to the worldGift to the world

•

Risk coronary heart Disease

Diabetes Dramatic increase

B.P SBP> 160mm Hg

DBP >95mm Hg

Two-three fold

Smoking 1.6 times

Stress Type A

Time urgency impatience workaholic

Double

Family History

Parent died before 65 years

30% increase

contd Framingham study 1948contd Framingham study 1948• Total cholesterol is positively related to

coronary heart disease

• LDL Bad cholesterol is positively related to

Coronary heart disease

• HDL good cholesterol is negatively related to CHD

• TC/ HDL =>4.5 Greater risk of CHD

contd Framingham study 1948contd Framingham study 1948

• Risk Coronary Heart Disease

Total Cholesterol>325mg%

4 times

Smoking 1.6 times

BP SBP >195mm Hg 3times

All above factors 16 times

Hungary Differential Price Rise VS Hungary Differential Price Rise VS CHDCHD

• Life style changes • Year 1960 price

index100• Year 1985 base

changes as shown in the Table

Fatty products

100

Cigarettes 100

Wine 200

meat 350

Average income

550

carrots 580

apples 650

Tomatoes 1260

Food cholesterol chartFood cholesterol chartQuantity 3.5 oz

Approximately 100gms

Cholesterol mg Saturated fats gms

crab 100 0.2

Lobster 70 0.1

shrimp 200 0.3

Chicken light no skin

80 1.0

Lamb lean 110 5.0

Egg 270 1.5

Liver braised 390 2.0

FatsFats

Good Fat Bad Fat

Fish Ice cream, Animal Fats

Olive oil, Peanut oil Canola (Rapeseed) oil

Coconut oil ,Palm oil,

Safflower ,sun flower, Corn, soybean

Trans fatty acids

cheese

cream, butter,

Unsaturated fatsUnsaturated fats

• Almonds

• Corn oil

• Cotton seed oil

• Fish

• Margarine(soft)

• Safflower oil ,soy bean oil,Sun flower oil

• Walnuts

How we can control cholesterol How we can control cholesterol levels?levels?

• Reduce fat intake <300mg of cholesterol daily• Salt Limit 1600mg or teaspoon • Stop smoking• No alcohol• Be active, control B.P. • Managed stress• Control wt Men strive for waist 35 inches or less • Women strive for waist 33 inches or less• Total cholesterol/HDL =>4.5