DEAR DOCTOR,

How do I monitor cholesterol levels? What is good or bad cholesterol? Any specific diet you can recommend to maintain this?

ARTHUR

DEAR ARTHUR,

Cholesterol is a type of organic molecule present in the blood. It is important for many physiological functions inside the body, like transportation of hormones, vitamin D3 and other fat soluble vitamins, transporting bile which is important to digest fats, helping in metabolism of fats, and maintaining the fluidity of cell membranes over varying body temperatures. Cholesterol is carried across in the body, bound to proteins called lipoproteins. Depending on the density of the molecules, there are low density, as well as high density lipoproteins.

Levels of cholesterol can be detected by a simple blood test, where amount of cholesterol present is measured. Blood cholesterol of 200mg/decilitre and above is considered high. A complete blood lipid profile can be done which shows levels of HDL (high density lipoproteins) as well as LDL (low density lipoproteins) as well, along with cholesterol and triglyceride levels. Ideally, this test should be done on an empty stomach, otherwise food ingested can interfere with results. HDL is considered to be the, "good lipid”, as it absorbs cholesterol and helps it in recirculation within the body. Whereas LDL, along with triglycerides is the, "bad cholesterol” and implicated in the maladies caused by high cholesterol levels.  Physically, high levels of cholesterol are manifest as orange coloured patches below eyes and around, called xanthealsmas, small hard swellings below tendons of joints, and there may be a whitish ring around cornea in the eyes. There is no physical symptom directly attributed to high cholesterol levels, but symptoms occur due to the complications caused by it.

Though cholesterol is an essential component of the body and has multiple beneficial functions, high levels are harmful for the body. High blood cholesterol or lipid levels cause fat to be deposited over the inner lining of blood vessels, thus reducing the blood supply, by choking the blood vessels. This leads to increased risk of chronic conditions like high blood pressure, diabetes. If the blood supply of heart is reduced, it causes problems like angina and heart attacks. Reduced blood supply of the brain can cause stroke, which is manifested by paralysis of one or more limbs of the body and other neurological problems. In case of involvement of the blood vessels of the legs, one feels cramp-like pain on walking, which is reduced on resting. These conditions are diagnosed by different specific tests. Reducing high levels of lipids forms essential part of therapy here.

Regular physical exercise helps in maintaining normal cholesterol levels.  Fat containing foods like cheese, butter, meat products (except fish), should be avoided to prevent high cholesterol levels. Alcohol and smoking also raise levels of harmful lipids, hence, best avoided. Fresh fruits, vegetables, whole grains and fish are better choice of food in this regard.

hich can be identified easily and is treatable.

Dr. Rachna Pande, Specialist internal medicine E-mail rachna212002@yahoo.co.uk