Hypercholestrolemia - Remedies

As discussed earlier about high blood cholesterol levels in blood and how it is harmful for your heart health, now we will discuss about how these cholesterol level can be controlled.

Blood cholesterol levels can be maintained in the following simple ways:

• Choose oil instead of ghee in your daily cooking. Restrict fat consumption to 3 tsp per day.
• Choose cholesterol cutting food items to include in your diet.
• Choose whole grains like whole wheat flour, oats, bajra, jowar etc. over refined cereals like maida, semolina etc. as the former binds with fibre and helps to decrease blood cholesterol levels.
• Replace full fat dairy products with their low fat counterparts.
• Indulge in an exercise programme regularly. It helps improve blood circulation and also destroys the excess bad cholesterol.

Power foods to aid in controlling high cholesterol levels:

Here are a few remedies for controlling high cholesterol levels:

Food item	Effects	Recipe
Coriander Seeds	Coriander seeds help lower the levels of total cholesterol, LDL (the ‘bad’ cholesterol), and triglycerides. Coriander seeds also have hypoglycemic effects and can be useful in diabetes management. Coriander seeds powder can be made by simply dry roasting the coriander seeds and grind them to make the powder.	1.       Add two teaspoons of coriander seed powder to one cup of water. 2.       Boil the mixture and then strain it. 3.       Drink this once or twice a day. You can add milk, sugar, and cardamom to it and use it as a replacement for your regular tea.
Onions	Red onions are beneficial in dealing with high cholesterol. They help reduce bad cholesterol and elevate good cholesterol levels. This, in turn, lowers the risk of developing heart disease.	1.       Mix one teaspoon each of onion juice and honey. Drink it once daily. 2.       Add one finely chopped onion and one-quarter teaspoon of pepper to one cup of buttermilk. Consume it on a regular basis.
Indian Gooseberry	Indian gooseberry, or amla, acts as a natural hypolipidemic agent, which means that it promotes the reduction of lipid concentrations in the serum. This fruit has antihyperlipidemic, anti-atherogenic, and hypolipidemic effects.	1.       Mix one teaspoon of Indian gooseberry powder, or dried and powdered Indian gooseberries, in a glass of warm water. 2.       Drink it daily in the morning on an empty stomach.
Apple Cider Vinegar	Apple cider vinegar helps lower your total cholesterol and triglyceride levels. In addition, it is a great home remedy for a number of ailments including acid reflux, high blood pressure, gout, upper respiratory infections, and others.	1.       Mix one teaspoon of organic apple cider vinegar in a glass of water. 2.       Drink this two or three times a day at least for a month. You can gradually increase the amount of apple cider vinegar to two tablespoons per glass.
Orange Juice	Drinking three cups of fresh orange juice daily can be a great help in reducing blood cholesterol levels naturally because it is rich in vitamin C, folate, and flavonoids.	Drinking 750 mL of pure orange juice daily can increase HDL cholesterol and triglycerides, and decrease the LDL/HDL ratio in hypercholesterolemic patients. Orange juice fortified with sterols is even better.
Coconut Oil	Though counterintuitive, coconut oil is considered a beneficial home remedy for high cholesterol, even though it is a saturated fat. Coconut oil contains lauric acid that helps increase HDL (the ‘good’ cholesterol) and improves the LDL/HDL ratio.	Add moderate amounts of organic coconut oil to your diet. You can have one to two tablespoons of this oil daily. Do not use refined or processed coconut oil.
Oatmeal	Enjoying a bowl of oatmeal is an easy yet effective way to reduce your cholesterol levels. It is full of soluble fiber and reduces the absorption of cholesterol and lowers bad cholesterol levels.	One and one-half cups of cooked oatmeal or one cup of oat bran contain approximately three grams of soluble fiber, beta-glucan. You can also add fruits and nuts such as apples, bananas, strawberries, and walnuts to your oatmeal for added health benefits.
Fish Oil	Fish oils and fatty fish such as mackerel, tuna, trout, herring, salmon, bluefish, sardines, and the like are packed with omega-3 fatty acids. They help lower triglycerides (fats in the blood) and prevent heart disease.	Consume about one to four grams of fish oil per day. If you have adopted a vegan or vegetarian diet, then include ground flaxseeds, which are also rich in omega-3 fatty acids, in your diet.
Red Yeast Rice	Red yeast rice contains compounds known as monacolins that inhibit cholesterol synthesis and hence help lower cholesterol. Simply put, it is rice fermented by red yeast (monascus purpureus). Besides, some red yeast rice products may contain lovastatin and other chemicals that may cause side effects. It is best to consult your doctor before you start taking them. Do not take these supplements during pregnancy, breastfeeding or when suffering from liver problems.	You can get red yeast rice tablets from pharmacies or health food stores. For high cholesterol, take 1200 to 2400 mg of the supplement once or twice daily.
Nuts	Walnuts, almonds, peanuts, hazelnuts, pistachios, pecans, and other nuts and seeds are useful in controlling high cholesterol because they are rich in plant sterols and fiber. Walnuts, in particular, have been found to help lower total cholesterol and triglyceride levels.	Enjoy a handful (one and one-half ounces) of delicious roasted nuts regularly; but do not overdo it. Also, increase your consumption of whole grains and other high-fiber foods.
Garlic	1 to 3 cloves of garlic has been proven to reduce the cholesterol levels in the blood thereby preventing the hardening of arteries.	Garlic chutney
Fibre rich fruits and vegetables	Fruits and vegetables like orange, guava, cluster beans, green peas, unpeeled carrot etc. help to keep the blood cholesterol levels at bay due to their high fibre content.	Fruit salads and vegetable salads, vegetable preparations

Post by Faiz Lahori

Dyslipidemia/Abnormal Lipid Levels in Blood

Dyslipidemias are disorders of lipoprotein (a complex of lipids and proteins) metabolism, including lipoprotein overproduction and deficiency. They may occur as one or more of the following - Elevated cholesterol, Elevated Low density lipoprotein (LDL), Elevated triglyceride levels and Decreased High density lipoprotein levels (HDL). Basically it is an imbalance of the level of fats in the blood due to a several reasons.

It is closely associated with atherosclerosis and is a major causal factor in the development of ischemic diseases (restriction of blood supply to tissues).

Cholesterol is a waxy fat carried through the blood stream by lipoproteins. HDL is considered as Good Cholesterol and LDL is considered as Bad Cholesterol. Good cholesterol (HDL) is stable and carries Bad cholesterol (LDL) away from the arteries. LDL sticks to the walls of the arteries and contributes to plaque build-up. Too complex? The diagram below will make it easy for you to understand.

Image Courtesy: http://www.hyderabadendocrinology.com/content/diabetes-and-bad-cholesteroldyslipidemia

For most people, abnormal cholesterol levels are the result of an unhealthy life style – most commonly, eating a diet that is high in fat, being overweight, heavy alcohol use, lack of exercise and leading an inactive lifestyle. Also, Diabetes and an underactive thyroid gland may lead to high cholesterol levels.

Primary dyslipidemia is caused by several disorders which affect plasma lipoprotein levels by overproduction of lipoproteins and/or decreased clearence. Many medical conditions are associated with mild or even severe dyslipidemia which is referred to as secondary dyslipidemia. Secondary causes of lipoprotein abnormalities are Hypercholestrolemia (high cholesterol levels in the blood) caused due to Hypothyroidism, obstructive liver disease, Anorexia, Drugs; Hypertriglyceridemia (high triglyceride levels in the blood) caused due to Obesity, Diabetes, Pregnancy, Alcohol, stress, sepsis, glycogen storage disease,acute hepatitis and drugs; and Low HDL caused due to Type II Diabetes, Rheumatoid arthritis, Malnutrition, obesity, smoking and anabolic steroids.

These lipid abnormalities may show no symptoms sometimes and may come to notice only during a routine health check-up. A Person maybe obese or have an early onset of chest pain. Sometimes, lipid abnormalities maybe diagnosed for the first time after a person suffers a myocardial infarction or stroke. Painless nodules called ‘xanthomas’ maybe seen on tendons, elbows, which arise due to intra- or extra-cellular deposition of cholesterol.

Dyslipidemia is a major risk factor for atherosclerosis which affects the coronary, cerebral and peripheral arterial circulation. Small dense LDL is more atherogenic , it enters the vessel wall, becomes oxidised and triggers the atherosclerosis process. Clinical event caused either by occlusion or haemorrhage in the arterial supply to the CNS results in Stroke. Peripheral Artery Disease is a manifestation of atherosclerosis in which the arterial lumen of the lower extremities becomes progressively occluded by atherosclerotic plaque.

Total Cholesterol level <200mg/dL is desirable, LDL Cholesterol level <100mg/dL is optimal, HDL Cholesterol level <40 mg/dL is low and ≥60 mg/dL is high and Triglycerides level <150 mg/dL is normal.

The essential features of lifestyle approach to reduce the risk for CHD are:

• Reduce intake of saturated fats (< 7% of total calories) and cholesterol (200mg/day).
• Therapeutic options for LDL lowering such as plant stanols, sterols and increased viscous fibre.
•  Increased physical activity and weight reduction.
• In most patients Therapeutic Lifestyle Change is initiated before drug therapy.
•  In high risk patients Therapeutic Lifestyle Changes and drug therapy work simultaneously.
•  If there is no improvement in the patient by Therapeutic Lifestyle Changes then drug therapy is started.

Insulin deficiency and hyperglycemia in Type-I diabetes produces lipid abnormalities which can be corrected with insulin therapy. Type II diabetes is associated with abnormal lipid metabolism. Diabetic patients tend to have higher Triglycerides, lower HDL and similar LDL levels compared to non-diabetics. In diabetics, the relative risk of Coronary Heart Disease is increased as the LDL is present as small dense particles. Diet and exercise are the first line therapies and are used with drug therapy when necessary.

Cardiovascular Disease is the leading cause of death for patients with Chronic renal disease as dyslipidemia accelerates renal deterioration. Management of this condition involves initiation of dietary modification and drug therapy.

Most new Coronary Heart Disease events and coronary deaths occur in older persons. Therapeutic Lifestyle Change is suggested for primary prevention of Coronary Heart Disease. LDL lowering drugs can be considered in those who are at higher risk.

Dyslipidemia in children and adolescents is commonly caused by genetic disorders, obesity and adverse diet. Total cholesterol levels are generally 40mg/dl higher in adults than in childhood.

The dietary modifications for dyslipidemia include reducing the dietary intake of saturated fats, trans-fatty acids and cholesterol. Most of the fat calorie consumption should be obtained from unsaturated fatty acids. MUFA and PUFA should represent 20% and 10% respectively of daily calorie intake.

NUTRIENTS	NOTE
Carbohydrates	50-60% of total calories should come from carbohydrates. Carbohydrates intake should consist mostly of foods rich in complex carbohydrates like whole grains, fruits and vegetables. Complex carbohydrates are low in calories and contain a wide variety of vitamins and minerals.
Proteins	20-25% of total calories should come from proteins.
Fats	Total fat intake should be limited to no more than 15-20% of total daily calories.
Dietary Fibre	Daily fibre intake should be 30-40 g/day.
Plant Stanols/Sterols	Recommended for patients with high serum cholesterol, as these reduce LDL-c levels. Plant sterols are isolated from soyabean and pine tree oils and can be esterified to unsaturated fatty acids to increase lipid solubility. Plant stanols/sterol esters at dosages of 2-3g/day lower LDL-c by 6-15% with a maximum LDL lowering effect occuring with dosages of 2g/day. Dietary consumption of plant stanols or sterols can be obtained from commercially available products containing plant sterols/stanols (i.e. margarine, juices etc.)
Fruits and Vegetables	3-5 servings/day

Read more about Fats in the Nutri-knowhow column.

Post by Faiz Lahori