Cholesterol

  • What is cholesterol?

Cholesterol is a fat-like substance found in all cells of our body. Cholesterol is used in the production of cell membranes and some hormones, but its presence in the blood in excess is harmful. While cholesterol is produced in the liver, it is also taken with food. Cholesterol is found in foods of animal origin such as meat, dairy products, eggs, but not in fruits, vegetables and grains.

  • Good Cholesterol (HDL-Cholesterol) – What is Bad Cholesterol (LDL-Cholesterol)?

LDL cholesterol is the main package that carries cholesterol in the blood. It is known as bad cholesterol. When it is high in the blood, it sticks to the inner surface of the vessels and forms plaques there. With the addition of some substances other than cholesterol, these plaques grow and the clots formed in the cracks formed on them block the vessels. This disease, which is very common in our age, is known as arteriosclerosis. If the atherosclerosis is in the heart vessels, it causes a heart attack, and if it happens in the brain vessels, it causes a stroke.
Some of the cholesterol in the blood HDL-Cholesterol It is transported in packages called It is known as bad cholesterol. HDL-Cholesterol It prevents the accumulation of cholesterol in the arteries. Research done HDL- Cholesterol It has been shown that people with high blood pressure are less likely to have heart disease. Smoking and obesity lower good cholesterol, increase regular exercise .HDL-C, LDL-C It has the opposite effect. It collects the cholesterol circulating in the blood and brings it to the liver to be eliminated from the body. Thus, it reduces the exposure of blood vessels to the harmful effects of cholesterol.

  • What Should Normal Blood Cholesterol Levels Be?

Blood Total Cholesterol, LDL-Cholesterol and HDL-Cholesterol levels are classified as follows:

Total Cholesterol

  • LDL Cholesterol
  • HDL Cholesterol

Normal

  • Less than 200 mg/dl
  • Less than 130 mg/dl
  • Higher than 40 mg/dl

Borderline High

  • 200-240 mg/dl
  • 130-159 mg/dl

High

  • Higher than 240 mg/dl
  • 160 mg/dl and above
  • higher than 60 mg/dL

While evaluating the cholesterol level and deciding on drug treatment, whether the person has vascular disease or whether there are factors that increase the risk of other diseases are also taken into consideration.

For example;While a level of 230 mg/dL does not pose a risk in a premenopausal woman with no other risk factors and high good cholesterol, the same level may require the initiation of cholesterol-lowering drug therapy in a 55-year-old man who has had a heart attack.
HDL-K There are different values ​​for miscarriage in men and women. If it is below 50 mg/dl in women and 40 mg/dl in men HDL-Kmentioned low.

  • How is cholesterol risk estimated?

In previous studies, total cholesterol was measured to determine the risk because it was cheaper and easier. Now LDL-Cand HDL-Kvalues ​​are easily viewed. LDL-C Each 10 mg/dl increase in blood pressure increases the risk of heart attack by 20%. Against this HDL-KThe higher the blood pressure, the lower the risk of heart attack. HDL-KEach 1 mg/dl increase reduces the risk of developing cardiovascular disease by 2-3%.

  • Who should have cholesterol measured and how often?

Serum cholesterol level should be measured in people over 20 years of age, and should be checked every 5 years in those who are found to be normal. If possible, also triglyceride and HDL-Cholesterollevels should also be measured. LDL-cholesterol (LDL-C=Total cholesterol)(HDL-K + Triglyceride / 5) is calculated using the formula

  • What Complaints Does High Cholesterol Cause?

The cells in our body need cholesterol to function. However, if this cholesterol is more than necessary, it will accumulate on the walls of the vessels. ‘atherosclerotic plaque’ form structures. These plaques enlarge over time, narrowing the vascular space. This narrowing can sometimes be slow and sometimes fast if the plaque ruptures and comes into contact with blood. As a result of the rapid or slow narrowing of the vascular space, insufficient blood is not supplied to the organs fed by these vascular structures, and as a result, life-threatening situations such as heart attack or stroke occur. For this reason, people over the age of 20 should know their blood cholesterol levels and implement the lifestyle changes required. Especially people whose mothers, fathers or siblings are known to have heart disease at an early age, diabetics should have their blood cholesterol measured and take the necessary precautions.

  • Why Is High Cholesterol Important?

High blood cholesterol levels increase the risk of cardiovascular disease. The higher a person’s cholesterol level, the higher the chance of heart disease. The leading cause of death among men and women in Turkey is cardiovascular disease.

  • Do lifestyle changes lower cholesterol values?

Positive changes we will make in our lives such as reducing fatty foods, preferring liquid oils, avoiding foods with excessive calories, exercising regularly, and reducing weight are especially important. HDL-K While increasing the triglyceride values. If we pay attention to our diet and exercise regularly LDL-CWe can achieve a 10-15% reduction in values.

Despite adequate diet and exercise, the targeted values ​​in blood fats cannot be reached most of the time. In this case, drug treatment is necessary. Several types of drugs are used to lower cholesterol. Among these, drugs called statins are the most used and for today. LDL-C These are the drugs that reduce the These drugs work by reducing cholesterol production in the liver. Doses used LDL-C25-50% reduction in HDL-K It provides 5-10% increase in . Apart from statins, other drugs can also be used. Drugs that reduce the passage of cholesterol from the intestines to the blood (ezetimibe) started to become popular. In combination with these drugs, especially with statins LDL-C’significant decreases are observed.

  • How low should our cholesterol be? Is there a normal or abnormal value for everyone?

There is no normal or abnormal value determined for all patients. The target is determined by looking at the diseases other than cholesterol disease in the patient. LDL-C value is determined. In addition, there are some tables that are used to determine the risk of a heart attack in the future. According to these tables, if the patient has a high risk of having a heart attack, these patients LDL-C values ​​should be lower. Target value only in those with high cholesterol, LDL-C It is below 160 mg/dl. Diabetes ( diabetes)in patients with diseases such as coronary heart disease LDL-C Although it is considered sufficient for the value to be below 100 mg/dl, these values ​​are now further reduced. In patients with diabetes and coronary heart disease LDL-C The target value is even lower, and there are studies that suggest it should be 70 mg/dl or even lower. desired LDL-CIt is recommended that you discuss with your doctor in detail about the values ​​​​and the risk of heart attack.

  • What should be done in low HDL-C?

HDL-K The first thing patients with miscarriage should do is to change their lifestyle. In addition to proper and adequate nutrition, exercise and quitting smoking lead to positive changes in cholesterol values. Statins, which are commonly used drugs in the treatment of high cholesterol, HDL-KWhile it provides only 5-10% increase in the values ​​​​of cigarette smoking, HDL-K increases its values ​​by 15-20%. Niacins for today HDL-Kare the drugs that increase the most, HDL-K can increase their value by 45%. However, this group of drugs is not available in Turkey.

  • What is Triglyceride? What Should Normal Levels Be?

Triglyceride is the form of fat found in nature. Like cholesterol, it is both made in the body and taken with food. Heart disease was found more frequently in those with high measured levels in the blood. Since the relationship between blood cholesterol level and heart disease is more pronounced, the second target is blood fat.

  • Triglyceride Levels

Normal

  • Less than 150 mg/dl

borderline high

  • 150- 199 mg/dl

High

  • 200- 499 mg/dl

Very High

  • 500 mg/dL and above
  • Does Lowering Blood Cholesterol Level Reduce the Chance of Cardiovascular Disease?

It has been conclusively shown that lowering the blood cholesterol level with diet or medication reduces the likelihood of developing the disease in those without heart disease, and prolongs life expectancy in those with heart disease. The prevalence of cardiovascular disease has also decreased in societies that have managed to change their diet as a society and whose average cholesterol level has decreased.

  • What are other risk factors for cardiovascular disease?

Age:Cardiovascular disease is more common in men over the age of 45 and women over the age of 55.
Family history:Heart disease is more common in those who have heart disease in their first-degree relatives, such as parents, siblings.

  • Cigaret
  • high blood pressure (Blood pressure above 140/90 mm Hg)
  • Diabetes

Obesity: Being overweight compared to height and the accumulation of body fat in the abdomen increases the risk of heart disease. Waist circumference greater than 102 cm in men and 88 cm in women increases the risk.
If people with these risk factors have high cholesterol or triglycerides in the blood, the risk of heart disease increases exponentially.

  • What are the types of fats in food and how do they affect blood cholesterol levels?

Fats in food are of three types.

  • saturated fatty acids,
  • Monounsaturated and polyunsaturated
  • Oils containing fatty acids.

Saturated fats are higher in solid fats, and unsaturated fats are higher in liquid oils. Saturated fats and cholesterol in the diet increase blood cholesterol levels. Saturated fats are found mostly in animal fats. Sheep meat, beef, dairy products made from whole milk, hard margarines are the foods with the most saturated fats. Liquid oils contain unsaturated fatty acids. Polyunsaturated fatty acids are found in oils such as sunflower oil and corn oil, and monounsaturated fatty acids are found in olive oil.

  • How much fat should a healthy diet contain?

30% of total daily calories should be taken from fats. This amount means 55-70 g of fat per day for men and 50-60 g of fat for women. Saturated, polyunsaturated and monounsaturated fats should be present in equal proportions.

  • What are the characteristics of a heart disease prevention diet?

People who are overweight should lose weight by reducing their total calorie intake and increasing their movements. Weight gain is a cholesterol-raising factor.
The visible fats in the meat should be separated before cooking, and the consumption of offal should be greatly reduced.
Processed meat products such as sausage, salami and sausage should be consumed less because they contain more saturated fat.
Chicken, turkey and fish meat should be preferred to mutton and beef. Instead of frying, cooking methods such as grilling, boiling, steaming should be used.
Fish meat is the most beneficial meat for heart health. However, taking fish oil as a medicine is not recommended unless prescribed as a treatment by your doctor. Shrimp and shellfish are rich in cholesterol.
Cereal, vegetable and fruit consumption should be increased. These foods are low in fat and rich in vitamins and fiber. It has been shown in various studies that soluble fiber lowers cholesterol. Oats, rye, beans, peas, rice husks, citrus fruits, strawberries are rich in soluble pulp. Bran, carrots, radishes, cabbage, cauliflower and fruit peels contain insoluble pulp, this type of pulp has no effect on cholesterol, but ensures the normal functioning of the intestines.
Instead of dairy products prepared from whole milk, those prepared from low-fat or skimmed milk should be preferred. It has been observed that people who eat less meat consume more cheese. Full-fat feta cheese and cheddar cheese, which are consumed frequently in our country, are high in saturated fat. Low-fat cheese and yoghurts should be preferred.
Cakes, creams and ice cream should be consumed sparingly as they mostly contain saturated fats and egg yolks.
No more than 3 or 4 eggs should be eaten per week. Egg yolk is rich in cholesterol. Egg white can be consumed more as it contains protein.

  • What can be done other than following a low-fat diet to lower cholesterol?

Smoking should be stopped because it causes cholesterol to accumulate on the vessel wall and the accumulated fat plaques to crack and block the vessel. Smoking causes the level of good cholesterol in the blood to drop. Increasing physical activity also leads to a decrease in bad cholesterol and an increase in good cholesterol. Walking for at least 30 minutes daily will reduce your risk of heart disease. It has been shown in various studies that small amounts of alcohol increase the level of good cholesterol. However, since the protective effect of the good cholesterol raised in this way from cardiovascular disease is unknown and because of the other harmful effects of alcohol, the use of alcohol is not recommended for prevention of heart disease.
If cholesterol or triglyceride levels cannot be reduced to desired levels despite diet and other lifestyle changes, medications prescribed by physicians should be used. The majority of patients who have had a heart attack or stroke use such drugs and their disease is prevented from recurring.
How long should a cholesterol-lowering diet, lifestyle changes, or medication be administered?
Since high cholesterol has emerged largely due to the lifestyle of our age and malnutrition, proper nutrition and other lifestyle features should be implemented starting from childhood and should continue throughout life. Only in this way can the epidemic of heart disease in our society be stopped. Those who have had a cardiovascular disease or stroke, or have many risk factors and are at high risk of becoming ill, can reduce their risk of heart disease by using lifelong medications that physicians deem necessary, if their cholesterol cannot be reduced to desired levels with diet and other measures.

  • SUMMARY

1- Do not skip meals. If you want to eat something between meals, fruit is a good choice, avoid desserts. Prefer light products.
2- Do not fill your plate completely during meals, eat slowly.
3- Prefer vegetable foods, boiled and grilled foods, avoid fried foods.
4- Consume white meat instead of red meat. Remove the skin from the chicken and separate the fat from the meat. Cook your meals in a steam and fireproof skillet.
5- Stay away from ready-made foods and animal foods as much as possible. While shopping, read the labels of ready-made foods and buy according to the amount of fat.
6- Choose starchy and fibrous foods instead of foods high in saturated fat. Fibrous foods prevent tumor formation.
7- Stay away from offal (liver, spleen, etc.)
8- Reduce the consumption of eggs and egg foods.
9- Eat complex carbohydrates such as Whole Rice, dry beans.
10- Make sure that milk and its products are fat-free. Do not eat cream and butter.
11- Use fat-free cheese. For this, you can consume Ülker Blue-Green White Cheese.
12- Cut down on smoking and quit.
13- If you have high blood pressure, make dietary changes such as reducing salt.
14- Exercise regularly. This is good cholesterol HDL– raise cholesterol LDLIt will lower cholesterol.
15- Since solid fats are naturally found in animal foods, they should be added to meals as little as possible, less fat should be added to meat dishes and the habit of consuming fat at breakfast should be abandoned.

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