Hypercholesterolaemia (cholesterol excess)
A yellow/white fatty substance called cholesterol is responsible for a large proportion of the heart attacks, strokes circulatory problems and kidney disease in the Western world. Yet cholesterol is essential for the normal functioning of the human body. It is responsible for cementing cells together, is a major constituent of bile and the basic building block for sex hormones. Only in excess is it harmful.
If too much cholesterol is carried around in our blood stream, it may be deposited in gradually increasing amounts inside the arteries. Slowly, the affected artery narrows until the flow of blood is sufficiently obstructed to cause the area supplied by that artery, to suffer. If that area is the heart, a heart attack will result. If it is the brain, a stroke will occur. This deposition of fat is known as arteriosclerosis, or hardening of the arteries.
The people most affected by high levels of cholesterol are overweight middle-aged men. Women, and people of normal weight, may be affected too, but not as frequently.
It has been proved that if you have cholesterol levels that are within normal limits, your risk of heart attack or stroke is greatly reduced. It is therefore important for anyone who feels they may be at risk to have a blood test to determine their cholesterol level. For this test to be accurate, it is necessary to starve for 12 hours (usually over night) and avoid alcohol for 72 hours before the blood sample is taken.
The actual cholesterol levels that are considered safe is a matter of some controversy in the medical profession. A level below 6.5 mmol/L is probably reasonable for patients over 40. Younger patients should aim for a level below 5.5 mmol/L, while the elderly are probably safe with levels as high as 7.0 mmol/L. A higher value is accepted in females than in younger males. Is lower cholesterol better or not? There is no evidence that a very low cholesterol level is of any added benefit to health.
Cholesterol is divided into high-density and low-density fats. If the amount of high-density fats is high, there is less to be concerned about, as it is the low-density fats that are a factor in heart disease and hardening of the arteries. These ratios can be measured if the total cholesterol is found to be high.
If you are found to be in the high-risk group, there are several measures you can take to bring you back to normal. The first step is to stop smoking, limit your alcohol intake, take more exercise and lose weight if you are obese. If these measures are insufficient, doctors will recommend a diet that is low in cholesterol. On this, the majority of people return to within the normal levels after a month or two.
A low-cholesterol diet involves avoiding all dairy products, fatty meats, sausages, offal, fried foods, nuts and egg yolk. There is no evidence that this diet will benefit people whose blood cholesterol level is within normal limits while already consuming the forbidden foods. The foods that are allowed include skim milk, poly-unsaturated margarine, lean meats, fish, all vegetables and fruits, cereals and soft drinks.
Despite a strict diet, there are still some people who cannot keep their cholesterol levels under control. They will require further lifelong medical management by the regular use of tablets or drinks that are designed to lower the level of fat in the blood. These are prescribed by a doctor only when necessary.
Once the fatty deposits of cholesterol are deposited inside the arteries, they remain there permanently. There are new surgical techniques available to clean out clogged arteries, but diet has little effect at this late stage. As in all diseases, prevention is much better than cure.