HIGH CHOLESTEROL (Hypercholesterolemia, Medoroga, Hyperlipidemia)

High Cholesterol

 (lipid disorder, hyperlipidemia, or hypercholesterolemia,Sukshma medovridhi)

Fat's in the fire

Full cream Milk , if it is used in excess it increases cholesterol in the blood

Is Your Blood Cholesterol Bothering You?

If you're wondering as to what you owe your high cholesterol levels to, it could be any thing from processed foods and a sedentary lifestyle, to nutrient deficiencies and stress. Mere cutting down on dietary cholesterol will be of little consequence for blood cholesterol .Consuming high cholesterol food like eggs, red  meat and high fat dairy metabolizes and excretes excess cholesterol, leaving blood levels unchanged. Furthermore, the liver compensates for the excess intake of cholesterol by reducing its own production. Its a silent killer.

All this happens if one is leading a healthy lifestyle, consuming a healthy dose of antioxidants in the form of fruits and vegetables, eating whole foods in the form of whole grain cereals, whole grain pulses and avoiding processed and refined foods, in addition to exercising. All these factors insulate one from mishandling dietary cholesterol. When you increase your intake of soluble fiber it helps bring down the blood cholesterol dramatically. A point to note here is that fiber occurs exclusively in plant food.

There is no doubt that a diet rich in soluble fiber  can lower blood cholesterol, blood pressure, and prevent strokes as well as heart attacks. Soluble fibers found in oat bran, fruits and vegetables. It has a powerful impact on the body's metabolism.

Understanding good and bad cholesterol ?

Cholesterol is just one of many substance created and used by our body to keep us  healthy. It promotes synthesis of cell membranes and hormones. Unfortunately cholesterol does not get  processed in a beneficial way every time. In other words, elevated level of bad cholesterol is a major risk factor for the rising epidemic of heart attack etc in our country. Covid 19 is pro-thrombotic, pro inflammatory and pro immunologic. These factors are responsible for severity and mortality, more so for those with underlying comorbidity.

                            "Healthy heart is not by chance, it is by choice."

Introduction

When Mrs. A, a 48 year old lady walked into the OPD, she was sweating, feeling uneasy and said that she had a  disturbed sleep the night before. She looked unwell and hence an immediate ECG was done. Which revealed a myocardial infarction (heart attack). Emergency life saving medications were given and  she was shifted to the catheterization lab, where her angiography revealed complete occlusion of one major artery and significant blockages in other arteries. Immediate angiography and stenting to the culprit artery is done as a life saving procedure. 

Further evaluation revealed very high cholesterol levels and a family history of premature cardiac death in 50 to 55 respectively. She was suffering from familial hypercholesteremia. Other conventional risk factors for coronary artery disease such as hypertension, smoking, diabetes obesity and a sedentary lifestyle were strikingly absent and she denied any symptoms related to heart disease in the past. We are increasingly seeing patients presenting with heart attack and heart failure without any premonitory symptoms.

The word "sterol" literally means “solid alcohol”. Since cholesterol was first isolated from gallstones it got this name meaning “solid alcohol from bile.” Cholesterol is an oily organic compound insoluble in water but soluble in organic solvent.

Cholesterol is a waxy soft, fat like substance found in all body cells and is essential for life. And the body needs it to build healthy cells.  However high level of bad cholesterol can increase the risk of heart disease, such as total cholesterol, triglycerides (T.G.L), low density lipoproteins (L.D.L). With high cholesterol levels fatty deposits develop in a blood vessels. Sometimes these deposits can suddenly break and form a clot that  cause a heart attack or stroke. Its often a result of unhealthy lifestyle choices which make it preventable and treatable. A healthy diet, regular exercise and sometimes medication can help reduce high level of cholesterol in the body. 

"High cholesterol has no symptoms and that is the biggest problem. A blood test is the only way  to detect whether you have it or not."

It leads to premature hardening of arteries, aorta, kidney arteries etc. Narrowing of arteries reduces  blood supply to tissues. High level of bad cholesterol and low level of good cholesterol (H.D.L) High density lipoproteins. L.D.L may be responsible for premature heart attack in the younger population, especially those who are obese with pot belly. Abdominal Circumference : (More than 90 cm in men and more than 80 cm in women). In Hypertensive, diabetic and smokers are all at risk.

Hyper Cholesterolaemia or increase in cholesterol is mainly a digestive problem caused by rich foods.

Cholesterol word spells terror for some people. When the level of cholesterol becomes high in blood, it starts getting deposited in blood vessel walls. Arteries become thickened or hardened (arteriosclerosis) and block the free passage of blood. This causes pressure and leads to cardiovascular diseases including heart attack. However, this condition of Hyper-cholesterolemia (increase cholesterol in the blood stream) can be easily tackled.

Atherosclerosis

Blood cholesterol is a soft waxy substance found among the lipids (fats) in the blood stream. The impression that cholesterol is an undesirable substance is wrong. It is essential for the formation of a cell membrane, bile acids, sex hormones and vitamins, hence a constant supply is necessary for our body. Cholesterol is recycled. It is excreted by the liver via bile into the digestive tract. Typically about 50% of the excreted cholesterol is reabsorbed  by the small bowel back into the bloodstream.

Xanthelasma

These are cholesterol spots which are bumps of fats that develop underneath the skin. No need to get rid of small harmless Xanthomas. It can be noticed around the eyes, usually in the inner canthus of the upper eyelid. They are yellow soft slightly raised bumps to occur on both sides.

Xanthomas are not dangerous in and of themselves, but they can be a signal of a more serious underlying condition, so they should never be ignored. They can develop anywhere in the body but are most common on the eyelids. There may be some itching associated with them. They are not contagious nor are they harmful. Treatment of eye Xanthomas is not necessary.

Why is cholesterol needed?

•       To manufacture steroids or cortisone- like hormones including sex hormones such as testosterone and estrogen.
•       It helps the liver to produce bile acids. These acids are essential for digestion of fats and ridding the body of waste.
•       It acts as a cell to interconnect "lipid molecule". A lipid molecule is needed to stabilize our cell membrane. Without cholesterol, our body ruins.
•        It is an important part of myelin sheath which is a neuron consist of fat containing cells that insulate the axon from electrical activity. It is to ensure our brain functions properly by aiding route of electric impulses. Without it, it would be difficult for the brain to focus and might lose his/her memory.
•           Finally, cholesterol is beneficial for the human body immune system
•      Dietary fat is categorized into bad saturated and good unsaturated fat.   While saturated fat raises total cholesterol levels and lowers H.D.L (good) cholesterol levels. Unsaturated fats found in tree nuts, fish, and seeds. lower total cholesterol, L.D.L (bad) cholesterol and triglyceride levels, reduce inflammation and prevent heart disease.  Lowering saturated fat intake and replacing it with polyunsaturated vegetable oils such as canola, mustard, soybean, sunflower and safflower  oils lowers heart disease risk by 30%; similar to the  reduction achieved  by using Statin drugs for treatment. 

"By the rule of thumb, oils that solidify at room temperature (around 20 degrees C) are unhealthy."

What are the sources of cholesterol?

●      An Exogenous sources from foods like cheese, egg yolks, poultry, fish, nuts.

     An endogenous source inside our body, cholesterol is synthesized from carbohydrates by liver and intestine. We consume about 250 - 750 mg cholesterol daily and produce about  1.2-2 grams.

●      On cholesterol free diet, cholesterol will be synthesized by liver and bowel to meet body needs.

●      Transportation

Cholesterol is carried through the blood attached to proteins. This combination of proteins and cholesterol is called lipoprotein. There are different types of cholesterols based on what the lipoprotein carries, they are :

There are several types of lipoproteins within blood, in order of increasing density, 

• Very low -density lipoprotein (V.L.D.H), 
• Low density lipoprotein (L.D.H), the "bad cholesterol", transports cholesterol particles throughout the body.. LDH cholesterol builds up in the walls of the arteries making them hard and narrow. 
• High density lipoproteins (H.D.L), the "good cholesterol", picks up excess cholesterol and it takes back to the liver. The more lipid and less protein, a lipoprotein have, the less dense it is .

Cholesterol is slightly soluble in water; it can dissolve and travel in the water based bloodstream at exceedingly small concentrations. Since cholesterol is insoluble in blood, it is transported in the circulatory system within lipoproteins.

There are several types of lipoproteins within blood, in order of increasing density, very low -density lipoprotein (V.L.D.H), low density lipoprotein (L.D.H), and high density lipoproteins (H.D.L), The more lipid and less protein, a lipoprotein have, the less dense it is .

●      Hypercholesterolemia

Abnormal cholesterol levels that is, higher concentrations of L.D.L and lower concentrations of functional H.D.L are strongly associated with cardiovascular disease because these promote atheroma (a fatty deposit in an artery) development in arteries atherosclerosis. This disease process leads to myocardial infarction (heart attack), stroke, and peripheral vascular disease. L.D.L particles are often termed “bad cholesterol” because they have been linked to atheroma formation.

On another hand, a high concentration of functional H.D.L, which can remove cholesterol from cells and atheroma, offer protection and are sometimes referred to as “good cholesterol”. These balance can be changed by body build, medications, food choices and other factors.

How is high Triglyceride level harmful to the body?

The source of Triglycerides is diet. If high it may be an independent risk factor for heart attack and brain attack.. Individuals with high triglycerides(> are two times more vulnerable to atherosclerosis than those with lower levels. 200 mg/dl). Regular exercise, healthy diet, reduced alcohol intake, fenofibrate may be recommended to reduce triglyceride levels.

What about fats?

Saturated fats are solid at room temperature. They are found in fats of animal origin such as beef, butter,, cream, coconut oil, though of plant origin is solid at room temperature and has high saturated fat content

High intake of saturated fat spikes cholesterol. On the contrary, unsaturated fats are liquid at room temperature. Sources of Polyunsaturated fats are plants such as sunflower, corn and soyabean. Consumption of  polyunsaturated fat oils lowers cholesterol level. Mono saturated fats are in olive, peanut, Avocado oil and lowers cholesterol levels.

What is the relationship between cholesterol and alcohol / smoking ?

Excessive alcohol intake can raise bad cholesterol. Triglycerides and may cause high blood pressure or heart attack. Tobacco consumption in any form raises bad cholesterol even L.D.H and Triglycerides lowers the level of H.D.L. H.D.L level decline is greater in women smokers as compared to men.

How are age and stress related to cholesterol?

Any kind of stress  may raise bad cholesterol. Also as age advances. It enhance vascular age and raise bad cholesterol. And after menopause bad cholesterol levels become high. and good cholesterol levels low.

What is the recommended protocol for lipid profile check after the age of 30?

Lipid profile should be checked on a yearly basis after 30 and every 6 months after 55.

What is the role of diet on reducing cholesterol?

Reduce fat intake, so that less than 10% of total calories comes from saturated fats and 10% from polyunsaturated fats. Eat more nuts, vegetables and one can have chicken and fish . No red meat. Avoid egg yolk, opt for egg while. Ditch junk, deep fried food such as samosa, burger, cutlets etc.

FATS                                         Saturated fat/100 gm
Good fat
Peanut                                    17
Soybean                                  16
Olive oil                                  14
Sunflower oil                         13
Corn oil                                    13
Mustard oil                              12
Sunflower                                 10
Safflower                                  8
Canola oil                                  7
Bad fat
Butter                                       63
Palm oil                                    49
Pork                                            39
Ugly fat
Coconut oil                              82
Palm kernel oil                       82

Diagnosis

●      Lipid Profile Normal Values are:

Measurement of total cholesterol, assessment of lipoprotein levels requires a 12-14 hours fast.

●      Total cholesterol: 150-250 mg/dl ideally  (blood cholesterol in an adult should be < 130 mg/dl

- desirable, 201-239- borderline & > 239 - high)

●      Triglycerides                     10 - 150 mg/ dL

- desirable < 130 mg/dl

●      LDL                                     60 - 130 mg/ dL

- desirable <70 mg/dl

●      HDL                          Greater than 40 mg/ dL

- desirable < 40 mg/dl in males and < 50mg / dl in females

●      V.L.D.L                                  2 - 38 mg/ dL

- desirable < 30 mg/dl

The cholesterol/H.D.L  ratio should be <4,

L.D.L/ H.D.L ratio should be less than 3

LPa level should be < 30 mg/dl,

“Check the L.D.L and triglycerides after 3 months”.

Effect of cholesterol in  body

Cause

A.     Environmental

●      Sedentary lifestyle increases cholesterol

·    Obesity

●      Dietary choices

B.     Secondary causes Diabetes Mellitus type 2, obesity, alcohol, dialysis, Nephrotic syndrome, obstructive jaundice, hypothyroidism, Cushing's syndrome, anorexia nervosa.

●      Hypercholesterolemia or increase in cholesterol is mainly a digestive problem caused by rich foods such as fried foods, excessive consumption of milk and its products like ghee, butter & cream, white flour, sugar, cakes, pastries, biscuits, cheese ice cream as well as non-vegetarian food like meat fish and eggs.

●      Irregularity in habits, smoking and drinking alcohol.

●    Stress has been to be a major cause of increased cholesterol. Adrenaline and cortisone are both released in the body under stress.

●      Medications like thiazides, diuretics, glucocorticoids, beta blockers etc.

●      In Ayurveda, hypercholesterolemia condition can be correlated with “Suksma medovrudhi”.

C.     Genetic factors

Signs & Symptoms

High cholesterol has no symptoms. A blood test is the only way to detect if you have it.

Heart Attack

Heart Attack

Stroke

Stroke/ Brain Attack

Type 2 Diabetes

Type 2 Diabetes

High Blood Pressure

High Blood Pressure

Peripheral Artery Disease (PAD) 

Pain in legs

Pain in leg

Discomfort in legs and feet

Foot & Leg Pain

Intermittent claudication

 Intermittent claudication is muscle pain that happens when you're active and stops when you rest

Intermittent Claudication

Cramping

Leg Cramps

  As PAD progresses, the symptoms start to occur more frequently and even when the body is at rest. And on the toes, a part of the body that none turns to, the signs start to appear when PAD gets severe. These include:

Thick Toe Nails  

Toe Nail

Toe Nail Turning Blue

Blue toe syndrome, also known as Trash Foot or Purple Toe Syndrome, is caused by a blockage of the small blood vessels in the foot that reduces the flow of blood and oxygen to the tissues. It usually develops due to a problem higher up the blood stream such as an aneurysm or atherosclerosis.

Burning sensation in toe

                  

Thinning the skin of leg

Thinning of skin of leg.

Pale skin

Pale Skin

                                   

Ulcers that do not heal easily

Low hair growth on leg

Cold leg specifically the lower part

Pain that does not go even at rest.                                          

●      Xanthelasma

Xanthelasma

●      Arcus senilis white or grey discoloration  of the peripheral cornea.

Arcus senilis

Inter Digital Planner Xanthoma

Inter Digital Planner Xanthoma

Erruptive Xanthoma

Eruptive Xanthoma

• Weight- Overweight or weight gain/pot belly.

Pot Belly

Fatigue

Fatigue

                                    

“The root cause is we do not digest and assimilate our food”

When to see a doctor

Given the high incidence of childhood obesity, fast food culture, a sedentary lifestyle in children as well as in adults and also very high incidences of  heart disease in Indians, that too at a younger age, it would be worth while to  screen first cholesterol levels between the ages of 9 and 11, and than repeat this every five years after that. It is also recommended that  cholesterol screening occur every 1 to 2 years for men in the ages of 45 to 65 and for the women in the ages of 55 to 65. People over 65 should  undergo cholesterol tests annually. More frequent tests also recommended for people who have a family history of high cholesterol, heart disease or  other risk factors such as diabetes and high blood pressure.

Risk Factors

Modifiable risk factors such as inactivity obesity and an unhealthy diet  contribute to harmful cholesterol and the triglycerides levels. The genetic make up of an individual (a non modifiable factor ) might make it more difficult for a body to remove. LDL cholesterol from the blood or break it down in the liver.

Medical conditions that can cause unhealthy cholesterol levels include:

• Chronic kidney disease
• Diabetes
• HIV/ALDS
• Hypothyroidism
• Lupus

Risk Factors

Factors that can increase the risk of unhealthy cholesterol levels includes :

• Poor diet : Eating too much saturated fat  or trans fat  can result in unhealthy cholesterol levels. Saturated fats are found in  fatty cuts of meat and full fat dairy products. Trans fats are often found in  packed snacks and deserts too.
• Obesity : Having a body mass index (BMI) of 30 or greater increases the risk of cholesterol.
• Lack of exercise :
• Smoking :
• Alcohol :
• Age: Unhealthy cholesterol levels are more common in people over the age of 40. As one ages, the liver becomes less able to remove LDL cholesterol                                                               

Complication

High cholesterol can cause a dangerous accumulation of  cholesterol and other deposits on the walls of arteries (atherosclerosis). These deposits ([plagues) can reduce blood flow through the arteries, which can further cause  chest pain, heart attack or a stroke.

●      Heart attack

●      Stroke

●      High blood pressure

●      Atherosclerosis

●      Hardening of arteries

●     Aneurysm of arteries and hemorrhage. In some cases, it causes a weakening of an artery. This can lead to bulging in an artery called an aneurysm. Aneurysms can break open (rupture). This causes bleeding or hemorrhage, that can be life threatening.

“Hyper-cholesterolemia can be controlled by improving the diet and changing the lifestyle”.

Lifestyle

●   Say no to stress, smoking, sedentary lifestyle, saturated fat, excess alcohol, salt, sugar.

●    Practice heart friendly exercise for 30 minutes daily.

●     Do not eat junk or fried food. Include  more nuts, fruits and vegetables in your diet.

●    Manage anger to enhance heart health. Also cope with stress by practicing all eight limbs of yoga and meditation.

●      Eat the right food at the right time, place in a right dose and the right environment.

●      Get annual health check-up done after the age of 30.

●      Optimize your heart mind connection for a more healthy heart.

●     Follow 3 Ms. (Mindfulness, meditation and Medication).

●     Please take Statin with your doctors advice.

●   Take regular exercise Jogging or brisk walking, swimming, bicycling, playing badminton are excellent forms of exercise.

●      Lose weight if obese

●     See that your digestion is proper and you have your food at the right time,

●    Control Diabetes and Hypertension.

●       Discontinue thiazides diuretics and beta- blockers.

●      Consumption of garlic and onion in your diet will help in reduction of cholesterol.

●      Switch over to Sesame oil  or  gingelly (till) oil

●   Deep breathing exercise for 15 minutes daily will help to refresh your system and is an effective distress technique too. Regular practice of pranayama and yoga will help to maintain normal lipids in the blood.

●    Undergoing Udwarthanam (dry Herbal powder massage) at regular intervals followed by steam bath will help to dissolve the accumulated fat in the body. 

●    To be cholesterol fit, ensure your adequately hydrated. Drink 2-3 liters of water every day, it stimulates the excretory activity of the skin and the kidneys. This, in turn, facilitates elimination of excessive cholesterol from the system.

●      Use of toned or double toned milk

●   Indulging in a variety of entertaining pleasing and recreation activities to beat stress, such as writing diaries,  blogs, dancing, travelling, reading books, or any other constructive hobby. etc.

Yoga

Yogasanas are highly beneficial as they help increase perspiration which stimulates sebaceous glands to effectively secrete accumulated or excess cholesterol from the muscular tissue.

A.     Ardhamatsyaendrasana

●      Sit in stretch leg position

●      Hands besides your body

●      Now fold your right leg at the knee and keep it under your left thigh.

●      Keep your left foot outer side of the right knee by keeping the support of your right hands.

●   Stretch your right hand up while inhaling and then lock your left leg by catching your left ankle.

●      Twist your body left side, look back.

●      Feel the stimulation on your pancreas.

●      Stay in normal breathing Release the posture after sometimes.

B.     Shalabhasana

                              

●      Lie flat on your stomach legs should be stretched out straight, feet should be together, chin and nose should rest on the ground and look straight ahead.

●      Place your arms under your body and keep them straight.

●      Now form fists with your hands and place them close to the thighs

●      Next, raise the legs. They should be kept together straight and stretch them as far as you can and avoid bending the toes and knees.

C.     Padmasana

                                                       

Sit erect with both legs placed straight forward. Bend the right leg on the knee joint. place the right foot at the left groin with right sole turned upwards and the heel in front of the pelvic bone. Place the left foot on the right groin in the same fashion. Straighten up with both hands placed on thighs. close the eyes and meditate. maintain this posture for one minute.

D. Vajrasana

                             

Sitting with the folded legs. Asana of sitting posture which involves forward bending thereby compressing the abdominal organs and stimulates the good functioning of abdominal organs.

Pranayama

A.     Surya Anuloma Pranayama

Sun is associated with heat. This Pranayama is performed with an intended therapeutic use of heating the body so as to burn fat cells in the body. Close the left nostril with the ring finger and the little finger. Now close half the right nostril at the bridge of nostril. Now breathe in from the right nostril in a controlled manner. When you have inhaled completely, close the right nostril and close half the left nostril at the bridge and exhale in a controlled manner. This is Surya Anuloma Pranayama.

B.     Ujjayi Pranayama

●   The practice of Ujjayi helps to conquer the mind. The practice of Manasika japa (mental repetition)   With breathing is usually associated with Ujjayi Pranayama.

●      To inhale, lift the head up then exhale and lower the head and lock the chin in such a manner as to constrict the wind pipe slightly. This posture is called a Bandha or lock and the name of this lock is Jalandhara Bandha.

● Maintaining a Jalandhara Bandha, breathe in and out with awareness on the throat. The constriction will initially produce a snoring kind of sound.

C.     Nadi Shodhana Pranayama  (Channel clearing) Alternate nose breathing

●      Having performed Surya Anuloma Pranayama, it is important that you balance the body and the mind. Nadi Shodhana Pranayama holds good to achieve just that.

●      Sit down in padmasana

●      Close your right nostril with right hands thumb and inhale through your left nostril as long as you can inhale. When your lungs are full, close both the nostrils and hold the breath for some times. Then slowly exhale through the right nostril closing the left. (use your ring & little finger).

●    Thereafter close your left nostril and inhale through the right nostril and then closing both the nostrils holding the breath of the body and ultimately exhale the breath through the left nostril.

Exercise

How can regular exercise influence cholesterol?

● Regular walking,, wogging, (a combination of walking and jogging, or walking and running.) jogging, swimming etc. are excellent for a healthy heart. And to reduce the level of bad cholesterol. and increase the level of good cholesterol.

●      Walking The practice of walking regularly helps build a sense of discipline in waking up early in the morning. Walking loosens the muscles in the body preparing it for other forms of exercises.

●   Passing the ball- This is one of the exercise that require coordination and in process of maintaining this condition, one forgets the amount of time and effort he or she has spent. This is an excellent exercise for a couple to practice.

"Daily requirement of fat is 15 grams per day".

Mudra

A.     Surya Mudra

                               

●      Formation- The tip of the ring fingers is to be placed at the base of the thumb and thumb is to be placed gently on the back of ring finger.

●      Surya means the sun, Surya Mudra generates heat in the body like the sun.

●      It is beneficial for the patient of High cholesterol in the blood.

B.     Prana Mudra

                          

●      Formation- The tip of little fingers and ring fingers are joined with the tips of the thumbs.

●      Practicing this Mudra makes a person mentally and physically strong.

C .  Apana Vayu Mudra

This mudra can save a person from 'heart attack', hence a mudra is called Sanjeevani Mudra, one that gives life to a dying person. This mudra gives instant results and the pain is reduced immediately.

Formation :

This is combination of two Mudras Vayu and Apana. From Vayu mudra by placing the tip of index finger at the base of the thumb and then form Apana Mudra by joining tip of the thumbs with the middle and ring fingers.

Effects :

There is combined effect of Vayu mudra and Apana Mudra. Vayu mudra relieves the pain instantly and Apana mudra maintains space to reinforce blood circulation to the heart. 

Benefits: 

Note:

Perform Apana Vayu Mudra-

1. When there is sleeplessness.
2. When there is over exertion.
3. When there is stress.
4. When climbing staircases and hills.
5. When there is crises.

Marma

A.     Hridaya Marma

●      Location It is located on the left side of the chest in between lungs.

●    Stimulation- It is stimulated with the help of fist. In  the resuscitation of heart this Marma point is pressed to start the heart functioning. If stimulated daily it increases the efficiency of the heart, coronary circulation is improved.

●      Make the fist of the right hand with the thumb inside, keep the hand over the heart. Then fold the left hand and keep it over the arm. Take normal inspiration followed by expiration and put gentle pressure over the heart. Pressure should be given 15-18 times.

Meditation

Meditation helps to relieve stress

“If we do not have any cholesterol in our diet there will not be any problem, as the liver and to a lesser extent the small intestine manufacture all the cholesterol we require”.

Diet

Bathua good for Cholesterol

●         Proteins- 10-15% as legumes, pulses, grains and nuts.

●         Dairy products like skimmed milk, low-fat cheese, yoghurt.

●         Carbohydrates 50-70% Vegetables and fruits.

●     Fats- Polyunsaturated. Reduce intake of whole milk, cream, butter, animal fat and organ meats and saturated vegetable fats like palm and coconut oil.

●      Fiber - High fiber diet reduces L.D.L cholesterol (bad cholesterol) . It also adds bulk to the diet producing sense of satiety. Unprocessed wheat bran, whole cereals such as wheat, barley, rye, legumes, potato, carrot, beet and turnip. fruits like mango and guava. Green vegetables such as cabbage lady’s finger, and celery. Oat bran is especially beneficial in lowering L.D.L cholesterol.

●   Vegetable oils The vegetable oil palm are high in saturated fats and these should be replaced by polyunsaturated fats such as sesame oil, olive oil and Saffola .

●      Mustard oil It has low saturated fat compared to other cooking oils, it reduces cholesterol.

●      Reduce the intake of Urad dal in your diet.

●    Polyunsaturated and monounsaturated fats - the “good fats” - actually contribute to your health and vitality. Food rich in healthy fat includes olive oil, nuts, fish and sea foods, ghee and avocados.

●    Low-fat diet or fat - free diet like old rice, barley, butter milk will help the body to synthesize cholesterol from internal sources.

●      Soybean Soy protein intake has beneficial effects on lipid changes.

●      Corn is good for cholesterol problems.

●      Minimize all animal fats including those in dairy and dairy products.

●     Make sure to eat lots of antioxidant compounds concentrated in fruits (especially citrus fruits, strawberries, apple etc.) and vegetables like carrots, broccoli and spinach.

●   Turmeric and curry leaves have cholesterol lowering properties, may be added when preparing various dishes.

●   Drink water boiled with 2 teaspoon coriander seed twice daily. It reduces cholesterol, improves digestion and flushes out toxins.

●  Bitter gourd (Momordica charantia) or Karela It is very effective in lowering hepatic triglycerides levels.

●      Garlic (Allium sativum) It has hypo-cholesterolemic as well as cardio protective properties. Fresh garlic has lipid - lowering activity.1 -2 cloves of raw garlic can be taken with meals.

●      Onion ( Alliun cepa) Take in your regular diet will help in reduction of cholesterol.

   Half a raw onion juice daily is beneficial in boosting H.D.L. Onions are good for high cholesterol.

·    Banana (Musa sapientum) The pulp of banana fruit has cholesterol lowering effect.

●  Food that lowers L.D.L cholesterol Almond, Apple, Avocado, Beans (dried) Carrot, Coriander seeds, (dried), fenugreek seeds, Grapefruit, Isabgol, oats, sunflower seeds and walnuts.

●   Fenugreek / Methi  Seeds : Soak the seeds over night. Drink its water in the morning. Cover the remaining seeds in wet cloth alow them to sprout. Then eat it.

                                 

“Saturated fatty acids found in foods should make up no more than ten percent of a person's total calorie intake each day”.

Avoid

●   Avoid saturated fat (egg yolk)  and trans fat - the “bad fats” -increase your risk for certain diseases, including heart disease and stroke.

●      Reduction of cholesterol by cutting out egg yolk and fats of animal origin.
*    Avoid consuming high cholesterol food like eggs, red  meat, and high fat dairy products. as it metabolizes   and excretes excess cholesterol, leaving blood levels unchanged.
*    Avoid meats including chicken, fish, beef, cheese, egg yolk, milk have no fiber to boost of.
*  Vegetables especially the way we cook it for Indian cuisine - soggy and overcooked destroys much fiber.
*   Juices have little or no fibers.
*  Unrefined grain products like dalia  (broken wheat), whole wheat flour, wheat puffs, brown rice, jowar, bajra flour.
*    Whole dals as chana, rajma, (kidney beans). chowli (black eyed beans), black dal, etc are high in fiber.
*    Wheat bran is one of the best fiber foods because its fiber content is about 50%.

Herbs

●  Guggul (Commiphora Mukul) Guggul has been shown to lower blood fat levels while raising levels of  H.D.L. It is useful in atherosclerosis.   20 mg of Guggul powder with water twice a day after meals for weight reduction and lowering blood cholesterol.

●      Haritaki (Terminalia schedule) Harad.

●      Ginger (Zingiber officinale) Eating a bit of ginger every day will help prevent a heart attack.

●      Ginkgo biloba Its leaf extract lowers blood cholesterol.

●      Vidanga (Embelia ribes) It has lipid lowering property.

●  Bhumihar Amalki  (Phyllanthus niruri)  It has been found to inhibit hepatic cholesterol biosynthesis, an increase in faecal bile acids secretion.

●  Arjuna (Terminalia Arjuna) Its bark powder has significant antioxidant action and has a hypo-cholesterol emic effect.

●      Ajamoda or Celery (Apium graveolens) It is good for lowering cholesterol levels.

●      Tulsi (Ocimum sanctum) Fresh leaves of tulsi is good.

●      Kokum (Garcinia Cambogia)

●   Coriander seed decoction  is a good diuretic and stimulates the kidneys. It is prepared by boiling dry seeds of coriander and straining the decoction after cooling

●      Asafoetida

●      Carom seeds

●      Apricot

●      Cherries

●      Amla

·    Cinnamin and cloves It lowers total cholesterol, L.D.L, and triglycerides.

●   Curry leaves Leaves flush out fat, reducing fat deposits in the body, as well as reducing bad cholesterol levels.

●      Turmeric Its regular intake may help reduce L.D.L

Home Remedies

●      Triphala 1 teaspoon of Triphala at bedtime.

·   The rhizome of AMA Haldi (Curcuma Amada, mango ginger) is roasted and given with black salt for lowering blood cholesterol.

●      Roasted gram powder Half teaspoonful mixed with a Half teaspoon of panchakola choornam and honey. make a paste and take it before breakfast and lunch for two months.

●      Take horsegram soup every day.

●      Drink every day plantain Stem juice

·     To improve your appetite take Hingh tab.

Prevention

The same heart healthy lifestyle changes that can lower cholesterol levels can help prevent one  from having high cholesterol in the first place. To help prevent high cholesterol one can.

• Consume a low salt  diet that emphasis on fruits, vegetables and grains.
• Limit the amount of animal fat and use good fat in moderation.
• Lose extra pounds and maintain a healthy weight
• Quit smoking
• Exercise on most days of the week for at least 30 minutes
• Avoid alcohol. If at all drink in moderation.
• Manage stress,

Treatment

●      Lipid lowering Drugs Fibrates, omega - 3 fatty acids

●      Hydrotherapy Cold hip bath for 10 minutes taken twice every day have proven beneficial

●      Steam baths are also helpful

●    Mud packs applied over the abdomen improves digestion and assimilation. They improve the functioning of the liver and other digestive organs and activates kidneys and intestine to promote better excretion.

●      Panchakarma It is a Bio - purification measures

Cholesterol is not that bad!
Emergency : Life saving Loading dose
1 Tab Disprin 325 mg 1 tab
2 Tab Atorvastatin 80mg 1 tab
3 Tab clopitab 150 mg 2 tabs (300mg)

“Cholesterol is good for the body as long as it is in normal range”

Link: https://madhuchhandacdmo.blogspot.com/2017/08/high-cholesterol-hypercholesterolemia.html

* Medicine as suggested above should only be taken under the consultation and supervision of registered medical practitioner.