Dealing With Dyslipidemia

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A disorder of lipoprotein metabolism, including lipoprotein overproduction or heart deficiency, dyslipidemias may be manifested by elevation of the total cholesterol, the “bad” low-density lipoprotein (LDL) cholesterol and the triglyceride (TG) concentrations, and a decrease in the “good” high-density lipoprotein (HDL) cholesterol concentration in the blood.

Most cases of dyslipidemia are hyperlipidemias: elevated lipid levels in the blood often brought on by diet and lifestyle. Since dyslipidemia puts you at significant risk for coronary heart disease (CHD) and other cardiovascular conditions, managing your lipid levels is critical to your overall health and wellness.

Classification:

Isolated hypercholesterolemia: When only cholesterol levels are increased

Isolated hypertriglyceridemia: When only TG concentrations are increased

Combined hyperlipidemias: When both cholesterol levels and TG concentrations are increased

Causes:

Primary causes: Single or multiple gene mutations that result in either overproduction or defective clearance of TGs and LDL cholesterol or in underproduction or excessive clearance of HDL cholesterol. The primary disorder occurs mostly in children and may not affect most cases of adult dyslipidemia.

Secondary causes: This is due to sedentary lifestyle conditions with excessive dietary intake of cholesterol, trans fats and saturated fats. Secondary causes contribute to many cases of dyslipidemia in adults. Trans fats are the fatty acids that are either polyunsaturated or monounsaturated, in which there are added hydrogen atoms. Trans fats are usually used in a lot of processed foods. Other secondary causes are:

– Alcohol abuse

– Diabetes mellitus

– Hypothyroidism

– Chronic kidney disease

– Other cholestatic liver diseases and primary biliary cirrhosis

– Drugs like thiazides, retinoids, oestrogens and glucocorticoids, among others

Symptoms and signs:

High cholesterol is one of the major risk factors for coronary artery disease, heart attacks, and
strokes. It also appears to increase the risk of Alzheimer’s disease.

High cholesterol leads to a build-up of plaque that narrows the arteries, a condition known as atherosclerosis.

High levels of TGs (> 1000 mg/dL) can cause acute pancreatitis.

High levels of LDL can cause arcus corneae and tendinous xanthomas at the elbow and knee.

Severe hypertriglyceridemia (> 2000 mg/dL) can give retinal arteries and veins a creamy-white
appearance (lipemia retinalis).

Severe elevations of TGs can have eruptive xanthomas (an irregular yellow patch or nodule on the skin, caused by deposition of lipids) over the trunk, back, elbows, buttocks, knees, hands and feet.

Diagnosis:
Dyslipidemia is diagnosed by measuring serum lipids.

Serum lipid profile: measured total cholesterol, TG and HDL cholesterol and calculated LDL cholesterol and VLDL

Serum Lipids Normal Ranges

Total cholesterol 200 mg/dL

LDL cholesterol 100-129 mg/dL

HDL cholesterol 40 to 60 mg/dL

Triglycerides <150 mg/dL

Treatment

Dietary modifications:

Eat small and frequent meals.
Consume more complex carbohydrates like whole wheat, brown rice, jowar, bajra, ragi, rawa, bran, whole pulses, dals, fruits, vegetables, etc.
Avoid refined flour (maida) and its products.
Your diet should be rich in fruits and vegetables because they are rich in fibre, essential minerals, vitamins and antioxidants.
Consume fish at least twice a week because it is rich in omega 3.
Cook with heart-friendly oils like peanut oil, rice bran oil, olive oil and canola oil.
Eat unsaturated fats which lower the LDL cholesterol such as almonds, avocado and walnuts.
Avoid saturated fats like ghee, butter, dalda and vanaspati because they increase LDL cholesterol.
Avoid trans fats which are present in most processed foods, which increase bad cholesterol and
lower the good cholesterol.
Meat and full-fat milk have protein but they are also major sources of cholesterol. So you should
consume skimmed milk and milk products and lean meat.
You should introduce soya protein into your diet.
Avoid simple sugars.
Avoid salty foods.
Drink adequate quantity of water.

Lifestyle modification:

Reduce weight: Losing weight can help you reduce your levels of triglycerides, LDL and total
cholesterol. A good balance of calorie intake and physical activity is required to achieve or maintain a healthy body weight.
Quit smoking: Your good cholesterol is likely to improve once you stop smoking.
Regular exercise: It lowers bad cholesterol. Choose an activity that improves your heart rate such as running, swimming or brisk walking. You should exercise for a minimum of 30 minutes everyday.

Some cholesterol-lowering foods

fruits and veggies