Newsletter - May 2008

It has been a while since my last newsletter and it is hard to believe we are already into May.

The last letter ended with me banging on about being overweight and cholesterol – a subject I said I would address again. I’ll just discuss cholesterol – you’ll know if you are overweight because you can see it – but you may not know if you have high cholesterol.

Cholesterol is a waxy, fatty substance in the blood that plays an important role in our cells and hormones. The liver produces all the cholesterol the body needs, but is encouraged to produce excess amounts by the fat (particularly saturated fat in meat/dairy products) that we eat.

A high blood cholesterol level is seen as dangerous to our health because excess amounts are deposited on the inside of arteries. If the blood cholesterol level continues to be high, more fatty material is deposited, narrowing the artery even more, resulting in restricted blood flow to the heart and other areas of the body. The restricted blood flow encourages formation of a blood clot, which may cause the final blockage. If the blood flow is blocked off completely, it can result in a heart attack or stroke.

High cholesterol is one of the major risk factors for heart disease. Other risks include smoking, high blood pressure, diabetes, lack of physical exercise and obesity. The higher the cholesterol level, the higher the risk of heart disease.

Because cholesterol cannot travel alone through the bloodstream, it has to combine with certain proteins. These proteins act like trucks, picking up the cholesterol and transporting it to different parts of the body. When this happens, the cholesterol and protein lock together to form a lipoprotein. The two most important types of lipoproteins are high-density lipoproteins (or HDL) and low-density lipoproteins (or LDL). Because of their very different effects on the body LDL cholesterol is also known as "bad cholesterol" and HDL cholesterol as "good cholesterol". Most cholesterol is LDL cholesterol, and this is the kind that is most likely to clog the blood vessels, keeping blood from flowing through the body the way it should.

About a quarter to a third of the total amount of cholesterol is HDL cholesterol. HDL cholesterol carries free cholesterol back to the liver, where it can be processed and expelled from the body.

Triglycerides

Triglycerides are a type of fat that is found in the blood. They are the most common type of fat and are a major source of energy.

When you eat, your body uses the calories it needs for quick energy. It converts excess calories into triglycerides and stores them in fat cells to use later. In normal amounts, triglycerides are very important to good health. However, having high triglyceride levels may increase a person's risk of developing coronary artery disease (CAD). Very high triglycerides may lead to pancreatitis in certain people.

Triglyceride levels are categorised as follows:

• Below 150 milligrams per deciliter (mg/dL) is considered normal.

• 150 to 199 is borderline-high.

• 200 to 500 is high.

• Above 500 is very high.

When the blood cholesterol level is tested, the total cholesterol, as well as the different types of cholesterol is determined. The following are target values:

Total cholesterol <5.0 mmol/l

LDL cholesterol <3.0 mmol/l

HDL cholesterol >1.2 mmol/l

What are the significant factors of high cholesterol?

For the majority of people, their cholesterol level is determined by both hereditary and dietary factors. Some people have naturally high blood cholesterol levels due to a hereditary condition known as familial hypercholesterolaemia (FH).

• Genetics: family medical history.

• Age: between the ages of 20 and 65 years, total cholesterol levels may steadily increase, where after they decrease slightly in men and tend to plateau in women

• Gender: women have higher HDL cholesterol levels than men and so have less risk of developing heart disease than men. With menopause the LDL increases and their risk equals that of men.

• Lack of Exercise: the more active you are, the higher HDL levels (and the other way around). It also helps control weight and blood pressure.

• Smoking can contribute to increased cholesterol levels and diabetes.

• Stress has been associated with increased levels

• Excessive alcohol intake may contribute to increased levels

• Weight: overweight people tend to have higher LDL and lower HDL levels and thus have an increased risk

Who should have their cholesterol tested?

Most people with high cholesterol feel perfectly healthy - there are usually no warning signs of high levels. The only way to find out is to test for it.

All adults should know their cholesterol level and have it tested at least once every 5 years. Those with a family history need to be tested more regularly. If your cholesterol levels are normal, you only need to test it again in a few years, but if it is high or you have a family history of high cholesterol or heart disease, have it

Here’s to your good health!

Regards

Nigel

PS: 2008 began with the Department of Health approving osteopathic tariff codes which has led to more medical aid schemes paying for osteopathy (e.g. Momentum, Sizwe, Spectramed, Nimas to name a few). The tariff rates should be approved next year. Sadly, Discovery, Motohealth, Liberty Medical Schemes are still not paying.

Regards