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Compiled by Dr.D.V.L. Rewal, Rtd. Regional Controller of Safety, Ordnance Factory Board.
What is Cholesterol and why do we have it? Cholesterol is a white crystalline solid which is optically active. Its m.p. 149oC. It is odourless. This is the sterol of the higher animals, occurring free or as fatty esters in an animal cells, particularly in the brain and spinal cord. Cholesterol was first isolated from human gall-stones. The main source of cholesterol are the fish-liver oils and the brain and spinal-cord of cattle. Lanoline, the fat from wool, is a mixture of cholesteryl palmitate, stearate and oleate. It does not dissolve in water. Cholesterol has many beneficial functions. It is a necessary ingredient of the cell-walls of all animals, including human beings. It makes our skin water-proof and slows-down water-loss by evaporation from our bodies. It acts as an insulator in the myelin sheath that surrounds nerves and allows normal transmission of nerve impulses. Cholesterol is transported in the blood-stream along with fats. It is in this capacity that cholesterol becomes implicated in heart disease. Cholesterol is the chief constituent of hormones specially sex hormones. Cholesterol in the blood comes from two sources. (i) From foods we eat. (The amount of saturated fat in foods is a more important factor in raising blood cholesterol levels. (ii) Produced in liver and intestines.
e. usually experienced on exertion. permanent damage to the heart may result. if we are strict vegetarians. fibrous. consumption of too much cholesterol can over-load our system and end-up in arterial system viz. thus narrowing the channel through which the blood flows. -2- . The Heart : Heart is a muscle that pumps blood through-out the body of an animal (including human beings) to deliver nutrients to all body cells and to remove waste-materials. Heart can increase its out-put nearly 5 fold. the mildest and earliest symptom of brief chest-pain. If the oxygen supply is cut-off for longer periods. These are transported in blood. our body would manufacture enough cholesterol for proper growth and development). This part of heart-muscle dies. Heart muscles need a constant supply of nutrient-rich. Fats. Proteins.Cholesterol comes in foods from animal-origin. These deposits thicken the artery walls. This is supplied by coronary arteries that branch off from the aorta The cause of Coronary Heart Disease : (Atherosclerosis) It is the clogging of the coronary arteries with fatty.e. This pain occurs when enough quantity of blood cannot get through the blocked arteries to supply oxygen to the heart musclecells. Cells-deprived of oxygen for only a few minutes can recover. Enzymes. break them down and release energy. oxygenated blood. which consists mainly of water. Minerals and Vitamins. However. Fats occur in foods and in our body as triglycerides. Plaques are caused by an excess of cholesterol in the blood. coronary. The plaque formation continues depositing during first 30-40 years resulting in decreasing the openings of the arteries. plaques start developing right in child-hood. Carbohydrates. cerebral etc. Result : Heart Attack or Sudden Death. which function in a water medium. How does the process start? When the food contains high amounts of saturated fats. a small blood-clot may become lodged in the narrowed artery and completely block the flow of blood to a particular portion of heart. cholesterolladen deposits called atheromata or plaques.e. the inevitable occurs. if we rest. When the artery feeding blood to heart muscles gets blocked to the extent of 75 percent. If one is not so lucky. Even if we consume no cholesterol at all (i. Angina : if one is lucky he feels the ‘Angina Pectoris’ i. thereby reducing the demand on the heart. Nutrients – The Role of Fats : There are 5 major classes of nutrients in our diet i. Even while we sleep the heart beats 70 to 80 times per minute and pumps 1800 gallons of blood each day (during 1 lakh beats).
are called lipo-proteins (‘lipo’ means fat). LDL particles remain in the blood-stream for different periods of time in different people.These fats are immiscible in water. which also contain proteins and cholesterol. The fat-depleted VLDL particles are called LDL Low-Density Lipids. triglycerides are removed from the particles and they enter the cells – these are used as a source of energy. in blood after the meals. For other people. cholesterol from the LDL is broken down. So fats are packaged into particles to keep them separating out from the water in the blood. The longer the period. (3) HDL Lipo-Proteins (The Good Cholesterol) : The High Density Lipo-Protein particles are the smallest of the lipo-protein particles. the more cholesterol is available to clog the coronary arteries and the higher is the risk of developing atherosclerosis and coronary heart-disease. (2) LDL Lipo-Proteins (Low Density Lipo-Proteins) (The Bad Cholesterol) : As the VLDL particles circulate through the blood stream. Here most of the cholesterol is broken-down into bile-acids and excreted into the small intestines. HDL removes cholesterol from LDL particles and cells and transports it to the liver. These are constituted by cholesterol and proteins. producing higher LDL level in the blood. There are three major types lipo-proteins:(1) VLDL (Very Low Density Lipoproteins) : The liver uses excess carbohydrates and fats from the blood. Total Blood Cholesterol Level = Sum of Cholesterol in VLDL + LDL + HDL -3- . A part of the cholesterol is reprocessed into VLDL particles. a high LDL Level results in high blood cholesterol level. By removing cholesterol from LDL. So their blood count shows that LDL is very low. In some fortunate people. VLDL particles contain large amounts of triglycerides and lesser amounts of cholesterol. HDL prevents cholesterol from accumulating in the coronary arteries and thus protects against the development of heart-disease. These VLDL particles are produced and released in large quantities. the more is the probability that a part of the cholesterol will be added up to the plaque that is building up in coronary artery walls. protein and other fats. LDL particles are quickly removed from the bloodstream by special LDL receptors on cell-surfaces. These triglycerides are packaged into VLDL for distribution from the liver to the rest of the body. Since these particles are so rich in cholesterol. The Higher the HDL level the more cholesterol is removed from the blood stream and lower the risk of heart attack. Thus. These particles. the higher the LDL level in the blood. we eat to make triglycerides (fats). Once inside the cells. LDL particles remain in the blood stream longer.
VLDL (Triglycerides) Risk increases if High Actions which help in reducing the risk (i) Restrict Alcohol. It should be given a fair and rigorous trial for at -4- .A.239 High Risk 240 + Keep the Blood Cholesterol below 200 mg/dl. (ii) Stop Smoking (iii) Lose weight if over-weight. diet control is the first line of treatment. For reduction in Blood Cholesterol below 200 mg/dl. it is calculated from triglyceride level (which is measured only after a 12 hour fast). By diet (and drugs. (iii) Lose weight if over-weight. Reducing blood cholesterol level lowers the risk of fatal and non-fatal heart attack. VLDL = Triglycerides 5 To sum-up : Lipoproteins and Risk of Heart Disease : LipoProtein 1. if necessary). (v) Reduce saturated fat consumption. LDL 3. (i) Exercise Regularly. that LDL cholesterol level decrease when saturated fat and cholesterol level in food-intake is decreased and when dietary poly-unsaturated fat is increased.S. (ii) Exercise Regularly. (i) Reduce saturated fat consumption. change in life-style and by changing the foods we eat. It is seen from studies conducted on volunteers in U.) Recommended Border Line Under 200 200 .A’s recommendation Age 20 + • • Blood Cholesterol Levels (mg/dl. HDL High Low The table above indicates some of the ways to lower our risks.VLDL is not measured directly.. National Institute of Health U. 2.S. Reduction of up to 33 percent in blood cholesterol level can be achieved by diet alone. (iv) Eat less simple sugar (sweets). • • • Removing saturated fat from diet has two-times the blood-cholesterol – lowering impact as does adding equal amount of polyunsaturated fat. (ii) Reduce consumption of cholesterol.
In Poly-unsaturated Fat there are Two or more double bonds. One can slow or even reverse the clogging of by-pass artery graft by changing what you eat and what you drink. family history of premature heart attach (before 55 years age) : Cigarette-smoking . low HDL (below 35 mg/dl. In mono-unsaturated Fat structure there is one double bond. Bypass artery grafts have been found to accumulate plaque at a faster rate when the blood cholesterol level is high. CHEMICAL STRUCTURE OF THE FATS : Triglycerides are composed of three fatty acids attached to a glycerol molecule. Palm Oil. In saturated fats. Today a blood-cholesterol level of 230-240 mg/dl is understood to be a prime factor in the development of heart-disease. SATURATED FAT RAISES LDL-CHOLESTEROL AND TOTAL BLOOD CHOLESTEROL LEVELS. • The presence of coronary heart disease or other risk factors for heart disease such as male-sex . -5- . high-blood pressure. Cocoa-butter (in chocolate) and hydrogenated vegetable oil (DALDA). cerebrovascular or peripheral vascular disease and severe obesity (30 percent or more over-weight) indicate the need for vigorous therapy. Most adults can control their blood cholesterol below 200 mg/dl. This need not happen. animal fats are high in saturated fats and plant fats are low. diabetes. by diet alone. thereby lowering the blood cholesterol level. BYPASS PATIENTS – TAKE CARE : Bypass surgery may eliminate the symptoms of heart disease such as angina : but they do not cure the underlying atherosclerotic process : which goes on depositing fat in the coronary arteries.least 6 months before even considering drugs. It is common for such grafts to close completely in 5 years time. Saturated Fat : 5 kinds of vegetable fats are saturated : Coconut Oil.) . In general. there is no double bond. Palm Keanel Oil.
Fats have 9 cal/gm whereas proteins and carbohydrates contain only 4 cal/gm. They lower blood LDL . Example : Olive Oil.cholesterol levels and to a much less extent HDL – cholesterol levels. Focus on Saturated Fat : Saturated fat is the most potent determinant of blood-cholesterol levels.e. fish. These are liquids at room temperature. pork. fruits. such as beef. Especially rich sources of cholesterol are egg yolks and organ-meats such as liver. Poly-un-saturated Fat : These fats have two or more points of un-saturation or double bonds. vegetable oils. Dietary Cholesterol : Dietary cholesterol raises LDL cholesterol is found only in animal products. cheese and other whole milk dairy products and eggs. 4 or more atoms of hydrogen less as compared to a saturated fat per molecule. -6- .O . In general. FATS MAKE US FAT.CH3 Poly – unsaturated (TWO OR MORE DOUBLE BONDS) Glycerol Fatty Acids portion Mono Un-saturated Fat : Such fat has one point of un-saturation that is there is onedouble bond or 2 hydrogen atoms less in a molecule than in a saturated fat. such as vegetables.O CH2 – O – C – CH2 – (CH2) 15 – CH3 Saturated (NO DOUBLE BOND) O CH . It is twice as effective in raising blood-cholesterol as poly-unsaturated fat is lowering it. i. Such fats lower LDL – cholesterol without lowering HDL – cholesterol. pancreas and brain. Cholesterol is not found in foods made from plants. except coconut and palm oils are high in poly un-saturated fat.C – CH2 – (CH2)6 – CH = CH – (CH2)6 – CH3 Mono-unsaturated (ONE-DOUBLE BOND) O CH2 – O – C – CH2 – (CH2)6 – CH = CH – CH2 – CH2 – CH = CH-(CH2)4 . poultry. nuts or seeds.
Enriching our diet with these foods has the additional advantage of increasing the intake of vitamins. Let us make sure that Poly-unsaturated fat does not contribute more than 10% of total calories. (2) The cholesterol we eat. whole-grain. When converted into crisp potato-chips it is around 400 calories. the amount of fats. -7- . As we remove saturated fat from our diet. We put 3 tablespoons of sour-cream (26 calories per tablespoon) on top and the innocent potato becomes 183 calories. It is what we do to it. Contrary to popular belief. especially saturated fat that we eat has a much greater effect on our blood cholesterol level than does the amount of cholesterol consumed by us. It is necessary to focus on saturated fats because : (1) Saturated fats and cholesterol usually occur together in the same foods. has much less effect on raising cholesterol levels.e. However. vegetables and fruits). A medium baked potato has 105 calories. (ii) Coconut oil. cholesterol intake should not be more than 300 mg. lard & beef tallow) by Polyunsaturated fats (such as margarine and vegetable oils other than coconut or palm oil). (3) Keeping track of saturated fat makes a simple yet effective plan to follow for lowering blood-cholesterol level. Potato does not make us fat. daily.Fats have been implicated as a risk factor in developing certain cancers such as breast and colon cancers. we are also avoiding foods high in cholesterol. The exceptions are : (i) Egg Yolks and Organ Meats (brain. So by avoiding foods high in saturated fat. liver and pancreas) are high in cholesterol but have only moderate amounts of saturated fat. kidneys. whole-grain breads and pastas. than does saturated fat. fruits and vegetables. How to reduce Saturated Fat Intake? (1) Substitute Full cream curds by low-fat curds. we will have to replace it with something else – say with complex carbohydrates i. Palm Kernel oil. pastas. Instead of foods rich in saturated fat start using foods high in complex carbohydrates (starches) and fiber (such as rice. bread & cereals. Cocoa Butter (in chocolate) and hydrogenated oils (the so called ‘Daldas’) are very high in saturated fat but have no cholesterol. minerals and fibers. (2) Substitute foods high in saturated fat (such as butter.
Similarly. Brazil-nuts and Coconut contain in increasing order. a piece of bread has 80 calories per slice. Avoid ‘heavy’ dinner i. Pecans. Make all your meals low-fat. and chicken with green beans expand the food-palate as well as taste-palate. healthy and filling. cabbage may be eaten raw or with a low-fat curds. About 40 shelled pea-nuts weigh an ounce (160-190 calories/ounce). broccoli. P/S ratio of greater than or equal to 1 : 1 is considered good and a ratio less than 1 : 1 is considered bad. It is the large amount of fat in the diet that leads to over-weight and obesity. The ‘Bad’ Nuts : Cashews. when we are least active. celery. Almonds. Useful Tips : • Use of Indian Vegetables and replacement of saturated fats with complex carbohydrates. Vegetables : Tasty. Macadamia Nuts. Try eating relatively larger breakfasts and lighter dinners. Fast foods : Avoid fast-foods having high-calories and with saturated fats. greater amounts of saturated fat. often overlooked as snacks are cut-up vegetables. Olive-Oil : used as cooking medium by Greeks. Nuts – as snacks. Pistachios and hazelnuts (about 13-17 saturated fat calories per ounce of dry-roasted shelled nuts). cucumbers. it becomes 180 calories per slice. Coconut is almost purely saturated fat.e. cauli-flower. It is a filling without fattening (unless it is drenched in butter or margarine). • Snacks : • • Micro-wave pop-corn is a great snack known to man-kind. It is an ideal oil – least risky – with minimum heart -8- . It should be avoided. The ones with least amount of saturated fat are Walnuts. When we add butter @ 100 calories per tablespoon. Mainly Mono-unsaturated Fat and a little Poly un-saturated fat P/S Ratio 6 : 1. Fats and Oils : The Poly-unsaturated fat to saturated fat ratio (P/S ratio) should be studied. saving most calories at the end of the day. like carrots.
High B.disease. 9 calories per gram. Coconut oil has a P/S ratio of 0.P. (Pea-nut oil is also mono unsaturated but causes clogging of coronary arteries. which is quite good.3 : 1. However. -9- . and diabetes. So why take a chance?) Second choice is vegetable oils with the lowest saturated fat content and highest Poly-unsaturated fat content. Corn-oil has 4. (C) OTHER RISK FACTORS : (i) (ii) Diabetes : Diabetics have a two fold greater rate of coronary heart disease than do normal people. mono-unsaturated and saturated fats. stroke and sudden death. Risk Factors for CORONARY HEART DISEASE : (A) RISKS ONE CANNOT CONTROL : (i) (ii) (iii) Family History Sex Age (B) RISKS WE CAN CONTROL : (i) (ii) Smoking : Smoking one pack a day doubles the risk of heart attack. Obseity : Obseity is associated with higher rates of angina pectoris. None contains only one type of fat. These risks are additive.4 : 1. High Blood Pressure : Both High B. So it is one of the most heart-risky fat known.e. The presence of two risk factors quadruples the risk. especially by people trying to maintain their desirable weight. All oils have equal calories : All the oils are really mixtures of poly un-saturated.6 : 1 and Soyabean (4 : 1). On hydrogenation these poly-unsaturated oils are converted chemically to saturated oils and lose their some (or all) heart-healthy properties.02 : 1 and 106 sat-fat calories per tablespoon.P. Sunflower oil has a P/S ratio 6. All are high in calories and should be avoided as much as possible. riskfactors for heart-disease are 3 times more common in obese people. Smoking more than one pack a day triples the risk. Safflower oil has a P/S ratio of 8. (Hypertension) and high blood cholesterol are silent killers. all the fats contain the same number of calories i.
cooked(c) liver (i) Chicken simmered (ii) Beef cooked (d) Scallops. weight-loss (if obese). restriction of alcohol consumption. Table : Cholesterol Contents of Selected Foods : (COMPILED FROM U.10 1 oz 1 oz 1 oz 1 oz 1 oz 1 oz 18-25 200 180 126 15 43 Qty. LITERATURE) Dairy Products 1. chicken. Egg yolk 4. Cheese (i) (natural & processed) (ii) low-fat 3.A.(iii) (iv) Lack of Physical Exercise. Fish & Poultry (a) cooked pork. Plant Products Fruits Grains Vegetables . Butter 2. fish (b) Kidney. reduced intake of sweets and saturated fats.S. turkey. High Blood Triglycerides : These levels can be reduced by physical activity. Milk Whole 20% Skim 5. beef. cooked(Shell fish) (e) Shrimp cooked 7. Meat. 1 cup 1 large 16-35 10 274 1 cup 1 cup 1 cup 8 oz 8 oz 33 18 5 10-14 0-1 0 0 0 . 1 pat Cholesterol (mg) 11 1 oz. Curds low-fat non-fat 6.
11 - .Vegetable oils 0 ♠♠♠♠♠♠♠ .
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