Worried about abnormal lipid profile!

Lipid function test is done on a fasting blood sample for identifying various lipid abnormalities and it includes the estimation of total cholesterol, Triglycerides, HDL-cholesterol, LDL-cholesterol. 

The major lipids present in the blood are cholesterol and triglycerides, which are transported in blood after incorporation into lipoproteins like chylomicrons, very low-density-lipoproteins (VLDL), intermediate-density lipoproteins (IDL), low-density lipoproteins (LDL), and high-density lipoproteins (HDL). 

Disorders of lipoprotein metabolism (Dyslipidemia) include primary and secondary conditions that increase circulating lipids.

HDL is considered as good cholesterol as it carries cholesterol to the liver from where it can be removed from the bloodstream before it builds up in the arteries. LDL on the other hand takes the cholesterol directly to the arteries which can cause plaque buildup and atherosclerosis which can eventually lead to heart attacks. Hence, LDL is termed as bad cholesterol.

Hypercholesterolemia (increased total cholesterol in blood), is a cause of cardiac diseases that is highly treatable and, therefore, persons should be actively screened. It is recommended by the National Cholesterol Education Program that a fasting lipid profile should be carried out every 5 years beginning at the age of 20 years.

Preparation needed for Lipid Profile Test:

  1. Sample for lipid analysis requires 12-hour fasting. 
  2. Triglycerides and LDL are affected by recent ingestion of food. Patients should be on a routine diet for 2-3 weeks before analysis.
  3. Lipid analysis should not be performed during acute illness and should be postponed for 3 months after a major illness.
  4. Drugs affecting lipid levels like steroids, oral contraceptives should be avoided. 

Possible underlying causes for Lipid profile abnormalities:

  1. Patients with high serum triglycerides>200 mg/dl have the risk of atherosclerosis, and those with >1000 mg/dl are at increased risk of acute pancreatitis. 
  2. An increase in triglyceride is associated with low HDL. Low HDL-cholesterol is a risk factor for coronary diseases even if the total cholesterol level is normal. 
  3. High LDL-cholesterol is a strong risk factor for atherosclerotic heart disease and is associated with obesity, high carbohydrate food intake, diabetes mellitus, lack of exercise, smoking.
  4. Secondary lipoprotein diseases arise from underlying causes like diabetes mellitus, alcohol abuse, hypothyroidism.

Management of Dyslipidemia:

  1. For patients who are overweight, weight loss can help to reduce triglyceride levels.
  2. Obesity or overweight care involves three essential elements of lifestyle: dietary habits, physical activity, and behavior modification. 
  3. Lifestyle changes are the first thing to tackle to reduce your chance of heart disease.
  4. Patients should receive dietary counseling to reduce the content of saturated fats, artificial trans fats, and cholesterol in the diet.
  5. The primary focus of diet therapy is to reduce overall calorie consumption. This reduction is consistent with a goal of losing 0.5-1kg/week. Examples include:
    • Choose smaller and frequent meals at regular intervals.
    • Eat more fruits and vegetables.
    • Increase intake of dietary fiber.
    • Consume more whole-grain cereals, beans, peas.
    • Select leaner cuts of meat and skimmed dairy & dairy products.
    • Reduce consumption of fried foods and foods with added fats and oils.
    • Drink water instead of sugar-sweetened beverages, reduce sugar and sweets. 
    • Decrease sodium intake.
    • Reduce saturated fat intake which you find in animal products. 
  6. Foods with low-energy-density include soups, fruits, vegetables, oatmeal, and lean meats should be preferred. 
  7. Foods with high-energy-density such as dry foods and high-fat foods such as cheese, egg yolks, potato chips, and red meat have a high-energy-density and should be avoided.
  8. The purpose of a Very Low-Calorie Diet (VLCD) is to have rapid and significant short-term weight loss over a 3 to 6 month period. 
  9. A combination of dietary modification and exercise is the most effective behavioral approach for the treatment of obesity.
  10. Adults should engage in 150 min of moderate-intensity or 75 min of vigorous-intensity aerobic physical activity throughout the week.
  11. Regular aerobic exercise can lower bad cholesterol (LDL) and raise good cholesterol (HDL). Maintain adequate weight for your height.
  12. Have foods with unsaturated fats like nuts, fish, vegetable oil, olive oil, canola, and sunflower oils.
  13. Patients who drink alcohol should be encouraged to decrease or preferably eliminate their intake.

If diet and exercise don’t lower cholesterol levels, then medications or a combination of treatments are prescribed by your physician after ruling out secondary causes.

-Dr. Pendurthy Anoosha

References:

  1. Jameson, Fauci, Kasper, Hauser, Longo, Loscalzo: Harrison’s principle of internal medicine, 20th ed, Ch 400, pg 2889-2902.
  2. Shirish M. Kawthalkar: Essentials of clinical pathology, 7th ed, ch 5, pg 69-74.

WOMEN AND DIABETES -WORLD DIABETES DAY 2017

Globally, 2.1 million women die due to diabetes as opposed to 1.8 million men and diabetes is the ninth leading cause of death among women. Diabetes increases risk of heart disease by six times and reduces life span by 8 years as compared to women without diabetes.

In India, prevalence of the disease is 17.7% among urban middle class women while it is 10% in rural areas. Higher body fat percentage and abnormal lipid profile has been attributed as the major factors responsible for increased prevalence of diabetes among women in the developed and developing countries Continue reading “WOMEN AND DIABETES -WORLD DIABETES DAY 2017”

Impact of uncontrolled diabetes

Impact of unctontrolled diabetes

Diabetes is caused when the blood glucose (blood sugar) level is too high & it affects proper functioning of the body. The blood sugar levels is maintained by insulin which is hormone produced by pancreas.

Type 1 diabetes is caused when body doesn’t produce any insulin at all, while type 2 diabetes is caused when body doesn’t produce sufficient insulin to control your blood sugar.

Diabetes is a progressive diseases and usually worsens with age. The consequences of uncontrolled diabetes can be visible on the entire body & its organs –  heart, foot, skin, kidneys, eyes, sexual organs, nervous system and many more. Continue reading “Impact of uncontrolled diabetes”

Are you a diabetic who is just avoiding sugar?

“I don’t take sugar in my tea but I take 2 marie biscuits / 2 slices of whole wheat bread along with it.” – One of the common statements made by diabetics. 

Just because marie biscuit is supposed to be light or bread does not taste sweet, it does not imply that these foods are  OK. As a dietician, I would rather enjoy my tea with one teaspoon sugar and ditch the bread and biscuit.

Here are some of the harmful effects that these food without sugar may have. Continue reading “Are you a diabetic who is just avoiding sugar?”

10 ways to prevent diabetes

10 ways to prevent diabetes

Diabetes is one of the most common diseases globally. It is a long-term medical condition that develops due to prolonged high levels of sugar in blood. It is typically manifested when body fails to produce insulin at all (type 1 diabetes) or when it doesn’t produce enough insulin for proper functioning (type 2 diabetes). Diabetes is often referred to as a silent killer, and if not kept under check, can cause several adverse health conditions.

Continue reading “10 ways to prevent diabetes”