High cholesterol for youngster - Easy way to save yourself from that

What is cholesterol ?

Cholesterol is a fat-like substance found in all cells of the body. Your body needs some cholesterol to make hormones, vitamin D, and substances that help you digest foods. Your body makes all the cholesterol it needs. Cholesterol also is found in some of the foods you eat.

Risk associated with cholesterol

1. High blood cholesterol will make a chance of getting coronary heart disease/coronary artery disease.

2. High Cholesterol Causes Heart Attack.

3. High Cholesterol Causes Stroke.

4. Can cause Chest pain as arteries that supply your heart with blood (coronary arteries) are affected.

What can cause high cholesterol?

1. Poor diet. Consuming saturated fat, found in animal products, and trans fats, found in some commercially baked cookies and crackers

2. Obesity. Having a body mass index (BMI) of 30 or greater puts you at risk of high cholesterol.

3. Lack of exercise. Exercise boost your body's HDL, or "good" cholesterol while increasing the size of the particles that make up your LDL, or "bad," cholesterol, which makes it less harmful.

4. Smoking. Cigarette smoking damages the walls of your blood vessels, making them likely to accumulate fatty deposits.

5. Diabetes. High blood sugar contributes to higher LDL cholesterol and lower HDL cholesterol.

How to control cholesterol

1. STOP eating foods full of saturated fats, trans fats, and dietary cholesterol.

Saturated fat foods include  butter, red meat, full-fat and low-fat dairy products, palm oil, and coconut oil.

Start using Omega-3-rich fish, such as salmon, sardines, herring, mackerel, and trout. select very-low-sodium or no-salt-added canned fish if using tin fish. Clams, oysters, mussels, scallops also good.

2. Eat a lot more fiber-rich foods

This include oats, oat bran, barley, peas, yams, sweet potatoes , legumes or beans, such as pinto beans, black beans, garbanzo beans, and peas.Vegetables such as carrots, Brussels sprouts, beets, okra, and eggplant. Fruit such as berries, passion fruit, oranges, pears, apricots, nectarines, and apples also good.

3. Walk daily 30 minutes

4. Take plant sterol supplements

Note: High cholesterol typically doesn't cause any symptoms. A blood test is the only way to know if your cholesterol is too high. So it is always advisable to have a blood test every 6 months

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Difficulty in emptying the bowels? Use Olive oil for constipation - Home remedies

Constipation is caused by many reason. The first and the foremost reason would be lack of regular exercise,less water consumption by individual or by low-fiber diet. When the bowel is present in our intestine for longtime, the colon will start absorbing the water from present in it which makes the bowel movement difficult.Why olive oil is considered a healthy fat as it contains monounsaturated fats which will improve cardiovascular health. With the consumption of olive oil makes the gallbladder to release more bile, which helps to digest the fat in the food fast and easily. Bile also maintains the moisture of the stool, which will free the difficulty and pain during bowel movement. Some key points to note are olive oil strengthens the mucus lining of the colon. It stimulates the muscle contraction of large intestine to make it easy for the stools to pass. Olive oil is rich in vitamin E and K, antioxidants, omega 3 and 6 fatty acids which help to boost the health of digestive tract.

How to use Olive oil

• Consume 1 tablespoon of olive oil on an empty stomach in the morning and the same before going to bed as well for a week.

or 

• Warm milk with olive oil helps to loosen the hard stools.

or 

• Olive oil can be added to your morning coffee which acts as a laxative.

or

• Add olive oil in any vegetables or fruits juice that are rich in fiber. 

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• Drink 1 tablespoon olive oil with 1 teaspoon lemon juice and drink before going to bed.

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• Drink 1 tablespoon of olive oil to a cup of yogurt and drink 2-3 times a day.

Side effects of using olive oil

1. Olive oil contains a lot of calories (120 calories in 1 tablespoon), there is a chance to put weight if used for longtime.
2. Over doses of olive oil can lead to diarrhea.
3. Regular usage of olive oil can decrease your sugar levels,People with diabetes should speak to their doctor before trying.
4. Never use olive oil for constipation in babies or newborns.

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Management of irritable bowel syndrome

IBS (Irritable bowel syndrome) is characterized by recurrent abdominal pain and alteration in bowel habits. After the diagnosis is made most important step is reassurance of the patient, because many patient will have a fear of colonic malignancy because of this symptom. In mild cases there is only symptoms at the time of stress, these people need not be treated. Those with severe  symptoms should receive treatment. All the symptoms will not be controlled with medication.

1. Patient counselling - This is done to reasssure the patient./

2. Lifestyle Changes - Since stress is part of normal life, in this modern era try to avoid stress as possible, you should spend time to relax, enjoy the life. Adequate sleep at night and regular exercise are also helpful. Patient should avoid tobacco, excessive use of caffeine and alcohol.

3. Diet  - Certain dietary recommendations are advised in people with IBS. Small frequent meals will help to reduce the symptoms. Food with low fat and high carbohydrate such as rice, cereals, vegetables and food with low fat and high protein (fish, skimmed milk and low fat cheese) may be advised. In patient with loosestools, fruits, fruit juices and dairy products are NOT advised. 

        

Certain patients have aggravation of symptoms after taking coffee, legumes, cabbage, disaccharide. Such patients should avoid these things. Excessive fructose and artificial sweeteners (sorbitol, mannitol) may produce loose stool, abdominal cramp and flatulence(feeling of fullness in abdomen) . Four week of very low carbohydrate  that is20 grams per day reduce symptoms in many patients.   

Medication used in the treatment of IBS.

1. Stool-Bulking Agents.

High fiber diet ,bulking agents such as hydrophyllic colloid help in relieving symptoms. It will increase the stool weight, decrease in colonic transit time ,improve constipation. It is also useful in diarrhea prone patients.

2. Agents to reduce abdominal pain(Antispasmodics).

These are given to reduce the abdominal pain. Majority experience pain shortly after food intake. So these drugs are given 30 minutes before food intake. Anticholinergic such as dicyclomine is beneficial.

3. Agents that reduce diarrhea(loose stools).

Antidiarrheal agents used to treat are loperamide, opiate, cholestyramine. Agents such as loperamide is useful especially in stressful situation.

4. Antidepressant Drugs.

Effect of anti depressant in IBS is independent of its antidepressant action. Abdominal pain also improves with anti depressants. Tricyclic anti depressants are used. Examples are desipramine, SSRI (Selective serotonin reuptake inhibitor) are also useful. mainly in IBS C patients.

5. Agent that reduce the flatulence

Patients are advised to eat slowly, avoid chewing gum and carbonated drinks. Antibiotics and pancreatic enzyme may be tried.

6. Modulation of Gut Flora.  

Antibiotic is used to treat a subset of people with IBS. The agent used is rifaximin. 

7. Serotonin Receptor Agonist and Antagonists

These agents are also tried in IBS. Chloride Channel Activators Lubiprostone is tried.

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Food sources of vitamin C

All fresh fruit and vegetables  contain Vitamin C. Unfortunately, vitamin c is easily leached out of vegetables if they are placed in water and is also easily destroyed  during cooking or exposure to copper or alkali. So fresh fruit and juices and salads are encouraged. Also advised to cook vegetables lightly and quickly. Vitamin  is lost during storage. About  40% of the U.S. population consumes vitamin C as a dietary supplement in which “natural forms” are no more bio available than synthetic forms.

The recommended  nutrient intake for adults

90 mg/day for males  in the United States - for healthy people.

75 mg/d for females

Following  are the rich sources of vitamin C.

1. Blackcurrants, guavas.

2. Rosehip syrup, green peppers.

3. Oranges, other citrus fruit, strawberries.

4. Cauliflower, broccoli.

5. Sprouts, cabbage, watercress.

6. Potatoes.

7. Liver and milk.

Absorption  of vitamin C

If the dose of vitamin C administered in a single dose is < 100 mg,  complete absorption occurs. At doses more than  1 g less than 50% is absorbed, this is because of increased degradation and fecal and urinary excretion of vitamin C at higher doses. As already mentioned above good dietary sources of vitamin C include citrus fruits, green vegetables (especially broccoli), tomatoes, and potatoes. People get recommended daily allowance by consuming five servings of fruits and vegetables a day. There are several drugs that interfere and cause vitamin C deficiency such as  corticosteroids, aspirin, indomethacin, phenylbutazone, and tetracycline. As the requirement of vitamin C increase during major surgery it is advisable to supplement vitamin C upto 250 mg  a day to cover major surgery. Bottlefed infants are advised to give orange juice. In the elderly scurvy can be avoided by consuming adequate  fruits and vegetables. Careful observation is required  in the elderly people who live alone. Rarely vitamin C supplementation is required.

Vitamin C requirements increase in the following situations.

1. Smoking,

2. Hemodialysis,

3. Pregnancy,

4. Stress

5. Infection

6. Trauma

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Diet for Heart disease - A must read for every one

Coronary artery disease (Heart attack) is  a multi factorial disease. Here the strongest environmental factor is diet. Basic abnormality that lead to coronary artery disease is  is atherosclerosis. Major constituent of atherosclerosis is cholesterol esters,which  are carried by LDL (Law Density Lipoproteins ) in the blood. LDL cholesterol is affected by the type of  dietary fat.
Saturated fatty acid raise the blood cholesterol,while polyunsaturated fatty acid decreases the cholesterol. Cholesterol is found only in  animal food.

Following are the dietary recommendation in patients with coronary artery disease.

• Balanced diet is recommended.
• High fiber content (Complex carbohydrates) - Effect is determined by the type of dietary fiber. Soluble fibers such as pectin, guar and oat fibers can produce moderate reduction of cholesterol. Wheat fibers (wholemeal breads or bran) wont reduce the plasma cholesterol, but those who consume more wheat fibers and whole grain food the incidence of CAD  is decreased.
• Weight reduction to achieve optimal BMI (Body Mass Index) - Overweight, especially abdominal obesity is an independent risk factor for CAD. Weight reduction will reduce the cholesterol.
• More vegetables and fruits - Soya protein if included in the diet help to reduce the total and LDL cholesterol. Vegetables and fruits are law in fat and contain pectin other dietary fibers ,flavanoids and antioxidants. Five servings of different vegetables and fruit per day (400 g/day average weight)  is recommended.
• Avoid excessive caffeine intake - Coffee contains small amounts of diterpenes (lipids), cafestol and kahweol - not caffeine - it raise plasma total and LDL cholesterol. Since the diterpenes are removed  filtered or instant coffee does not raise the cholesterol.
• Avoid junk food.
• Avoid  foods with high fat content especially MUFA, excess salt ,cholesterol.
• Fish oil (omega 3 PUFA), garlic, plant sterols, antioxidants all help in reducing the cholesterol.
• Salt (NaCl)   should be restricted to 6 gram/day for the general population this is more important for CAD  patients.
• Fish  at least twice a week preferably fatty fish is recommended, it should not be fried in saturated fat. EPA (eicosapentanoic acid) help in reducing  CAD.
• Alcohol one or two drinks per day may be beneficial in middle aged people at risk for CAD, because of complications of over intake not recommended in general population.
• The following dietary components reduce the risk of coronary heart disease. Fruits and vegetables, cereal fiber,  PUFA, linolenic  acid, alcohol and fish, nuts, vitamin E, folate.

Glossary

1. BMI - Body mass index
2. CAD - Coronary artery disease
3. LDL - Law density lipoproteins
4. MUFA - Monounsaturated fatty acids, plant-based fats found in avocado, nuts and seeds, oils, olives, and dark chocolate
5. PUFA - Cutting off all vegetable oils except coconut oil, olive oil and palm oil. 

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