A common health concern among South Asians is managing one’s Cholesterol. There are so many articles available online and people around us give us so many different (and at times contradictory) opinions about things you can do to lower the bad cholesterol levels and increase the goods cholesterol levels that it can get confusing.

On today’s show I had the pleasure of talking to Dr Milan Shah who is a very experienced GP about cholesterol. He said that cholesterol is very important and everyone needs to know about it because by monitoring cholesterol levels, doctors can understand the risk of a patient having a heart attack, cardiovascular disease or stroke.

Cholesterol is a type of fat which is in the blood. It is produced by our liver and it circulates in our blood. Some cholesterol is actually good for the body said Dr Milan. The bad cholesterol gets attached to some of our arteries and this is caller arteriosclerosis that is where the arteries start to narrow either in the heart or the brain or other parts of the body. When there is narrowing it can cause symptoms like pain in the heart. But sometimes the blood sticks to these narrow arteries and forms a clot that’s when you actually get a heart attack, and for this reason the blood is thinned at times.

The cholesterol is usually measured by a simple blood test. A cholesterol level by itself is not so useful until a ratio if the good and bad cholesterol is considered according to Dr Milan. He said that at charity events or some other places a spot test is done to check the cholesterol levels, but he recommends getting a proper blood test done to actually get an idea about the overall cholesterol and the ratio of good and bad cholesterol. There is no reason to fast before going for a cholesterol test. He said that normally the ratio should be between 4 and 4.5 and the total cholesterol should generally be 5 or below. Some people panic when they find that their cholesterol is at 7. But when checking the ratio it may turn out to be only 3 because of equally high levels of good cholesterol. He said that the good cholesterol has an effect in dissolving the built up in the arteries.

Dr Milan believes that cholesterol is important but a part of the bigger picture. When a patient comes to him he would also check the blood pressure, find out about any family history and then do a blood test. He would then put the results in a risk calculator, giving him the risk of a person developing an ailment. This helps greatly in providing the right treatment. He also said that while cholesterol levels are very important to keep in check one must not ignore other health aspects because of it.

Depending on the risk of being moderate, low or high, treatment is given. There are some things that one can do to reduce cholesterol levels when there is not the immediate need to start medication. Dr Milan said that the evidence at the moment on exercise and cholesterol levels is controversial. There are some studies that show doing rigorous exercises has some effect on the HDL or LDL levels and other studies haven’t shown that. He said that he is not sure about the effect that exercise has on cholesterol but it is very good for overall health and other risk factors for heart disease.

But when the risk level is high then Statins are given as medication to reduce the level. Dr Milan said that this a long term treatment plan, if you take the medicines for a few months and then get a blood test done to check the cholesterol levels it will have reduced but research shows that a 5 year treatment plan is necessary and that would make a real difference.

He also spoke about healthy eating habits, saying that it’s necessary to not have a heavy meal for dinner, he suggests not to eat much after 6 or 7 in the evening as the body cannot burn that off and it starts the process to turn into fat. The main meal of the day should be breakfast and lunch.

Talking about losing weight and also about how people focus more on the calorie intake he said that fat is not very high calorie, it is the sugar that increases the calories in any food. Our body is not designed for intake of refined sugars which go into our blood stream, the body does not know what to do with it, so it secretes some insulin and the sugars are converted into fat. People feel that any product that says ‘’fat free’’ is healthy but that is not the case according to Dr Milan. He said that these foods are full of refined sugar and are not healthy. Many processed foods including breakfast cereals are full of refined sugars according to him.

The trans fats or hydrogenated fats where the fats are taken, the chemical content is completely changed and then it is put back into certain foods mostly junk foods or fast food, are the main fats to avoid and also the very deep saturated fats like hard cheese or full fat milk are not so good. Speaking about Ghee which dominates south Asian food he said that there are lots of Ayurvedic theories which say that ghee being a refined fat actually has beneficial properties but he is not fully convinced one way or the other about it and believes that if one can cut out sugars and hydrogenated fats it would be ideal.

Talking about the different kinds of oils he says sunflower, vegetable or olive oil is supposed to be the healthiest according to all the readings that he has read about them. The fats which at room temperature are in the liquid state, are supposed to be better rather than the ones that are solid like butter.

Talking about the symptoms that would prompt someone to go and get the cholesterol levels checked he said that people might not have any symptoms at all. He said that everyone needs to consider the following factors

  • Does anyone in the family have a history of cholesterol?
  • Are you the type of person who has very less physical activity?
  • Not exercising enough?

Generally if someone is living an unhealthy lifestyle they need to get their levels checked. At a young age it won’t make that much of a difference but when people reach their 30s or early 40s they need to really work out the risk.

Dr Milan gave the following tips to help reduce cholesterol levels:

Don’t get too fixated on the cholesterol numbers, and control

  • Healthy diet –low fried food more fruits and vegetables
  • Sugar and salt intake
  • Blood pressure
  • Exercise
  • Avoid smoking and alcohol

After talking to Dr Milan and learning about cholesterol I feel it is necessary to make changes to one’s lifestyle and eating habits from a young age because as he rightly said avoiding the food that you love to eat is easier said than done.