What is Cholesterol?

Cholesterol is a waxy, fat-like substance that your body needs to build healthy cells, but too much cholesterol can be harmful. There are two main types of cholesterol in your blood:

1. Low-Density Lipoprotein (LDL):

Commonly known as “bad” cholesterol, high levels of LDL cholesterol can lead to the build-up of plaque in your arteries.

1. High-Density Lipoprotein (HDL): Often referred to as “good” cholesterol, HDL helps remove LDL cholesterol from your arteries.  

LDL stands for “Low-Density Lipoprotein,” which is a type of lipoprotein in the bloodstream. It is often referred to as “bad” cholesterol. LDL cholesterol is a critical component of your overall cholesterol profile and is associated with an increased risk of cardiovascular diseases, such as heart disease and stroke.

Here are key points to understand about LDL cholesterol:

1. Cholesterol Transport: LDL particles transport cholesterol from the liver to cells throughout the body. Cholesterol is necessary for various bodily functions, such as cell membrane structure and hormone production.
2. Cholesterol Build-up: However, when there is an excess of LDL cholesterol in the bloodstream, it can lead to the build-up of cholesterol in the walls of arteries. This can result in the formation of plaques, which narrow and harden the arteries, a condition known as atherosclerosis.
3. Risk Factors: High levels of LDL cholesterol are a significant risk factor for cardiovascular diseases. The higher the LDL cholesterol levels, the greater the risk of heart disease.
4. Optimal Levels: Optimal levels of LDL cholesterol can vary depending on individual risk factors. Generally, lower levels are better, but healthcare providers assess your overall cardiovascular risk to determine target LDL levels.
5. Monitoring and Management: Monitoring your LDL cholesterol levels through blood tests is essential. Lifestyle modifications such as a heart-healthy diet, regular physical activity, and smoking cessation can help lower LDL cholesterol. In some cases, medications, such as statins, may be prescribed to reduce LDL cholesterol levels.
6. HDL Cholesterol: It’s also important to consider HDL (High-Density Lipoprotein) cholesterol, often referred to as “good” cholesterol. HDL cholesterol helps remove LDL cholesterol from the bloodstream and transport it to the liver for excretion. Higher levels of HDL are associated with a lower risk of heart disease.

Here is why I call HDL cholesterol a “Hero”:

 High-Density Lipoprotein (HDL) is a type of lipoprotein, which is a complex of lipids (fats) and proteins that transport cholesterol and triglycerides in the bloodstream. HDL is often referred to as “good cholesterol” because of its beneficial role in cardiovascular health.

1. Cholesterol Transport:

HDL is involved in the transport of cholesterol from the tissues and arteries back to the liver. This process is known as reverse cholesterol transport. Essentially, HDL helps remove excess cholesterol from cells and tissues, including the walls of blood vessels.

2. Anti-Atherogenic Properties:

Atherosclerosis is a condition where cholesterol and other substances build up on the walls of arteries, forming plaques. HDL has anti-atherogenic properties, meaning it helps prevent the formation of these plaques by removing excess cholesterol from arterial walls.

3. Anti-Inflammatory and Antioxidant Effects:

HDL has anti-inflammatory and antioxidant properties, which contribute to its protective effects on the cardiovascular system. Inflammation and oxidative stress are factors that can contribute to the development of atherosclerosis, and HDL helps mitigate these processes.

4. Cardioprotective Effects:

Higher levels of HDL in the blood are generally associated with a lower risk of cardiovascular diseases. It is thought that the ability of HDL to promote the removal of cholesterol and its anti-inflammatory effects contribute to its cardioprotective role.

Health professionals often consider the ratio of HDL cholesterol to total cholesterol as an important indicator of cardiovascular health. A higher ratio is generally associated with a lower risk of heart disease.

Maintaining a healthy lifestyle, including regular exercise, a balanced diet, and avoiding smoking, can contribute to higher levels of HDL cholesterol. Conversely, factors like a sedentary lifestyle, poor diet, and smoking can lead to lower levels of HDL.

It’s important to note that while HDL is often referred to as “good cholesterol,” it’s just one part of the overall lipid profile, and a balance between different types of cholesterol is crucial for optimal health.

Let’s know about triglycerides— a type of fat (lipid) found in our blood.

They are essential for your health as they store excess energy from your diet. When you eat, your body converts the calories it doesn’t need right away into triglycerides, which are stored in your fat cells. Later, when your body needs energy, hormones release triglycerides for energy.

Here are some key points about triglycerides:

1. Dietary Source: Most of the triglycerides in your body come from the food you eat, particularly from fats in your diet. Foods high in saturated fats, trans-fats, and added sugars can lead to increased triglyceride levels.
2. Energy Storage: Excess calories from your diet are converted into triglycerides and stored in fat cells. When you need energy, hormones release these stored triglycerides.
3. Blood Lipid Profile: Triglycerides are a component of your blood lipid profile, along with cholesterol. This profile is assessed to evaluate your risk of heart disease.
4. High Triglycerides: Elevated triglyceride levels, often referred to as hypertriglyceridemia, can be caused by various factors, including a high-sugar and high-fat diet, obesity, physical inactivity, smoking, and excessive alcohol consumption.
5. Health Implications: High triglycerides are associated with an increased risk of heart disease and stroke. They can also contribute to other health problems, including pancreatitis (inflammation of the pancreas).
6. Management: Lifestyle changes can help lower triglyceride levels. These changes include eating a heart-healthy diet, losing excess weight, engaging in regular physical activity, limiting alcohol consumption, and quitting smoking. Medications may be prescribed in cases of severe hypertriglyceridemia.

Consequences of high cholesterol:

High cholesterol levels can lead to several health problems, including:

1. Atherosclerosis (pronounced as A-thero-sclero-sis): Elevated LDL cholesterol can lead to the accumulation of plaque in your arteries, making them narrow and less flexible. This condition is called atherosclerosis, which can increase the risk of heart disease and stroke.
2. Heart Disease: Atherosclerosis can lead to coronary artery disease, increasing the risk of heart attacks and chest pain (which doctors call angina).
3. Stroke: Blocked blood vessels due to cholesterol build-up can lead to strokes.

Managing High Cholesterol:

The good news is that high cholesterol can often be effectively managed through lifestyle changes and, if necessary, medication. Here are some key steps to manage high cholesterol:

1. Healthy Diet:
   • Choose a diet rich in fruits, vegetables, whole grains, and lean protein sources.
   • Limit saturated fats found in red meat and full-fat dairy products.
   • Avoid trans fats found in many processed and fried foods.
   • Incorporate foods rich in soluble fibre like oats and legumes.

For a healthy diet, we need to understand that certain foods have higher cholesterol content or may contain ingredients contributing to elevated cholesterol levels. Adopting a heart-healthy eating pattern consistently can be beneficial in reducing cholesterol. This includes:

1. 1. Incorporating abundant vegetables, fruits, and whole grains.
   2. Diversifying protein sources with an emphasis on healthy options like fish, seafood, legumes (such as beans and lentils), nuts, and seeds. While eggs and lean poultry can be included in moderation, if opting for red meat, choose lean cuts and limit consumption to 1-3 times per week.
   3. Choosing unflavoured milk, yogurt, and cheese, with a preference for reduced-fat options for those with elevated blood cholesterol.
   4. Making mindful choices regarding fats by including healthy options like nuts, seeds, avocados, olives, and their oils for cooking.
   5. Enhancing flavour with herbs and spices instead of relying on salt.
   6. Consuming foods containing plant sterols, natural cholesterol-like substances found in small amounts in fruits, vegetables, nuts, and cereals, which can aid in lowering high cholesterol levels
      

      We should choose to have a rich intake of vegetables, fruits, and whole grains for optimal heart health. Despite the immense benefits of these foods, many Australians fall short of the recommended consumption levels. Packed with essential vitamins, minerals, fibre, and antioxidants, vegetables and fruits have proven efficacy in preventing heart disease.

      Fruit and vegetables play a crucial role in lowering the risk of heart disease, stroke, type 2 diabetes, and certain cancers.

      – They aid in managing cholesterol levels and weight.

      – Unfortunately, less than 10 percent of Australians meet the recommended intake of these vital foods.

      – Strive to include fruit or vegetables in every meal, emphasizing variety.

      Serving Recommendations:

      – We need to aim for at least five servings of vegetables and two servings of fruit daily for optimal heart health.

      – Adjustments may be necessary for children, pregnant or breastfeeding women.

      What Constitutes a Serving?

      – Fruit: Examples include a medium apple, banana, orange, or pear, or 1 cup of diced/canned fruit (no syrup).

      – Vegetables: Half a cup of cooked vegetables or one cup of raw or salad vegetables are ideal servings.

      Practical Tips to Increase Intake:

      – Fresh, frozen, canned, and dried options; all contribute to a healthy diet.

      – Planning main meals around vegetables and considering legume substitutes for meat in recipes is healthier option.

      – We can prepare and cut fruits and vegetables in advance for convenience.

      – Enhance sandwiches with added vegetables, turning a meal into a wholesome delight.

      – Opt for seasonal produce for freshness and cost-effectiveness.

      – Make it a habit to fill half your plate with a variety of coloured vegetables.

      – Sprinkle fruit on breakfast, add them to cereal or porridge for flavour and nutrition.

      – Choose vegetable-based options when dining out and consider ordering sides for additional greens.

      – Rethink snacks by opting for fresh or frozen berries and unflavoured yogurt.

      – Incorporate vegetables into pasta dishes, soups, and casseroles for added nutrition.

      – Experiment with creative ways to prepare and present vegetables and fruits to make healthy eating enjoyable.

      Incorporating a diverse range of fruits and vegetables into daily meals not only adds colour and variety but also ensures a well-rounded intake of fibre, vitamins, and minerals. By adopting these practices, achieving a heart-healthy diet can become second nature, promoting overall well-being.

      Diving deeper into the realm of heart-healthy eating, let’s explore the significance of incorporating whole grains into your diet:

      – Wholegrains encompass foods utilizing the entire grain, such as wholegrain bread, wholemeal pasta, and oats.

      – Consumption of wholegrains contributes to a reduced risk of heart disease.

      – The fiber content in wholegrains aids in cholesterol reduction and regulation.

      – Opting for wholegrain foods over refined grains enhances heart health.

      Exploration of Wholegrains:

      Understanding what constitutes wholegrains amidst the myriad options for bread, cereal, and pasta is crucial. The information on packaging can be perplexing, making it essential to delve into the world of wholegrains for informed choices.

      Types of Grains:

      The term ‘grains’ encompasses a variety, including wheat, corn (maize), rice, barley, oats, rye, millet, quinoa, and teff. These grains can be consumed whole or transformed into products like couscous, porridge, and polenta. Bread, breakfast cereals, pasta, and noodles are derived from these grains. The distinction between ‘wholegrain’ and ‘refined grain’ lies in the degree of processing, with wholegrains preserving the bran, germ, and endosperm.

      Defining Wholegrains:

      Wholegrains encompass foods that retain all three parts of the grain—bran, germ, and endosperm. Less processing results in higher fibre, vitamins, and minerals in wholegrain foods compared to other grain products. Examples include brown rice, wholemeal flour, oats, wholegrain bread, popcorn, and buckwheat. In contrast, refined grains undergo more processing, with some parts removed, resulting in lower fibre, vitamin, and mineral content. Examples of refined grains include white rice, white bread, pasta, processed breakfast cereals, and white flour.

      Health Benefits of Wholegrains:

      Making the switch from refined grains to wholegrains can positively impact heart health. The fiber in wholegrain foods aids in reducing LDL cholesterol (often termed as bad cholesterol), thereby lowering the risk of heart disease. Additionally, the fiber contributes to a prolonged feeling of fullness, aiding in weight management.

      Simple Wholegrain Food Swaps:

      Incorporating more wholegrains into your diet can be a straightforward endeavor. Consider these delectably simple swaps in your meals to enhance heart health.

      By embracing the knowledge of wholegrains, you can make informed choices that not only contribute to heart health but also enrich your overall well-being.

      Should I adopt a low-carb diet?

      Diets that limit carbohydrate intake have been in existence for a considerable period. Typically, these diets restrict specific food groups based on their carbohydrate content. Examples include items like cookies, pastries, bread, pasta, and some may even limit the consumption of fruits, dairy, and whole grains. Current evidence suggests that reducing carbohydrate intake may benefit certain individuals in improving their health. However, when it comes to heart health, the focus should not solely be on reducing carbohydrates but rather on choosing the right carbohydrate-containing foods.

      Lowering the intake of less healthy foods, such as cakes, biscuits, pastries, and fried items like potato chips, not only reduces carbohydrate intake but also lowers salt, added sugar, and saturated and trans-fat consumption. This, in turn, is advantageous for heart health.

      Incorporating foods like whole grains, vegetables, fruits, and dairy products, all of which contain carbohydrates, consistently correlates with good heart health. Evidence indicates that these foods can contribute to reducing cholesterol levels and lowering the risk of high blood pressure. Thus, these are foods to include rather than avoid in a heart-healthy eating pattern.

      It’s important to recognize that a food’s impact on health goes beyond its carbohydrate content. For insights into incorporating the healthiest carbohydrate foods into your diet, consider reading our article “Swap it, don’t stop it.”

      Implementing small changes can have a significant impact on heart health. Start by swapping refined grains for their whole-grain alternatives, such as brown rice, wholemeal pasta, grainy bread, and oats, which are rich in fiber and can help lower cholesterol.

      Additionally, including a variety of healthy protein-rich foods is crucial. Opt for plant-based proteins like beans, chickpeas, lentils, nuts, and seeds, as well as fish and seafood, which have been shown to reduce the risk of heart disease. Eggs and poultry are also protein-rich options that can be part of a heart-healthy eating pattern. However, it’s advisable to limit red meat intake to 1-3 meals per week, as research indicates an association with an increased risk of heart disease.

      Protein, a macronutrient composed of amino acids, plays a vital role in repairing and building bones and muscles, serving as a source of energy, and contributing to heart health. Consuming healthy proteins from various sources, both plant and animal, as part of a balanced diet can help lower the risk of heart disease.

      When choosing protein foods, consider a diverse range of sources, as each can have different effects on heart health. Legumes, plant-based protein sources, not only provide protein but also contain soluble fiber and micronutrients, contributing to lower total cholesterol levels and reducing the risk of heart disease.

      Legumes, also referred to as pulses, serve as plant-based protein sources and are rich in soluble fiber, micronutrients, and possess a low glycemic index (GI). The inclusion of legumes, especially those high in soluble fiber, in your diet can contribute to reducing total cholesterol levels, thereby lowering the risk of heart disease. Examples of legumes include various types of beans, chickpeas, lentils, split peas, and soybeans.

      To incorporate more legumes into your diet, consider their diverse forms such as dried (uncooked), tinned, frozen, or ground into flour. When opting for tinned legumes, choose varieties with no added salt or reduced salt. Here are some suggestions for including more legumes in your meals:

      – Add legumes to soups and salads.

      – Enjoy roasted chickpeas as a convenient on-the-go snack.

      – Serve hummus with vegetable sticks as a wholesome snack.

      – Substitute lentils or chickpeas for mince in homemade burger patties.

      Nuts and seeds, being plant-based foods, provide a robust nutritional profile, including protein, fiber, healthy fats, and essential micronutrients, all of which contribute positively to heart health. The following are examples of nuts and seeds:

      Nuts:

      – Almonds

      – Brazil nuts

      – Cashews

      – Hazelnuts

      – Macadamias

      – Peanuts

      – Pecans

      – Pine nuts

      – Walnuts

      Seeds:

      – Chia seeds

      – Flaxseeds/linseeds

      – Poppy seeds

      – Pumpkin seeds

      – Sesame seeds

      – Sunflower seeds

      To integrate nuts and seeds into a heart-healthy eating pattern, consider the following:

      – Add nuts and seeds to stir fries or pasta dishes; for instance, cashews, peanuts, and sesame seeds work well in stir fries, while pine nuts and walnuts complement pasta dishes.

      – Include lightly toasted almonds, walnuts, or sunflower seeds in salads for an added crunch and flavor.

      – Sprinkle chopped nuts or seeds on porridge, cereal, or yogurt.

      – Enjoy a handful of plain, unsalted nuts or peanut butter on wholegrain toast as a nutritious snack.

      Fish and seafood serve as excellent sources of protein and omega-3 fatty acids, which can potentially decrease the risk of heart attacks and heart disease-related mortality. Since our bodies do not naturally produce omega-3, it is essential to consume foods containing this beneficial fatty acid, with fish being a top dietary source.

      Notable examples of fish and seafood include whiting, trout, basa, prawns, oysters, scallops, calamari, crab, and mussels. Fish with the highest omega-3 levels, often referred to as ‘oily fish,’ include salmon, tuna, sardines (fresh or tinned), and mackerel (fresh or tinned).

      To incorporate more fish and seafood into your diet, consider frozen or tinned options as convenient and cost-effective alternatives to fresh. When choosing tinned fish, be cautious of salt and other ingredients in flavored varieties, or opt for unflavored alternatives. Some ideas for including fish and seafood in your meals are adding unflavored tinned tuna or salmon to sandwiches or salads, enjoying baked or steamed fish parcels for a simple dinner, incorporating seafood marinara mixes into stir-fries and pasta dishes, and using various herbs and spices for flavor.

      The Heart Foundation recommends including 2-3 servings of fish per week (150-200g per serve) as part of a heart-healthy eating pattern. The suggested serving size is 150-200g of fresh fish, approximately the size of your hand.

      Eggs, being a complete source of protein and rich in essential vitamins and minerals, have a neutral impact on heart health, meaning they neither increase nor decrease the risk of heart disease for most individuals. There is no set limit on the number of eggs one should eat per week, but a maximum of seven eggs is recommended for those with high LDL cholesterol, type 2 diabetes, or existing heart disease. Pairing eggs with balanced, healthy meals or snacks, such as eggs and avocado on wholegrain toast or combining eggs with vegetables, is encouraged.

      Poultry, including chicken, turkey, duck, and other birds, is a good source of protein, niacin,      vitamin-A, magnesium, and zinc. Poultry consumption has no known impact on heart disease, and while there is no specified maximum limit, it is not directly beneficial to heart health. Tips for healthier poultry consumption include removing the skin and choosing lean cuts like chicken or turkey breasts.

      Red meat, comprising beef, veal, pork, lamb, mutton, kangaroo, rabbit, and other game meats, is a common animal-based protein source providing iron, zinc, and vitamin B12. However, high red meat consumption has been linked to a moderate increase in the risk of heart disease and stroke, as well as potential weight gain. Limiting red meat intake to 350 grams (or 1-3 meals) of lean meat per week can significantly improve heart health. Opting for lean cuts and removing visible fat before cooking is advisable. The recommended serving size for red meat is 100g, equivalent to the size of your palm, and two small chops constitute a serving

      Unhealthy Proteins: Processed Meat

      Processed and deli meats consistently show associations with adverse health outcomes. These products typically contain elevated levels of salt, additives, and saturated fat, which are correlated with an increased risk of heart disease and other chronic conditions. To prioritize heart health, it is advisable to either avoid or limit the consumption of processed meats.

      Processed meats undergo preservation methods to extend their shelf life, such as curing, salting, smoking, drying, and canning. Examples of processed meat include sausages, ham, salami, beef jerky, and bacon.

      To make healthier choices, consider swapping out processed meats with alternatives:

      – Substitute ham or other processed meats in sandwiches and salads with roast chicken, unflavored tinned tuna, or eggs.

      – Opt for falafels or homemade veggie or meat patties as an alternative to sausages in wraps and burgers.

      When selecting proteins, it’s crucial to recognize that no single food or nutrient exclusively promotes heart health; rather, the overall eating pattern matters most. Choosing healthier protein sources can contribute to minimizing the risk of heart disease.

      Protein and Heart Health

      – Protein-rich foods can impact the risk of heart disease differently.

      – Beneficial sources of protein include legumes (e.g., chickpeas, beans, and lentils), nuts, seeds, fish, and seafood.

      – Eggs and poultry have a neutral impact on the risk of heart disease.

      – Red meat should be limited to less than 350g (1-3 meals) per week.

      – Processed meat consumption can increase the risk of heart disease and should be avoided.

      Protein, a macronutrient composed of amino acids, plays a vital role in repairing and building bones and muscles. It serves as a source of energy and is crucial for heart health. Consuming healthy proteins from both plant and animal sources as part of a balanced diet can help lower the risk of heart disease.

      When choosing protein foods, aim for variety, considering sources from both plant and animal origins. Each protein source can have a beneficial, neutral, or potentially harmful effect on heart health and the risk of heart disease.

      Regarding drinks, water is the preferred choice for heart health. However, if you are looking for alternative beverages for flavour or enjoyment, the following options are heart-healthy:

      – Sparkling water (consider adding chopped fruit or herbs, like fresh mint).

      – Unflavoured milk.

      – Plant-based milks with added calcium, such as soy, almond, oat, or rice milk.

      – Tea.

      – Coffee.

      – A small glass (125ml) of 100% fruit or vegetable juice.

      It is not recommended to consume sugary drinks, and the consumption of alcohol is not advised for heart health. For more information on the best and worst drinks for heart health, additional resources are available.

      Avoiding overeating is crucial for heart health. The ideal portion size depends on various factors, including the type of food served. Using a plate with balanced proportions from different food groups, such as 1/2 vegetables, 1/4 carbohydrates, and 1/4 protein, along with healthy oils, herbs, and spices, can help guide portion control.

      For individuals with heart disease or risk factors like high blood pressure or high blood cholesterol, the Heart Foundation recommends specific changes to their eating pattern:

      – Choose reduced-fat and unflavoured milk, yogurt, and cheese.

      – Limit egg consumption to less than seven eggs per week.

      – Include 2-3 grams of plant sterols daily from fortified food products (special varieties of margarine, milk, yogurt, and breakfast cereals) to help lower LDL cholesterol levels.

      – If consuming red meat (such as beef, pork, veal, and lamb), opt for lean cuts and limit intake to no more than 350g per week.

      Making these dietary adjustments can aid in recovery and reduce the risk of further heart problems. A balanced heart-healthy diet has been shown to decrease the risk of cardiovascular disease (CVD) events and mortality, as well as manage CVD risk factors like high blood pressure and high cholesterol.

      Let’s learn about different types of oils and how can they impact on cholesterol levels in various ways.

      1. Olive Oil:

      Effect on Cholesterol: Olive oil, especially extra virgin olive oil, is a heart-healthy choice. Packed with monounsaturated fats, it’s known to boost high-density lipoprotein (HDL or “good” cholesterol) and decrease low-density lipoprotein (LDL or “bad” cholesterol).

      2. Canola Oil:

      Effect on Cholesterol: Canola oil is a smart choice, being low in saturated fat and rich in monounsaturated fat. It effectively lowers LDL cholesterol without compromising HDL cholesterol levels.

      3. Coconut Oil:

      Effect on Cholesterol: Coconut oil, high in saturated fat, has been linked to increased LDL cholesterol levels. It’s recommended to use coconut oil sparingly, especially for individuals concerned about cholesterol.

      4. Avocado Oil:

      Effect on Cholesterol: Similar to olive oil, avocado oil is a rich source of monounsaturated fats, potentially promoting positive effects on cholesterol levels.

      5. Soybean Oil:

      Effect on Cholesterol: Soybean oil, low in saturated fat and high in polyunsaturated fats, is effective in reducing LDL cholesterol levels.

      6. Sunflower Oil:

      Effect on Cholesterol: Sunflower oil, rich in polyunsaturated fats, contributes to a heart-healthy diet when used in moderation.

      7. Corn Oil:

      Effect on Cholesterol: Corn oil, high in polyunsaturated fats, may help lower LDL cholesterol levels.

      8. Fish Oil:

      Effect on Cholesterol: Fish oil, abundant in omega-3 fatty acids, is renowned for its cardiovascular benefits. It enhances HDL cholesterol and lowers triglycerides.

      9. Flaxseed Oil:

      Effect on Cholesterol: Flaxseed oil, a source of omega-3 fatty acids, supports heart health by reducing LDL cholesterol and triglycerides.

      While oils play a role in managing cholesterol, it’s crucial to consider overall dietary patterns, including various fats and other dietary components. Individual responses to dietary fats can vary, emphasizing the importance of consulting with healthcare professionals or registered dietitians for personalized dietary guidance based on individual health needs and goals. Remember, a well-rounded approach to diet contributes significantly to heart health.

      1. Regular Exercise:
         • Engage in regular physical activity, such as brisk walking, swimming, or cycling, for at least 150 minutes per week.
      • Engaging in physical activity can elevate levels of HDL, also known as ‘good’ cholesterol, and reduce triglycerides. Both aerobic or cardio exercise and resistance training play key roles in managing cholesterol levels.
      • Begin with attainable, small goals and gradually progress towards the suggested 30-60 minutes of moderate-intensity physical activity (such as brisk walking) on most days of the week.
      • Incorporate muscle-toning activities twice a week, which may involve bodyweight exercises like push-ups and squats, or tasks that include lifting, such as carrying groceries.

      Sitting is called as “the new smoking”. Let’s learn how we can sit less and move more:

      We need to limit our screen time on social media, television, and phone – there are applications like Off time and Moment that can assist us with this. When watching television, we would utilize commercial breaks to take short walks around the house or engage in some household chores. We would swap evening TV sessions with a leisurely walk. We can experiment with standing while reading a newspaper or checking mobile messages. Regular breaks every 30 minutes to stand and stretch can be very helpful; we can even consider setting an alarm on our phone or watch for reminders. Standing while performing simple tasks at work, such as during a stand-up meeting or a phone call. Where possible, we can have a sit-stand workstation. We can swap for manual tasks whenever possible like handwashing our car instead of using a drive-through car wash.

      As we know that people who minimize their sedentary behaviour throughout the day experience a reduced likelihood of premature death, particularly from specific causes. Much of the existing research has focused on the impact of watching television on health, given its prevalence as the most common leisure activity among adults. Those who watch less than two hours of television daily are less prone to type 2 diabetes and obesity, displaying overall lower health risks.

      It’s noteworthy that adults engaged in regular planned exercise, such as gym workouts or running, can still accumulate prolonged sitting periods daily. While individuals meeting the Australian Government’s physical activity guidelines are classified as “physically active” by engaging in at least 30 minutes of moderate-intensity physical activity on most, if not all, days of the week, recent evidence suggests that additional health benefits may be gained by reducing overall sitting time. Irrespective of one’s total television viewing, prolonged sitting has been associated with an elevated risk of health issues, including cardiovascular disease (CVD).

      Conversely, minimizing sitting time and incorporating regular interruptions, even as simple as standing up, has been linked to a reduction in risk factors for coronary heart disease and diabetes. Thus, the emphasis is not only on meeting physical activity recommendations but also on mitigating sedentary behaviour to enhance overall health outcomes.

      1. Medications:
         • In some cases, your doctor might choose to prescribe cholesterol-lowering medications, such as statins, if lifestyle changes are not sufficient.
      2. Quit Smoking:
         • Quitting can improve our cholesterol levels and overall cardiovascular health. I have discussed the benefits of quitting smoking in a separate section under smoking.
      3. Regular Check-ups:
         • Monitor your cholesterol levels regularly as advised by your healthcare provider.

      In summary, high cholesterol is a manageable condition, and you can take control of your health by making lifestyle changes and following your healthcare provider’s guidance. It’s essential to understand your cholesterol levels and work towards maintaining a healthy balance. By doing so, you can reduce your risk of heart disease, stroke, and other cholesterol-related health issues, ultimately leading to a healthier and longer life.

      Medical guidelines can change over time, and it’s essential to refer to the most current and reputable sources for up-to-date information on managing high cholesterol.

      The treatment of high cholesterol primarily involves lifestyle modifications and, if necessary, the use of cholesterol-lowering medications. Cholesterol management aims to reduce the levels of low-density lipoprotein (LDL) cholesterol, often referred to as “bad” cholesterol, and minimize the risk of cardiovascular diseases. Please note that treatment guidelines and options may have evolved since then, so it’s essential to consult your healthcare provider for the most current recommendations.