WHAT IS CHOLESTEROL?

Cholesterol is found throughout whole body and particularly in brain, nerves, heart, intestines, muscles and the liver.

Cholesterol is used for production of adrenal gland and gonad hormones.

Cholesterol does not freely found in the blood circulation and it is bound to proteins resulting with formation of lipoproteins. There are three types of lipoprotein.

1. Low-density lipoproteins:

They account for 70% of the cholesterol. They are small molecules; they may damage walls of vessels after they penetrate into the walls. They are referred as bad (hazardous) cholesterol.

2. High-density lipoproteins (VLDL cholesterol):

They carry unused cholesterol to the bile ducts. They remove excess cholesterol. They are referred as good (useful) cholesterol.

3. Very low-density lipoproteins:

For cardiovascular health, level of useful cholesterol should exceed 40 mg/dL and level of the bad cholesterol should be below 100 mg/dL.

Several substances such as smooth muscle cell and calcium deposit on vessel walls, when bad cholesterol is excessively found in the blood circulation. Low level of the useful cholesterol is also associated with risk.

Cholesterol level of 9-10 million people is over accepted ranges in our country. Level of useful cholesterol is hereditarily low in our country. This applies to 70 % of male subjects and 40 % of female subjects.

Blood cholesterol level is influenced by many factors.

These are as follows:

- Genetic factors,

- Nutrition style,

- Life style,

- Age,

- Diabetes Mellitus,

- Smoking,

- Stress,

- Thyroid diseases,

- Renal diseases,

- Overweight

Genes have significant influence on cholesterol level.

Excess ingestion of foods rich in saturated fats such as offal, animal foods, full fat milk, clotted cream and cream will elevate the cholesterol level.

Overweight, sedentary life style, advanced age and menopause (for female subjects) will increase the cholesterol level. Good cholesterol level decreases at rate of 15-20 % in smokers. Excess bad cholesterol deposits on coronary arteries resulting with vascular damages, occlusions and heart attack.

The deposition on vessels supplying blood to brain (namely carotid arteries) will lead to stroke, speech disorders and unbalanced gait.

Deposition on renal arteries will cause hypertension and renal failure, while deposition on intestinal vessels will result with intestinal necrosis and abdominal pain; deposition on ocular arteries will lead to blindness and vision disorders and deposition on leg vessels will lead to leg and thigh pain, when patient walks, and gangrene.

It was demonstrated that controlling high cholesterol level with diet and medical treatment may prolong survival and strictly decreases rate of death secondary to cardiovascular diseases. In addition, blood glucose level should be regulated, weight should be lost, smoking should be quitted and blood pressure should be adjusted.

It is very important to change the nutritional habits. Diet with poor content of saturated fats and cholesterol should be preferred. Oils are rich in unsaturated fats and therefore, edible oils should be preferred. Fruits, vegetables and cereals should be preferred. Offal and fried foods should be avoided; low-fat cheese and milk should be preferred.

Nuts such as hazelnut and walnut have proven positive effects on cardiovascular health. Hazelnut or walnut at amount of 140 g per week elevates level of good cholesterol in addition to decrease in the level of bad cholesterol.

Tuna fish, scurf, rye bread and fresh fruits are beneficial. Sausage, Salami, pasta cooked with butter, cakes, chocolate, chips and butter has hazardous effects.

Mayonnaise, ice cream, sweet pastry with nuts, cream pasta and skin of fowls should be avoided.

Smoking should be strictly quitted. Regular exercise elevates level of good cholesterol in addition to decrease in the level of bad cholesterol. Jogging for 30-45 minutes at least three times or ideally 5 times a week, swimming and bicycling should be done.

Alcohol elevates level of good cholesterol. However, alcohol has many negative influences on health. Male and female subjects may consume wine at volume of 30 ml/day and 15 ml/day, respectively.

The popular drug used for medical treatment includes statins. This group lowers bad cholesterol level, while they elevate good cholesterol level. They prevent clot formation and heart attack by reinforcing capsule of intra-vascular plaque structures. They may have adverse effects on the liver and the striated muscles. The frequency of such side effects is around 4-5% and blood tests should be analyzed at frequent intervals. Diet and exercise advices should be strictly followed in addition to the medical treatment and the smoking should be quitted.

Misinformation published at various media organs and offered to the public opinion on statins and cholesterol level should be taken into consideration.

If necessary, statins are very useful if they are used under controlled conditions. It is demonstrated that they ensure protection against cardiovascular diseases, regression of cardiovascular diseases and decrease in frequency of complications.