Routine check-up, the first step in cholesterol control

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dr. Sheena R. Angelia, Sp.GK, M.Gizi.
dr. Sheena R. Angelia, Sp.GK, M.Gizi. Photo: SILOAM HOSPITAL

Jakarta, IO – Cholesterol, whether low density lipoprotein (LDL), high density lipoprotein (HDL), or triglyceride, is an important element for bodily function. However, if it exceeds a normal level, it will accumulate and form plaque that can obstruct blood vessels and eventually lead to heart attacks or strokes. Nature journal’s global data of 200 countries shows that Indonesia is the 37th country with the greatest excess of cholesterol sufferers. Hypercholesterolemia or high cholesterol results in 3.9 million deaths a year, half of which occurs in Asia. The National Base Research 2018 shows that 6.3% of our 15-34 year-old population have abnormal cholesterol. 

“Cholesterol is required by the body to produce hormones, vitamin D, and food digestion enzymes. However, if we have too much of it, or if there is an imbalance between LDL and HDL levels in our bodies in the long term, we will suffer blood vessel obstruction which, among others, causes hypertension. There are no symptoms in the initial stage. However, if levels exceed 200 mg/ dL, you will start to suffer from headaches, stiffness or hardness in the neck to shoulder area, joint pains, and even swelling in the joint, a lump on the tendon (xanthoma) or acne-like bumps on your eyelids (xanthelasma),” said dr. Sheena R. Angelia, Sp.GK, M.Gizi, Siloam Hospital Kebon Jeruk’s clinical nutrition specialist, in Jakarta, Monday (28/03/2022). 

There are many ways to maintain proper cholesterol levels: adopting a nutritionally-balanced diet with lower consumption of high-fat foods, 150 minutes of routine physical activity a week, sufficient rest, stopping smoking and stress management. Complement this living a healthy lifestyle by consuming 2-3 grams of plant stanols every day if you can. Unfortunately, obtaining this amount is not easy. To illustrate, if you chew up 161 grams of almonds or 120 grams of cashew nuts, they will only provide you with 100 milligrams of plant stanols. Most vegetables and fruit contain even less plant stanols. 

“What are stanols and sterols? They are fibers that stabilize plant membranes and generate chemicals in plants’ bodies. They are bioactive components that have similar functions and structure as cholesterol, but with a slightly different biochemical chain, so they help reduce cholesterol absorption into the body. Stanols are not water soluble, and they require esterification to absorb. This is why they are also called ‘stanol esters’,” dr. Sheena said. 

Declining Metabolism Rate and Cholesterol Levels 

Plant stanol esters compete with cholesterol in the intestines during absorption process, which means that they inhibit cholesterol from foods from being absorbed by the body. Plant stanol ester also helps enzymes push cholesterol back out from both the intestine and the heart to the intestinal cavity for excretion in feces. It’s this two-pronged process that allows plant stanol esters to help people control their cholesterol levels, especially if they suffer from hypercholesterolemia. 

That being said, hypercholesterolemia sufferers are not the only people who need plant stanol esters. People with normal cholesterol levels must also consume them to prevent getting hypercholesterolemia later, “As the body ages, our metabolism rate also slows. This in turn lowers the body’s ability to process cholesterol. The best action you can take in relation with possible increase in your cholesterol levels is to maintain a healthy lifestyle, including routine medical check-up to catch hypercholesterolemia early, because it starts without any symptoms whatsoever,” dr. Sheena said. “We are entering the fasting month of Ramadhan soon. This is actually a great time to lower our cholesterol intake by fasting, but a lot of people actually break their fasts in the evening with high cholesterol foods and drinks instead! Please avoid this.” (est)