Beware the Fatted Calf!

When the Prodigal Son's dad slaughtered a fatted calf‚ to welcome his boy back home, he was providing what in those days, 2000-odd years ago, would have been considered a fine treat. Today, dishing up a fatted calf could be seen as an act of hostility by urbanised Westerners who already have an overload of fats in their diet, and whose arteries would suffer from a concentrated dose of dietary cholesterol!

"Cholesterol, of course, is not in itself a bad thing. It is one of the forms of fat present in our blood; it's a natural constituent of many of our body tissues, and is an essential factor in the creation of hormones. It's made by the body in the liver - that's why your doctor will talk about dietary cholesterol (cholesterol you ingest as food) as opposed to the cholesterol you make yourself, independently of the food you eat," says Dr Eugene Watson, Principal Officer of the Government Employees Medical Scheme (GEMS).,

Undergoing a simple test to establish the cholesterol levels in your arteries is one of the wisest steps you could take says he. Some people have a genetically-inherited tendency to make too much cholesterol. This condition is known as hypercholesterolaemia, and it requires strict monitoring to avoid premature death from heart disease.

"There are two kinds of cholesterol: LDL (low-density lipoproteins) and HDL  (high-density lipoproteins). LDL is the dangerous kind (remember: L is for lethal!), so any action you take should be aimed at reducing the levels of LDLs in the blood," explains Dr Watson.

Dangers of cholesterol

But if cholesterol is made by the body itself, why is it so dangerous?  Recent and extensive studies in the States seem to indicate that a high level of cholesterol, in and of itself, is not a predictor of heart disease. However, if you have other risk factors for heart disease - such as being overweight, a smoker or your parents suffering from heart disease - then that in combination with a higher than normal cholesterol level puts you at greater risk. Since you don't and can't always know what your risk profile is, it's a good idea to make sure that you control one of the things you can control - your cholesterol level.

When you have excessive amounts of cholesterol in your blood, it tends to build up inside your arteries - rather as fat builds up inside your sink s drain! The plaques that are formed in this way in the arteries leading to the heart or in the brain narrow the passageways. This can ultimately lead to a heart attack, where the heart is starved of the blood and oxygen it  needs because of such a blockage. Every year around 50 000 South Africans die because of the massive damage that a heart attack can cause.

The other possible consequence of the blockages, which are called atherosclerotic disease, is a stroke. This is the result when the brain is deprived of blood and oxygen, and causes a rapid die-off of brain cells which can lead to irreparable brain damage.

The good news

That's the bad news about cholesterol.  The good news is that you don't have to sit around waiting for a heart attack or stroke - you can do a lot to improve the risk of heart disease right now.

First and most important, change your diet.  Switch from a diet rich in animal fats to one rich in vegetable oils - use a good polyunsaturated margarine instead of butter, and olive or other vegetable oils for salad dressings and so on. Certain research seems to indicate that vegetable oils raise HDLs (the good guys) at the expense of LDLs. Reduce the amount of red meat you eat, and avoid fatty cuts. Organ meats (heart and liver) are especially rich in dietary cholesterol, so that gives you an excuse to stop eating liver!

One of the most beneficial changes you can make in your diet is to increase the fibre content - fibre seems to act as a broom‚ to sweep away cholesterol, at least to a certain extent. Eat oats (porridge is a great way to start the day), brown rice and whole-wheat bread. Try to eat as much fruit and vegetables as possible - the World Health Organisation recommends at least five servings a day.

The second thing you should do is get more physical exercise. Most of us get far too little to keep our bodies in good nick, and there is solid evidence to show that even a small increase in physical activity fights high cholesterol levels and improves our heart disease risk. The recommendation is to do 30-40 minutes of aerobic exercise four times a week.

You don't have to buy a gym membership to achieve this: a brisk walk with the dog will do. Give up smoking if you have the habit - it increases your risk of atherosclerotic disease.

And have your cholesterol level checked regularly by your GP, or at your local pharmacy - many of them run clinics which will do the tests at a nominal fee.  If you do have an unacceptably high cholesterol level, there are a number of drugs on the market, which are pretty effective at lowering the figures - and keeping you safe from heart disease!