||25 October 2010 07:00
|Show: ||Carte Blanche Medical|
High cholesterol affects around 16 million South Africans, but it's not all bad. It's a matter of numbers and ratios of good versus bad cholesterol explains GP Dr Ela Manga from a wellness centre based in the Cradle of Humankind.
Dr Ela Manga (General Practitioner): 'It's not the enemy; the problem comes in when you LDL levels are too high and the cholesterol becomes oxidised. So it is the oxidised form of cholesterol that is the problem because that's the cholesterol that tends to stick on the sides of the arteries.'
These raised levels are a leading cause of heart disease and strokes.
Dr Manga: 'The stats show that 80% of westernised South Africans have high cholesterol and 20% of those have a cholesterol level that falls in the high-risk category for heart disease.'
Dietician Dr Anne Till believes this is in line with some disturbing global trends.
Anne Till (Dietician): 'And currently the World Health Organisation predicts that about 60% of the death that occur every year are attributed to lifestyle associated disease and half of these are actually heart disease or coronary heart disease. That means that heart disease is our No. 1 killer worldwide.'
Cholesterol is a major cause - 80% of those affected fall within what is termed 'moderately elevated cholesterol levels' with figures of between 5 and 8. It is critical to know your number - I had mine tested using a simple capillary test.
Derek Watts (Carte Blanche Medical presenter): 'So we've got the reading?'
Lee: 'Today's result is 5.22.'
Derek: 'So I'm over the limit?'
Lee: 'Ja, the standard for health is 5 and under.'
Derek: 'So over 5, like myself, you should be checked out thoroughly, but that doesn't mean you'll have to take medication - you should be able to cholesterol down using lifestyle changes.'
Executive Neil Swartz has been forced to adopt a new approach.
Neil Swartz: 'I'm 52 years old now and the decision was that I should have a look at everything and get myself checked up. So I went and booked an appointment with my doctor and we had it checked up.'
Derek: 'What were the numbers?'
Neil: 'I was around 5.58 as my total cholesterol and my doctor - he's a great doctor - he said, 'We need to try and manage it through diet and exercise.''
Neil didn't need statins as his levels were just slightly elevated, but he's careful about what he eats.
Neil: 'Business meetings and lunches, meetings at the office - those are the areas that I've really had to make a big sacrifice on because quite often we'd have things like toasted sandwiches. So I steer clear of that.'
It has certainly paid off - Neil's lost 7kg in the past 10 weeks.
Neil: 'Well, it is now 4.38.'
Anne is thrilled with his results, but she says it's critical that he maintains it.
Anne: 'Diet and lifestyle is not a band aid for cholesterol - it is a solution, but it is only a solution for as long as it is maintained. You can't say, 'Oh well, I'll do this for eight weeks - thank goodness my cholesterol is gone and now I can revert to my old patterns of eating.''
Derek: 'Once you start fighting those numbers you enter the world of good fats and bad fats. Now it can be a complicated business. Maybe experts should help us out?'
Anne: 'Bad fats are associated with high cholesterol and high bad cholesterol where LDL cholesterol is what we call saturated fats and transfatty acids. And saturated fats are usually fats from animal origins. So the good fats are more plant-based fats, those more liquidy ones like olive oil and canola oil, and, if you're going to use a margarine, it has to be a soft tub one.'
Anne's dietary advice means that when we go shopping we need to stock up on fresh fruit and veg, buy lots of wholegrains and good fats like olive oil and avos, eat omega-3 rich fish like salmon and avoid fatty red meats.
Derek:'(putting red meat in shopping basket) Don't tell Anne!'
But what about an evening tipple?
Dr Manga: Alcohol is another risk factor. It increases the sugar, it increase the way that you body metabolises fat.'
Derek: 'Two glasses of wine a day - red?'
Dr Manga: 'A glass or two of wine a day... nothing wrong. The thing is moderation.'
Ela believes that that stress of our lifestyles plays a huge role in our raised cholesterol.
Dr Manga: 'I think that as South Africans we are living in survival mode where the body goes into flight-or-flight response. As a result our cortisol levels are quite high. Our whole endocrine system is out of balance. We are quite insulin resistant and that seems to be linked to high cholesterol levels.'
Ela takes an integrated approach to treating patients with elevated cholesterol.
Dr Manga: 'I would go for a four pronged approach. The first being diet, the second is exercise - so doing a form of exercise that brings the body back into balance, something like yoga, the third factor is a nutritional supplementation - there are many nutritional supplements on the market that have been shown to positively affect cholesterol levels, and the fourth is stress management.'
St John's private school secretary Michelle Ruferer believes stress is a major trigger for her high cholesterol, which at one point was 11.
Michelle Ruferer: 'I believe that cholesterol is a direct result of stress. And, you know, what happens you start [getting] tightly drawn up. And when something draws you up tightly, naturally you seek comfort. So you find cheeseburger or something - the quickest or the cheapest way - and you find that you need it more often. Then you put on weight and that's stress in itself.'
Ela put her on a holistic programme.
Michelle: 'At the end of the day you need to disengage and I got what I call my 'kenako time'... just 10 minutes to pray, read a book, or just be quiet.'
Derek: 'Now when you first saw her, what was your reading?'
Michelle: 'Well over 8.'
Derek: 'Over 8?'
Michelle: 'About 8.4.'
Derek: 'And now?'
Michelle: 'And now it went down to about 6.1.'
Both Anne and Ela believe there is no quick fix.
Anne: 'The key is making those good food choices and those lifestyle choices on an ongoing and a daily basis.'
Dr Manga: 'The answer is to create a sense of living consciously, living with awareness and getting in touch with what your body is trying to communicate to you.'
IMPORTANT DISCLAIMER:While every attempt has been made to ensure this transcript or summary is accurate, Carte Blanche or its agents cannot be held liable for any claims arising out of inaccuracies caused by human error or electronic fault. This transcript was typed from a transcription recording unit and not from an original script, so due to the possibility of mishearing and the difficulty, in some cases, of identifying individual speakers, errors cannot be ruled out.