[Local Medical]Exercise, adjust diet, manage cholesterol and prevent heart disease

Written by ◆Dr. Zheng Huiyi and compiled by ◆Liang Yingxiu

Cardiovascular disease is the leading cause of death worldwide, with an estimated 17.9 million people dying from cardiovascular disease in 2019, accounting for 32% of total global deaths. 85% of them die from heart disease and stroke.

Heart attacks and strokes are usually acute events caused by blockages in blood vessels that prevent blood from flowing to the heart or brain.

KUALA LUMPUR: The most common cause is fatty deposits in the lining of blood vessels that supply blood to the heart or brain. Strokes can be caused by bleeding from blood vessels in the brain or blood clots.

Dr Tay Hui Sian, specialist in geriatrics and internal medicine, points out that the most important behavioral risk factors for heart disease and stroke are unhealthy diet, lack of exercise, smoking and harmful use of alcohol. The impact of behavioral risk factors on individuals may manifest as increased blood pressure, blood sugar, and lipids, as well as overweight and obesity.

33.3% of adults have high cholesterol

“High cholesterol is an important factor leading to cardiovascular disease. Especially low-density lipoprotein (LDL) cholesterol (bad cholesterol), which will be deposited on the artery wall to form atherosclerotic plaques. These plaques It can narrow and harden arteries, restricting blood flow. In addition, atherosclerotic plaques can rupture, causing platelets to clump together and form blood clots, which can cause heart disease if the blood clots block the coronary arteries that supply the heart. If the arteries supplying the brain are damaged, a stroke will occur.”

“According to the Malaysian Ministry of Health report, there is a higher prevalence of high cholesterol nationwide, although there is no specific data specifically for the elderly group.

The 2023 National Health and Morbidity Survey (NHMS) shows that about 33.3% of adults have high cholesterol. “

She reminded that high cholesterol not only increases the risk of cardiovascular disease, but also causes various other complications such as peripheral arterial disease (atherosclerosis of the arteries in the limbs), which affects blood flow and causes pain, ulcers and even tissue necrosis. Atherosclerosis can also affect the renal arteries, causing decreased kidney function.

“Metabolic syndrome includes high blood pressure, obesity, and high blood sugar, which together increase the risk of cardiovascular disease. High cholesterol can cause damage to blood vessels and nerves, affecting sexual function, especially in men, manifesting as erectile dysfunction. These metabolic abnormalities May increase risk of Alzheimer’s disease and other cognitive disorders.”

Obesity, smoking and drinking are high risks

She noted that high cholesterol itself often has no obvious symptoms, but if left unchecked for a long time, some signs and symptoms may develop, including xanthomas and corneal rings. Xanthomas are yellowish fatty deposits under the skin, usually on the eyelids, while corneal rings are gray-white ring-shaped deposits that form around the cornea. Both symptoms are generally more common in older people.

“Modern people’s unhealthy lifestyle can increase an individual’s risk of high cholesterol, which mainly includes unhealthy diet and lack of exercise. Unhealthy diet includes excessive intake of saturated fat and trans fat foods, such as fatty meat and full-fat foods. Dairy products, processed foods, and fried foods, while lack of physical activity can lower high-density lipoprotein (HDL) cholesterol levels and increase LDL cholesterol levels.”

She reiterated, “Obesity, especially abdominal obesity; genetic factors, that is, people with a history of high cholesterol in the family are more likely to suffer from it. Age and gender also affect the chance of suffering from it. As we age, wealthy women are more likely to suffer from it. There is a higher risk of high cholesterol after menopause.”

“Undoubtedly, risk factors for high cholesterol include smoking and alcohol intake. Smoking has the opportunity to reduce HDL cholesterol levels and damage blood vessel walls, while excessive alcohol consumption will increase total cholesterol and triglyceride levels.”

Reduce intake of harmful fats

Ways to manage high cholesterol include lifestyle changes and medication. Bad eating habits are the main culprit of high cholesterol. Therefore, the first thing patients should do is to make adjustments in their diet.

First, reduce unhealthy fats. Unhealthy fats include saturated fats and trans fats, and patients should avoid fatty meats, full-fat dairy products (such as butter, cream, ice cream), baked products (such as pies, cookies, buns, pastries), fried foods, and Processed food.

Second, increase healthy fats. Choose foods rich in unsaturated fats such as fish, nuts, seeds, olive oil and avocados.

Third, increase fiber intake. Eating more fruits, vegetables, whole grains and legumes can help lower cholesterol levels. Fourth, reduce cholesterol intake. Examples of high-cholesterol foods include offal, shellfish, such as clams, shrimps, squid and egg yolks, etc., which need to be limited.

Fourth, regular exercise, including aerobic exercise and strength training, can also help improve high cholesterol. She recommends that patients get at least 150 minutes of moderate-intensity aerobic exercise per week, such as walking, running, swimming and biking. Strength training is recommended at least 2 times a week, which can help increase basal metabolic rate and lower cholesterol levels.

In addition to the above-mentioned lifestyle changes, patients must also receive drug treatment provided or recommended by their doctors. Only by cooperating with each other can they effectively control cholesterol levels.

When managing high cholesterol, a diet plan should focus on a healthy, balanced diet, reducing the intake of harmful fats while increasing nutrient-rich foods.

high cholesterol diet plan

1. Increase healthy fats

◆Monounsaturated fats: olive oil, avocado, nuts and seeds.

◆Polyunsaturated fats: such as fish (especially fish rich in omega-3 fatty acids, such as salmon, mackerel and sardines).

2. Reduce saturated and trans fats

◆Limit red meat, full-fat dairy products, fried foods and processed foods.

3. Increase dietary fiber

◆Soluble fiber: oats, beans, apples, pears and carrots.

◆Insoluble fiber: whole grains, vegetables and fruits.

4. Increase fruits and vegetables

◆Eat at least 5 servings of fruits and vegetables of different colors every day.

5. Choose lean protein

◆Chicken breast, turkey, fish, beans and soy products.

One day sample meal plan

breakfast

◆Add a serving of berries and a handful of nuts to oatmeal.

◆One cup of low-fat or skim milk.

Lunch

◆Whole wheat sandwich with chicken breast, lettuce, tomato and avocado slices.

◆A vegetable salad with olive oil and vinegar dressing.

◆An apple.

Afternoon snack

◆A small handful of almonds or carrot sticks.

dinner

◆Grilled salmon or chicken breast.

◆Brown rice or whole wheat pasta.

◆Steam vegetables (such as broccoli, carrots and pumpkin).

◆A mixed leafy green salad with olive oil and lemon juice.

Evening snack

◆A small bowl of low-sugar yogurt with a handful of nuts or seeds.

beta-glucanHelp control blood sugar Eat more oats to lower cholesterol

Beta-glucan and soluble fiber can help manage high cholesterol. Whole grains such as oats, oat bran, barley, brown rice and whole wheat bread are important sources of beta-glucan.

Zheng Huizhen pointed out that oat beta-glucan is a soluble fiber that has a cholesterol-lowering effect due to its high viscosity. Its mechanism of action is that it dissolves in the digestive tract, forming a thick gel in the small intestine. The sticky “net” traps cholesterol and cholesterol-related particles (bile acids) and prevents them from being absorbed into the bloodstream. They are then passed harmlessly out of the body. This reduces circulating LDL levels.

Do aerobic exercise regularly

In addition, beta-glucan helps stabilize blood sugar levels and reduce post-meal blood sugar spikes by slowing food digestion and glucose absorption. The fibrous nature of beta-glucan helps improve insulin sensitivity and, therefore, is beneficial for high cholesterol and high blood sugar.

Adults should consume 25 to 30 grams of fiber per day, at least some of which is soluble fiber and beta-glucan. So how to consume it through diet? First, try to increase your intake of oats and barley, such as eating a bowl of oatmeal for breakfast every day, and replace some staple foods with barley, such as barley rice or barley soup. Second, eat more fruits and vegetables. At least half of each meal should be fruits and vegetables, especially types rich in soluble fiber. Third, add beans and seeds to your food. Eat legumes such as black beans, lentils, and peas several times a week, and add flax or chia seeds to salads, yogurt, or oatmeal.

In this way, you can effectively harness the benefits of beta-glucan and soluble fiber to help manage high cholesterol and high blood sugar. Whether high cholesterol can be completely reversed depends on a variety of factors, including the type and severity of the disease, the individual’s health, and the lifestyle and treatments taken.

High cholesterol can be reversed

“Medical treatments such as statins and other cholesterol-lowering drugs can significantly reduce LDL cholesterol, and patients can reduce their cholesterol levels to the normal range with a combination of medication and lifestyle changes.”

Because high cholesterol may have no obvious symptoms in its early stages, it is important to have regular physical exams and blood tests for early detection and management. By controlling cholesterol levels, adopting a healthy lifestyle (such as eating properly, exercising regularly, quitting smoking and limiting alcohol), and taking medications as prescribed by your doctor, you can effectively reduce the risk of cardiovascular disease.

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