Question

Discuss the following:

Patient A is a 60 year old male who smokes. he has normal blood pressure and no history of heart disease in his family. His lab results are: Total Cholesterol 240 mg/dl, HDL 80 mg/dl, LDL 95 mg/dl.

Patient B is a 50 year old female. She does not smoke, and she exercises regularly. Her lab results are: Total Cholesterol 210 mg/dl, HDL 35 mg/dl, LDL 110 mg/dl.

In your opinion, which patient is at higher risk of cardiac disease and WHY? What could either of them do to lower their risks?

Answer 1

Fats are essential for the body, as it forms component of plasma membrane. It also provide energy, having high calorific value of 9 calories per gram.They tend to accumulate in the body making it difficult to consume proper food later. Thus, it is also essential to measure the amount of fat consumed.

• A cholesterol level below 200 mg/ dL is considered as desired cholesterol level.Cholesterol level of 200 mg/ dL – 239 mg/dL is considered borderline level.While, cholesterol level of 240 mg/dL or above is considered as high-risk level.LDL levels: 100 mg/dL- optimum level, 100-129 mg/dL-near to optimum, 130-159 mg/dL-Boderline, 160-189mg/dL- high, above 190 mg/dL-very high.HDL levels: 40-50 mg/dL for women, 50-60 mg/dL for men. Higher than 60 mg/dL is considered good for checking harful fats.

The first patient has cholesterol level of 240 mg. Thus, is at high risk level for cholesterol. However, he has got a higher level of HDL and optimum level of LDL.

The second patient has boderline level of cholesterol, very low HDL level and very high LDL levels.

Thus, both the patients have high risk of having heart problems.

Recommendation for first patient:

• Quit smoking
• Avoid food with high cholesterol or saturated fat.
• Thus, food sources laden with saturated and trans-fat should be replaced with unsaturated fat sources.
• Exercising regularly as per physical condition and medical advice.

Recommendation for second patient:

• Make dietary changes to lower LDL level and increase HDL level.
• Fats like, coconut, palm and palm kernel oil contains saturated fatty acids like palmitic acid.
• These oils may increase the bad cholesterol level or LDL (low density lipo proteins).
• These may be stored in the cytoplasm, due to excess lipid, less or improper absorption, enzymatic problems, etc.
• LDLs accumulate in the arteries, resulting in artherosclerosis or narrowing of the blood vessels. This may result in heart diseases and increases risk of heart problems, heart attack.
• Saturated fat results in increased amount of endothelial lipase (EL). This also enhances the inflammatory effects.
• Accumulation of bad fat, may also rest in obesity, diabetes, and possess risk to some cancers.
• Some lipids are called “Good lipid” like present in avocados, nuts, etc. Like HDL or high density lipoproteins.
• HDL can scavenge other types of lipids like the bad lipids. They direct the bad lipids to liver, where they are destroyed.
• Thus, all fats may not cause heart disease.
• Monounsaturated fatty acid (MUFA-like oleic acid) and Polyunsaturated fatty acid (PUFA- like Omega 3 and Omega 6 fatty acids) type of fat are considered as good fat.
• Fat sources like canola oil, olive oil, peanut oil, nuts are contain MUFA. Sources like sunflower, sesame, safflower, soybeans, fatty fishes (like sea fishes, salmon), are rich in PUFA.