CHOLESTEROL, EGG AND STATIN

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By: Dr. Samayug Bhowmik, Bureau Chief-ICN West Bengal

KOLKATA : Cholesterol is a wax like substance produced by different metabolic processes and also absorbed by cholesterol rich food intake.

It travels in different parts of our body in a vehicle called lipoproteins . It is stored later  in our body in certain organs such as heart, brain,liver and blood vessels.

Our body needs cholesterol to build healthy cells by maintaining the integrity of the cell membrane ,takes part to produce several hormones and to maintain proper integrity and activities of our brain too.

On the other hand,  if there is high level of cholesterol it may increase the risk of certain life- threatening medical conditions such as stroke and heart attack.

Elevated levels of cholesterol in the blood may be a consequence of high intake in diet, obesity, by genetic inheritance or the presence of other diseases such as type 2 diabetes and underactivity of thyroid gland.

This high level of cholesterol travelling through the  blood stream of a person can develop cholesterol deposits in the walls of blood vessels which, if not controlled or reduced, eventually grows larger and may cause the narrowing of the diameter of the concerned blood vessels and thus will create reduced blood flow through them.

Sometimes, these huge deposits may partially break and form a clot which again starts travelling and may ultimately obstruct a blood vessel supplying blood to a part of an organ causing a heart attack or a brain stroke.

Cholesterol was first isolated from gallstones in 1784. Cholesterol fascinated scientists to further explore in the field of medical science. Thirteen Nobel Prizes were awarded over the researches related with cholesterol.

Nowadays people are  very conscious about how to maintain normal cholesterol level even if they are having normal cholesterol and  not on any medication. They are mostly concerned about healthy diet.

But in their daily healthy diet  a persistent query is frequently arising with consumption of egg as to whether they should eat egg or not as egg increases cholesterol.They have the query that If they eat egg shouldl it be full or only egg white.

Although apart from egg, they skip all other food which also contain cholesterol in very large quantity than one egg. I want to provide some current concept over the same. People want to know if eggs are  good for health. The simple answer to this question is ‘YES ‘. as the reasons stated below.

Egg contains good quality protein and there are several health benefits that can be obtained from egg .

If you take one egg daily you can get vitamin A, vitamin B-2,vitamin B-12,vitamin B-5 Vitamin D,Vitamin E,Biotin,Choline,Folic acid, Selenium ,Iodine,Iron,Lutein, Xanthin ,Omega 3 fatty acids by which we can develop and maintain Strong muscles, Alert Brain, Healthy Body Defense System, Good Eyesight, Reduction of Body Weight and its maintenance, firm and glowing skin and finally studies show that it lowers the risk of heart disease.

Now let’s see how it does so.

The protein contained in  whole egg helps us to keep our different muscles working well.

Eggs contain vitamins and minerals and omega-3 fatty acids. These are needed for the regular functioning of brain cells, whole nervous system of our body, and to keep our memory intact.

Vitamin A, Vitamin B-12, and Selenium maintains our healthy defense system.

Lutein and Xanthin help to prevent macular degeneration of eye which is the leading cause of age-related blindness.

The high quality of protein within eggs might help keep people energized. A feeling of fullness  prevents frequent intake of food. This in turn reduces overall calorie intake and thus prevents us from putting on extra body weight.

But despite their taste, value, convenience and nutritional value, due to fear of increase of cholesterol level in blood, egg was discarded in the daily breakfast by many throughout the world till few days ago.

Extensive  and continued  research have demonstrated that healthy adults can enjoy one  egg daily without significantly impacting their risk of heart disease.

Furthermore  researches have shown that consumption of saturated fat and trans fat may be more likely to raise a person’s serum cholesterol than dietary cholesterol which is present in egg.  Egg contains large amount of good unsaturated fat ,is very low in saturated fat and has no trans-fat.

According to the United States Department of Agriculture (USDA) nutrition data, eggs are lower in cholesterol than previously recorded. The USDA recently reviewed the nutrient composition of standard large eggs and results show the average amount of cholesterol in one large egg is 184 mg. contain 41 IU of Vitamin D. Thus  enjoying an egg in a day will not create any adverse effects.

Again nearly half of the protein and most of the vitamins and minerals are contained in the yolk so don’t skip to eat the yolk . Several international health promotion organizations – including Health Canada, the Canadian Heart and Stroke Foundation, the Australian Heart Foundation and the Irish Heart Foundation – promote eggs as part of a heart-healthy diet,

Cholesterol is essential for the functioning of our different organs, but it is nevertheless the cause of coronary heart disease. Over the course of nearly a hundreds of investigation, scientists have developed several evidences that establish the causal connection between blood cholesterol, atherosclerosis, and coronary heart disease.

High cholesterol level in our body does not produce any symptom only by blood test it is detected . The test is known as Lipid Profile. This test is not routinely done in our country till a person does not feel any wrong in his bodily activities or suffer with any other illness contrary to western world where Children and young adults having no risk factors nor suffering with any disease are usually tested once between the ages of 9 and 11 and again between the ages of 17 and 19.

Retesting in adults is usually done every five years if they are maintaining disease free health status. If your test results aren’t within desirable ranges or if you have a family history of high cholesterol, heart disease or other risk factors, such as smoking, diabetes or high blood pressure, your attending doctor might recommend more-frequent tests.

As Lipid Profile test signifies a composite statement of different types of cholesterol. They are based on which lipoprotein carries which fraction and are stated and measured as follows.

Low-density lipoprotein (LDL). LDL, or “BAD  cholesterol”, transports cholesterol particles throughout our body. LDL cholesterol deposits in the walls of our arteries, making them hard and narrow.

High-density lipoprotein (HDL). HDL, or “GOOD cholesterol”, picks up excess cholesterol and takes it back to our liver.

Very Low-density lipoprotein (VLDL)…it is also a bad cholesterol but it plays major role to carry triglyceride and a part role in the formation of clot.

Triglycerides, which when gives can also increase your risk of heart disease and may also produce Pancreatitis. Interesting to note that it is usually raised in most of the Indians since their childhood without their knowledge.

These  VLDL and Triglyceride are frequently getting elevated in the Diabetic Individuals and in their offspring even when they are on  non-diabetic state.

Also there are some other factors such as inactivity, obesity consumption of cholesterol rich diet contribute to high LDL/VLDL/Triglyceride and low HDL cholesterol. Factors beyond our control such as family history of high cholesterol, some genetic disorders , Diabetes and or Hypothyroid state  might play a role too.

Now the question arises as to  how to manage the condition.

After different investigations, trials and protocols, a generalized guideline is framed as below.

Eat more fruits, vegetables and whole grains.

Limit the intake of animal fats,ghee,butter etc.

Target to loss extra weight and to maintain desired weight.

Quit smoking.

Drink alcohol in moderation, if at all.

Manage or reduce excessive stress either mental or physical.

Exercise or walk at least five days in a week for at least 45 minutes.

But again with the above guidelines there are failures to reduce or to manage the extra cholesterol and thus a necessity aroused to find a medicine which will reduce the high level of cholesterol.

Building on that knowledge, scientists tried and developed few cholesterol lowing drugs of which the first generation of cholesterol-lowering medicine Nicotinic Acid was invented by a Canadian pathologist Rudolf Altschul in 1955 and which became commercially available since 1960.

Later  Clofibrate was synthesized and it’s most powerful derivative Fibrate had minimal to moderate cholesterol lowering activity. Another drug Cholestyramine is highly effective in the treatment of many patients  but all the above drugs were not well tolerated by all patients.

Therefore, none of these agents was considered ideal in terms of efficacy, tolerabily and safety and thus researches were going on to find out a good drug and at last a new chemical was identified which in broad term is known as Statins which lowers the cholesterol level in blood and thus reduces the frequency of heart attacks or Strokes.

There are different varieties of statins are available in India and abroad now. I am not going to elaborate in details here. It is upon the treating doctor who will decide which group of statin will be most effective in any individual case.

Statin is very much effective to reduce excess cholesterol present in our blood and to maintain the elasticity of our blood vessels for which it is also called as wonder drug. Due to its effectiveness it is halting so many disasters now a day.

But overenthusiastic use and may lead to Pain in muscles, as it produces ultra structural damage in skeletal muscle. It also elevates some enzymes inside the liver although it is transient in nature in most cases.

Again to note that apart from different tissues and other chemicals, our brain contains significant amount of cholesterol nearly 70% of the brain cholesterol is present over myelin which covers our brain as well as over the other nerves in our body. As the half of the white matter of brain is composed of myelin, it is found that brain is the most cholesterol-rich organ in our body.

The concentration of cholesterol in the brain and other nerves is consistent with the essential functions of brain and alsomaintains functional integrity during our cognition, different wishes, commands, body movements and so on.

Several studies have shown that low cholesterol in brain and very low cholesterol in our blood  is associated with lower cognition and in long run may produce Alzheimer’s disease where as optimum  level of cholesterol gives us a protection against the disease. Again low serum cholesterol level has also been found to be a biological marker of major depression and suicidal behavior.

Therefore the use of statin should be judicious and optimum as per individual requirement for that a doctor plays a vital role.

Now on above discussion the take home messages are as follows:-

 

  1. Cholesterol keeps our brain  working smoothly.
  2. Cholesterol takes part during formation of important hormones.
  3. Cholesterol builds our muscles.
  4. Check Lipid Profile periodically
  5. Avoid cholesterol rich food as far as practicable.
  6. Try to maintain correct body weight.
  7. Exert yourself without strain.
  8. Do not take Statin without consulting your doctor.

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