Managing Our Own Health, Start with Cholesterol

Ian Waterston is an executive working in corporate finance; he had his first heart attack at the age of 30 when he went for hill climbing during the weekend. He learned a precious lesson from the incident, don’t be dumb. Like him, many of us think that someone as young and fit as him is impossible to have a heart attack, and according to Ian, it is dumb. We heard many stories of friends and family members suffered from heart problems, in certain cases it involves sudden heart attacks which may lead to unexpected death. It may alert us for a while, however most of time, when it comes to managing our health, we prefer to take the passive role and let the nature to take it’s course. 

Why should you manage your own health? 

Most of us leave our health to the doctors. However, we only go to see doctors when we are sick. And that comes with a hefty price tag, its either expensive medical bill, or emotional stress; sometimes it even causes loss of days of productivity. However, if we are to manage our health actively, many diseases are preventable, for example - Cardiovascular disease or in lay man term - heart disease. 

Cardiovascular (CVD) disease is the number one cause of death globally, whereby 1 in 4 deaths in government hospitals are attributed to either heart disease or strokes. To make it worse, it is a silent chronic disease which can take years to develop without any symptom at all. However, by managing the level of bad cholesterol in your body can greatly reduce the chance of getting heart disease. And you don’t even need a doctor to tell you how. 

It’s all started with Cholesterol

Heart disease occurs when a substance called plaque builds up in the arteries that supply blood to the heart. Plaque is made up of cholesterol deposits, which can accumulate in the arteries. When this happens, the arteries can narrow over time. Plaque build-up can cause chest pain/ discomfort, because the heart muscle doesn't get enough blood. A heart attack occurs when plaque totally blocks an artery carrying blood to the heart. It also can happen if a plaque deposit breaks off and clots an artery. On the other hand, a stroke happens when blood flow to a part of the brain stops. When brain cells are not getting sufficient blood and oxygen, it will be damaged and lead to loss of brain function, and even death. 

To lower bad cholesterol in your body only requires easy step such as be informed with what you eat every day. Food such as meats, poultry, shellfish, eggs, butter, cheese, and milk contain additional cholesterol, and this is on top of the cholesterol which is manufactured by our body.  Hence, have more fibrous food and complex carbohydrate such as fruit, raw vegetables, brown rice, whole grain breads in your diet. The American Heart Association recommends that you eat at least 25 grams of dietary fiber every day2.

Knowing your DNA 

However, there are also some factors which can lead to high cholesterol in your body but is not modifiable, such as hereditary. The amount of bad cholesterol in our body makes and how fast it is removed from body is determined partly by genes. If an individual inherited certain genetic mutations in those genes from his/her parents, there is a high chance that he/she is suffering from a familial disease called Hypercholesterolemia (A condition where high cholesterol is present in the blood). Today, there are many DNA test available which can ascertain whether an individual’s has inherited the genetic mutations which causes Familial Hypercholesterolemia from his/her parents. Using an advance biochip technology, Molecular Screening Services such as INFOHaem FH1536™ screens for genetic mutation from LDLR, ApoB (ApolipoproteinB) gene and PCSK9 gene. The test also involves clinical examination associates the individual’s lifestyle, family history and medical history to Familial Hypercholesterolemia. If the DNA test found to be positive, it’s important to inform your doctors immediately as you may require certain cholesterol lowering medication. 

In summary, take care of high cholesterol as soon as possible and manage your own health actively. Not doing so will put you at a higher risk of suffering from heart disease. 

1. http://collectivewizdom.com/MyHeartAttackAtAge30.html

2. http://www.americanheart.org/presenter.jhtml?identifier=514

3. http://www.infovalley.net.my/~infovall/fh1536%E2%84%A2-test-takers

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INFOVALLEY® Molecular Screening Services is registered under Ministry of Health’s Medical Device Bureau’s MeDVER programme (Registration number: A-000531). INFOHaem™ Molecular Screening was recognized by Frost and Sullivan’s Malaysian Excellence Award 2012, as best product Innovation. For more information, kindly refer to www.infovalley.net.my. 

By Susan Ong, Product Portfolio Manager

Are You Afraid of Cholesterol?

Since we are living in a fast paced world, many of us tend to neglect the significance of taking good care of our health. As we age, our body needs the urgency for medical check up. Whenever any of us see the word “CHOLESTEROL” in the report, we are inclined to think that it is something bad to our body. To tell the truth, cholesterol is not necessarily bad for our body because there are two types of cholesterol; namely good cholesterol and bad cholesterol. Typically, cholesterol is a fat formed by the liver and is fundamental for usual body operation. It exists in the external coat of each cell in our body and has numerous functions. These functions aid the regular function of our body.

Before one starts to be afraid of cholesterol, it is better to learn the significance of good cholesterol to our body. Firstly, cholesterol builds and maintains cell membranes which are the outer layer of each cell. These cell membranes have permeability which is essential for determining which molecules can pass into the cell and which cannot. This helps to eliminate unwanted molecules from entering the cells. Moreover, cholesterol aids in the production of bile. We have read in books that sunshine provides Vitamin D to our body but has anyone wondered how is it possible for the sunshine to convert to Vitamin D? Well, with the aid of cholesterol, it is possible because it converts sunshine to vitamin D. Furthermore, it is also imperative for the body to enhance metabolism of fat soluble vitamins, including vitamins A, D, E, and K. With all these functions in hand, there isn’t any necessity to be afraid of cholesterol unless you have LDL.

Now you may ask what LDL is. LDL is the acronym for low density lipoprotein. People often refer to it as bad cholesterol. LDL carries cholesterol from the liver to cells. If too much is carried, too much for the cells to use, there can be a harmful buildup of LDL. This can increase the risk of arterial disease if levels rise too high. Most human blood contains approximately 70% LDL but this may vary, depending on the person. Too much LDL can cause the arteries to become blocked, which increases the risk of heart disease and stroke. Blocked arteries occur when excess LDL and other fatty substances attach themselves to the walls of the arteries, causing them to become narrower, meaning that blood cannot pass through as easily. Over time, partially blocked arteries also become hardened and inflamed, increasing the risk of breakage. All this increases the risk of a range of vascular diseases, such as heart disease, stroke and kidney disease. When there is bad cholesterol, the good comes along. HDL (high density lipoprotein) is often referred to as good cholesterol. Experts say HDL prevents arterial disease. Moreover, HDL does the opposite of LDL. It takes the cholesterol away from the cells and back to the liver. In the liver it is either broken down or expelled from the body as waste. 

In addition, high cholesterol itself doesn't cause any symptoms. This means that we could have high cholesterol and not know about it. The only way to know our cholesterol level is to have it tested. Once receiving the results, it is not necessarily something devastating because level of bad cholesterol in body can be reduced or controlled if we follow a balanced diet, live a healthy lifestyle and obviously by following the instructions from doctors. High cholesterol level becomes deadly only when we refuse to change our habits that contributes to the increase in cholesterol in our body.

In a nutshell, living a healthy lifestyle is everyone’s dream. Daydreaming about it but living an unhealthy lifestyle, for example, smoking, eating food which is high in cholesterol and not exercising regularly will never help in avoiding ourselves from getting high cholesterol. Cholesterol is not something to be afraid of because as stated above good cholesterol does play a vital role in our body. It is our responsibility to restrict the increase in bad cholesterol in our body. Prevention is always better than cure. Therefore, start preventing from getting high bad cholesterol since a very young age instead of trying to reduce it after getting affected. We only live once. 

Why waste it by being afraid of something that we can restrain?

References
• Grundy SM, et al. (2001). Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA, 285(19): 2486-2497.
• National Heart, Lung, and Blood Institute (2005). Your Guide to Lowering Your Cholesterol With TLC (NIH Publication No. 06-5235). Available online: http://www.nhlbi.nih.gov/health/public/heart/chol/chol_tlc.pdf


By Khamsigan a/l/ Munretnam, Molecular Research Scientist

Are you Afraid of Cholesterol?

During my university years, one of my friends used to frustrate his parents by throwing away egg yolks and eating only the whites. He thought that he was reducing the risk of heart disease by avoiding cholesterol. How about you? Are you afraid of cholesterol or having high cholesterol? Are you throwing away egg yolks because you think they're bad for your health?

Let’s learn more about cholesterol. Cholesterol is a chemical compound that is naturally produced by the body and is structurally a combination of lipid (fat) and steroid. Cholesterol is a building block for cell membranes and for hormones like estrogen and testosterone. The main sources of dietary cholesterol are meat, poultry, fish, and dairy products. Organ meats, such as liver, are especially high in cholesterol content, while foods of plant origin contain no cholesterol.

Cholesterol is not a deadly poison, but a substance that you need to be healthy. High cholesterol itself does not cause heart disease. People who have low blood cholesterol have the same rates of heart disease as people who have high blood cholesterol. The cholesterol found in your blood comes from two sources: cholesterol in food that you eat and cholesterol that your liver makes from other nutrients. The amount of cholesterol that your liver produces varies according to how much cholesterol you eat. Normally, liver produces 75% of the cholesterol that circulates in our blood. The other 25% comes from food. If you eat a lot of cholesterol, your liver produces less. After a meal, dietary cholesterol is absorbed from the intestine and stored in the liver. If you don't eat much cholesterol, your liver produces more. This is why a low cholesterol diet does not typically decrease a person's blood cholesterol by more than a few percent.

Types of Cholesterol

There are two types: Bad" and "Good" Cholesterol. Particles called lipoproteins carry cholesterol in the blood. There are two kinds of lipoproteins you need to know about: LDL and HDL.

Low-density lipoproteins (LDL) cholesterol makes up the majority of the body's cholesterol. LDL is known as "bad" cholesterol because having high levels can lead to a buildup in the arteries and result in heart disease. It is very important to keep LDL levels low. LDLs are produced by the liver and carry cholesterol and other lipids (fats) from the liver to different areas of the body, like muscles, tissues, organs, and the heart. 

High-density lipoproteins (HDL) cholesterol absorbs cholesterol and carries it back to the liver, which flushes it from the body. High levels of HDL, or "good" cholesterol, reduce the risk of heart disease and stroke.

Very low density lipoproteins (VLDL) are lipoproteins that carry cholesterol from the liver to organs and tissues in the body. They are formed by a combination of cholesterol and triglycerides. VLDLs are heavier than low density lipoproteins, and are also associated with atherosclerosis and heart disease.

What Boosts Your Risk?

Several health factors, lifestyle and genetic factors can make you more likely to develop high cholesterol:

• Condition

– Age: everyone's risk for high cholesterol increases with age. Women's LDL ("bad" cholesterol) levels rise more quickly than do men's.

– Diabetes: Having diabetes can also make you more likely to develop high cholesterol. Diabetes affects the body's use of a hormone called insulin. This hormone tells the body to remove sugar from the blood. With diabetes, the body either doesn't make enough insulin, can't use its own insulin as well as it should, or both. This causes sugars to build up in the blood.

• Behavior

– Diet: Certain foods raise your cholesterol levels. These foods tend to contain saturated fats, trans fatty acids (trans fats), dietary cholesterol, or triglycerides.

– Weight: being overweight can raise LDL, lower HDL, and raise total cholesterol levels.

– Physical inactivity: Not getting enough exercise can make you gain weight, which can lead to increased cholesterol levels.

• Heredity

High cholesterol can run in families. People who have an inherited genetic condition, called familial hypercholesterolemia, have very high LDL cholesterol levels beginning at a young age.

Diseases linked to high cholesterol

Diseases linked to high cholesterol

• Coronary heart disease: If your cholesterol is too high, it builds up on the walls of your  arteries. Over time, this buildup (called plaque) causes hardening of the arteries (atherosclerosis).

• Stroke can result if the blood supply to part of the brain is reduced. 

• Peripheral vascular disease: High cholesterol also has been linked to peripheral vascular disease (PAD), which refers to diseases of blood vessels outside the heart and brain. 

• Type 2 diabetes is another disease linked to high cholesterol because diabetes can affect the different cholesterol levels. 

• High blood pressure (hypertension) and high cholesterol also are linked.

• Leriche syndrome: there is a block in the lower part of the aorta just before the starting point of the common iliac arteries leading to Claudication, Impotence and Decreased pulses

Diseases linked to low cholesterol

• American researchers found that low cholesterol predicts an increased risk of dying from diseases of the stomach, the intestines and the lungs. Most of such diseases are infectious.

• Low Cholesterol Predisposes To HIV And AIDS

• Low cholesterol levels have been shown to increase the risk for cancer.

• Low cholesterol over the long term may lead to depression, increased risk of stroke, and numerous problems related to hormonal imbalances. If you are not getting enough vitamin D from your diet, having low cholesterol may lead to vitamin D deficiency, as sunlight creates vitamin D in your body by acting on cholesterol found in your skin.

• Smith-Lemli-Opitz Syndrome: children with this syndrome are born with very low cholesterol because an enzyme that is necessary for the body’s synthesis of cholesterol does not function properly.

The Positive Roles of Cholesterol

Actually, cholesterol is essential for survival and plays many vital roles in the body.

• Cholesterol is integral part of membranes and membrane integrity depends on the obligate presence of cholesterol.

• Cholesterol is required for the synthesis of several hormones including the sex hormones.

• Vitamin D is synthesized in the body from cholesterol and it is now known that the roles of vitamin D go beyond bone formation.

• Bile salts are essential for the digestion of the fats consumed and this compound is also produced from cholesterol.

• Cholesterol is anti-inflammatory.

• Cholesterol’s presence is required for the normal functioning of the serotonin receptors. Since serotonin is a mood elevator, low cholesterol levels produce aggressive behaviour and mood swings.

Now the question is do you need Cholesterol? Definitely, you do. The cholesterol is an essential biological molecule present in our body and survival without this compound, is not possible.

The cholesterol is required to form the bile acids and salts, required to digest the fats which you consume. A wide variety of steroid hormones are produced, with the cholesterol as the precursor. It also leads to the formation of vitamin D, required for keeping your bones healthy. So, don’t be afraid of cholesterol. It is a problem only when you have more than what is needed by you.

The essential point is we need to keep ourselves healthy and not just get treated when we our cholesterol levels go badly. I am working as a Bioinformatician in INFOVALLEY since more than four years and was involved in the FH project which resulted in a high density FH1536 chip which is able to diagnose the molecular basis of Hypercholesterolemia, screening for at risk individuals, prognostic about the heart attack and stroke and also advise the doctor the most appropriate medicine. FH genotyping screening can be undergone by subjects of all ages.

Reference:

http://www.medicinenet.com/cholesterol/page2.htm#what_is_cholesterol

http://www.ravnskov.nu/the%20benefits%20of%20high%20C.htm

http://vnsatakopan.hubpages.com/hub/Does-Cholesterol-Deserve-All-the-Blame-it-Gets

http://www.ravnskov.nu/cholesterol.htm#a

http://drbenkim.com/articles-cholesterol.html

http://www.medicinenet.com/cholesterol_levels_pictures_slideshow/article.htm

By Kavitha IS, Bioinformatician

Heart of The Matter

In conjunction with World Heart Day this Saturday, Nurulhafizah Samsudin suggests ways to keep this powerful organ healthy.

 

THE heart is an amazing organ. It beats an average 72 times per minute and will continue beating approximately 2.5 billion times during an average lifespan of 66-years.

It ensures 11 other major organ systems in your body receive sufficient amounts of oxygenated blood while de-oxygenated blood is pumped back to your heart.

Your heart works tirelessly. So help it by preventing it from having to work harder unnecessarily. An irregular accumulation of fatty materials such as cholesterol on the artery lining is one of the factors that may cause the heart to overwork.

This fatty accumulation may be due to an unhealthy diet, sedentary lifestyle and smoking. The accumulation thickens the artery walls, developing a condition called atherosclerosis.

The heart beats harder and eventually causes the arteries to constantly expand and contract with each heartbeat. Heart disease and stroke may also result from the narrowing and hardening of blood vessels due to fatty acid accumulation.

Cardiovascular disease is a term that covers a wide range of heart and circulatory disorders. They can include coronary artery disease (narrowing of the arteries), myocardial infarction (heart attack) and heart failure.

A heart attack occurs when blood flow to the heart muscles is blocked and a part becomes damaged. The damaged area causes scarring in the heart muscle, making the heart unable to pump the blood efficiently.

Adequate sleep is important to remain relaxed and cool

Risk factors for heart disease are diverse. Some of the risks include ageing or having a family history of heart disease. However, there are also other risk factors such as high blood cholesterol, high blood pressure, smoking, excess weight, diabetes and physical inactivity.

The good news is you can tackle most of these cardiovascular disease risk factors and safeguard your heart.

Eating good, fresh food helps maintain heart health

Lead a healthy lifestyle and your heart will function well. Here are five things you can do to maintain a healthy heart:

1. EAT HEALTHY FOOD

Eat colourful, low-fat meals. An assortment of vegetables and fruit gives a variety of vitamins and minerals essential for your body and heart.

Other foods that benefit the heart include fibre-rich whole foods, unprocessed carbohydrate-rich food and fish. Corn, kidney beans, chickpeas, brown rice, lentils, almonds and barley give not only the essential energy that your body requires, but they also boost dietary fibre which then lowers the cholesterol level in the body.

Fish oil is rich with heart-protecting eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) that help reduce irregular heartbeats and lower triglycerides level in the blood.

Dark chocolate is tasty and is also good for the heart. Cathecin, a natural antioxidant found in dark chocolate, is good for your heart because it can lower blood pressure and improve moods.

2. EXERCISE REGULARLY

Take your partner or your family for a 30-minute walk in the evening, at least five days a week. It need not be hard toil in the gym.

Brisk walking, jogging and bike riding are great ways to keep your heart healthy and help you maintain a healthy body weight.

3. TOBACCO FREE

Smoking is bad for your health. You are at advantage if you are a non-smoker. If you are a smoker, it is wise to cut down or stop smoking completely.

Quitting smoking reduces the risk of recurrent heart attacks and heart disease-associated deaths by 50 per cent or more after just one year.

4. STAY CALM AND COOL

While it is impossible to lead a stress-free life, reducing stress is just as important as a healthy diet and getting enough exercise.

Figure out the causes of your stress, face the issues, and look for appropriate solutions. Never be shy to ask for help.

The feeling of hopelessness, guilt, persistent sadness, and worthlessness are just some of the symptoms of depression. If you sense the onset of depression, regular exercise may ease your symptoms.

Research has shown that depressed individuals who exercised regularly had 60 per cent lower mortality rate associated with heart failure.

Having enough sleep is also important to stay relaxed. How much you need varies from individual to individual. On average, an adult needs between seven and eight hours of sleep a night.

5. SCREENING

Blood tests for lipoprotein profiling tell you exactly the levels of total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides in your blood. You need to know your numbers as these are essential for you to monitor and make sure your lipoprotein profile is within the healthy range.

Hard fat facts

Lipoprotein type and desirable or ideal level

Total cholesterol <200 mg/dL

HDL > 60mg/dL

LDL < 10 mg/dL

Triglyceride < 150 mg/dL

Article written by Nurulhafizah Samsudin, Molecular Research Scientist

Published in New Straits Times, 25th September 2012

http://www.nst.com.my/life-times/health/heart-of-the-matter-1.147950

INFOVALLEY Wellness Quadrant (IWQ™)

At INFOVALLEY we believe in WELLNESS.  Wellness does not mean only a healthy body and sound mind. Wellness means being genetically healthy beside physically well. We at INFOVALLEY believe that understanding our genetic wellness is the solution to a healthy future. 

World Health Organization (WHO) defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or symptoms. INFOVALLEY takes the WHO definition of health one step further and views wellness as a dynamic state of health in which an individual continually progresses towards their maximum potential and higher quality of life. 

The INFOVALLEY Wellness Quadrant to distinguish between SICKCARE and WELLNESS.  We believe that all everyone in the world will fall into the INFOVALLEY Wellness Quadrant. Sick care is associated with treatment of diseases while wellness is associated with preventive medicine.

The INFOVALLEY Wellness Quadrant (IWQ™) has 4 quadrants with each quadrant representing the different concepts of wellness and sick care:

Wellness and Prevention	Clinically Negative; Molecularly Negative (Upper Green Quadrant)	Individual is healthy with no genetic risks or clinical symptoms.
	Clinically Negative; Molecularly Positive (Upper Yellow Quadrant)	Individual has genetic variations that may cause susceptibility to diseases but show no clinical symptoms.
Sickcare and Therapeutics	Clinically Positive; Molecularly Negative (Lower Yellow Quadrant)	Individual has no genetic risk for getting diseases but has clinical manifestation of disease. The illness may be acquired as a result of unhealthy lifestyle habits and environment.
	Clinically Positive; Molecularly Positive (Lower Red Quadrant)	Individual is sick (both genetically and clinical disease is manifested and will require treatment )

In Wellness, we strive to keep you healthy and disease free. Genes contains DNA which is the code for our body and its functions. Our genes hold all these information which could help you identify mutations or variations that may predispose you to getting certain diseases. By understanding our genes we will be able to prevent or delay the onset of diseases as well as learn to manage our health better. Wellness is an important part of medicine and should redefine future healthcare.

With the INFOVALLEY Wellness Quadrant (IWQ™), INFOVALLEY aims to drive the realization of wellness potential by transforming “sickcare” to true healthcare.

By Dr Oliver Chew & Dr Premalatha, 

Clinical Research Scientists

Cholesterol (Hyperlipidemia) Medical Health Quiz

Cholesterol (Hyperlipidemia) Medical Health Quiz on MedicineNet.com

Beside the quiz, here are some useful links to share:

1. The Cholesterol Article
2. High Cholesterol: Are Your Genes To Blame?
3. Cholesterol