LIPID PROFILE

LIPID PROFILE

• SERUM CHOLESTEROL.
• SERUM TRIGLYCERIDES.
• LDL.
• HDL.
• VLDL.
 Myth : fat deposits at old age!
It starts from 2 years of Complicated
age
Foam Fatty Intermediate Fibrous Lesion/
Cells Streak Lesion Atheroma Plaque Rupture

From First From Third From Fourth

Decade Decade Decade

Adapted from Pepine CJ. Am J Cardiol. 1998;82(suppl 104).

 Atherosclerosis

• Over time, fatty deposits called plaque

build up within the artery walls. The
artery becomes narrow. This is
atherosclerosis
 CHOLESTEROL
Group of fats vital to cell membranes, nerve
fibers and bile salts, and a necessary precursor
for the sex hormones. High levels indicate diet
high in carbohydrates/sugars. Low levels
indicate low fat diet, malabsorption, anemia,
liver disorders, carbohydrate sensitivity.

Optimal Adult Range: 100-200mg/dL

 Cholesterol ( A type of fat)
• Everybody needs cholesterol, it
serves a vital function in the body.
• It circulates in the blood.
• Too much cholesterol can deposit
in the arteries in the form of
plaque and block them
• No symptoms till heart attack
 Where does it come from ?
65% 35%

• Two sources of
cholesterol: Food
& made in your
body
• Food sources: All
foods containing
animal fat and
meat products
Common Causes of Cholesterol Increase: Early
stages of diabetes, fatty liver, arteriosclerosis,
hypothyroidism
Less Common Causes of Cholesterol Increase:
biliary obstruction, multiple sclerosis, pregnancy
Common Causes of Cholesterol Decrease: Liver
dysfunction, chemical/heavy metal overload,
hyperthyroidism, viral hepatitis.
 Good vs. BAD Cholesterol
• LDL cholesterol is known as bad
cholesterol. It has a tendency to
increase risk of heart disease
• LDL cholesterol is a major component
of the plaque that clogs arteries
• HDL cholesterol is known as the good
cholesterol. Higher in women,
increases with exercise
• HDL cholesterol helps carry some of
the bad cholesterol out of arteries.
CHOLESTEROL/HDL RATIO

This ratio is an important marker for

cardiovascular health. A ratio <4.0 is
considered adequate. A ratio <3.1 is
ideal.
 LDL
LDL is the cholesterol rich remnants of the lipid
transport vehicle VLDL (very-low density
lipoproteins) there have been many studies to
correlate the association between high levels of
LDL and arterial arteriosclerosis.

• Optimal Adult Range: <100mg/dL

Common Causes of Cholesterol LDL
Increase: Arteriosclerosis, diabetes,
Syndrome X
 HDL
A high level of HDL is an indication of a
healthy metabolic system if there is no sign
of liver disease or intoxication. The two
mechanisms that explain how HDL offers
protection against chronic heart disease are
that HDL inhibits cellular uptake of LDL
and serves as a carrier that removes
cholesterol from the peripheral tissues and
transports it back to the liver for
catabolism.
• Optimal Adult Male Range: >55mg/dL
• Red Flag Range <35mg/dL

Common Causes of HDL Cholesterol Decrease:

Arteriosclerosis, diabetes, Syndrome X
Less Common Causes of HDL Cholesterol Decrease:
Cigarette smoking, steroids, beta-blockers

Nutrition Note: Diets high in refined carbohydrates,

lack of exercise and genetic predisposition have been
found to lower HDL
TRIGLYCERIDES
 These are fats used as fuel by the body, and as
an energy source for metabolism. Increased
levels are almost always a sign of too much
carbohydrate intake and hyperlipidism.
Decreased levels are seen in hyperthyroidism,
malnutrition and malabsorption
• Clinical Adult Range: 50-150mg/dL
• Common Causes of Triglycerides Increase:
Hyperlipidism, diabetes, alcoholism
• Less Common Causes of Triglycerides
Increase: Hypothyroidism, early stages of fatty liver
• Common Causes of Triglycerides Decrease:
chemical/heavy metal overload, liver dysfunction,
hyper thyroid function

Clinical Notes: Resistive exercise training has been

found to be effective in lowering elevated triglycerides
 Limit / Avoid
• Foods rich in Cholesterol and Saturated
fats
–Egg Yolk
–Fatty meat & organ meat( Liver)
–Butter chicken / Batter fried fish !
–Milk fat – Desi Ghee, Butter, Cheese, Malai,
Rabri, Khurchan, Doda, Ice Cream, full
cream milk,
-Hidden Fat like Bakery biscuits, Patties (!),
Cakes, Pastries,
 Cooking Oils: The mystery of
PUFA / MUFA
• Saturated Fats : Increase Cholesterol – Avoid
– Coconut oil, Palm oil, Vanaspati ghee
• Monounsaturated Fats (MUFA): Heart healthy
– Olive oil, Groundnut oil, Canola oil, Mustard oil
• Polyunsaturated Fats (PUFA): Heart healthy
– Sunflower oil, Soybean oil

• Omega-3-Fatty acids Fish oil : Heart Healthy

Rotate the oils or Mixture of oils

 Benefits of reducing
cholesterol

10% reduction of blood

cholesterol produces 20-30%
decline in CHD deaths

All Adults >20 yrs must get tested- if normal test again
after 5 years, if elevated, work towards normalizing the
levels with lifestyle modification and drugs as needed