The aim of treatment to reduce cholesterol and fat levels should be to achieve the threshold values (200 mg/dl) for the indicators provided. Once serum cholesterol has been normalized, follow-up tests are performed four times during the first year and twice a year in subsequent years. Treatment of elevated cholesterol levels always begins with dietary treatment. Diet is of fundamental importance. A properly selected diet can be a very positive factor in maintaining health. Conversely, an inappropriate diet can be very harmful.
The primary role in atherosclerosis is played by free radicals produced inside the body or supplied externally. Free radicals have harmful effects on cells, nucleic acids, enzymatic processes, collagen degradation, damage to cell membranes, and disturbances in prostacyclin synthesis. The body's defense against free radicals consists of antioxidants (“scavengers” of free radicals). When preparing meals, we pay attention to certain important elements. Food should be boiled in water or steamed, baked in foil, grilled, prepared in a microwave oven, etc.
It is recommended that frying be significantly limited (frying in oils rich in polyunsaturated fatty acids, such as palm or coconut oil, is particularly unfavorable). Oils containing large amounts of monounsaturated fatty acids, such as olive oil or low-erucic rapeseed oil, are suitable. Foods fried repeatedly, such as French fries and doughnuts, should be excluded from the diet. Fats from meat stocks and soups should also be rejected.
Practical treatment recommendations:
1. Avoiding foods that introduce free radicals from outside or those whose technical processing causes the production of free radicals (e.g. animal fats and some vegetable fats, medicines—antibiotics and anthracyclines—carcinogens, and cigarettes).
2. Promoting proper, healthy nutrition, that is, dietary management based on daily food rations of approximately 2,000 kcal; limiting the intake of unsaturated fats to 10% in a first-degree diet and to more than 7% in a second-degree diet (preferably consuming vegetable fats raw). Recommending dietary fiber, including wholemeal bread, graham bread, buckwheat, oatmeal, beans, lentils, etc. Large quantities of fruit and increased fish consumption are also recommended.
3. Supplementing food with natural antioxidants such as vitamins C, E, and A (cod-liver oil), as well as supplementing the diet with trace elements, namely magnesium, selenium, copper, and zinc.
4. Engaging in regular physical activity and reducing excess weight.
5. Reducing stress, since more than 75% of cholesterol is produced in the liver under the influence of adrenaline.
If the desired cholesterol levels cannot be achieved through diet, pharmacological treatment is introduced. The strategy for pharmacological treatment is determined by the physician and requires precise selection of the medicine and conscientious cooperation from the patient. We distinguish first-line drugs:
- bile acid sequestrants, e.g. cholestyramine and colestipol,
- HMG-CoA reductase inhibitors, e.g. lovastatin (Mevacor), simvastatin (Zocor), and pravastatin,
- nicotinic acid. Second-line drugs
- fibric acid derivatives (clofibrate), Lipomid, bezafibrate, and Lipanthyl) primarily have an auxiliary effect.
I remind you that treatment with pharmacological agents leads to threshold values. It is known that low cholesterol content in the body is associated with increased incidence of malignant tumors. Thus, cholesterol is a very necessary compound in metabolic processes, and excessive reduction of its level is undesirable. Please remember about natural antioxidants (vitamins A, E, and C) during treatment for elevated cholesterol, as well as in situations involving the risk of cancer.