Keep your heart pumping

Learn the dangers of high blood cholesterol levels and what they can do to your heart.

YOUR heart is your most valuable organ, continuously pumping oxygen and nutrient-rich blood throughout your entire body to sustain life. Unfortunately, many of us do not realise how important it is to look after one’s heart, in order to prevent heart disease. Contrary to what people think, heart disease is not a disease on its own; it is a group of conditions that affects the structure and function of the heart.

Did you know that seven out of 10 Malaysians suffer from a non-communicable disease (NCD) such as hypertension, diabetes, obesity and high cholesterol, which are all risk factors for heart disease? The number of obese or overweight Malaysian adults has also increased to 40% while 21% of Malaysian adults have high cholesterol levels. High cholesterol is in fact one of the major factors that lead to the development of heart disease.  

The good news is that the power to prevent heart disease is in your hands. This is why World Heart Day 2010, with its theme, "Workplace Wellness", is calling on everyone to work their hearts each day. You can definitely make small changes that will make a big difference in favour of good heart health. Start by understanding what heart disease is all about.

What exactly is cholesterol and where does it come from?

Cholesterol is actually a waxy substance that is made and used by the body to keep us healthy. It is used to protect the nerves, make cell walls as well as produce certain hormones. Your liver and other cells in your body produce about 75% of cholesterol while another 25% comes from the foods that you eat. Cholesterol is only found in animal products such as cheese, whole milk, butter and fatty meats.

The good and the bad

In the body, cholesterol is transported by two different protein particles, low-density lipoproteins (LDL) and high-density lipoproteins (HDL). LDL cholesterol, also known as the "bad cholesterol", carries cholesterol from the liver to cells. An excessive amount causes a build-up on the artery walls, leading to blockage in the blood vessel (known as atherosclerosis). When this affects the coronary arteries, ischaemic heart disease or "heart attack" occurs. On the other hand HDL cholesterol, also known as the "good cholesterol", carries cholesterol away from cells back to the liver, where it is then broken down and passed out as waste products.

Elevated levels of triglycerides, another form of fat made in the body, are usually brought on by obesity/overweight problems, lack of exercise, smoking and excessive alcohol consumption. High levels of triglycerides, especially in conjunction with low HDL cholesterol levels, also predispose to coronary heart disease.  

Progressive atherosclerosis with deposition of the LDL cholesterol in the walls of the arteries causes a build-up known as plaque. Sometimes, the plaques may crack, leading to the formation of blood clots which block the blood flow in the arteries. When blood flow to your heart or brain is obstructed, a heart attack or stroke may occur.

  • Coronary artery disease: Plaques may remain stable in the coronary arteries causing angina or chest pain. A heart attack occurs when these plaques rupture and result in blood clot formation and total obstruction in the arteries.
  • Cerebrovascular disease: Atherosclerosis in the blood vessels of the brain leads to stroke.
  • Peripheral artery disease: Atherosclerosis in the arteries of the limbs results in poor blood circulation. Walking causes pain, while wounds tend to heal more slowly.

Eat smart for your heart

In general, the most common risk factors for heart disease are poor dietary habits and lack of physical activity. But the good news is that you can do something to change this. Reducing your cholesterol level and reducing the chances of heart disease lies in the way you live your life, especially in the way you eat.

  • Healthy foods like fruits and vegetables
  • Whole grain breads, rice, pasta
  • Cereal products such as oats
  • Baking, roasting, broiling, boiling, steaming, grilling your foods

  • Foods that have saturated fats like cheese, bacon, whole milk
  • Salty and sweet seasonings
  • Dressings and flavourings like mayonnaise and ‘santan’ for salads and curries

>Know your fats

Saturated fat, found mostly in foods from animals, is the main dietary source of high blood cholesterol. Total fat intake should only be 25-35% of your total daily calories and saturated fats should only comprise 10% of your total daily calories. When cooking, no more than 5-8 teaspoons of fats and oils should be used a day and all visible fat and skin from meat and poultry should be trimmed off prior to cooking.

Other types of fats include polyunsaturated and monounsaturated fats. Unsaturated fats are found in salmon, trout, avocados, olives and vegetable oils like soybean and canola. Another type of fat, known as trans fats, raises your bad (LDL) cholesterol levels and lowers the good (HDL) cholesterol levels. Eating foods that contain trans fats such as French fries and baked goods increases your risk of developing heart disease and stroke.

>Heart-healthy oats

Diets high in oatmeal or oat bran and low in saturated fat and cholesterol may reduce the risk of heart disease as stated by The US Food and Drug Administration (FDA), 1997.  

When you eat oats, the soluble fibre (beta-glucan) that is released binds the cholesterol-laden bile acids in your gut and both are eliminated through the bowel. This means the cholesterol is prevented from entering your bloodstream, leading to lower blood cholesterol and a reduced risk of heart disease.

It is recommended to consume 70 grams of oats daily, which provides about 3 grams of beta-glucan needed to reduce the cholesterol levels in our body.

Keep it pumping

The second step to a healthy heart is to ensure you keep moving. Nowadays with modern amenities, people tend to lead sedentary lifestyles that naturally cause their weight to increase to dangerous levels. This extra weight actually puts a strain on the heart and blood vessels, thus contributing to an increased risk of heart disease.

Losing weight can be done gradually and safely on a regimen of high-fibre, low-fat diet along with regular exercise. Exercise helps in preventing heart disease, high cholesterol and many other health problems.

You can start off by exercising 30 minutes daily. Do simple exercises that just keep your body moving. Give your maid a day off and take over the household chores instead. Also, other activities such as sweeping and mopping the floor, gardening and washing the car can help in burning off extra calories. Of course, if you do smoke, quit smoking!

High cholesterol levels is one of the most controllable risk factors for heart disease. With good diet management and regular exercise, you can keep your levels of cholesterol down and heart disease at bay.


Datuk Dr Khoo Kah Lin is the consultant cardiologist and director of the Heart Foundation of Malaysia. This article is courtesy of the Quaker Smart Heart Programme, which supports the foundation’s Healthy Heart Programme.

This article was first published in on 26 September 2010.