Hereditary high cholesterol can be reduced by changing the diet.

Sparkling white, de-husked rice, oily parathas, and curries cooked generously with coconut oil — these are certainly not strangers to our dining tables. However, neglecting fruits, vegetables, and fiber-rich foods and getting accustomed to such a diet alone has a severe impact on our body's cholesterol levels.

Many people believe that high cholesterol is an unchangeable fate inherited from their lineage and genes. However, a recent study has confirmed that even if you have inherited a cholesterol risk from your family, it can be completely altered through correct daily dietary choices.

This latest study, conducted on 1,020 adults in Chennai, India, shows that even individuals with a genetic risk of elevated 'bad' cholesterol (LDL) levels can bring about a critical change in their blood indicators through the quality of their daily diet. Those who followed a medium or high-quality dietary pattern completely mitigated their genetic risk for high LDL and total cholesterol, while only those who followed a poor dietary pattern succumbed to high cholesterol levels.

This study (CURES–165), published in the scientific journal ‘PLOS ONE’, is based on long-term data from the Chennai Urban Rural Epidemiology Study (CURES). It included 452 men and 568 women aged between 25 and 80 years. Three genetic variants, TCF7L2 rs7903146, FTO rs8050136, and rs1588413, were examined, and a specific genetic risk score was calculated. Furthermore, the quality of their diet was measured using an Indian Diet Quality Index under 8 categories, including pulses and legumes, fruits and vegetables, dairy products, white rice, dietary fats and oils, added sugar, added salt, as well as chicken and eggs. Researchers confirmed a significant association between high genetic risk and elevated total cholesterol as well as LDL cholesterol levels in individuals in the low-quality diet category. This difference was not statistically significant in the medium and high-quality diet categories.

"Although genes determine an individual's risk for metabolic diseases, how that risk manifests can be altered through a person's dietary habits. Even if you are born with a genetic predisposition to cholesterol and diabetes, a healthy diet can further control cholesterol levels," says Dr. V. Mohan, co-author of this paper, President of Dr. Mohan's Diabetes Specialities Centre and Madras Diabetes Research Foundation (MDRF). A relationship between the genetic risk score and fasting blood sugar levels, as well as the average blood sugar level over the past two to three months (HbA1c), has also been revealed here.

Although this study was conducted in Chennai, its results are applicable to a wide range. Dr. Mohan points out that data from a city like Chennai, where people of various languages and cultures live, including Telugu-speaking residents, Marwari, Jain, Bengali, as well as those from states like Uttar Pradesh and Bihar, provides a representation for the entire region. He also cites the ICMR-INDIAB study, stating that even though the staple diet varies regionally, the impact of excessive carbohydrate consumption is observed everywhere.

When carbohydrates are consumed in excess of what the body needs, the surplus is converted into fat in the liver and released into the bloodstream as triglycerides. This alters the composition of LDL and HDL ('good' cholesterol), leading to the creation of smaller, denser LDL particles that can bind to artery walls and cause blockages. Therefore, his advice is to choose brown rice with bran instead of completely refined white rice, and whole wheat flour instead of refined flours like maida. Furthermore, using unsaturated fats like peanut, mustard, sesame, and sunflower oils is healthier than saturated fats like coconut oil, palm oil, ghee, and butter, which raise cholesterol.

This is not about completely eliminating one type of food but maintaining a balance in the overall diet, emphasizes Dr. R. M. Anjana, co-author of the research and Managing Director of Dr. Mohan's Diabetes Specialities Centre. "People don't eat just one specific type of food. Everything contributes to the body's functioning," she says. She points out that highly refined carbohydrates, sweets, and sugary drinks have the fastest impact, and if one consumes something with carbohydrates or fat, adding more protein and fiber can mitigate the adverse effects.

Dr. Anjana also provides simple guidance on what a healthy food plate should look like. According to her, half of the plate should be reserved for vegetables and fruits, including leafy greens. Of the remaining half, a quarter should be for protein, and the other quarter for low-starch carbohydrates. Water, as well as foods like milk and curd, can also be included. However, these proportions may vary depending on an individual's Body Mass Index (BMI), diabetic status, and nutritional needs.

She also approves of consuming whole fruits instead of packaged fruit juices, and thoroughly washing and eating raw vegetables like carrots, cucumbers, and tomatoes. She further points out that while avoiding packaged foods as much as possible can be difficult in a busy life, it is extremely important.

Although cholesterol parameters can be improved through a good diet, these experts strongly emphasize that individuals with very high LDL levels, for whom a significant reduction is not observed merely by lifestyle and exercise changes, should not delay medicinal treatment for cholesterol control. Even though genes provide an early warning, the final decision regarding our health largely rests on the food choices we make.

(Source: The Times of India)