Hyperlipidemia and HIV/AIDS: High Cholesterol and Triglycerides
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Lipids are fats and fat-like substances in the blood. Cholesterol and triglycerides are lipids. Your body uses cholesterol to build and maintain cells and to make some hormones. After eating, energy that is not needed right away is converted into triglycerides, which are stored in fat cells.
While having some cholesterol and triglycerides in the blood is important for the body to function properly, having too much is unhealthy. Having high levels of lipids is called hyperlipidemia.
There are many possible causes for high lipid levels, including HIV and some of the HIV drugs. This puts people living with HIV (HIV+) at particular risk for developing hyperlipidemia. Although you cannot tell if you have this condition without lab tests, it can cause serious long-term health problems.
The main danger of hyperlipidemia is heart disease. If you have too much cholesterol in your blood it can build up on the inside of your arteries (blood vessels), and form plaques. This buildup of plaque can lead to a heart attack or a stroke. High triglycerides can also increase your risk of getting pancreatitis (a painful inflammation of an organ in your abdomen called the pancreas).
Some HIV+ people experience lipodystrophy. Lipodystrophy means abnormal body fat changes, and can include body shape changes and metabolic changes like hyperlipidemia. These changes have been linked to increased chances of developing diabetes, heart disease, and strokes. (For more info, see TWP sheets on lipodystrophy).
There are two main kinds of cholesterol. One is low-density lipoproteins (LDL) or "bad" cholesterol, which can clog the arteries. The higher your LDL, the higher your risk of heart disease. The other kind is high-density lipoproteins (HDL) or "good" cholesterol, which can help reduce the risk of heart disease.
Your health care provider can tell you if you have high cholesterol or triglycerides by doing a simple blood test called a fasting lipid profile. This will measure total cholesterol, HDL, LDL, and triglycerides. It is important that you have nothing to eat or drink for eight to 12 hours before the test is done. The following levels are ideal:
There are several types of fat found in the foods we eat. These include saturated fats, trans fats, polyunsaturated fats, and monounsaturated fats. Saturated and trans fats raise cholesterol and increase the risk of heart disease the most. They are considered "bad" fats. Polyunsaturated and monounsaturated fats tend to keep cholesterol low and are considered to be "good" fats.
Saturated fat is usually solid at room temperature (e.g., butter). It is found in the fat of animal products like meats and dairy. It is also found in a few vegetable products like coconut, palm, and palm kernel oil. To keep your intake of saturated fat low, check food labels and choose dairy products with low fat content like skim (non-fat) or one percent milk, and low fat cheese and ice cream. When you are buying meats, choose leaner cuts of meat and trim off fat before cooking. Lean meat has less visible 'marbling' (white fatty swirls or stripes that can be seen in the pinkish meat). If you have any questions, ask your grocer or butcher to help you find leaner cuts of meat.
Most trans fats are industrial or synthetic fats. These are the result of food processing techniques that partially hydrogenate unsaturated fats. To reduce how much trans fat you eat, check food labels for trans fat and any partially hydrogenated oils.
Polyunsaturated and monounsaturated fats ("good" fats) are usually liquid at room temperature and generally have plant-based sources. These include oils (olive oil, safflower oil, peanut oil), nuts, and avocados. If you use oil in cooking, the two best choices are canola and olive oil.
Eating a lot of "refined" carbohydrates or simple sugars (e.g. sugary foods, sodas, white bread, white rice) can raise triglycerides. If you need to reduce total cholesterol, LDL, and triglyceride levels it is important to limit the amount of bad fats and excess sugar in your diet. See a registered dietitian to help you make good choices and plan your meals. Many AIDS service organizations have registered dietitians on staff who will see you free of charge. For more information, see TWP's sheet on nutrition.
Aerobic, or cardiovascular exercise, is the kind of physical activity that will help lower your lipid levels. A brisk walk, or other activity that gets your heart pumping moderately hard counts as aerobic exercise that can benefit your heart. This kind of exercise has been found to lower total cholesterol, triglycerides, and LDL; it can also raise HDL. Try to get 20 to 30 minutes of aerobic exercise three to five times a week.
This article was provided by The Well Project. Visit The Well Project's Web site to learn more about their resources and initiatives for women living with HIV. The Well Project shares its content with TheBody.com to ensure all people have access to the highest quality treatment information available. The Well Project receives no advertising revenue from TheBody.com or the advertisers on this site. No advertiser on this site has any editorial input into The Well Project's content.
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