Pregnant? This is what you should know about cholesterol

A little biology lesson first. There are two types of cholesterols. There is the good and the bad kind. The good kind is the high-density lipoprotein (HDL) and the bad kind is the low-density lipoprotein. You want more of HDL and low levels of LDL. HDL will protect you from heart attacks and strokes, while LDL will cause just that by depositing on the walls of the blood vessels. Usually, the HDL will transport the LDL to the liver to be flushed out, because high levels of LDL are dangerous. Now that we have dispensed with that, let’s get into how the waxy substance that is cholesterol, can be a big menace.

Pre-eclampsia is one of the hypertensive disorders in pregnancy that cause maternal and newborn morbidity and mortality. Preeclampsia is often manifested through high blood pressure, with increased protein levels in urine (proteinuria) after 20 weeks of gestation. It complicates about five per cent of pregnancies worldwide and affects about 5.6 per cent to 6.5 per cent of pregnant women in Kenya.

It can increase risks of:

· Damage to the brain

· Detachment of placenta from the uterus (placental abruption)

· Kidney failure

· Seizures in infants

· Death

Some of these symptoms could result in premature delivery.

Even though early detection helps in the management of preeclampsia, it is unfortunate that the condition does not disappear until the baby is born. A study on clinical presentation and outcomes of preeclampsia done at the Kenyatta National Hospital established that late detection and poor management of pre-eclampsia in primary healthcare facilities negatively affects newborn and maternal health outcomes. Researchers, who conducted this study, recommended that understanding the preeclampsia burden is necessary for improving care for women experiencing early and late-onset pre-eclampsia and eclampsia. Management is by monitoring and alleviating the symptoms until the baby is born. Could the cause of preeclampsia be the missing piece to the treatment puzzle?

Cholesterol; a primary cause

Scientists at the Norwegian University of Science and Technology have highlighted with scientific evidence that cholesterol was significantly higher in women with preeclampsia. The motivation behind examining the role of cholesterol in preeclampsia was due to the fact that women who have the condition carry an elevated risk of developing cardiovascular disease later in life. “A pregnancy is actually a kind of natural inflammatory condition and in the case of preeclampsia, the inflammation has become too strong and leads to disease,” says Gabriela Silva, one of the researchers.

How does cholesterol escalate inflammation? 

There is scientific evidence that cholesterol particles are responsible for inflammation that can result in blood clots. “Cholesterol crystals are identified at harmful substances in the body that need to be cleared out. But the defence cells that come on to do the job are not able to break them down. They call for reinforcements, and more immune cells come in, to no avail. The immune response runs wild and the inflammation process escalates,” Silva breaks it down. It is of paramount importance to note that inflammation was observed to be highest at the maternal-fetal interface. Even though all expectant women have high cholesterol levels, those with preeclampsia have elevated levels of the bad type, putting them at risk of cardiovascular disease. This observation was made after examining the placenta samples and uterine tissue of women with preeclampsia.

With these findings, scientists believe that the treatment of preeclampsia will be more effective in future. This would mean the incorporation of medications that lower cholesterol levels and are safe to use in pregnancy in addition to the World Health Organisation recommendation of magnesium sulphate in the management of preeclampsia. Better still, cholesterol levels should be part of preconception and antenatal care.

Managing your cholesterol levels

When the doctor warns you about your cholesterol, here are some dietary recommendations nutritionist Faith Biongo recommends.

1. Know your oils and fats.  Choose healthier fats and oils. Fats and oils derived from plants like olives, canola, sesame and sunflower are a good source of unsaturated oils which are good for your health.

2. Limit dietary cholesterol. This is important in reducing the amounts in the blood. Egg yolk, shellfish and organ meats like liver, kidney, heart and brain contain considerable amounts of cholesterol

3. Increase fibre intake. Increasing fibre consumption, especially soluble fibre, can lower bad cholesterol. Fruits and vegetable are very good sources of fibre and are naturally low in fat. Unlike refined grains, whole grains are an excellent source of fibre, which as a part of an overall healthy diet, not only lowers the bad cholesterol but also reduces the risk of heart diseases, stroke and type 2 diabetes.

4. Increase consumption of plant sources of protein and moderate intake of animal proteins. This lowers intake of saturated fats.

5. Excessive consumption of alcohol and smoking can increase the amounts of bad cholesterol and lower the good cholesterol in the blood. Reducing their consumption or cutting them off your lifestyle enhances the chance of maintaining blood cholesterol at healthy levels.

6. Being physically active can help lose excess weight and cholesterol.

Different people process cholesterol differently. Some people have genes that direct their liver to produce extra cholesterol or slow its excretion. In such a case, one would still have high cholesterol even if they maintain a healthy lifestyle. Medical treatment would be the most appropriate in such a case.