Content. Your individual result report. Your test result. What are cholesterol & Co. needed for and what are they made of?

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2 Content 1 Your individual result report 3 2 Your test result 4 3 What are cholesterol & Co. needed for and what are they made of? 6 4 Consequences of arteriosclerosis 7 5 Further risk factors for arteriosclerosis 8 6 How can I reduce the risk of arteriosclerosis? Change of diet Physical activity Reference list 2 / 11

3 1 Your individual result report Patient: Max Mustermann Sample number: test125 / P Date of birth: Receipt: Weight: 90 kg Issue: Max Mustermann, As per your request, we determined your risk of arteriosclerosis by measuring the concentration of your blood fat values. The test determines the total cholesterol, HDL (High-Density-Lipoprotein), LDL (Low-Density-Lipoprotein) as well as the triglycerides levels. On top, we determine your personal LDL/HDL ratio. This test cannot and doesn t intend to replace a visit to the doctor. If the test result shows an increased risk of arteriosclerosis, please consult with your doctor to discuss further steps. Do not discontinue medication or change their dosage without consulting with the treating doctor. This document was created automatically and is valid without signature. If you want a personal consultation regarding your test results or have general questions, feel free to contact one of our nutritionists at support@cerascreen.co.uk or Your cerascreen Team 3 / 11

4 2 Your test result Blood lipid values normal range* your measurement result Cholesterol <= 5,0 mmol/l 6,00 mmol/l LDL-cholesterol < 2,59 mmol/l 4,3 mmol/l HDL-cholesterol > 0,90 mmol/l 1,3 mmol/l LDL/HDL ratio < 3,0 3,3 Triglycerides <1,7 mmol/l 0,0 mmol/l Sometimes the values are given in mg/dl. The conversion is: cholesterol, LDL, HDL mmol/l x = mg/dl and triglycerides mmol/l x 87.5 = mg/dl. *Please note that the reference values refer to adults only. Your LDL cholesterol value: Your LDL cholesterol value exceeds the normal range of < 2.59 mmol/l. This indicates an increased risk of arteriosclerosis. If there are further risk factors, you have a high risk of arteriosclerosis. Try to reduce your LDL values by following the tips of chapter 6. If you have further risk factors, try to reduce them. Your HDL cholesterol value: Your HDL cholesterol value is within the normal range which means you are protected against arteriosclerosis. Try to keep this value within this range and control it regularly. Your LDL/HDL ratio: The ratio of your LDL and HDL values exceeds the normal range. This indicates an increased risk of arteriosclerosis. Avoid further risk factors and try to reduce your increased LDL value by applying the tips of chapter 6. Your triglyceride level: As you can see in the table above, your measurement value of triglyceride is within the normal range of < 1.7 mmol/l. This does not indicate an increased risk of arteriosclerosis. However, you should avoid further risk factors. If further blood lipid values exceed the normal range, try to reduce them by applying the tips of chapter 6. 4 / 11

5 If you should not manage to rebalance your blood lipid values by following the recommended action, consult with a doctor who may reduce your risk of arteriosclerosis by drug treatment and initiate further measures. 5 / 11

6 3 What are cholesterol & Co. needed for and what are they made of? Tasks of cholesterol: formation of steroid hormones (esp. androgens, estrogen, cortisol and aldosterone) stabilization and construction of cell membranes bile acid production vitamin D is made from cholesterol Cholesterol is needed as a building substance on the other hand, a surplus has far-reaching consequences. Balancing your cholesterol levels is the aim! LDL cholesterol LDL cholesterol is a protein which transports water-soluble substances, such as cholesterol, to the body s periphery. High LDL concentrations lead to deposits of cholesterol and thereby to arteriosclerosis. That s why it is also colloquially known as the bad cholesterol. HDL cholesterol Like LDL cholesterol, HDL cholesterol is a transport protein which re-transports cholesterol from the body s periphery to the liver. HDL levels within the normal range are a protection factor against arteriosclerotic diseases. That s why HDL cholesterol is also called the good cholesterol. Triglycerides Triglycerides are also called neutral fats and occur in natural lipids and oils. They are ingested through food and then transported in the blood via other lipoproteins, the chylomicrons. In addition, the body can also produce them itself. 6 / 11

7 4 Consequences of arteriosclerosis Heart attack A heart attack is the most severe and most frequent consequence of arteriosclerotic changes to the blood vessels. This causes a death of the heart muscle tissue due to oxygen deficiency. The lack of oxygen is often caused by occlusion of the supplying blood vessels (arteries) by a thrombosis. The thrombosis is created by the deposit of cholesterol in the blood vessel walls and the resulting constriction in this areal. This can lead to the formation of blood clots. Arteriosclerotic changes in the vessels deposits in the blood vessel walls Coronary heart disease The so-called coronary heart disease (CHD) is another effect of arteriosclerosis. It is a disease of the heart caused by the occlusion or constriction of the coronary vessels (coronary arteries). These blood vessels supply the heart with oxygenated blood and energy-supplying nutrients. The symptoms range from angina pectoris attacks, arrhythmia, shortness of breath and cardiac insufficiency to attacks. Stroke Arteriosclerosis can cause a stroke. This is caused by insufficient blood supply to different areas in the brain. Symptoms differ according to the affected area. In one case the affected person may only have their mouth corners hanging down, in other cases the stroke may cause speech and visual disorders. Other symptoms are signs of paralysis and numbness - typically affecting one side of the body only. Dizziness and movement disorders can also occur. Immediate medical aid is required to keep the level of permanent damage as low as possible. Smoker s leg The so-called smoker s leg, medically called peripheral arterial occlusive disease (PAOD), is also caused by arteriosclerosis. The constriction (stenosis) caused by arteriosclerosis impairs or completely interrupts the blood flow. The term smoker s leg arises from the fact that the effects are especially visible in the legs and that mostly smokers are affected. Symptoms often only occur if major harm to the blood vessels was already caused. Therefore, regular checks of the blood lipid values is advisable. 7 / 11

8 5 Further risk factors for arteriosclerosis Apart from increased triglyceride and cholesterol values (increased LDL cholesterol AND and reduced HDL cholesterol), the following factors pose further risks: high blood pressure (hypertension) overweight (adiposis) smoking diabetes mellitus genetic risk factors (cardiovascular diseases of blood relations) The more risk factors there are, the higher the chance of developing arteriosclerosis and the above-mentioned secondary diseases. All risk factors have to be treated to avoid arteriosclerosis. The risk of developing arteriosclerosis and secondary diseases rises with increasing age. More men than women are affected. 6 How can I reduce the risk of arteriosclerosis? The risk of arteriosclerosis is closely related to certain food components. A dietary change can thus have positive effects on your blood lipids. Physical activity and the reduction of overweight also have a valuable contribution on the reduction of an increased risk. Obesity has an unfavourable influence on your blood lipid levels. Overweight people have higher LDL cholesterol levels, too low HDL cholesterol levels and raised triglyceride levels in their blood. When you avoid diabetes and high blood pressure or if these diseases are well treated with medicine, it also reduces the risk. 8 / 11

9 6.1 Change of diet The following recommendations for diet optimisation contribute to the lowering of the risk of arteriosclerosis: fat optimized diet (less saturated and trans-fatty acids, more natural fats, less fats of animal origin) drink less alcohol reduce salt consumption eat more fruit and vegetables eat fish and fish oil reduce cholesterol intake prefer filter coffee and espresso to brewed coffee eat more nuts and wholegrain cereal eat more foods rich in folic acid eat more plant sterols which can be found in all fatty plant foods such as oils, nuts, seeds, cereals, beans Increased LDL values In addition, there are special recommendations in case of increased LDL values. Listed below are the recommendations of the German association Lipid-Liga e.v. : 1. Reduce visible and hidden fats (especially in cheese and cold cuts). 2. Prefer low-fat cooking methods such as grilling or steaming. 3. Eat less animal foods to reduce the intake of fat, saturated fatty acids and cholesterol. 4. Prefer fat-reduced animal foods (which do not always have less cholesterol!): - Choose fat-reduced meat and cold cuts. - Prefer fat-reduced milk and dairy products. - Prefer animal foods low in saturated fats e.g. fish, poultry, veal and venison. - Avoid foods high in cholesterol such as egg yolk and foods produced from it as well as innards. 5. Eat fruit or vegetables several times a day, if possible as raw vegetables or salad. 6. Use vegetable oils and diet margarine. Increased triglyceride levels The Lipid-Liga e.v. recommends the following measures for increased triglyceride levels: The most effective one is reducing - or better avoiding - alcohol. Some people already reach normal blood values due to this measure. However, this doesn t mean that they drink too much alcohol but that their body reacts with an increase in triglycerides in the blood to alcohol. Please don t switch from alcohol to lemonades, colas and fruit juices as these contain sugar which quickly pass into the blood and have the same effect on your triglyceride blood levels. 9 / 11

10 If you cannot normalize your blood levels by avoiding alcohol, then please reduce sugar. Please consume less sweets. If this is still not enough, restrict your intake of animal fats. Additionally helpful is losing weight and increasing physical activity. Fish oil capsules can reduce triglycerides very effectively. An intake of the required dosage of g a day is not possible through the diet. The implementation of these recommendations could look as follows: 1. Don t eat too rich! Every additional kilogram raises your triglyceride levels. 2. Avoid alcoholic beverages! 3. Avoid fruit juices, lemonade and colas! 4. Limit eating sweets! 5. Become physically active! 6. Non-smoking supports your efforts substantially. Increased cholesterol values In case of increased cholesterol values, the total intake of cholesterol and the fat content of your foods should be reduced and the percentage of carbohydrates should be increased accordingly. It also has a positive effect if you increase the intake of fibres to 35 g / day and if you limit coffee and alcohol consumption. 6.2 Physical activity Increasing physical activity can have positive effects on many risk factors. It positively influences high blood pressure, dyslipidemia, diabetes mellitus and overweight. It is proven that regular physical activity raises HDL levels in your blood. Therefore, this is particularly important for fighting your risk of arteriosclerosis. This does, however, not only mean sports activities. Even physical activities in your daily life can have positive effects. Take the stairs instead of the elevator or ride the bike/walk instead of going by car. 7 Reference list Biesalski, H.-K., Grimm, P. (2011). Taschenatlas Ernährung. Stuttgart: Georg Thieme Verlag. Bundesinstitut für Risikobewertung (BfR) (2015). BfR online. Fragen und Antworten zu Pflanzensterinen. Stand Deutsche Gesellschaft zur Bekämpfung von Fettstoffwechselstörungen und ihren Folgeerkrankungen DGFF (Lipid-Liga) e.v. Online. Stand Deutsche Gesellschaft für Ernährung (DGE) (2015). Leitlinie Fettzufuhr und 10 / 11

11 Prävention ausgewählter ernährungsmitbedingter Krankheiten. DGE online. Stand Rehner, G. und Daniel, H. (2010). Biochemie der Ernährung. Heidelberg: Spektrum Akademischer Verlag. Kasper, H. (2014). Ernährungsmedizin und Diätetik. München: Urban & Fischer. Schäffler, A. (2014). Laborwerte für Heilpraktiker. Stuttgart: Karl F. Haug Verlag. Schenk, A. (2011). Ernährungslehre kompakt. Sulzbach im Taunus: Umschau Zeitschriften Verlag GmbH. 11 / 11