WHAT IS THE HYPE ABOUT CHOLESTEROL?
During conversations with friends and families or during our doctor’s visit, one topic for discussion that usually comes up is cholesterol. “How is your cholesterol level?” or “Are you taking any medicines to control your cholesterol?” It is estimated that 83 million adults in U.S. have high cholesterol.
What is cholesterol?
It is a waxy fat substance or lipid that is made in the liver. It can also come from food that we ingest. It is an essential component for the body to function well. It has various functions such as making cell membranes or certain hormones, vitamin production, digestion and more. Some of these hormones like cortisone, aldosterone, estrogen, progesterone and testosterone regulate the whole-body function and immune system. Normal levels of cholesterol are good for the body. Problems are only when it goes too high. Extremely low levels of cholesterol are also not good.
When routine blood tests are done, they include measurement of cholesterol levels as lipid profile. Cholesterol circulates in the blood by attaching itself to a protein molecule and hence it is called lipoprotein. This includes total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL) and triglycerides. There is also a low-density lipoprotein called VLDL. One third of Americans do not check for their cholesterol levels until it is too late.
HDL is the ‘good cholesterol.’ It should be 60 or above. LDL is the ‘bad cholesterol.’ It should be 100 or below. Other good markers are triglycerides below150 and total cholesterol below 200. These are not exact figures, but a general guideline.
What causes cholesterol levels to go up?
Some people are born with a genetic abnormality called lipoprotein- a or Lp(a) which results in high cholesterol. It can also run in families as a familial disorder. Several genetic connections have been identified with high cholesterol levels. But vast majority of us have high cholesterol due to our lifestyle and eating habits. Certain medical conditions can make it difficult for the body to get rid of LDL and thus raise the bad cholesterol levels. Some such conditions are diabetes mellitus, chronic kidney disease, HIV/AIDs, Lupus and hypothyroidism. Finally, certain medications that you are taking for other reasons can also affect cholesterol levels. Obesity, smoking, alcoholism and substance abuse disorders are harmful. Older age people are at higher risk too.
High cholesterol by itself does not cause any symptoms. It is the aftereffects of high cholesterol that create various disorders. When the cholesterol level is too high in the blood, it can initiate deposition of fats and cholesterol inside the blood vessels. Calcium and other inflammatory agents deposit over these areas and over time it leads to plaque formation inside the arteries, otherwise known as atherosclerosis. This leads to blockage of arteries and distal emboli, initiating various complications depending upon the organ that is affected. Such arterial blockages cause chest pain, heart attacks, high blood pressure, stroke and gangrene of extremities. Doctors usually find the presence of such blockages inside the lumen of arteries by doing various tests, including an angiogram. These patients will then require further procedures such as angioplasty, stent placement or surgery.
Besides arterial blockage, high cholesterol and triglycerides can cause other problems too. Liver can undergo changes called fatty liver, eventually leading to a type of disorder called ‘Metabolic Dysfunction Associated Steatotic Liver disease’ (MASLD), progressing to cirrhosis of liver and liver failure. Pancreas can get inflamed resulting in acute or chronic pancreatitis. Skin changes can occur due to xanthomas resulting in yellowish patches under the eyes, or bumps near elbows and knees. One can develop chronic kidney disease secondary to damage to blood vessels.
How do you keep the cholesterol levels in control?
The first measure is diet. Diet consisting of whole grain foods, legumes, nuts, fruits, fresh vegetables of all colors, avocado, fish or fish oil, olive oil, soybean, polyunsaturated fats are good. Items to avoid are red meat, highly processed food, fried foods, fast foods, pizza, doughnuts, pastries, snacks, cakes and sweet desserts. Shrimp, bacon, sausage, hot dogs, hamburger, French fries are items with high cholesterol content. Saturated fats and trans fats are bad, especially when they are used to fry food items. Reducing salt and sugar in the food is helpful.
The second good measure is exercise. Regular daily exercise for half an hour will do it. Any type of exercise is good. A simple morning walk is adequate. Other lifestyle measures such as avoiding smoking, managing body weight and moderation in drinking are useful. Proper management of other illnesses such as diabetes mellitus or kidney disorders are beneficial in controlling cholesterol too.
Some individuals will require medications to supplement the above measures for more effective control. These medications are generally called as ‘statins’ or ‘anti-lipids’. There are many different varieties, and different physicians may have different opinions. Some of them are in pill forms and some others are injections. You should consult your primary care physician for best advice. These medications do effectively reduce cholesterol levels.
It is important to monitor your cholesterol levels with periodic blood tests, especially if you are taking any type of medication or having any type of chronic illnesses.
EYE CARE
An Eye on the New Year
By Dr. ARUN GULANI
As December rolls in, Florida's unique charm shines brightly. From sunny days to festive evenings filled with sparkling lights and coastal celebrations, it’s a time for reflection and renewal. While we plan holiday gatherings, year-end vacations and resolutions for the new year, lets focus on the health of our eyes — our window to the vibrant world around us.
The year’s end is often a time of hustle and celebration, but it’s also an opportunity to pause, reflect and make thoughtful choices about our health and well-being, including our vision. Whether it’s taking better care of your eyes or exploring new ways to maintain their health, December offers a unique moment to prepare for the year ahead with clarity, literally and figuratively.
Toy Safety: Protecting Young Eyes During the Holidays
December is also Toy Safety Month (American Academy of Ophthalmology) and of course a season of gift-giving, and while toys bring joy and excitement to children, they can also pose unexpected risks to their vision. According to eye health organizations, thousands of toy-related eye injuries are reported annually, many of which occur during the holiday season. When selecting toys, opt for age-appropriate items and avoid those with sharp edges, small projectiles or laser components that could harm a child’s eyes. For sports-related gifts such as balls or bats, include protective eyewear to encourage safe play. By choosing thoughtfully and supervising playtime, you can help ensure the holidays are memorable for all the right reasons — keeping young eyes healthy and safe for the new year.
Florida’s lifestyle, with its abundant sunshine, outdoor activities and beautiful coastal scenery, puts unique demands on eye health. Exposure to UV rays is a year-round concern here, even during the cooler months of winter. The reflective surfaces of water, sand and even holiday decorations amplify glare, making proper eye protection essential. Sunglasses with UV protection aren’t just a summer accessory; they’re an everyday necessity for Floridians.
December’s cooler and often drier air can also contribute to dry eye symptoms, particularly when combined with the use of indoor heating. While we may not experience the extreme cold of northern states, these subtle changes in the environment can still affect our eyes. Simple measures like staying hydrated, using a humidifier and applying lubricating eye drops can make a big difference in maintaining eye comfort during the winter months.
December naturally inspires reflection. It’s when we look back on the year that’s passed — what we’ve achieved, what we’ve experienced and what we’d like to improve. For many, vision might not be top of mind, but it plays a crucial role in nearly every aspect of our lives.
Consider how much you rely on your eyes daily, whether it’s watching a Gulf Coast sunset, reading holiday cards from loved ones, or navigating crowded markets during holiday shopping. If you’ve been putting off addressing vision concerns, such as difficulty seeing at night or blurred vision at a distance, the end of the year can be a great time to take action.
Here are a few tips to help you maintain a healthy vision during the holiday season and beyond:
- Protect Against UV Rays: Even in December, Florida’s sun can be intense. Invest in quality sunglasses that block 100 percent of UVA and UVB rays. Polarized lenses can also help reduce glare, especially when driving or near water.
- Stay Hydrated: Florida’s mild winters can still lead to dehydration, which affects eye moisture. Drink plenty of water throughout the day and consider using a humidifier at home to combat dry air.
- Mind Digital Eye Strain: With holiday shopping, family video calls and end-of-year work deadlines, screen time tends to increase. Follow the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds.
- Eat for Your Eyes: Incorporate foods rich in nutrients that support eye health, such as omega-3 fatty acids (found in fish such as grouper and snapper), vitamin C (abundant in Florida’s citrus fruits), and leafy greens like kale and spinach.
- Schedule a Check-Up: If you haven’t had an eye exam in a while, now’s the time to make an appointment. Routine exams can catch issues early and ensure your eyes are healthy heading into the new year.
The new year is synonymous with fresh starts and new possibilities. Clear vision —whether literal or metaphorical — can significantly influence how we approach the goals and adventures ahead. Improved eyesight enhances not only your ability to see but your confidence, productivity and overall quality of life too.
If you’re noticing changes in your vision, such as difficulty seeing at night, frequent headaches, or increased reliance on reading glasses, it might be time to explore options. The good news is that modern eye care has made addressing vision concerns more accessible and effective than ever before. Advanced laser techniques like Next Generation Lasik LaZrPlastique®, and cataract surgery LenzOplastique®, including repair techniques for those with failed eye surgeries like Radial Keratotomy, premium lens cataract surgery, Lasik or keratoconus surgery are now available.
The Year-End Lens: Looking Back, Planning Ahead
As you jot down your resolutions for the new year, consider adding eye health to the list. Whether it’s scheduling that long-overdue eye exam, investing in high-quality sunglasses or making small lifestyle changes to support vision, these steps can pay off for years to come.
The holiday season is all about seeing the world in its best light — both literally and figuratively. This December, take a moment to reflect on the role vision plays in your daily life and how taking care of your eyes can bring a brighter, healthier 2025.