PETALING JAYA, Sept 10 — More young Malaysians are being diagnosed with abnormal cholesterol levels, often without symptoms and despite believing they lead healthy lifestyles.
Dr Richard Chan Tze Ming, a consultant cardiologist at Sunway Medical Centre, Sunway City, said many of these cases involve dyslipidemia — a condition where levels of certain fats in the blood, such as cholesterol and triglycerides, are too high or too low, disrupting the body’s balance and raising the risk of cardiovascular disease.
Cholesterol and triglycerides are types of fats found in the blood. Cholesterol is carried by particles known as low-density lipoprotein (LDL), or “bad” cholesterol, and high-density lipoprotein (HDL), or “good” cholesterol. Triglycerides store excess calories and provide energy.
High levels of LDL or triglycerides can increase the risk of heart disease, while higher HDL levels are generally protective, as HDL helps remove excess cholesterol from the bloodstream.
“Dyslipidemia is when we have higher levels of bad cholesterol and lower levels of good cholesterol,” Dr Richard told CodeBlue in an interview. “As a result, it can disrupt a few things and cause plaques formation in the blood vessels wall.”
Although cholesterol is a natural substance in the body, problems arise when LDL is too high and HDL is too low. This imbalance often goes undetected until a person experiences a heart attack or stroke.
‘But I’m Young, I Exercise, I Eat Healthy’
Many people assume that being young or slim protects them from cholesterol problems. But Dr Richard said a person’s cholesterol levels are largely determined by genetics — not just diet.
“About 80 per cent of the total cholesterol floating in our bloodstream is produced by our own body, and only 20 per cent comes from dietary intake,” he explained. “Someone who has got genetics of high cholesterol, even if they don’t drink a drop of oil, they can still get high cholesterol.”
In these cases, lifestyle changes alone may not be enough to bring cholesterol down to a safe range.
“If a patient comes in with really high cholesterol, no matter what they do, their cholesterol will still be on the high side. Even if they exercise or they are on a diet – of course, the cholesterol level will go down a bit – but it will still be on the high side,” Dr Richard said. “So for these kinds of patients, we will recommend them to start cholesterol medications.”
No Warning Until It Hits
Dr Richard said more younger people are coming in for health screenings, partly due to greater awareness about their health.
“I think the awareness is getting better nowadays, especially through social media, whereby we hear and see cases of a person just collapsing while exercising, jogging, or playing badminton or golf,” he said. “So we do see these incidents happening. This, in a way, creates a lot of awareness among young people.”
While such incidents may prompt check-ups, some patients only discover they have dyslipidemia after experiencing serious complications. “When a heart attack happens, patients will complain of chest pain, sweating, dizziness, and even fainting. For stroke, they will have limb weakness, weakness on one side,” Dr Richard said.
There may be earlier signs, such as xanthelasma, or white patches around the eyes. “If you have that, there is a high chance that you’re having very high levels of cholesterol,” he added.
Screen Early, Especially With Family History
Dr Richard emphasised that those with a family history of heart disease or stroke should screen early — ideally in their 20s — and not wait until middle age.
“People are just born with high levels of cholesterol. It means that their body just produces more bad cholesterol than others,” he said. “And if they have this background of genetics, an unhealthy lifestyle certainly doesn’t help — it worsens that condition.”
At minimum, a basic medical check-up should include cholesterol and blood sugar levels. Further tests may be recommended depending on risk level such as a stress test or heart imaging.
When it comes to diet, Dr Richard advises moderation rather than strict restriction.
“I always tell patients to eat in moderation because I believe lifestyle is important as well. We need to balance it. If we want to pursue something over the long term, it needs to be realistic and sustainable,” he said.
“Of course, I can tell patients, okay, stop taking all this trans-fat food. Maybe they can do it in the first month. Then after that, there will be revenge eating. And then after that, everything goes haywire.”
Lifestyle, Food Delivery Culture Driving Risk
While genes play a major role, lifestyle habits are making things worse — especially among urban young adults who are less active and rely heavily on food delivery.
“Nowadays, people will cook less, they eat out more. And food deliveries are so convenient. Even if you’re at home, even if you can cook, and you have all the ingredients at home to cook, you will still want to order some food or snack,” Dr Richard said.
He added that food sold outside the home often contains unhealthy oils and trans fats, especially when cooked using reused or recycled oil.
“Processed food and fast food like french fries, fried chicken — all these things — have a lot of trans fat and it is very bad because it increases a lot of your bad cholesterol or LDL, and decreases the good cholesterol (HDL),” Dr Richard said.
“A lot of young people are going for these kinds of things. Although they can exercise but after exercise, where do they go? They go for fast food or mamak.”
As more young Malaysians face the silent risk of dyslipidemia, Dr Richard said it’s important to recognise that even those who exercise and eat well may still be at risk, especially if they have a genetic predisposition.
For young adults, particularly those with a family history of heart disease or an inactive lifestyle, Dr Richard recommends getting a cholesterol check as early as their twenties. A simple screening can help establish a baseline and guide any necessary changes.
If cholesterol levels are high, early intervention — whether through lifestyle changes, medication, or both — can help reduce long-term cardiovascular risks.
“Even if you’re young and feel healthy, it’s better to know now with screening than to find out when it is too late.”
Sunway Medical Centre, Sunway City is the largest private quaternary hospital in Malaysia, with over 60 medical specialities across 28 Centres of Excellence. Its Wellness Centre helps to manage potential health risks by providing personalised screenings and consultations. including History & Clinical Examinations, Body Mass Index (BMI), Blood Pressure Screening, Thyroid Screening, Full Blood Count and more,
The hospital recently launched its Genomic Medicine Services, also provides a comprehensive range of genomic testing for timely, actionable genetic insights. These advanced diagnostics support early intervention and optimised care planning, further enhancing patient outcomes.
In conjunction with World Heart Day, Sunway Medical Centre, Sunway City will also host a public forum to raise awareness on cardiovascular risk factors and prevention measures for long-term heart health. Honourable speakers will be Dr Richard, and also Dr Gary Lee Chin Keong, a consultant cardiologist and electrophysiologist.
