My battle with Cholesterol

Published: November 22, 2012
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I had to let go of most things I ate; as it turned out, I consumed only one type of food - fried. PHOTO: REUTERS

Three years ago, I went in for what was supposed to be a routine yearly physical. I walked into the doctor’s office full of confidence waiting for full marks on my blood test results. Instead, he gave me the grim news that my cholesterol numbers were elevated.

I couldn’t believe this.

How could this happen to me, a doctor?

I felt that my body had betrayed me. I had no symptoms, no pain, no signs.

“I feel fine,” I insisted.

He looked at me and said,

“You know, that is why it is called the ‘silent killer’”.

He said that the only way to discover high cholesterol before any symptoms manifest was with yearly physicals. My diligence was probably going to save my life.

Cholesterol.

The very word makes you feel a little ill, a little heavy in the arteries, and a tiny bit achy in the heart. My doctor said that he didn’t want to me to start medication right away, and recommended a “wait and watch” strategy for a year – but only if my levels did not go up. He also said that I should educate myself on treatments other than medications.

Being a medical doctor I had an inherent distrust of any remedy that wasn’t manufactured by a pharmaceutical company and didn’t come with an entire scroll of side effects. But I didn’t want to wage chemical warfare on my body until I was sure that it was the only way to go. I knew that I had to start working out more — a resolution that I reserved for the new year, ‘every year’. I had to make healthier choices concerning what I ate, so basically I had to let go of most things I ate; as it turned out, I consumed only one type of food–fried.

But I was looking for more information.

Somewhere out there was cholesterol’s Achilles heel, and I was going to find it and deal it a deathly blow before it took me down.

As with all great searches, the way to go was the internet. I sat at that computer for countless hours bookmarking pages, joining web groups and e-mailing purveyors of miracle cures for more information on their products. And after hours of squinting at a screen I found something that finally made sense.

The main line of defence against high cholesterol is a healthy diet. Grease and oils have to be eliminated as much as possible substituted with foods high in dietary fibre and nutrients. The following are a few choices:

  • Foods high in dietary fibre should be preferred, like legumes, beans, daals and psyllium husk commonly known as Isapghol.
  • Switching to fat-free milk and dairy products eliminates fat from the diet while holding on to all the wonderful calcium and other nutrients.
  • Garlic has been shown to lower cholesterol. This can be taken raw or cooked and is also available as a capsule.
  • Grains and cereals are an excellent source of dietary fibre especially oats. Baked products containing whole grains are also a wonderful way of getting fibre and essential nutrients into the body.
  • Substituting olive oil wherever you can in your diet has great benefits. The monounsaturated fatty acids in the olive oil lower the bad cholesterol and elevate the good cholesterol levels.
  • All nuts, fruits and vegetable are a chock full of phytosterols which block the uptake of cholesterol in the intestines.

Long story short – it’s been three years since my diagnosis and my numbers are the same. I am still not taking any medications, yet, but I go in and have my levels checked every year religiously. I take Ispaghol once a day and try to incorporate fruits, vegetables and nuts in my diet as much as I can. I work out, I choose water instead of Coke and I pray.

Hopefully this combination will work for me.

For some of us this will be enough and others will need to add cholesterol lowering medications to their arsenal. But whichever group you may fall into, give cholesterol a good fight.

Read more by Zeba here or follow her on Twitter @zebansari

 

Zeba Ansari

Zeba Ansari

A graduate of Bolan Medical College, Zeba has been researching and writing for various organizations and websites. She writes from the perspective of the common man and tweets as @zebansari

The views expressed by the writer and the reader comments do not necessarily reflect the views and policies of The Express Tribune.

  • Yuri Kondratyuk

    When it comes to cholesterol, the ratio of LDL to HDL is what matters the most. Consume foods that increase HDL levels (eg: flax seed powder), dietary fiber (especially the soluble kind found in oats) and do a combination of cardio and strength trainingRecommend

  • http://blogs.tribune.com.pk/author/430/faraz-talat/ Faraz Talat

    Through much research and personal experience, I’ve learned to live by the following rule:

    “If it tastes good, it’ll get into your body and clog everything.”

    Seek foods that are either tasteless (high water content), taste like dirt (rich in dietary fibre), or leave you even hungrier than you were before (green salads and low-calorie appetizers).

    If its sweet or tasty, it’s rich in carbs. If if its filling, it’s rich in fats and cholesterol. Nature has designed the body to attain and conserve maximum amount of energy, not to shed it off. It’s an uphill battle, often complicated by genetic or environmental factors beyond one’s control.

    It is, however, a battle worth fighting..Recommend

  • Nandita.

    As strange as this may sound, I’ve had less than 20-30 bars of chocolates in my entire life. I don’t think I’ve eaten more than 4-5 pizzas and have had may be 7-8 bottles of soft drinks in my entire existence on earth. I’m not fond of pizzas and soft drinks anyway.
    I do eat junk ( pastas/potato chips/samosas) from time to time but these occasions are rare.

    As a child, I’d eye my classmates tiffins with envy because they always had these exotic looking foods (cheesy pastas) that I was not allowed to eat by my mom. As a result, I don’t think I ever ate any junk at all during all the time I lived with my parents. My childhood habits stuck and I don’t eat junk even now. My mom never let me drink tea/coffee so I never got into the habit of consuming these beverages. I have tea maybe once every few years to remind myself what it tastes like.

    My diet consists of rotis, lots and lots of vegetables, fruits, nuts, milk, pulses, grains,different kinds of dals, curd,rice. I eat out a lot when I’m in India but even then I mostly visit restaurants that offer ‘ thali ‘ meals.

    People ask me how I don’t miss the ‘good stuff’.
    Now, How can I miss something I never had in the first place?Recommend

  • Dr. Saghir Akram

    Read up a bit. Most docs in Pakistan will not have read the last 10 years of research in fat and obesity. You will have to do your own research. Much of it is changing how we view over weight (not obesity) and cholesterol etc.

    Do avoid starches and sugars. These stimulate insulin release and conserves fats in your body. Actually research shows that fatty foods that dont have high carbs do cut down your tendency to gain fats, perhaps because they signal to the body that you have enough fat and to stop eating. Randomized control trials have shown that people told to eat as much fat as they like will automatically restrict their diets to what works for them and dont feel hungry all the time. Those randomized to eating restricted normal diets feel hungry and break the dietary restrictions more often and gain more weight.

    This is a good place for a start and for references
    http://www.econtalk.org/archives/2011/11/taubesonfat_s.html

    Good luck. Recommend

  • Hemant

    @Nandita.:
    You really do not know what you have missed Recommend

  • Nandita.

    Hemant:

    I may have missed out on the pleasures of junk food.

    But I am healthy and I am thin. People generally hate their figures/bodies. I love mine.Recommend

  • Ed T

    5 years ago, on a very low fat diet with lots of fiber, my total cholesterol was over 220 and my HDL was 30.

    2 years ago, I started to drastically limit carbohydrates and increase my fat intake, especially saturated fats from coconut oil.

    I now eat 300 grams of fat daily, 200 of which is saturated. I limit my carbohydrates to non-starchy vegetables, berries and coconut products. I cannot get my total above 185 and my HDL stays around 60. My triglycerides are 50.Recommend

  • Insaan

    @Ed T: I now eat 300 grams of fat daily, 200 of which is saturated. I limit my carbohydrates to non-starchy vegetables, berries and coconut products. I cannot get my total above 185 and my HDL stays around 60. My triglycerides are 50.

    How often do u get your Cholesterol (HDL & LDL) and triglycerides levels checked? Your triglycerides level should not be that low with that kind of diet.
    Have you changed your physical activity drastically?
    There is a possibility that your fat does not get digested properly?

    If you don’t eat carbohydrates, you body my start converting dietary fibers to fat or energy.
    Cows don’t eat any meat but produce lot of fatty milk. Blocking arteries may be a revenge by Cows.

    I am just guessing you are taking at least 3000 calories per day. How much do you way? Do you jog every day?

    How much calories you use every day is also important.Recommend

  • Insaan

    @Nandita.: ” My diet consists of rotis, lots and lots of vegetables, fruits, nuts, milk, pulses, grains,different kinds of dals, curd,rice. I eat out a lot when I’m in India but even then I mostly visit restaurants that offer ‘ thali ‘ meals. ” But I am healthy and I am thin. People generally hate their figures/bodies. I love mine.

    There are wrestlers (in Haryana) who just eat vegetarian food. One can eat what you eat and be fat. Loving ones figure and body has more to do with ones psychological mindset. Being thin may be good for you, being normal may be good for others. Recommend

  • Insaan

    @Dr. Saghir Akram: Do avoid starches and sugars. These stimulate insulin release and conserves fats in your body.

    According to your statement, Big Mac, Cheese burgers, fried chicken etc is the best diet, low carbohydrates and low sugars. I hope you are not a medical doctor advising people on diet. Our body runs on glucose. If people avoid starches and sugars, where they going to get glucose from.Recommend

  • Eric Kumar

    It intrgues me the writer calimes to be a “Physician” and She does not know about cholestrol. Therefore, I have no comment about this story.I will recommend not to go this person for treatment. Cholestrol are are basic chemistry a doctor ask for. If this doctor have no clue about basic chemistry tests then it is scary.Recommend

  • mahmood

    Good new if you are female. High choloesterol in females does not cause as much plaque as the same level does in males. Recommend

  • UHS

    I take Ispaghol once a day and try to incorporate fruits, vegetables and nuts in my diet as much as I can. I work out, I choose water instead of Coke and I pray.

    So easy to hear, yet so difficult to practice.

    Thanks for sharing your experience anyways.Recommend

  • http://www.twitter.com/1cricfan Cricfan

    Most comments are spot on regarding the causes of high-cholesterol levels but there is a key element that is missing here.
    Genetics can also play a key role in high-cholesterol levels and forces liver to produce excessive cholesterol. Certain single-gene variations/defects can result in high cholesterol level regardless of your good diet. So, please make sure you discuss this with your doctor.
    Cheers! Recommend

  • Milind

    @Hemant – Its better to miss the junk (it never got u anywhere), rather than repent at leisure… Agree with Nandita… Basically your upbringing helps inculcate the right eating habits
    As a middle-class kid, my tiffin used to be packed with rotis and sabji (including dudhi/loki.. which I disliked)…
    The junk food during my school days was relatively ‘healthy’ compared to the explosion of high-calorie options (double whipped cream cake, latte, big-sized /super-sized Mac) we witness now.
    Now reaching mid-life I thank my parents for force-feeding me the humble daal-bhaaji-roti…

    The aim is move your butt more and mouth less…
    The HDL/LDL ratio should be right, eat stuff high on anti-oxidants (Fruits/apple, occassional glass of red wine, dark chocolate), beans (water soluble fibers) to manage cholesterol (or its bad effects).Recommend

  • Nandita.

    @Insaan:

    Sushil Kumar (presuming you are referring to him) works out to make his body the way it is. And a wrestlers consumption is so many times that of a normal human being. So irreleveant comparison.

    Having said that, yes, one can put on weight by eating the stuff I do so It’s imperative to work out. But what I eat is healthy and I’d rather eat that than junk food.Recommend

  • Ed T

    @Insaan:

    If carbohydrates are restricted, the bodies uses ketone bodies (i.e. acetone, acetoacetic acid and beta-hydroxybutyric acid) as the primary fuel source instead of glucose. The body can make all the glucose it needs from protein using a process called gluconeogenesis.

    There are many disorders caused by fat or protein deficiency . There are none caused by carbohydrate deficiency. Before insulin was discovered, the treatment for type 1 diabetes was a very low carbohydrate diet.Recommend

  • SurelySure!!

    ahhmm,,,anything tasty is of high cholestrol (which is a big troll ;)Recommend

  • Dr. Saghir Akram

    @Insaan:

    Your body makes glucose from just about anything. I am not saying that you should (or even can) completely eliminate carbs from diet. Some less processed carbs are not only ok but are necessary.

    I hope your comment about big Macs is facetious. You seem to be someone who is trying to understand. Please read up something newer than the early 90s and then think about it. big Mac is just as much carbs as anything. It is also fried in seed oils (which are cheaper and therefore the staple of restaurants and mass production) that are rich in omega-6 as opposed to the “good” omega-3.

    Do please listen to the link that I placed or at least read the transcript. There is a ton of literature out there. We are re-thinking fats and obesity in a profound way

    And yes I am a medical doctor that advises patients, I also teach medicine.Recommend

  • faraz

    @SurelySure!!: Not necessarily; you can find tasty stuff that’s healthy and low in cholesterol (or at least prepare it yourself).Recommend

  • Insaan

    Author “Long story short – it’s been three years since MY DIAGNOSIS and MY NUMBERS are the same. I am still not taking any medications, yet, but I go in and have my levels checked every year religiously.”

    Seems like all your research and changes in your diet have not done much for you.Recommend

  • Insaan

    @Ed T: “If carbohydrates are restricted, the bodies uses ketone bodies (i.e. acetone, acetoacetic acid and beta-hydroxybutyric acid) as the primary fuel source instead of glucose.”

    Ketosis is a condition in which levels of ketones (ketone bodies) in the blood are elevated. Ketones are formed when glycogen stores in the liver have run out. The ketones are used for energy. Ketones are small carbon fragments that are the fuel created by the breakdown of fat stores. Ketosis is POTENTIALLY a serious condition if keytone levels go too high. Recommend

  • jgjk

    For my mother, whose cholesterol turned out to be very, very high; she decided to go near-vegetarian; like eat maybe a small potion of meat in a week. (She also avoided oily stuff in general, which she never ate much of anyway, and took to eating nuts which have good cholesterol). In just a few weeks her bad cholesterol was down to normal levels. The doc couldn’t believe it.

    So I’ve been inspired to try and gradually reduce the meat I eat too since hypertension and heart disease runs in the family. As it turns out the amount of meat considered healthy is much, much less than what we eat.

    I should also point out that my family, parents are not over-weight.Recommend

  • Doosam

    how about adding fish and fish oil supplements like Omega 3 fatty acids and Niacin (Niaspan) medication available over the counter can also help decrease LDL and increase HDL.

    http://www.mayoclinic.com/health/hdl-cholesterol/CL00030/NSECTIONGROUP=2
    http://www.webmd.com/heart/how-to-boost-your-good-cholesterol?page=2Recommend

  • jahandad

    AN excellent eye opener topic,,,,,,,,BUT ,,,,IN PAKISTAN FOOD HABITS IN MIDDLE CLASS PUT THEM in this danger zone,,,,,,WHILE super rich do care about theses things ,,,,,bcz they have to survive for the looted money ,,,,ANY HOW doctor,,,,,IN MY OPINION ONE THING is missed by you and all above commentators,,,,,and that is the streesful and anxiety oriented and type a personalities and cholestrol co relation ,,as cholestrole is formed in liver ,and anxiety causes all bad harmones to rise in blood,,,and that in return changes stored fates into moblized forms to be thrown out by liver into blood vessels ,,,,,and remember 3/4 of blood cholestrol raises due to this phenomenon,,,,,,Recommend

  • YP

    Hydrogenated vegetable oils, which is used in biscuits and lots of fried items, is worst for
    health and should be avoided as much as possible.

    http://www.naturalnews.com/024694oilfood_oils.htmlRecommend

  • Shoaib

    @Nandita.:
    you surely have some some issues with your diet believe it or not….and trust me when I say….you are missing out on many blessings of GOD…..all they say….eat whatever you want…but it must be healthy and always exercise……that’s the way to go…..Recommend

  • http://India Feroz

    Being in my mid fifties I find a lot of my peers suffering from real as well as imaginary ailments. I was finally persuaded by my family members to go for my first medical check up only after I crossed fifty. The result of every test was a borderline case. I would describe my lifestyle and habits as terrible, whichever way one looked at it. Having eaten, drunk and smoked in more than ample measure and having decided life had to be lived and enjoyed, there is nothing for me to complain about. The more we worry about our health, higher are the chances of being adversely affected by it. Am not sure whether most of the ailments reside in the mind or the body.
    One thing I do know is that if one has lived life honestly in tune with ones conscience and principles many sufferings and obstacles may come our way — however you will always sleep well at night and generally be free of all physical, psychological and mental ailments.

    When Fauja Singh was asked how he is able to complete a Marathon at his age of over a hundred, he said — I do not drink or smoke, more importantly I have never taken any medicine. So to many friend who live like me enjoying the good things take my sound advice, do not take medicine as it will kill you. Cheers, on the rocks ! Recommend

  • Khan Sahab

    Thank you for this blog … I am facing this health issue myselfRecommend

  • jgjk

    @Feroz:
    I liked your comment by mistake. That’s terrible advice, actually. If your doctor tells you take meds, take them. Conscience and principles doesn’t prevent hypertension and heart disease I’m pretty sure. And, you’re probably pushing your luck in your lifestyle (no offence intended).

    My father almost died on account of not taking his blood-pressure meds. The scare also caused him to quit smoking and start paying attention to his health (in his late sixties). Most people are fine as long as they are fine. Then one day they’re not. That is when they regret their choices; never before.Recommend

  • Ed T

    @Insaan:

    I have a non-fasting lipid panel every couple of months and a fasting lipid panel twice a year, one of which is an NMR lipoprotein lipid panel which also measures LDL particle count and LDL directly. My caloric intake is in the 3400 to 3800 calorie a day range. I strength-train 3 days a week and have started to resume cardiovascular workouts. I’m currently at 195.

    My non-fasting and fasting serum cholesterol are almost the same. My fasting triglycerides are 50 and non-fasting around 130. Also keep in mind that when triglycerides are low, the calculated value for LDL is overestimated.

    Years ago when I ate a very low fat diet (<10%) with virtually no saturated fat, my fasting triglycerides were 140, even though I worked out 12 hours a week. Back then I asked what factors would increase my triglycerides and she stated that eating a fatty meal the night before would elevate them. If I were eating a standard high carbohydrate diet, she would have been right. However, on a low-carbohydrate (<5%) diet, fat consumption has radically different effects. Back then the factor which led to elevated triglycerides was carbohydrate consumption, especially from fructose. Unlike starches, which are converted to glucose in the gut, most fructose is converted directly to triglycerides.

    Another advantage of restricting carbohydrates is that my blood glucose is fairly low, even though I’m predisposed to T2 diabetes. My fasting and non-fasting glucose is around 65 to 75. I also measure by blood ketones using a meter and my ketones run from 2.0 to 4.6. As someone else pointed out, excessive blood ketones (ketoacidosis) can be deadly, but at a range of 1 to 5, it indicates that my body is using fat as its primary fuel.

    I slowly transitioned to a low-carb, high-fat diet because it took time for my body to assimilate the extra fat. I also eliminated artificial sweeteners and shortly thereafter, my sense of sweet became very sensitive. I can’t eat anything sweeter than a berry; anything sweeter is unpleasant.

    My dietary studies are fatally flawed because most rely upon “validated food questionnaires”, which typically bear no resemblance to anybody’s data. That results in the collection of bad data and there’s no statistical technique which can convert bad data to good data. Almost all dietary studies also ignore the role of sugar and industrial seed oils in metabolic dysfunction.

    As a rule-of-thumb, most dietary research is not right. Most of it isn’t even wrong.Recommend

  • Rambino

    Most cholesterol is produced by the liver, so it could be that the author of this article has unfortunate genes. Unfortunately, South Asians are often predisposed towards having this and many middle/upper Pakistanis are exacerbating this by having a very unhealthy diet and moving very little. Recommend

  • Insaan

    @Ed T: I have a non-fasting lipid panel every couple of months and a fasting lipid panel twice a year, one of which is an NMR lipoprotein lipid panel which also measures LDL particle count and LDL directly. My caloric intake is in the 3400 to 3800 calorie a day range.

    My friend I feel you seemed to be obsessed with your heart health. Why are you doing all this? You may suffer from OCD like problems. Recommend

  • Ed T

    @Insaan:
    Since every man in my family has had a significant heart attack or stroke before the age of 50, I am obsessed with it, especially since most doctors are completely ignorant about nutrition. Since the medical field offers only treatment options and not prevention, I’m part of a growing group of people who will not let their doctor make all the decisions. I realize that most doctors are well-intentioned and don’t have the time to commit to specialized research. I also realize my health and well-being is far too important to be left to well-intentioned, but ignorant doctors.

    Having taken a nutrition course or two hardly prepares anybody to understand the complexity of biochemistry, thermodynamics, pharmacology and basic chemistry. Most of the published research on nutrition and heart disease is wrong. All of it is based upon the premise that lots of carbohydrates are healthy. Take any research article and study the introduction. There is where the researcher’s biases and prejudices are stated. Examine the materials and methods to see if the results are based upon solid science. Most important of all, examine the conclusions in the study. Most conclusions are based upon the validity of the assumptions. If the assumptions are invalid, the study results are also invalid.

    Since the medical community has such a myopic view of medicine and nutrition, I do not consider any recommendations, however well-intentioned, useful. Most recommendation are actually harmful.

    I do collect data on my biomarkers because it helps me understand how my body reacts to different foods.

    I’ll close with a quote for Lord Kelvin, a noted physicist and engineer, “In physical science a first essential step in the direction of learning any subject is to find principles of numerical reckoning and practicable methods for measuring some quality connected with it. I often say that when you can measure what you are speaking about and express it in numbers you know something about it; but when you cannot measure it, when you cannot express it in numbers, your knowledge is of a meagre and unsatisfactory kind: it may be the beginning of knowledge, but you have scarcely, in your thoughts, advanced to the stage of science, whatever the matter may be.”Recommend