Yippee! I actually passed my cholesterol and blood pressure exams today and quite frankly these have been the hardest exams I have ever had to take. Some five weeks ago, I had a small health scare. My doctor said that both my cholesterol and blood pressure were too high and she was threatening to put me on medication to control both ailments. For someone who thinks they are reasonably healthy, the immediate question was “how can I be so unhealthy when I feel perfectly fine”? The reason is that both high cholesterol and high blood pressure are silent killers of women (and men too!). So, obviously my first thoughts were incoherent blind panic. Second thoughts were to do a bit of research.
My immediate questions were:
Question 1: What is high cholesterol and how does one get this on a “reasonably” healthy diet?
Summary of answer from Netdoctor.co.uk
There are two types of cholesterol: HDL (good as it protects from narrowing of arteries) and LDL (bad as it causes heart disease). Our bodies use cholesterol for cell generation and energy. The cholesterol we intake is metabolised by the liver and the chances of having high cholesterol levels is based on: diet (the amount of fat we eat) and genetic inheritance (familial hypercholesterolaemia (FH)). The ideal cholesterol level in the blood is less than 5mmol/l.
HDL content can be controlled by exercise and LDL can be controlled by a low-fat diet or medication.
[HDL is short for high density lipoprotein and LDL is low density lipoprotein]
Question 2: Does high cholesterol cause high blood pressure?
Blood pressure depends on a combination of two factors:
- how forcefully the heart pumps blood around the body
- how narrowed or relaxed your arteries are.
High Blood Pressure (hypertension) is caused when blood is forced through the arteries at an increased pressure. High levels of LDL can cause a narrowing of vessels contributing to high blood pressure. Other factors are: a tendency in the family to suffer hypertension, obesity, smoking, diabetes, kidney diseases, high alcohol intake, excessive salt intake, lack of exercise and certain medicines such as steroids.
Blood pressure is measured in two readings: systolic (heart contracts) & diastolic (heart relaxes). For people who don’t have diabetes, the treatment goals for blood pressure for are: Systolic pressure of less than 140mmHg and Diastolic pressure of less than 85mmHg.
Question 3: Is my diet reasonably healthy?
This is a difficult one to answer without keeping a food diary and accurately reading food labeling. I also discovered that just because you cook your own food, does not necessarily mean that you have a healthy diet. Cooking your own food is indeed better than buying convenience food or eating takeaways, but it is important to measure the fat content in your ingredients and take command of portion control, i.e. how much you serve to each person.
The information provided on recommended daily amounts (RDA) for men and women varies quite a lot. The best chart I found indicated a recommended daily calorie count of 2500 for men and 2000 for women – it also breaks this down by carbohydrates (300g for women), fats (70g for women of which only 20g should be saturated), protein (45g for women) and salt (5g for women with only 2g of sodium). Click for a copy of the chart.
I also discovered that a lot of Indian food has very poor food labeling, wildly inaccurate figures and there are no good calories counters for prepared Indian foods. The Indian food industry had better watch out, my next project is to change all that!
Question 4: Is a change of diet enough or is more exercise important in reducing high blood pressure?
A change of diet on its own is not enough. A change in lifestyle is needed, including stopping smoking, losing weight, exercising regularly, cutting down on alcohol, eating a varied diet and reducing stress by trying different relaxation techniques, or by avoiding stressful situations.
These changes will lower blood pressure – to reduce your risk of developing the condition in the first place or to treat hypertension.
Question 5: Do cholesterol-reducing foods actually work?
Answer, courtesy of Netdoctor.
“Research has demonstrated that margarines like Benecol work. They contain natural substances that reduce the absorption of cholesterol from the gut and therefore lower cholesterol levels in the blood. A 2g average daily portion of these substances added to margarine can reduce the average LDL cholesterol level by between 0.3 and 0.5 mmol/L, depending on your age.
This reduces the risk of heart disease by as much as 25 per cent, so it seems a worthwhile investment at that dose, particularly if you are at greater-than-average risk of developing coronary heart disease.
Stick to a healthy diet, low in saturated fat, and use Benecol if you’re happy to buy it. Keep fit with regular cardiovascular exercise (the sort that gets you short of breath).”
Question 6: What about fats?
Answer courtesy of the NHS website.
Saturated fat is found in foods such as pies, meat products, sausages, cheese, butter, cakes and biscuits. It can raise your blood cholesterol level and increase your risk of heart disease. Most people in the UK eat too much saturated fat, which puts us at risk of health problems.
Unsaturated fats, on the other hand, can help to lower cholesterol and provide us with the essential fatty acids needed to help us stay healthy. Oily fish, nuts and seeds, avocados, olive oils and vegetable oils are sources of unsaturated fat.
Question 7: So what did I decide to do?
Obviously everyone’s choice will be different, but with a lot of helpful advice from friends I:
(a) Switched my style of cooking from Indian to a simpler (Mediterranean) style. No use of ghee and a measured use of oil (e.g. maximum 2 tablespoons for a ‘shaak’ curry). This didn’t suit my family so I reverted to cooking my own food separately, replacing a home-made soup to their curry.
(b) Switched to making chapattis with no oil. Again, this didn’t suit the family so have reverted back but eat plain chapattis with no ghee.
(c) Switched from semi-skimmed milk to skimmed milk
(d) Switched to Flora pro-activ margarine which has plant sterols to help reduce cholesterol.
(e) Switched from red meat to fish and chicken and ate no more than 2-3 eggs per week
(f) Switched from cheddar cheese to cottage cheese. Hard cheese has so much fat! Also watch out for fat content in mozzarella, parmesan and feta cheese as it gives the fat measurement per 100g and the pack is usually 250g or 500g.
(g) Cut out crisps, sesame slims, roasted cashew nuts, biscuits, cakes, chevdo (Bombay mix), sev and anything fried and replaced with Dole fruit pots, fresh fruit, Danone low fat yoghurt and low-fat custard. Cornflakes are not just for breakfast – they make a great mid afternoon snack.
(h) Ensured I got my five-a-day of fruit and vegetables although this is not hard to do on a restricted diet like this.
(i) Cut out all Indian mithai (sweets), boiled sweets, chewing gum and chocolate. [NB. I have not eaten chocolate for a number of years as this is one of the triggers for migraine anyway.]
(j) Stopped drinking wine and switched to gin & tonic or champagne (as it is a pain to fix a G&T and too expensive to drink champagne, this meant my alcohol consumption has plummeted, which is a good thing!)
(k)Allowed myself bread, a weekly allocation of two croissants and as much pasta as I liked with a nod to reasonable portion control.
(l) Switched from virgin olive oil dressing to a low fat oil dressing. Although olive oils are better for you than other oils, I think I was taking Jamie Oliver’s recommendation for a “glug” of olive oil on my salad too literally.
(m) Allowed myself as much tea, water and fresh juices as I liked. Drinking a lot of water before a meal ensures you eat less. Discovered I quite like pomegranate and cranberry juice together when they are diluted correctly.
(n) Allowed myself treats like eating sensibly if invited to dinner or when going out. After all, you don’t want to be a party bore!
(o) Took up short 10-min pilates workout sessions at home. Also did some yoga and breathing/meditation exercise, but will need to work on the latter for good long term improvement.
Question 8: So what were the results?
Again your results will be specific to you as factors such as gender, age, height, weight, medical and family history all need to be taken into account. The results for me were:
Blood Pressure: My blood pressure went from 155/99 to 134/91 – the diastolic pressure (lower number) should be below 90 and ideally around 85, but the reduction over a five week period without medication is good.
Cholesterol: My cholesterol went from 5.8mmol/l to 5.2mmol/l. Ideally it should be 5mmol/l or less. Triglycerides went from 1.9 to 1.4 – not sure what this means, will need to check.
Weight: Reduced by 3kg. This was a pleasant side effect.
[NB. This is not meant to be a health fact sheet, it is just a personal story of what I did – please consult your own doctor or health professional for advice].
References:
High cholesterol level (hypercholesterolaemia)
http://www.netdoctor.co.uk/diseases/facts/hypercholesterolaemia.htm
Recommended Daily Amounts: Easy to Use Table
http://www.npt.gov.uk/default.aspx?page=3360
Reading Food Labels
http://www.nhs.uk/Livewell/loseweight/Pages/readingfoodlabels.aspx
Indian Calorie Chart
http://www.hindustanlink.com/recepiet/indian_calorie_chart.htm
Nutrition data of homemade Indian Food
http://www.fatfreekitchen.com/nutrition/indian-foods.html