Eat, Drink, Data

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Yesterday I posted about the improvement that I saw in the past 6 months in my cholesterol levels and my bloodwork.    So how did I do it?   Overall, I basically made a commitment to eat better and exercise more.  None of the changes I did were earth-shattering, but a lot of little changes adds up.  I heard once that we make 200 decisions a day regarding what foods we eat.  I dont have to change all of those decisions, but if I could change a few key ones, hopefully it would help.

I did some research.  To lower triglycerides, eat lots of fiber, fruits and veggies, and fatty fish (omega-3). For lowering overall cholesterol, go low carb.  Fats are tricky: some say to avoid fats altogether, others say fats should be limited but are ok if they are unsaturated, yet others say that you should bulk up on good fats (like olive oil) as much as possible to drive down the caloric % of carbs.  How can I know who to believe!?!

I am a big fan of Michael Pollan, and his manifesto:  “Eat food.  Not too much.  Mostly plants.”   Can’t argue with that one.  So in that spirit,  I rolled my own plan.  It is based on  a few rules that I dont follow religiously, but try to keep in mind as I am making my 200 decisions every day….

  • Take one fish oil pill daily (one per day) – Omega 3s impact triglicerides
  • Try and eat more fish in general, especially fatty fish like salmon.
  • High fiber cereal every morning
  • Salad bar every day for lunch at work.   I found lunch was the easiest meal to really change my habits and make a difference.  I’d often eat a big sandwich or 2 slices of pizza or the burrito special at lunch just cause it looked good.  After lunch I would often feel bloated and full and then have a crash around 3pm.  Eating a salad, with lots of veggies, some chopped chicken or ham and a little dressing,  is yummy, fulfilling, and I generally feel better thru the day.
  • lots of leafy greens on the salad.  Spinach, not iceberg.
  • Cut back on sweets – note that I didn’t cut them out, just cut back.  Smaller portions, less portions, and smarter choices.  Sometimes just a little dark chocolate can satisfy my sweet tooth, which brings me to…
  • Cut back on snacking: that pre-bedtime cookie snack binge can add hundreds of calories and fat when you need them least.   A handful of cashews and dried fruit can suffice if I am really hungering.
  • Less cheese.  I used to eat a lot of cheese, and would gravitate towards meals in restaurants smothered in it.  No more.
  • Less fried food.  Fried food creep is everywhere.   Does sushi really need to be deep fried?  I usually ask for a side salad to replace fries on my meal — especially since I can steal a few fries from my kids’ plates and dont need a half a plate full of em.
  • Do a detox plan 2-3 times a year

and last but not least:

  • More dark chocolate and red wine.  The jury is out on whether these are good for your heart, but some studies have shown it is true, and that is what I choose to believe 🙂

I’m kind of making it up as I go along.  I have self imposed rules – for instance, I am much more stringent during the work week than on the weekend.  I dont fret over what I eat for dinner usually, but focus more on portion size and not taking a second (or third) plateful.   Anyway, it has worked for me, and I really dont feel like I am denying myself of very much food pleasure (and I really *do* love to eat!).

Of course, this may all be a red herring.  My doctor told me when I got my first blood test that no one should ever get their blood tested during the holidays, because we all eat like crap from Thanksgiving until the end of the year.    That first blood test was on December 21.  He also warned me that even though I had fasted for 12 hours before the test, if I had eaten a cheeseburger as my last meal it would affect the test.  That was exactly what I had eaten (how did he know?).

For the second test, I fasted for longer and ate really well the day before.  So who knows whether the improvement was due to this ‘gaming’ of the test, or really due to my diet/exercise regime?  Guess we wont know until the next data point!

Statistics of the Heart

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Followers of this blog may remember back earlier this year, when I posted about my detailed bloodwork I even posted a scan of my bloodwork, with all of these fancy blood counts that I had never heard of before.

There were a few scary numbers on that chart.  In particular, there were two numbers that made me really worry.   My trigliceride count was 209, well within the high risk period.  And something I had never heard of, LDL particle count, LDL-P, was at 2164.   I didnt know what this meant, but it was pretty clear that it was bad, since the low risk category was < 1000,  and it only took a score of 1600 to be high risk.  And I was at 2164!

Some friendly commenters after that post pointed me to a great series of posts on cholesterol measures and coronary risk (check out the 9 part series here when you have time !).  That detailed set of posts argues that of all the numbers on that sheet, it is LDL-P which is the most predictive risk factor.  It was even worse.  I thought it was good that my LDL-C was reasonably low.  But the blog post pointed out that made me discordant, and people with profiles like me, with high LDL-P and low LDL-C, are actually at the highest risk for heart disease!

Well, I was already motivated to eat better and exercise more because of my project.  But this solidified it.  I figured I would try some lifestyle changes and measure blood again in 6 months.   My doctor was suspicious and wanted to put me on statins, but I made him a bet…if there was no improvement in 6 months, I’d do it.   Just like this entire project, stating my goals out loud, and putting someting on the line helps me to stick to the program.

Anyway, the results are in…drumroll please….and I have some decent improvement!  yay!  Still got to work on this, but here are the main numbers:

  • Total Cholesterol  : Down from 199 => 190
  • Triglycerides : Down from 209 => 105  (High risk to low risk!)
  • HDL-C : Up from 29 => 37 (that’s good!)
  • VLDL : Down from 42 => 21 (high risk to low risk!)
  • LDL-C : 139 => 140 (still in a good range)

and the newfangled ones

  • LDL-P : 2164 => 1791 (still high risk, but big improvement)
  • small LDL-P : 1855 => 830 (gets me just out of the high risk category, but not by much)
  • LP[a] 39.7 => 47.6 (this is the one bad change that I dont fully understand)

I got to these changes by making some changes in eating, exercise, and general lifestyle.  My next post will be about what these changes are, and what my next steps are.  Nothing incredibly drastic, but definitely something that takes diligence, and that I hope to continually improve on.  My father had coronary problems, starting in his late 50s, so this is something I really want to stay on top of.

Here’s the blood numbers for those who know what they mean: