This month’s New Yorker featured this cartoon. Between the balding men and the ladies and the subtle things, it’s apparent how boring the topic of cholesterol is. The men of seventies, my peers, may still be interested to read on but others please enjoy the cartoon and feel free to leave the page. I don’t even wish to see you coming back reading this.
The very first annual checkup I did ten years ago in Bangalore tagged me as a cholesterol boarder case. Rule says below 240 mg/dl is normal but a good number stays below 200. My reading was 220 and it lazed comfortably in a 200-240 bright yellow broad boarder. Considering the young age and bad eating habits the physician suggested more exercise and some dietary changes. Probably I did not fully understand what dietary changes meant then. But I did increase the running and gym visits that made me hungrier for the Little Home meals. Little Home, a restaurant that served Kerala style food, was at a walking distance from where we lived in Koramangala. The food they served -predominantly beef, chicken or fried fish - was so delicious that we have decided to close our kitchen down until we are tired of the restaurant. We never got tired and also realized how tiring the occasional cooking was. Sheena likes this note: I was not married then and I was sharing the apartment with another boarder case who accompanied me to Little Home but never to the gym. I still was concerned about the medical report and called my older relatives to know how they were doing on Cholesterol levels. A hasty confirmation followed: ‘it probably runs in the family’.
Eleven lipid profiles in last 10 years, without missing a single year in between, are now tracked in a Google spreadsheet. There are time series graphs in this shared document for analytically savvy users. (Shared with family but no other users, yet). Blood test results correlated with the life events and the lifestyle. Horrid 2005 report is also a story of a bachelor’s one year stay in Connecticut, closer to a pizzeria, Burger King and a bar. Thanks to double whopper burgers, strawberry milkshakes, meat lover’s pizzas and long island ice teas, a twenty five handsome pounds were added to an already ‘healthy’ body. The doctor suggested medication that I refused with a promise. On my return to India, I reduced the weight and brought the numbers back to the comfortable family boarder levels. Year 2007 was probably the best as cooked meals, rigorous swimming and running in Des Moines summers reduced the body weight to 175 pounds and the total cholesterol fell just below the 200 mark. However, that also significantly reduced the so called good cholesterol (HDL) and the bad good ratio (yes, heart attack odds) stayed above five, unfavorably.
Relocation to California in 2010 offered a lot more opportunity for Asian food and outdoor activities. Miles of running and a lot of seafood and vegetables were happily added to the everyday routine. However, body weight and cholesterol levels nudged a few points every year, soon crossing the comfort levels. The event that tipped the scales was a three weeks, cross country road trip we did to the East Coast by the end of 2012. We let ourselves loose on food, fearing we never see them again. Mexican cuisine in Santa Fe, steak houses in Texas, Corky’s BBQ in Memphis, Philly cheese steaks in Philadelphia and New England clam chowder in Boston- you get the picture. Though not worth the mention, there were plenty of meals in between with fried, BBQed, sandwiched, topped pickled or scrambled meats. I always loved the way my body responds to a rash eating season. On our return, the body weight was eight pounds higher at 188 and the total cholesterol trekked to 242. Two points above the boarder, this number is now in a creepy zone, like a sub 600 FICO in a banker’s lexes.
The following weekend was busy streaming Netflix documentaries looking for a secret sauce to reduce cholesterol. There were quite a few to cover on healthy eating, fast food, obesity, dieting, alternate medicines, Yoga, Ayurveda, vegetarianism and none of them seem to change our understanding about the good food and health in general. However, there was this documentary ‘Fork over Knives’ that quite convincingly suggests that a plant based diet could reverse many of the abnormalities caused by lifestyle and eating habits. It’s not hard for an Indian to be vegetarian, but plant based diet demanded that dairy products are also in check. No big deal, we thought, so have decided to be vegetarians for next three months. This meant we ate no fish, meat and eggs and avoided diary as much as possible.
We had issues with plant based diet advised and practiced in the western world as it goes to the extreme of juicing vegetables and consuming them raw. This is far from our idea of enjoying life in a spicy uncertain world where we count one day at a time. Besides, when I look at a bowl of crisp green salad, my microscopic vision shows me salmonella lurking beneath the ranch dressing. It was a thanksgiving time for our vegetarian Indian friends as we called them for the recipes of the stuffs we remembered relishing at their place. Dozens of curries using pulses (legumes) of different colors and shapes – brown, green and white chickpeas and grams, kidney beans, lentils-often combined with green leaves of mustard, spinach or fenugreek-were recreated in our kitchen. There is something addictive about these tasty beans and Sheena started experimenting these recipes with our favorite leaves -Yu Choy, Collard Greens, Ong Choy, Buck Choy and Amaranth - with excellent results. Life as a vegetarian is even better until you step out of home. I found it’s tiring to get a healthy vegetarian food for lunch at office and also when you travel. Indian food as it is served in the U.S restaurants is heavy with added oil and diary and ironically presents as a healthy vegetarian choice. Pastas, pizzas, garden burgers, burritos and cheese quesadillas comfortably fit into the same cohort as greasy Indian food. At evenings, Guacamole made from California avocados and boiled peanuts with mustard and cilantro garnish become my favorite snacks. Three months passed quite quickly and at the end I weighed 170 pounds. An eighteen pounds reduction from where I started. We also realized that we ate a lot less quantity than we were used to.
The three months experiment was controlled for a plant based diet. I reduced my running to once a week, six miles or less. Heavy exercise for weight reduction is overrated as even a ten miles run will burn only 1,000 calorie, less than a big Mac burger. We also did thirty minutes basic Yoga, four days a week, and it was not the demanding kind we normally see on YouTube. We gave the tests by end of March and I heard nothing back in three weeks. Lab Corp, the laboratory, sent the results to WebMD because my employer’s wellness managing company, Summit Health, directed them to do so. Healthcare here is not very complex and I just had to call four different organizations to trace the results and every time, in despair, I told them about the plant based diet. On fourth week the report was uploaded to WebMD and I saw the total cholesterol dropped 50 points to below 200, the green happy zone. The bad to good cholesterol ratio also dropped to below five, first time in last 10 years.
The whole story seems to justify the plant based diet. But I have also made a few other observations. I strongly believe it’s the quantity you eat is the major culprit. In my case, total cholesterol levels correlated with body weight every time and this was true even when I was on a predominantly meat based diet (2007). A filling plant based meal generates half the calories as compared to a similar meat based meal. This makes a big difference and what your body does with excess calorie is anyone’s guess. Individual portions in restaurants are unreasonably large for an individual and your body does not even need twenty percent of it. It’s quite surprising that when you reduce the body weight, you are less hungry for food and more energetic all day. Reducing the body weight by eating less is a lot easier than working out hours in gym and injuring your body in the process. Walking long distances is probably the best exercise, preferably in a trail away from smoking vehicles and other pollution. I love to run long distances and I still do it but I don’t think it’s necessary to reduce weight.