Good Fight on Bad Cholesterol

There’s a battle raging for our hearts.

There’s a battle raging for our hearts. Not the one that goes sha-la-la, romps in the rain, and jumps into our mouth every time we think of a life without love. That’s good only for Insta stories. We’re talking about the chappie who doesn’t make it to social media; the ungainly muscular organ sitting in our chest, pumping blood through our circulatory system. Unlike other full-time workers, this one doesn’t get any credit for working overtime or at too clipping a pace. Slowing down isn’t tolerated either; the bloke gets a stent or is bypassed altogether. The smart performers, therefore, plod at a steady pace, taking pains never to fall out of rhythm. 

The war over this champ is being fought by my dietician and my cardiologist. The former is very new-age, constantly quoting new research and leaning on innovative ideas. My cardiologist, young as she is, is a complete traditionalist when it comes to food habits and medication. Here’s how they stand. My dietician espouses the cause of butter, cheese and meat. “Saturated fat is no monster. Bring home the bacon; pour on the ghee. Eat some greens, but skip the fruits and carbs. Don’t bother about cholesterol; it’s got nothing to do with heart disease,” she says.

Across the Kurukshetra stands my heart doctor, fuming at the dietician’s promotion of animal foods and cream-loaded dairy products. “This is highly irresponsible. The occasional consumption is all right when balanced with greens and carbohydrates but going overboard on saturated fat is just evil. All fatty foods do is over-produce bad cholesterol which, in turn, causes heart disease,” she says, very angrily. As a lay person looking to eat well but stay healthy, I’m totally confused. I can’t but be tempted by my dietician’s offerings of pork chops and cheese-filled, two-egg omelettes in ghee, but the cardiologist-induced fear of clogged arteries looms large.

Cholesterol, and the medicines used to tackle it, seem to lie at the heart of the battle. My dissident dietician says the cholesterol we eat has little to do with the cholesterol in our blood. Though that seems counter-intuitive to me (shouldn’t eating too much cholesterol-rich foods raise blood cholesterol levels?), she says it works just the other way.

According to her, the body regulates the cholesterol in the blood by controlling its production; so when our dietary intake of cholesterol goes down, our body just makes more. In any case, a heightened cholesterol level is just inflammation at work and can be tackled by walking 30 minutes a day and eating a high-fat diet, she says. Her parting shot is since cholesterol levels don’t matter, taking medicines (aka statins) to lower them is futile. 

When I repeat this to my cardiologist, she is furious. “Not only is there no doubt that high cholesterol is a significant risk factor for coronary heart disease, reducing your intake of fat foods will definitely slash your cholesterol level,” she says through gritted teeth.

“And since your dietician values lab findings over experience, please tell her that multiple studies have shown that a steady intake of statin cuts off cholesterol production at the source, and prevents heart attacks even in high-risk individuals with hypertension or diabetes. And once you’ve told her that, can you please stop going to her?”That conversation happened last night. Timidly, I had oats for breakfast. But there’s prawn curry, liver and salad for lunch. Suggestions anyone?

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