12.3 The Cholesterol Diet

In 1998 Mary Ann and I moved to a new city. After get­ting set­tled into the new house, I took steps to find a doc­tor.

I called to make the ap­point­ment. The voice on the tele­phone told me that they were go­ing to draw blood and she in­struct­ed me on how to fast. I was to eat no food af­ter 6:30 pm, but I could drink wa­ter un­til mid­night.

My nor­mal eat­ing pat­tern is a late night snack and break­fast right af­ter I get up.

No food af­ter 6:30 pm and my blood draw ap­point­ment not un­til 8:30 am meant that I would be hun­gry when I woke up. It seemed that the log­i­cal way to min­i­mize the hunger would be to have a huge din­ner pri­or to 6:30 pm.

My din­ner that night was a big steak, a pack­age of lima beans, and a gen­er­ous help­ing of French fries. At 5:45 I was work­ing on my sec­ond Foster’s lager. At 6:10 I fin­ished eat­ing and I poured my­self a half glass of wine. At 6:23 I fin­ished it. I poured an­oth­er half glass. At pre­cise­ly 6:30 I drained the glass.

In hind­sight, and with my pre­sent knowl­edge, I know that this was a ter­ri­ble strat­e­gy to pre­pare for a blood test. The re­sults were pre­dictable.

A week lat­er, I got the re­sults back. I was in great shape in ev­ery re­spect ex­cept one—the fat con­tent of my blood was too high. My to­tal choles­terol was 261.

I got this news via a call from the doc­tor’s of­fice. “Your choles­terol’s 261. Come in and we’ll start you on the drugs.” I was amazed by this since I knew that drugs have some po­ten­tial­ly bad side ef­fects (for ex­am­ple, liv­er dam­age) and there are non­drug ways to achieve the same end. I have since learned that a “drugs first” ap­proach is com­mon with doc­tors. Some doc­tors sim­ply don’t know that a lifestyle change can be ef­fec­tive in re­duc­ing choles­terol. Others, who are aware of its ef­fi­ca­cy, think that it’s a waste of time sug­gest­ing lifestyle change since al­most all pa­tients won’t stick to it.

I de­cid­ed to do some re­search. I read books and searched on the In­ter­net. My re­search yield­ed a wealth of in­for­ma­tion but one fact stood out: get the fat out of my diet and my choles­terol will go down.

On this reg­i­men, the amount of fat I al­lowed my­self was only 20 grams a day. It is dif­fi­cult to get down to this lev­el. I changed my eat­ing habits by sub­sti­tu­tions, like skim milk in­stead of 2% milk, and by elim­i­nat­ing foods, like cheese, that are high in fat. I also cut out beef and pork and cut back on chick­en and turkey. I sub­sti­tut­ed shrimp, clams, and fish. I re­searched veg­e­tar­i­an recipes and added sev­er­al to my diet.

My goal in adopt­ing this diet was to get my choles­terol down. You can read more about this in the “Choles­terol” sec­tion be­low. How­ev­er, there was a com­plete­ly un­ex­pect­ed side ef­fect.

I have al­ways been some­what care­ful of the por­tions that I eat. I keep the quan­ti­ties with­in rea­son so that I don’t get too fat. I didn’t change this when I went on the new reg­i­men. I kept it down to my nor­mal four meals a day. Co­coa and ba­nana nut bread for break­fast. A ba­nana sand­wich and a cup of tea (no cream) for lunch. A large din­ner. And for my mid­night snack some non-fat yo­gurt, or maybe a pint of low-fat ice-cream or frozen yo­gurt. Plus, of course, the nor­mal com­ple­ment of beer and wine.

What came as a com­plete sur­prise was that I start­ed to lose weight. It was grad­u­al, about a pound a month. Over a whole year I lost eleven pounds and I was nev­er hun­gry. I went down from 162 lb. to 151 lb. and then my weight sta­bi­lized. In the years since I made that lifestyle change, my high­est record­ed weight has been 153.75 lb.

In ret­ro­spect I un­der­stand what hap­pened. I had dras­ti­cal­ly cut down the fat con­tent of what I ate. Fat is the high­est calo­rie macronu­tri­ent. By re­duc­ing it, the en­er­gy den­si­ty of my food was less. Thus, I ate the same amount of food as be­fore, but with­out the fat my to­tal calo­rie in­take was less and so I lost weight.

Los­ing the weight was won­der­ful, but even bet­ter was that I kept it off. In the past, af­ter I di­et­ed, I al­ways re­gained some or all of the weight. This time I lost weight not with a diet, but with a lifestyle change. Un­like a diet, a lifestyle change is per­ma­nent. You don’t come off it af­ter the weight is lost, so the weight loss is per­ma­nent too.

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