How to control high triglyceride and uric acid levels?

Q: I am 170 cm tall and I weigh 70 kg. I am a regular drinker of alcohol, but not an extreme case. I used to smoke almost 20 cigarettes but have stopped completely from the past 2 and a half years. I am very conscious about my food habits and I exercise regularly. I play tennis 5 times a week for 40 minutes and do 20/25 push ups as well. I recently went for a regular check up and got the following results: SGOT - 16; SGPT - 28; GT - 44; Total HDL/LDL/Triglyceride Ratio - 162/33/108/ 177/4.9; Uric Acid - 9. My triglycerides and uric acid are high and cholesterol is borderline. What are the ways of decreasing these three? How can I improve my HDL levels? What food habits should I opt for and what should I avoid? What are the effects of high uric acid?

A:The first step in treating hypertriglyceridaemia (high uric acid) [photo gallery] is a low fat diet with a limited amount of sweets, regular aerobic exercise, loss of excess weight, reduction of alcohol consumption, and stopping cigarette smoking. A low cholesterol diet would be an excellent option for you. It will help to reduce your blood cholesterol level to decrease your chance of developing heart disease, future heart attacks, and other heart disease complications. Keep in mind these points:

• Less than 7% of the days total calories from saturated fat.
• 20-25% or less of the days total calories from fat.
• Less than 200 milligrams of dietary cholesterol a day.
• Limit sodium intake to 2.4 grams a day.
• Just enough calories to achieve or maintain a healthy weight and reduce blood cholesterol level.

What to eat?

Eat foods low in saturated fat, such as:

• Fat free or 1% fat dairy products – skimmed milk
• Lean meats
• Fish and shellfish
• Skinless poultry
• Whole grain foods
• Fruits
• Vegetables
• Oats
• Certain fruits (e.g. apples, pears & guava)
• Certain vegetables (e.g. cabbage, green leafy and carrots)
• Dried peas and beans. Dry peas and beans also have a lot of fibre, which can help to lower blood cholesterol. Try adding a ½ cup beans to pasta, soups, and vegetable dishes.
• Egg whites have no cholesterol, and you can substitute them for whole eggs in recipes - two egg whites are equal to one whole egg.
• Buy low fat dahi (curd) or make it at home using only skimmed milk. Try topping it with fruit.
• Choose liquid vegetable oils that are high in unsaturated fats - like canola, corn, olive, peanut, safflower, sesame, soybean, and sunflower oils.
• Choose whole grain breads. They have more fibre than white breads.

What not to eat?

Limit foods high in cholesterol, such as:

• liver and other organ meats
• Egg yolks. Yolks are limited to no more than 3 yolks per week
• Full-fat dairy products , whole milk etc.
• Limit butter. It is high in saturated fat and cholesterol.
• Limit sweet baked goods that are made with lots of saturated fat, mostly from butter, eggs, and whole milk such as croissants, pastries, muffins, biscuits, butter rolls, and doughnuts. These are also high in cholesterol.

Limit foods high in saturated fat, such as:

• High fat processed meats (e.g., sausage, kheema) and fatty, untrimmed red meats.
• Fried foods

How to prepare food?

When preparing foods, the following cooking methods tend to produce lower saturated fat levels:

• Baking
• Broiling
• Microwaving
• Poaching
• Grilling
• Roasting
• Lightly stir-fry or sauté in small amounts of vegetable oil.

Keep track of what you eat on a typical day. The labels on packaged foods that includes fat grams can help you determine what percentage of the calories you eat comes from fat. As far as your uric acid levels are concerned:

• Alcohol, especially beer, should be avoided. Limit alcohol consumption to 1 drink 3 times a week. Alcohol increases uric acid production by accelerating purine breakdown. It also reduces uric acid excretion by increasing lactate production, which impairs kidney function. Elimination of alcohol is all that is needed to reduce uric acid levels
• Drink 2 to 3 L of fluid daily. Adequate fluid intake helps dilute urinary uric acid.
• Avoid acid forming items like artificial sweeteners, Carbonated soft drinks & fizzy drinks, Cigarettes, Flour (white wheat), Goat, Lamb, Pastries & cakes from white flour, Pork, Sugar, Beer, Brown sugar, Chocolate, Coffee, Custard with white sugar, Jams, Jellies, Liquor , Pasta, Semolina, Table salt(refined & iodised), Tea black, White rice, vinegar.
• Avoid High-Purine foods like organ meats, whole eggs etc
• Consume a moderate amount of protein. Limit meat, fish and poultry to 4 - 6 oz per day. Use preferably good protein food such as low fat dairy products and soy protein.
• Limit fat intake by choosing leaner meats, foods prepared with less oils and lower fat dairy products.

If your uric acid levels are high it can lead to gout, where uric acid crystals are deposited in joints, tendons, kidneys, and other tissues, where they cause considerable inflammation and damage.