Friday, April 30, 2021

3 "highs”- 三高- is not a death sentence

    A chance encounter with my cousin Charmain online, we came to realize that we both started blogging! So, we thought it would be a great idea to collaborate and write about nutrition and health as well. She is a Registered Dietitian Nutritionist while I am a retired physician, so hopefully we can help our readers achieve a healthier life. We thought we will start with something common, the "3 highs" - 三高. Through this series of blogs, we hope to explain the "3 highs" in ways everyone can understand and to work through some lifestyle modifications.

    Now that we are in the latter half of our life's journey, we pay more attention to our health, or at least we should. We eat healthily and exercise so that we can get a good report card during our annual well visit. I actually first heard the name "3 highs" from patients! They believed that once you have the "3 highs", you are on your way to your grave! Well, while there is some truth to it, the “3 highs” markedly increase one’s cardiovascular risk, but it is not a death sentence. The risk of cardiovascular death can be reduced with medications and therapeutic lifestyle changes (TLC).

    The 3 "high"s are:

        high blood pressure

        high cholesterol

        high blood sugar. 

    The diseases they can lead to are:




    It may be too simplistic to think of them as just numbers that are elevated. In fact, they are indications that certain organs in the body are not functioning normally anymore, the blood vessels are starting to change and are signs of diseases at the early stages. It will be a super long blog to write about all 3 and nobody wants read lengthy articles. It is long enough as it is! So, we will discuss the 3 separately.

   Why do people fear the "3 highs"? With every one "high" and the subsequent disease, the cardiovascular risk is increased. So, for example with just high blood pressure, the risk for a heart attack and stroke is significantly increased compared to someone without. Adding high cholesterol, the risk is further increased. Having all 3, the risk for cardiovascular disease is even higher. Again, things are actually not that simple with risks not exactly additive and other factors do play their roles, but hopefully, you get the sense of it. 

    When the numbers are elevated but not to the level of the definition of disease, lifestyle modification is the most important treatment. Let's use high blood pressure as an example. Normal blood pressure for a normal weight adult is around 110/70. When the reading is over 130/80, then they have hypertension. Before it gets to hypertension, it is elevated blood pressure. At this stage, eating healthily, exercising and losing some weight are key in preventing or slowing down the disease progression.  

    As we grow older, our internal organs and blood vessels begin to age. Living a healthy lifestyle helps but eventually, a lot of us still need medications. Many people hesitate do take medication and always bargain with physicians for more time for TLC (not tender loving care, but therapeutic lifestyle changes). The need to start medication does not mean that you failed. It is actually an adjunct to the overall treatment and to reduce your overall cardiovascular risk. So when your doctor prescribes medications for you, they are not just treating the numbers, they want to protect your internal organs, like your brain, heart, kidneys, etc, as well as your overall health. The numbers are just a barometer that represents the state of your body.

    The next part of the blog is from Charmain Dietitian on how to change your diet, which includes:

        1. Eat a variety of whole and fresh foods everyday. Frozen, canned or dried nutritious foods are equally good to use. Read label on the package and choose the most natural ones with less ingredients, and keep a check on fat, salt and sugar content. 

        2. Enjoy a rainbow color of fruits and vegetables to achieve a wide spectrum of vitamins and minerals. 5 A Day ( 5 servings of fruits and vegetables a day) is a good start.

        3. Choose a variety of options from each food group

                - high fiber starchy food

                - low fat dairy or dairy alternatives such as soy drinks

                - eat some beans, pulses, fish, eggs, meat and other lean protein. Among protein foods, consume plant-based protein more often, such as legumes, nuts, seeds, tofu, fortified soy beverage

                - choose unsaturated oils and spreads, and eat them in small amounts

                - fluids 6-8 cups per day. Water should be the beverage of choice

        4. Pay attention to portion size

        5. Limit foods and beverages high in add sugar, saturated fat and sodium; i.e. eat less processed foods

        6. Stop smoking

        7. If you drink, limit alcohol to 2 drinks or less in a day for men and 1 drink or less a day for women, according to CDC and NHS. Spread your drinking over 3 or more days if you regularly drink as much as 14 units a week. If you wish to cut down the amount you drink, a good way to help achieve this is to have several drink-free days each week.

        8. People at high risk of or people with cardiovascular disease who are overweight or obese, seek advice and support to work towards achieving and maintaining a healthy weight.  

        9. Resources American Dietary Guidelines, Canada's Food Guide, UK Eat Well Guide.

    For more details for specific dietary changes, refer to Charmain's blog.  If you find the above dietary information useful and wants to start making some lifestyle changes, Charmain would like to help. Feel free to contact her for 1:1 consultation or group sessions. 

    So, I hope that you will be interested in learning more about the 3 “highs” and have the incentive to further improve your lifestyle by subscribing to our blogs! Do not hesitate to ask questions!

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