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Suggest Treatment For High VLDL And Triglyceride Levels

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Posted on Wed, 26 Apr 2017
Question: Namasthe sir,
I am 39year old male,height 5feet 5inches and weight 91.5kg.
i went for a routine health checkup(self). please see the fasting,post lunch,HBA1C and lipid profile in the attachment. i also added my diet chart which i am following 80percent of times.
i found my triglycerides to be high and VLDL high.
it seems that i m in prediabetic range.
i walk for 30 minutes daily(weekly 4times guaranteed) at 120+BPM.
what is your opinion?
I will ask few questions in the follow up.
let me tell you that i am on Selekon XL 50mg for last 5years which was suggested to me to reduce my heart rate as i used to eat zarda paan(10 to 15 pans daily since 2002) earlier which i stopped completey since 2013.my resting heart rate is 70+ (i use VIVOACTIVE HR watch to find this).i attached the HRM graph while doing my walking. plese observe that.
i prepared my diet plan which i m following for last few weeks(80 percent of times) and since it is in doc wordfile i m not able to upload it. so i am giving here below(plese go through it and tell me if i need to add anything or stop anything considering my reports).
400calorie BREAKFAST @ 8 to 9 AM
3glasses of warm water for bowl movement
Tulsi leaves+fenugreek seeds(overnight soaked)
Chiaseeds(overnight soaked)------------------------------------------------------------each 1tsp

Raagi(finger millet) malt mixed with flaxseed powder(1tsp)+cinnamon powder(1/4tsp)+black pepper powder(1/4tsp)
3Garlic+3Ginger-------------------------------------------------------------each2to4piece
=70cal

Millet upma(foxtail millet +littlemillet+Quinova)
Or Jonna-whet ravva upma……………--------------------------------------------1cup =180cal
Sorakaya/Beerakaya/Tamota/allam/putnalu chutney-----------------------------2 tsps =50cal

Seeds n nuts(pumpkin seeds+watermelon seeds+sunflower seeds+muskmelon seeds+
Almonds+walnuts)---------------------------------------------------------------------1 tsp=100cal

100alorie Morning snacks @11 to 11.30AM
Fruit -------------------------------------------------------------------------------------1cup=100cal
(Apple/Grapes/Orange/pomangrate/watermelon)

800calorie LUNCH @ 1to 1.30PM
Roti(pearlmillet/Godhuma)----------------------------------------------------1pc      = 80cal
Brown Rice-------------------------------------------------------------------1.5cup      =270cal
Greenleaf Dal or Veg Dal---------------------------------------------------1 cup      =180cal
Veg Curry---------------------------------------------------------------------1 cup =100cal
Sorakaya/Beerakaya/Tamota/allam/putnalu chutney------------ ----------2 tsps =50cal
Curd with pinch of turmeric+cuminseeds+tymolseeds+onionpiecs---1 cup      =100cal
50calorie Mid Afternoon snack @4PM
buttermilk-------------------------------------------------------------------------1 glass =50 cal

100calorie Evening snacks @5.30 PM
Papaya pieces with ---------------------------------------------------------------1cup =100cal
200calorie DINNER @9PM
Vegitable Soup with crackers-----------------------------------------------1 n1/2 cups =200cal
                                             TOTAL =1700cal
                                        










Thanking you
doctor
Answered by Dr. Dr Sameer Maheshwari (1 hour later)
Brief Answer:
Diet plan is fine

Detailed Answer:
Hi,
Welcome.
This is Dr Sameer, cardiologist from Fortis Hospital.
I went through all the attachments.
You are definitely following a great diet plan & you should continue following it. Their is no need to change it.
Your HbA1c is 6.4 which falls in prediabetic range. Fasting & post prandial glucose also falls in prediabetic range. Their is no need for medication currently. For such we prescribe Diet restrictions (which you are already doing) & exercise (at least 30min of brisk walking for at least 5 days a week). It will decrease the insulin resistance & increase insulin secretion in body.
Coming to heart rate. Your graph is showing that it is sometimes high, but otherwise it is in 70-80 range which is very good. Continue taking Seloken XL which is a very good drug & prevents future cardiac events also.
Now about your Lipid Profile- Cholesterol is fine, but Triglycerides is bit high & HDL(good cholesterol) is low. For this we advice dietary restrictions (which you are already doing) & exercise (same - at least 30min of brisk walking per day for at least 5/7 days).

So all you need is adding exercise to your daily routine & you will be fine & healthy.
Thanks & take care
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Dr Sameer Maheshwari (14 hours later)
Thank you for your reply sir.
My heart rate is sometimes high while walking because of the way i walk.I walk for 10 minutes at 120 BPM and then climb 3 to 4 floors in my apartments where my BPM raises to 135+ to 140+ . I do this for 3 times i.e., 3 rounds.i learned that 180 is my maximum heart rate(rule 220-age40). And walking for 30minutes while walking at 66%(120+BPM) of maximum heart rate and introducing 1minute spike of 75%(135+BPM) of maximum heart rate. Is this OK?
i have few more doubts which i gave below
1.     How to reduce my triglycerides. Am I eating any food which is increasing this.
2.     what about nuts and seeds. I eat them in moderation to get good fat. 2 almonds,2 wallnuts,1 tsp of seeds like pumpkin,watermelon,sunflower and muskmelon. Is it ok to eat sunflower seeds?( i use sunflower oil and rice XXXXXXX oil for cooking)
3.     I learned that metformin will be useful to reduce weight also and in turn helpful in bringing down HBA1C. Shall I start metformin and continue for few months and discontinue. Is it possible?
4.     Shall I use apple cider vinegar to reduce blood sugar.if so,please tell me how to use it?
5. i normally prefer walking in morning on empty stomach. sometimes i dont get chance to do so. so i walk in the evening. will i get same benefit?
Thank you Sir

doctor
Answered by Dr. Dr Sameer Maheshwari (4 hours later)
Brief Answer:
Please see detailed answer

Detailed Answer:
Hi,
Welcome back.
It is good to know that you are doing exercise daily which is causing heart rate spikes.
You are taking good diet plan which is good for both abnormal lipid profile & pre diabetic range.
Considering your questions one by one.
1) As you are doing enough exercise & taking proper diet but still have abnormal lipid, I'll recommend you to take a Ayurvedic medication Cap PRELIPID 500mg twice daily. It is a good medication with very less side effects. So you can start it.
2) Nuts & Seeds are good for health & you should continue taking it. For cooking, I'll advice you to use Olive oil which is considered better in keeping lipids stable.
3) You currently do not need any medication for Diabetes & i DO NoT recommend taking Metformin. Do exercise regularly & continue monitoring the sugars.
4) Apple cedar vinegar is not proven to reduce sugars & prevent progression of diabetes. But it considered good for health & you can take it.
5) Walking in morning or evening both have same benefits & you can do it as per your convenience. But remember that it should be brisk walking which makes you sweat & that only will benefit.

If you have any more question, i'll be happy to help.
Thanks & take care
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
Dr.
Dr. Dr Sameer Maheshwari

Cardiologist

Practicing since :2010

Answered : 818 Questions

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Suggest Treatment For High VLDL And Triglyceride Levels

Brief Answer: Diet plan is fine Detailed Answer: Hi, Welcome. This is Dr Sameer, cardiologist from Fortis Hospital. I went through all the attachments. You are definitely following a great diet plan & you should continue following it. Their is no need to change it. Your HbA1c is 6.4 which falls in prediabetic range. Fasting & post prandial glucose also falls in prediabetic range. Their is no need for medication currently. For such we prescribe Diet restrictions (which you are already doing) & exercise (at least 30min of brisk walking for at least 5 days a week). It will decrease the insulin resistance & increase insulin secretion in body. Coming to heart rate. Your graph is showing that it is sometimes high, but otherwise it is in 70-80 range which is very good. Continue taking Seloken XL which is a very good drug & prevents future cardiac events also. Now about your Lipid Profile- Cholesterol is fine, but Triglycerides is bit high & HDL(good cholesterol) is low. For this we advice dietary restrictions (which you are already doing) & exercise (same - at least 30min of brisk walking per day for at least 5/7 days). So all you need is adding exercise to your daily routine & you will be fine & healthy. Thanks & take care