16/09/2024
Francesca Angelini, writer at The Times, underwent her first health MOT, showing her cholesterol in the red. It forced a dramatic lifestyle rejig, but the hard part was making the changes stick. Read below to find out more from Francesca.
In February my colleague Matt Rudd sent a pleading email: “Help! I need volunteers for a blood health panel screening. Hooked on the fact that a million people in the UK have undiagnosed T2 diabetes.”
My Italian grandmother had diabetes. I had never had a proper health check in my life. It probably wasn’t a bad idea to have an MOT.
By my reckoning, I was in reasonable nick for a 37-year-old mother of a two and a five-year-old: I cooked from scratch, didn’t eat red meat and cycled (occasionally and slowly) to work. I banked on getting the health equivalent of a B+.
But I very much did not get a B+. The results from my £65 “Vital” Randox Health check were graded by a traffic light system. Ten per cent of me was, firmly, in the alarming red zone and 13 per cent was amber. The (main) issue was not pre-diabetes, but high cholesterol. My total was 6.22mmol (millimoles per litre) when it should have been less than 5.
“I’m really freaking out,” I messaged my partner, Tom. “I’m going to get heart disease. Or have a stroke.”
Closer inspection showed that my LDL, which Google informed me was the bad kind of cholesterol, the kind that clogs up the arteries and kills you, was 3.56. It should have been below 3. My iron levels were also low, again throwing up more red. And I wasn’t fit. My body mass index was in the green but I had a metabolic age of a 40-year-old. “This is really sub-optimal,” I added to Tom.
But it was the high cholesterol, which is usually without symptoms, that bothered me. Nearly 50 per cent of the population is estimated to have high cholesterol and it often runs in families, explains Julie Ward, a cardiac nurse at the British Health Foundation. “It’s really prevalent in society, but often people, especially younger people, have no idea at all until they get checked. The key is to talk to your relatives, to your parents. Ask them if there’s a family history.”
I peppered my trim mum with anxious messages. Why didn’t I know about this? “I told you that I had high cholesterol,” she replied. When? “You were 14.” Somewhere between the Smirnoff Ice and Marlboro Lights, that particular health concern apparently hadn’t lodged in my mind.
I told my twin brother about our genetic predisposition, which he seemed relaxed about. I was anything but relaxed. I think it was the recognition that I could no longer “wing it” that struck me. Call it my coming of age. And my worries spiralled from there: I wanted to be around and healthy for my children as they grew up. Which meant that as Sir Keir Starmer said about the NHS, I had two options: reform or die.
The question was: what to do about it? Changing habits, some of which developed in childhood, is extremely challenging. I took a hard-nosed look at my lifestyle. Exercise didn’t really feature, other than the 25-minute cycle to the office and a bit of tennis. None of which, Tom pointed out, made me break into a sweat.
I ate lots of vegetables, fish and pulses, but I also ate cheese straws, crisps and pasta. At restaurants, I was all about fried and/or beige: croquetas, ay kind of tempura, burrata, tuna tostadas. The bread basket. Nor did I ever contemplate the long rigmarole of putting our kids to bed without eating a hefty wedge of toasted sourdough, butter and mature cheddar.
So what could I do? The answers were predictable: exercise, cut out saturated fats (found in cakes, biscuits, pastries, processed food), eat more pulses and vegetables, and eat plenty more seeds, nuts, oily fish and avocado, all sources of good cholesterol, the kind that takes the bad away from the arteries.
Let’s retest in six months, suggested Matt Rudd. Here was a competition, something I could get on board with.
“I’m making radical changes,” I told Tom as I filled our online Sainsbury’s cart with butter beans, chickpeas and beetroot (none of which I much liked). “No more bread, white pasta, potatoes, white rice. No cheese, no deep-fried food. No more Tony’s Chocolonely. And I’m going to work out two mornings a week.”
The first major test came two days later when we went on a rare childfree trip to Venice, home of chichetti and Aperol Spritz. At 6pm, drinking white wine beside the lagoon, I was presented with a (free) plate of tiny smoked salmon white bread sandwiches and bruschette piled with salted cod. Oh tentazione!
But I had decided to go cold turkey. Any other approach and I knew my willpower would evaporate before Tom could say “stroke”. Dinner was torture: obviously I wanted the spaghetti alle vongole but instead I made myself order cuttlefish stew (no carbs!).
Back in London, I carried on. Toast with butter and marmite was replaced with chia and flaxseed-heavy oat bircher. My mid-afternoon snack of pop chips became walnuts and almonds. A salad for the old me was 60 per cent crouton.
Dinner became something like veggie chilli, no rice, or spicy butter beans with spinach and tofu. Biscuits, cakes and puddings were taken off my menu. As was my after-supper chocolate.
Classpass, a monthly subscription that gets you access to various gym classes, also worked for me. Mainly because its policy is to fine you for missing a class. Brutal but effective.
It takes 60 days to form a habit, Tom kept telling me when I wavered: don’t give up. A dogma confirmed by Jenna Hope, a nutritionist who advises her clients on how to break and reform habits. “It’s hard, but there are tricks,” she says. One is to focus on what is making you sit down on the sofa with a tub of ice cream after work. “If that is what you do for relaxation, you need to replace the ice cream with something else, something healthy. Don’t just say, ‘I’m not having ice cream any more’, that’s much harder.”
Each person is different, she says, some need to make changes slowly. Others, like me, need to go nuclear. Either way, the key is consistency.
Competitiveness also drove me. I wanted to beat Matt Rudd. Though when he opened his desk drawer to reveal a supermarket-sized stack of Jammy Dodgers, Mini Cheddars and Haribo, I realised he’d given up.
By two months in, I was feeling a hell of a lot better. I no longer had stomach aches and I was fitter and had lost weight. I’d also developed a taste for crouton-free salad.
Take the Randox test, my editor kept asking me. But I was worried: what if, after all this effort and self-denial, my cholesterol hadn’t changed? Can you even do anything about it when it runs in your family?
Last week, I caved and took the test. The great news was that I had reduced my metabolic age from 40 to 23. And my cholesterol? Still red but definitely leaning more pink: from a total of 6.22 it had dropped to 5.6. And the bad kind was now at the healthy level, below 3, at 2.79mmol.
“That’s a really good level,” said Joanna Lilburn, a scientific consultant at Randox. “And I wouldn’t worry about the total level because a lot of that is good cholesterol.”
Which is what I wanted to hear. Lifestyle changes were working. Albeit slowly. What I didn’t want to hear is that cholesterol levels increase as you age. Which means that now, warned Lilburn, comes the hard part. “It’s about keeping it going.”