March 8, 2010
This article originally appeared in Black AIDS Weekly, the newsletter of the Black AIDS Institute, on Feb. 9.
People who take certain HIV medications often get high cholesterol as a side effect of the drugs. Recently my doctor told me that I have high cholesterol. But is it a result of my drug regimen? I had been taking Reyataz, Norvir and Truvada, all of which have high cholesterol as a possible adverse effect. It could be my genes or my lifestyle -- or even a combination. I may never really know. But since high cholesterol increases your risk of having a heart attack or stroke, it's time for me to make some changes.
My average cholesterol is 234.1; the average of my doctor's patients is 185. My LDL, or "bad cholesterol," is 143.1, which is borderline high. My HDL, or "good" cholesterol, is 52, which is good. (Learn more about cholesterol levels.) My triglycerides were also high.
High cholesterol runs in my family. For years I have known that my dad has it. Over the holidays I learned that my mother does too. This double shot of high cholesterol means that I really have to be careful, especially since being male and of African American descent may increase my risk of heart disease also. Fortunately I don't smoke.
Rather than immediately change my meds, which is complicated, my doctor decided that we'd first approach the problem by making lifestyle changes. There are two areas that I can take charge of on my own: eating and exercise.
First I had to slow my cholesterol intake. Now that I'm 30, my body doesn't process foods at the same speed that it did when I was 19. This meant that I had to examine my food choices. During the week, my diet was relatively healthy. Here was my diet on a typical day:
Breakfast: Ensure nutritional supplement Snack: ravioli Lunch: Quiznos sandwich, but sometimes McDonald's, pizza or buffalo wings Snack: banana Dinner: pasta, red meat or fish with rice, and wine, preferably red
But the weekend was a whole different story: I love a good steak-and-eggs breakfast; I also eat a lot. Here is an example of a typical weekend day:
Breakfast: pork bacon, ham, pancakes, biscuits, hash browns and maybe some grits (I also smothered foods with butter) Lunch: chips, pickles and soda Dinner: pizza, chicken wings with ranch sauce, or a steak with mashed potatoes
Many of these foods are high in cholesterol (Learn more about foods to eat and foods to avoid). I also used a lot of condiments that were high in cholesterol. And I didn't work out much.
Yet my waist is still a size 28 -- okay, 29 -- so until my doctor said something, I thought everything was okay.
But I realized that I had to improve my eating habits, particularly on the weekend, and head to the gym. Given the choice between big steaks and a healthy life, to me the choice is clear.
So I've changed my eating habits. On a typical weekday I now eat:
Breakfast: banana and a cinnamon-raisin bagel Snack: orange juice, an apple, water Lunch: club sandwich without bacon, iced green tea Snack: crackers Dinner: baked fish, greens, rice and wine, preferably red
And on weekends I now eat:
Breakfast: pancakes, muffin with honey, turkey bacon Lunch: tuna fish sandwich with mayonnaise Dinner: catfish, rice, couscous and wine
I also take one multivitamin, fish oil to protect against heart disease, and vitamin D because my doctor has noticed in some of his patients who take it that their T-cell, or CD4, counts have gone up. This is on top of the three HIV meds (six pills) I take every day.
And I've started hitting the gym three times a week to lift free weights. On my off days, I try to run at least one mile.
Just because people look fit on the outside doesn't mean they're fit on the inside. And I may only be 30, with a 29 waist, but I have more than just HIV to worry about.