DEAR DOC: I’m thin, how can I  have cholesterol?

Dr Flo, we had a medical check up at our work place and I was told I have high cholesterol. I am wondering, how it is possible and yet I am quite thin?  In case it is true, is there any medication for it? And will I have to lose the little weight that I have? KJ

Dear KJ,

It is possible to have high cholesterol levels in the blood even when you are thin. It is also true that obesity is associated with high cholesterol levels, but it is not the only factor. Other risk factors include diets that have a lot of “bad” fats (trans fats and saturated fats — the ones in processed foods and fried foods), lack of exercise, smoking, excessive alcohol intake, and diabetes.

There are also some people who have an inherited disease that interferes with how the body deals with cholesterol, leading to very high blood cholesterol levels.

High cholesterol levels are dangerous because they form deposits, called plaques, on the walls of blood vessels. These deposits can then cause narrowing of the blood vessels and weakening of their walls, leading to stroke, kidney failure, heart disease and heart attacks, and even blindness.  This happens because of reduced or blocked blood flow to the organs — the brain, kidneys, heart, and retina.

There are two kinds of cholesterol: the “good” HDL cholesterol and the “bad” LDL cholesterol and triglycerides. The target is to have more of the good type and less of the bad.

To avoid having high levels of bad cholesterol, keep off trans- and saturated fats and go for the unsaturated variety (like olive, sunflower, and corn oil); eat fish, seeds and nuts; eat whole grains, oatmeal, whole wheat bread and pasta, and brown rice; eat more vegetables and fruits and other high fibre foods; and reduce your egg, whole milk and red meat intake.

Also, get regular exercise — for the sake of being healthy, and not necessarily to lose weight. Medication can be prescribed if the above measures do not work within a few months.

Dr Flo, every time I walk a long distance I feel pain in my heels. This pain is also there in the morning when I wake up, but it disappears after I walk around for a few minutes. I am still young — I am 34 years old. Could I be suffering from arthritis? Does it have a cure? Naliaka

Dear Naliaka,

What you are suffering from is called plantar fasciitis, which means inflammation of the fascia on the bottom of your foot. The plantar fascia is like a sheet of fibrous tissue that connects the heel to the front of the foot, where the toes start.

It supports the foot and helps us walk by acting as a shock absorber. It can easily get injured or torn due to too much pressure on the feet though. When this happens, there is pain, usually after starting to walk after sitting or lying down for long, or after being on your feet for long.

It is more common in those who are overweight or obese, those whose jobs require them to stand or walk for long durations of time, and also long distance runners.

It can also occur during late pregnancy, and also in those with flat feet or a high foot arch. Wearing shoes with poor arch support also contributes to the problem.

To manage it, reduce the pressure on your feet by reducing the walking and standing. You can stretch and massage your feet before getting out of bed in the morning and after being on your feet for long.

Wear shoes with a cushioning sole, for example, those with a thick rubber sole, or sneakers. Also, get shoes with good arch support, and buy heel cushions from your local hospital, pharmacy or even supermarket.

Pain killers help to reduce the pain and inflammation, but you can see a physiotherapist to help with the exercises for the feet and legs. In case you have tried all this and you are still in a lot of pain, you may require a steroid injection to the damaged area, which should be done by an orthopaedic specialist.

Other treatments that the orthopaedist may recommend include using splints, plantar iontophoresis (using an electric current to get an applied drug to get into the foot), extracorporeal shock wave therapy, and surgery.

All the best!

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