Dr Bernadette Carr answers your questions on cholesterol and writer's cramp

Q. I am a 60-year-old man and my recent blood tests show I have high cholesterol. 

My GP has suggested I try to improve my lifestyle. What should I include in my diet to help me improve my cholesterol?

A. High cholesterol is a risk factor for the development of cardiovascular disease (CVD) which causes hardening of the blood vessels in the body and of the heart.

If this happens, the likelihood of an individual experiencing a heart attack or stroke is increased.

Other factors such as family history, smoking status, high blood pressure and being overweight can also increase your risk of CVD.

There are two types of cholesterol in the blood. One is good cholesterol (HDL), the other is the harmful cholesterol (LDL). The aim is to improve both types of cholesterol in reducing your CVD risk.

Reducing the level of saturated fat (found especially in red meat and dairy products) is recommended.

Healthier fats to include in the diet are poly- unsaturated fat, which can be found in margarine spreads or fish oil containing omega 3 and 6.

Poly-unsaturated fat and mono- unsaturated fat will help improve your dietary cholesterol levels. Mono-unsaturated fat can be found in nuts and seeds.

It is a good idea to eat two portions of fish a week (at least one of which should be an oily fish).

Trying to include at least five portions of fruit and vegetables into the diet a day is also important. Eating foods high in soluble fibre such as oats, beans, peas and root vegetables has also been shown to have a beneficial effect on cholesterol levels.

Weight loss (if overweight) will also help lower cholesterol levels. Dietary changes and exercise will be important factors in reducing cholesterol to normal levels — aiming for at least 30 minutes of exercise a day.

Drinking alcohol to excess can also worsen your cholesterol profile. Some studies have linked consumption of a small glass of red wine daily with an improvement of cardiovascular risk, however, it is advised that you aim to stay well below the recommended drinking limits when trying to reduce cholesterol

Q. I recently went back to college a couple of days a week, I take notes at the lectures and type up later.

In the last couple of weeks the fingers of my right hand where I hold my pen have become painful particularly after lectures. Could I have writer’s cramp?

A. It is possible the symptoms you describe may be from what is known as writer’s cramp where repetitive motion (mainly writing or playing a musical instrument) leads to cramp, tremor or involuntary movement of the hand or arm.

Writer’s cramp is often the result of repetitive movement or an increase in the time spent on the activity each day or a combination of both.

It is also more likely to occur if you don’t take regular breaks. The condition can be followed by tightening of the fingers, hands and forearm while writing.

Here are some suggestions to consider:

* Try to avoid gripping your pen or pencil. This is easier said than done as sometimes in our eagerness to take down every word our grip on the pen gets tighter as we write.

* Don’t use the same pen or pencil, bring a selection with you of varying sizes and thickness.

* Before and in between lectures, gently massage and rotate your fingers and wrists.

* When you get home, put your hands into a bowl of warm (not hot water) for a few minutes and gently move your fingers in the water.

* Correct posture is very important. Your feet should be on the floor, avoid crossing your legs. Regularly check your posture during the day and rotate your shoulders during your breaks.

* Once your fingers and hands have become used to the increased activity, these symptoms should ease.

* However, if there is no improvement, or they increase, then you need to make an appointment with your GP, who can examine your hand and establish why you are experiencing pain and advise on the appropriate management.