I think you need to look closely at your diet — this can do a lot to lower these blood fat levels. Your optician is probably referring to fatty deposits in your eye — this is pretty common in people with such high blood fat levels.

To bring both fat levels down you need to be more particular about the way you eat than if you had only a high cholesterol level to tackle. Triglycerides are a completely different type of fat found in the blood, and can contribute to an increased risk of heart disease, particularly in female diabetics and older people.

As well as the cholesterol-lowering advice, which I’ll take you through in a minute, you need to watch your sugar and alcohol intake — avoid as much as possible high-glycaemic-index foods such as sugar, sweets, chocolate, biscuits and sweet fizzy drinks. Sugar has little effect on cholesterol, but with high triglyceride levels you need to cut back. Similarly with alcohol, your triglycerides mean that you are best advised sticking to just a glass of wine or beer a night, as the liver could do with not having more than one unit a day to deal with.

The quantity and regularity of meals have an impact on triglyceride, so three small meals a day, with perhaps some fruit in between, is best. They are also kept in check with omega-3 fatty acids — which is where your oily fish and/or flax oil come in. Mackerel (including smoked), herring, salmon, fresh tuna, sardines, and trout are all good omega-3-rich fish. If you use flax (linseed) oil as well, you are taking in more than your body needs omega-wise, and it is high in calories.

On the animal fat side, because your cholesterol level is very high you need to reduce your intake of butter, cream, cheese, fatty meats, buttery cakes, pastries and buttery/creamy pasta sauces since these foods stimulate the liver to produce bad LDL cholesterol. I’d also ensure that your diet is as low as possible in trans fats, found in some processed foods — check the label for trans fat or hydrogenated fat, as both mean the food can contain these damaging fats, which reduce levels of HDL, the good sort of cholesterol. We need high levels of HDL because that’s what transports surplus LDL out of our body.

Try to eat a five portions of fresh fruit or vegetables a day, plus oats, pulses (chickpeas, beans, etc), porridge and unsweetened muesli, as these contain soluble fibre. A high-fibre wholemeal bread/wholegrain rice diet with a good 2.5 litres of water a day — which helps your body to digest the fibre — is the way to go.

As a commuter I can only hope that I smell more fragrant than some fellow passengers in this hot weather. For those of us who wish not to cause offence, can you advise on what to eat, and what to avoid, in the heat?

The most obvious foodstuffs to avoid during this hot weather are strong-smelling spices (especially cumin) and garlic, although onions and asparagus can also be culprits. The time between eating them and perspiring them differs from person to person, and it depends on how much you sweat — odours can be perspired for a day or so, and of course it also depends on other people’s sense of smell.

To stay cool generally, drinking plenty of fluid helps, as your body gets rid of excess heat by sweating. Drinking warm tea causes you to sweat more, which cools you down more than cool drinks. Some people swear by sage, either 50 drops of the tincture or 350mg of the dried herb powder capsule (from www.napiers.net) three times a day. You can also make sage tea by steeping sage leaves in hot water for 5-10 minutes — drink it throughout the day (especially effective if sweating is due to menopausal hot flushes). Medicinal herbalists recommend dandelion and milk thistle if sweating results from a toxic life of alcohol and not great eating.

Everybody sweats — it’s the body’s biological way of relieving heat. It’s a myth that washing makes body odour worse; it doesn’t, so wash away.

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