What are your cholestrol numbers?

[surfhb]

This is sucky....I received high numbers on my blood test

Total 226
LDL - 163
HDL- 35

Has anyone lowered their numbers and how?     I dont eat crap (although it could be a less fat diet) and exercise moderately 5 days a week.    Super bummed ;(

[FuckRx]

LDL was 70's and HDL like 50. Went vegan and gluten free and rechecked numbers and I went down to LDL of 50's and I think HDL went up a tad.
LDL and Tg come down drastically with a plant based diet and less bread/rice consumption.

[Noodle]

A couple years back, my triglycerides (which are somewhat different, but tested in the same panel) came in at the lower edge of the "High" zone. It took about a year of changed diet to get them down to where they needed to be. Here's the thing...it was not that hard. With triglycerides carbs are a concern, so I switched over to whole grains, made things like pizza and sandwiches on thick bread an occasional treat, became a dessert snob (when you pay $5 for a cupcake, you are not eating many of them!), and tried to have one low-carb meal per day and not go bonkers with carbs on the other 2 meals (ie, you can have high-fiber pasta, but a moderate portion w. lots of veggies and protein). That took care of it. I bring it up not because that would necessarily be what you would do, but because I had immediately panicked and assumed that I would have to go on some draconian diet, a notion which the Internet did nothing to ameliorate. (My dr. had been less than helpful with actual advice, so I was kind of on my own.)

[surfhb]

This sucks!   I love food

It shouldn't surprise me.   I eat pretty much anything i want as long as its not from a drive through.   

Need to do some soul searching

[Daisy]

I just had mine done and all were normal/low. Can't remember them off hand but Cholesterol was 165. I stick to a mostly vegan diet with lots of fruits, veggies, plant proteins and some kind of thoroughly disgusting (and delious!) high calorie snack everyday. Lots of working out too which I believe helps a lot. I think making even small changes in diet can bring numbers down very quickly.

ETA: I also don't starve and eat well over 2,000 or more calories/day.

I have been trying to limit the amount of meat I eat.

I'm curious what a 2,000 calorie/day vegan diet looks like. Would you care to share what a typical day's eating looks like?

What kind of plant proteins do you eat? I'm not a fan of the "fake" meats. I'd much rather eat nuts, beans, etc. A holistic vegan doctor once told me that a lot of veggies have protein too. She also said we are way too obsessed with eating protein.

I'd love to see how an active and healthy vegan fuels their body. Thanks!

[Daisy]

I used to have a total cholesterol level above 250. Some doctors mentioned it might be bad. But the funny thing is my HDL level has always been VERY high...off the charts even. And the HDL/LDL ratio was always a great number since the HDL was very high and the LDL was probably average...this ratio was also out-of-the-ranges (in the good sense). So I had a doctor tell me I shouldn't worry about my cholesterol levels.

These days, my total cholesterol is about 180-190 or so. I still have a ridiculously large HDL level and a great HDL/LDL ratio. So again, no worries.

I'm not sure when my cholesterol level dropped so much. It was around the time I resolved a lifelong eczema issue using holistic medicine, but I have no idea if there is a relation there. As a result of the guidance for my skin issues, I did cut out some foods such as dairy. I never ate a ton of processed foods, but now I barely eat anything processed and eat a lot of whole foods. I also eat a lot more and varied vegetables now than in the past.

[forummm]

This is sucky....I received high numbers on my blood test

Total 226
LDL - 163
HDL- 35

Has anyone lowered their numbers and how?     I dont eat crap (although it could be a less fat diet) and exercise moderately 5 days a week.    Super bummed ;(

Cholesterol from diet comes from eating sugar and other refined carbs. If you want to drop your levels, start by cutting out all sugar. Then simple carbs (breads, etc) if that doesn't do enough for you.

[GuitarStv]

YMMV with the low carb recommendation.

I eat a lot of simple carbs (bread, rice, pasta, oats, potatoes, fruit) usually aiming for about 3000 calories total each day, about a 30/30/40 split between protein, fat, and carbs.  My HDL was 70 and LDL was 110, which I was told was good.  I don't remember the other numbers off the top of my head, but they were all in the average/ideal ranges.

[Bob W]

I suggest you do a little research on vitamin B.   It appears that bad proteins associated with low B is the culprit with clogged arteries and heart disease. 

You can find very legitimate decades old studies on the relation of Vitamin B to cardiovascular issues.

You might do a bit of independent unbiased research on cholesterol while you are poking around on the web.   I think what you will find will be an eye opener with regard to relation between cholesterol and cardio issues. 

http://paleoleap.com/cholesterol-is-not-bad/

"Despite previous medical and pharmaceutical consensus, however, new studies are showing that dietary cholesterol may actually stop inflammation, prevent blood clots from forming, support the immune system, and prevent disease causing mutations in cells.
•Countries with higher average cholesterol have less heart disease
•Popular statin drugs do not lower cholesterol, they lower inflammation (typically caused by blood sugar spikes)
•The 2004 National Cholesterol Education Program guidelines have been expanded to recommend that people who don’t have heart disease should take statins to prevent heart disease (8 of the 9 panel experts had pharmaceutical industry ties).
•People with the lowest cholesterol as they age are at highest risk for cognitive impairments, dementia and brain degeneration, heart disease, and death."

[MandalayVA]

What are my cholesterol numbers?

Meaningless.

[forummm]

YMMV with the low carb recommendation.

I eat a lot of simple carbs (bread, rice, pasta, oats, potatoes, fruit) usually aiming for about 3000 calories total each day, about a 30/30/40 split between protein, fat, and carbs.  My HDL was 70 and LDL was 110, which I was told was good.  I don't remember the other numbers off the top of my head, but they were all in the average/ideal ranges.

This is a great diet, and along the lines of what I eat and recommend (although I don't eat potatoes and bread is rare). I don't think oats are simple carbs unless you process them. As I said, the big one to eliminate is sugar. And if you're eating a good balance of fats and proteins (which you are) you are by definition limiting excessive carbs.

[bacchi]

I also eat a lot of carbs in a vegetarian diet. Mostly whole grain; I've been trying to reduce the amount of sugar. In any case, my numbers are fine: 50 HDL, 111 LDL, 70 Tg.

[mrshudson]

I suggest you do a little research on vitamin B.   It appears that bad proteins associated with low B is the culprit with clogged arteries and heart disease. 

You can find very legitimate decades old studies on the relation of Vitamin B to cardiovascular issues.

I was going to suggest this, but BobW beat me to it. Specifically, Niacin. Check with your doctor on whether a tiny amount of supplement is an option, or consume brewer's yeast by the bucket and lots of organ meats if you are not squeamish.

As to whether carbs is bad or meat is bad, I leave it up to the panel, but here's a data point of one: I'm a lifelong vegetarian, eat moderate amount of carbs (say maybe three-to-five cups of various kinds everyday like rice, oatmeal, non-gluten pasta, and the occasional slice of bread and pizza). I do eat eggs and dairy, and nosh on veggies and fruit. Cook everything in EVOO or EV coconut oil and I don't skimp on those. Absolutely no sugar, no soda, no fruit juice. I'll gladly accept a glass or two of beer and dry red wine every day. Exercise moderately, about 30-60 minutes daily. I call my diet "pegan" (a bit of paleo and a bit of vegan). My HDL/LDL ratio is terrific (knock-on-wood). Last time I checked (about a year back), it's 220 total, 110 triglycerides, HDL > 100 and LDL< 50 when fasting.
 

[GuitarStv]

Veggies and fruit are carbs.

[Hank Sinatra]

This is sucky....I received high numbers on my blood test

Total 226
LDL - 163
HDL- 35

Has anyone lowered their numbers and how?     I don't eat crap (although it could be a less fat diet) and exercise moderately 5 days a week.    Super bummed ;(

Unfortunately for your doctor, these are not "bad numbers".  Ask the medical hobbyist  what the death difference is (or if you prefer just the  heart-attack occurrence difference) between these numbers and other "better" numbers.

Then ask the medical hobbyist to re-assess your risk using ALL risk factors not simply the most lucrative for him/her.  Obviously a fat person with high blood pressure has a higher risk with those  numbers than you do, ergo any chart he tries to read off of to scare you is bullshit. Ask the practitioner why he or she is obsessing over one risk factor and disregarding more important ones.

Then ask if he/she knows what your arteries look like. If he/she says "yes" he's/she's lying. If he/she says "no" ask just what the hell it is he's/she's trying to diagnose and treat. Obviously clear arteries and high cholesterol would be different from clogged arteries and low or high cholesterol.

If he insists on scaring you with imaginary heart attacks ask when you might have this heart attack. He/she will not  be able to tell you.  If he/she hazards a guess he/she will be unethical.  Demand to KNOW, not guess.  If it's anything over age 60  he/she is full of crap. Nobody and no doctor who is not a liar or mentally ill is going to place any bets on otherwise healthy people, regarding  who will have a heart attack and who won't, and when,  after the age of 60, especially on dubious evidence like cholesterol numbers.

Remember also that every time your doctor treats you --you are assuming risk---.

Trading a theoretical heart attack 10,20, 30 yrs from now for a chance to die or be permanently crippled a week from now from  a statin or other unnecessary drug is not a fair trade off.

[AJ]

Add me to the list of carb-loving vegetarians with great cholesterol numbers. I forgot to fast on my last test, so I didn't get total or triglycerides, but my most recent HDL was 80 and LDL was 50. Physical activity and keeping your weight in the "healthy" range are big factors - arguably bigger than your macro-nutrient ratio.

[Frankies Girl]

I don't think anyone mentioned this already, but try some krill oil suppliments (along with subbing out a few meals per week that are normally beef or pork for fish).

My husband has high cholesterol and triglyceride numbers when he's not on any supplements. We started him on fish oil and the numbers came down into normal range, but he hated the "fish burp" effect (just like it sounds - you burp, it tastes like fish). I researched and found krill oil, which is better concentration of omega 3, and no fishy taste/burping. His numbers dropped even more into normal ranges.

He lost 40+ pounds over the last 4 months (unrelated to fish or krill - just exercise/eating healthy) and had bloodwork done recently. He had stopped the krill oil pills a few months ago as we ran out and he thought maybe with the weight loss and healthy eating that he didn't have to take them any more... nope. Right back up in the too high ranges, so I picked up some more krill oil and he's going to go retest in 3 months.

Some people just have naturally high cholesterol/tryglycerides without supplements apparently.

Oh - and I eat practically the same diet and have very light exercise habits compared to him, and my cholesterol/tryglyceride has always been excellent - even when I weighed 50 pounds heavier last year.

[Michread]

What are your triglycerides?  That's the number you need to worry about NOT your total cholesterol. 

http://www.drperlmutter.com/cholesterol-setting-the-record-straight/

http://articles.mercola.com/sites/articles/archive/2010/08/10/making-sense-of-your-cholesterol-numbers.aspx

[SingleMomDebt]

Specifically, Niacin.

Until you experience a Niacin flush. That'll freak one out.

[forummm]

Veggies and fruit are carbs.

Complex carbs are OK. The carbs in vegetables are bound up in lots of fiber. They release more slowly into the blood stream. Some people are more sensitive than others. If you eat whole foods (unprocessed) you are probably fine. Oats are a great example of complex carbs.

What you want to avoid is eating simple carbs, which rush right into your bloodstream, cause your blood sugar to spike, which causes your insulin levels to spike, and which results in the sugar being turned into fat and cholesterol being generated. Having a constant healthy blood sugar level is good (which is what complex carbs can do, but eating protein and fat is good at promoting that too)

[mrshudson]

Specifically, Niacin.

Until you experience a Niacin flush. That'll freak one out.

Right. I was pointing out to the possibility of a niacin *deficiency*, which is well established as one of the reasons HDL to LDL ratio gets skewed. Which is very different from binging on niacin to the point of having a niacin flush.

[Philociraptor]

Total was 146 when I donated blood this past Sunday. Moderate-carb Paleoish here. 3-5 servings of meat, 4-6 servings of veggies, 1-2 servings of fruit, 1 scoop of protein, 1 sweet potato, and 1 cup of rice or beans per day for diet. Crossfit 4-5 days/week.

I've lost a bit of weight and gained some muscle since then, but here are my numbers from lab tests last September (9/30/14):
Blood Glucose: 81
Cholesterol: 164
Triglyceride Total: 79
LDL: 83
HDL: 65

[Noodle]

This sucks!   I love food

It shouldn't surprise me.   I eat pretty much anything i want as long as its not from a drive through.   

Need to do some soul searching

You can still love food! Whatever dietary changes you go with, there is good eating to be had within the new parameters. And unless you get extremely strict instructions from your doctor (unikely at this stage) you can still have anything you like as long as it's an occasional treat--which makes it tastier and more enjoyable, in my experience--hello hedonic adaptation!

[stephenandrew]

•Popular statin drugs do not lower cholesterol, they lower inflammation (typically caused by blood sugar spikes)

With all due respect, this statement is contrary to significant medical/scientific evidence.


Sent from my iPad using Tapatalk

[sisto]

It's all about moderation, you don't necessarily need to be on an all plant based diet to have low cholesterol. You do need to control intake of sugar and processed foods though. Like someone else said earlier Triglycerides are really important and I also believe blood glucose is too.

Total Cholesterol = 148
Triglycerides = 64
Blood glucose = 80

[No-stache]

Mine from last month:

Total cholesterol: 206 high
HDL: 58
LDL: 133 high
Triglycerides: 73

Not sure why it's so much higher than it was last July. My total then was 155.

[Daisy]

I just had mine done and all were normal/low. Can't remember them off hand but Cholesterol was 165. I stick to a mostly vegan diet with lots of fruits, veggies, plant proteins and some kind of thoroughly disgusting (and delious!) high calorie snack everyday. Lots of working out too which I believe helps a lot. I think making even small changes in diet can bring numbers down very quickly.

ETA: I also don't starve and eat well over 2,000 or more calories/day.

I have been trying to limit the amount of meat I eat.

I'm curious what a 2,000 calorie/day vegan diet looks like. Would you care to share what a typical day's eating looks like?

What kind of plant proteins do you eat? I'm not a fan of the "fake" meats. I'd much rather eat nuts, beans, etc. A holistic vegan doctor once told me that a lot of veggies have protein too. She also said we are way too obsessed with eating protein.

I'd love to see how an active and healthy vegan fuels their body. Thanks!

It's a lot of food but also high in fat (plant-based things like avocados, nuts, nut butters, etc...), protein and lots of carbs - again plant based from fruits, veggies, whole grains, beans and legumes. I like the fake meat things myself but generally only veggie burgers (prefer Boca brand burgers). I also stick to a lot of raw foods because that's what I like the best. Lots of salads, sandwiches, and giant smoothies. All very high calorie, high fat, high carb and high protein. I think processed carbs and animal food sources are the only thing I don't eat. Everything else is pretty loaded with everything an active body needs.

Thanks!

I eat a lot of the same stuff....plus some meats.

[dungoofed]

Stay Calm and Read On

http://www.marksdailyapple.com/forum/thread4723.html

[dungoofed]

btw my total cholesterol would make you weep (unless you were a doctor prescribing statins, in which case you'd get dollar signs in your eyes)

[Daisy]

I used to have a total cholesterol level above 250. Some doctors mentioned it might be bad. But the funny thing is my HDL level has always been VERY high...off the charts even. And the HDL/LDL ratio was always a great number since the HDL was very high and the LDL was probably average...this ratio was also out-of-the-ranges (in the good sense). So I had a doctor tell me I shouldn't worry about my cholesterol levels.

These days, my total cholesterol is about 180-190 or so. I still have a ridiculously large HDL level and a great HDL/LDL ratio. So again, no worries.

I'm not sure when my cholesterol level dropped so much. It was around the time I resolved a lifelong eczema issue using holistic medicine, but I have no idea if there is a relation there. As a result of the guidance for my skin issues, I did cut out some foods such as dairy. I never ate a ton of processed foods, but now I barely eat anything processed and eat a lot of whole foods. I also eat a lot more and varied vegetables now than in the past.

We just had a health screening at work which is usually done for free once a year. They used to check all sorts of things in your blood test, but this time around the only thing they measured was HDL (no LDL), total cholesterol, and sugar level. I asked if this limited test was part of the new "cost cutting" at the company (ha ha), but the nurse told me these numbers alone are a very good measure of health.

Oh well, as suspected my previous claims of ridiculously high HDL continued. These numbers come from a non-fasting blood test...not sure how it would change with fasting:

HDL: 85
Total cholesterol: 210
Cholesterol/HDL ratio: about 2.5 (target should be below 5.0 and she said anything below 3.5 was very good)
Sugar: 81

The nurse said those were excellent numbers. Remembering this thread, I asked her what gives one a high HDL number. She said exercise, eating a lot of nuts, veggies, whole foods. I nodded my head and said that is exactly my diet...along with some occasional meat. But really a lot of nuts and veggies and fruits. No artificial sugars. I consume very limited added sugar other than naturally occurring in fruits. I only add a little sugar when drinking espresso (not regular coffee) or some oatmeal.

[Roots&Wings]

Another who eats primarily a whole foods, plant based diet (fruits, veggies, nuts, whole grains) with limited added salt and oil.

Total - 132
HDL - 43
LDL - 66

Lowered cholesterol (and blood pressure) but most importantly feel so much better by eating this way thanks to Eat to Live, Forks Over Knives, China Study, The Spectrum, Engine 2, etc, and regular exercise (walking mostly).

Several family members have high cholesterol (and blood pressure), take expensive prescriptions, eat anything, don't exercise much, and blame it on genetics. Personally wanted to try the diet & exercise route first, before pills & bills.

[Hank Sinatra]

Another who eats primarily a whole foods, plant based diet (fruits, veggies, nuts, whole grains) with limited added salt and oil.

Total - 132
HDL - 43
LDL - 66

Lowered cholesterol (and blood pressure) but most importantly feel so much better by eating this way thanks to Eat to Live, Forks Over Knives, China Study, The Spectrum, Engine 2, etc, and regular exercise (walking mostly).

Several family members have high cholesterol (and blood pressure), take expensive prescriptions, eat anything, don't exercise much, and blame it on genetics. Personally wanted to try the diet & exercise route first, before pills & bills.

Nope. I was a vegetarian for 22 years, Triglycerides off the rails.(Dr said pay o attention. It deosn't matter until that pill came out that said "When lowering your cholesterol isn't enough....!) Cholesterol at least 230 or higher. HDL in the low 20s.  Taking statins put them in the teens

Health collapsed. I was diagnosed with a brain tumor based on body chemistry/hormonal imbalances.  They said that was the only thing that could cause what they were seeing on the blood tests) Gained 40 pounds. (Altho that was likely just the statins because "weight gain" is listed as a side effect)

I went on the Atkins diet and improved dramatically within 2 weeks. And all that brain tumor shit disappeared after about a year.

[Cezil]

Several family members have high cholesterol (and blood pressure), take expensive prescriptions, eat anything, don't exercise much, and blame it on genetics. Personally wanted to try the diet & exercise route first, before pills & bills.

I'm exactly right there, too.  Doctor wants to send me to a specialist (a lipidologist) to figure out what proper ("expensive in the beginning, from there we're not sure") medication regimen to put me on to control these numbers.  I asked if I could try eating a better diet and starting to exercise and get in shape to first see how much that affected my numbers before we put me on daily pills like my parents - to which I was told that both improved diet and exercise are not going to help me because, A) high cholesterol (and blood pressure) run in the family, it's genetic, there is nothing I can do, and B) I'm so small and young that there is nothing I could be doing to affect myself so greatly; it's likely genetics.  (BTW, I'm happy to hear the doctors opinion - she is a professional - however, I also know that money is a big part of the health care industry so I'm also leery.)

TC: 277 (previously 282)
Triglycerides: 120 (previously 180)
HDL: 52 (previously 49)
LDL: 201 (previously 197)

I'm battling myself right now - I'm really tempted to give this a shot and prove them wrong with fantastic numbers in a year from now by eating healthy (and cutting sugar, carbs, etc) and getting my butt up off the couch; or, at least prove to myself that despite my hardest, best efforts, it's something I'll need medication for.  Either way, I want to know! instead of just assuming from the numbers that it's all doom and gloom from here.  It's hard, though, when the doctor responds that there was another patient recently that was also anti-pills, and then just had either a stroke or heart attack.  (Never mind this unfortunate woman was in her later years, obese, and perhaps ate crappy foods?  But what do I know, I'm not the doctor.)  So I'm fearful that even if I try to eat better and exercise, I'm still going to die shortly anyway no matter what I do.  :/  Maybe I should go see that specialist.  Ah, insecurities and fear..

[fartface]

Funny. I had my cholesterol checked in 2004 (age 30) and then not again until 2014 (age 40).

My cholesterol was 151 BOTH TIMES...TEN YEARS APART.

[Vanguards and Lentils]

Mine's attached. Summary: Total = 175, Triglycerides = 61, HDL = 77, LDL = 86. My doctor said I had some of the best numbers he had ever seen which was a pleasant surprise, especially the high amount of good cholesterol. At that time, I had been eating 3-4 eggs per day, and fast food (BK, McD's) several times per week. High carb, fat, cholesterol, sodium, everything. The most consistent part of my diet is 2 smoothies a day, which include: bananas, berries, kefir, oats, almonds, peanut butter. I eat a lot of "unhealthy" foods, but taken as a whole my diet seems pretty nutritious. It just goes to show that high fat in a diet doesn't necessarily result in high triglyceride levels, nor does high dietary cholesterol result in high LDL levels.

Other info: my job is sedentary but I exercise about 1 hr/day, mostly lifting weights, and occasional cardio. Age 24, BMI 23.

[amberfocus]

You might do a bit of independent unbiased research on cholesterol while you are poking around on the web.   I think what you will find will be an eye opener with regard to relation between cholesterol and cardio issues. 

http://paleoleap.com/cholesterol-is-not-bad/

"Despite previous medical and pharmaceutical consensus, however, new studies are showing that dietary cholesterol may actually stop inflammation, prevent blood clots from forming, support the immune system, and prevent disease causing mutations in cells.
•Countries with higher average cholesterol have less heart disease
•Popular statin drugs do not lower cholesterol, they lower inflammation (typically caused by blood sugar spikes)
•The 2004 National Cholesterol Education Program guidelines have been expanded to recommend that people who don’t have heart disease should take statins to prevent heart disease (8 of the 9 panel experts had pharmaceutical industry ties).
•People with the lowest cholesterol as they age are at highest risk for cognitive impairments, dementia and brain degeneration, heart disease, and death."

With all due respect, practically everything in that list is either flat-out hogwash or very misleading. As a biologist working in the cardiovascular field, I can't just let this slide.

"Countries with higher average cholesterol have less heart disease"

No. Higher serum cholesterol is robustly correlated with a higher incidence of coronary events in multiple epidemiology studies.



Figure source: Thematic review series: The Pathogenesis of Atherosclerosis. An interpretive history of the cholesterol controversy: part II: the early evidence linking hypercholesterolemia to coronary disease in humans, Journal of Lipid Research, 2005

"Popular statin drugs do not lower cholesterol, they lower inflammation"

Statins have been around for decades and we know exactly how and why they work. Their mechanism of action is the inhibition of an enzyme called HMG coA reductase, which is the rate-limiting step of the cholesterol biosynthesis pathway. They also happen to lower inflammation, but it's an incidental effect.



Figure source: Lovastatin and beyond: the history of the HMG-CoA reductase inhibitors, Nature Reviews Drug Discovery, 2003

"The 2004 National Cholesterol Education Program guidelines have been expanded to recommend that people who don’t have heart disease should take statins to prevent heart disease"

Misleading. In 2004, the NCEP issued revised guidelines that lowered the recommended LDL goal to 70 mg/dL, which is admittedly extremely difficult to achieve without statin therapy. What often gets missed is that this recommendation only applies to individuals in the highest risk category, which are essentially folks who already have coronary heart disease. Lower risk groups have no change in their recommendations, and for healthy people, the goal is 160 mg/dL, and drug therapy is not recommended until you can't get below 190 mg/dL. And regardless of which risk group you're in, drug treatment is *always* second-line therapy after TLC, or therapeutic lifestyle changes.

The link to the actual guideline revision is here, but you need institutional access to see it. I happen to have the paper (along with reams of other literature) on my computer, so I can send it if you're interested. An abridged version of the original ATP III guideline is here. The FULL (200+ page) report is here (and yes, I have actually read it).

People with the lowest cholesterol as they age are at highest risk for cognitive impairments, dementia and brain degeneration, heart disease, and death

I have absolutely no clue where any of these claims come from, and as far as I'm aware, they're completely false. Humans with a loss-of-function PCSK9 mutation, which result in dramatically lower LDL-C levels, suffer absolutely no other effects aside from an apparent immunity to heart attacks.

Source: The PCSK9 Decade, Journal of Lipid Research, 2012

I did take a look at that Paleo website, and I don't see any citations. From my academic and professional experience, the above claims are just plain wrong, and I can't let them go unrefuted. Apparently, cholesterol denialism is a thing (just like HIV denialism and anti-vaxxers), but I was not expecting to encounter it here. Apologies for going vaguely nuclear on you, but this topic is near and dear to my heart (pun not intended). ;)

As for my cholesterol numbers, I believe the last time I got them checked, LDL was 100 mg/dL, and HDL was 60 mg/dL.

And thus concludes your impromptu biology lecture of the day! :)

[forummm]

Thanks amberfocus for rebutting the list. Initially, I just rolled my eyes at it and moved on.

Cholesterol is widely misunderstood. As I mentioned in my prior posts, the real culprit is #1 sugar, #2 refined carbs, and there is a genetic component as well. Eating whole meats or fats or eggs is not the problem.

It's also unclear whether reducing your cholesterol via statins actually reduces your risk for heart disease. More research is needed. They definitely can lower your cholesterol though--for whatever that's worth.

[Pigeon]

Amberfocus, +1

There are a lot of people here who are deeply into the woo when it comes to health issues.

[DocSteve]

Thank you, Amberfocus. Too much unscientific stuff out there these days.

I am pushing 70 years young; diet is mostly vegetarian but I do have an egg or two
every week, and fish 1-2x a month. I have a glass of wine most evenings, and
exercise moderately and daily. My HDL is 44, LDL is 99, total is 173. My awesome
Nurse Practitioner wife and an equally awesome family doctor keep me in
really good health. (I take one medication for acid reflux, but that's it.) Most
people peg me at being 20 years younger than I am. Thank the gods for that!

[amberfocus]

Cholesterol is widely misunderstood. As I mentioned in my prior posts, the real culprit is #1 sugar, #2 refined carbs, and there is a genetic component as well. Eating whole meats or fats or eggs is not the problem.

Actually, dietary saturated (but not total) fat is the strongest predictor of serum lipid levels, which in turn strongly predicts cardiovascular risk. Here's another figure from the same paper I referenced in my earlier post, from Ancel Keys's seminal Seven Countries Study, that shows the correlation between percent calories from saturated fat and cardiovascular events  --



Nutritional science is really complex, and it's supremely difficult to speak accurately in terms of absolutes -- e.g. X (and only X) causes Y but not Z. And of course the myriad of confounding factors (such as genetics, environmental factors, and lifestyle/behavioral choices) further complicates matters. There are only a handful of macromolecule classes (proteins, lipids, carbohydrates, and nucleic acids are the major ones) and it is not helpful to make blanket statements that implicate an entire class of them in some health issue without context or nuance.

At the end of the day, you can still eat all the things, and be healthy. You can have a steak, or an ice cream, or a soda, or a glass of wine, and not keel over from a heart attack, so long as it's not *all* you eat, to the exclusion of fruits and veg. It's all about moderation.

But dietary (saturated) fat? I'm sorry to have to correct you on this, but it is definitely linked to heart disease.

It's also unclear whether reducing your cholesterol via statins actually reduces your risk for heart disease. More research is needed. They definitely can lower your cholesterol though--for whatever that's worth.

Cholesterol reduction via statin therapy absolutely, positively, without a single shred of doubt decreases your risk for coronary events. The clinical evidence collected over the past few decades in hundreds of thousands of subjects is utterly overwhelming at this point. The figures below (from O'Keefe et. al, "Optimal low-density lipoprotein is 50 to 70 mg/dl: Lower is better and physiologically normal", Journal of the American College of Cardiology, 2004), shows the relationship between LDL-C and coronary events in a slew of different clinical trials.





If I really wanted to, I could probably pull a more up-to-date figure that includes even more studies that were done in the past decade, but it's Sunday and I don't feel like VPN'ing onto PubMed. But there's a reason why Lipitor (atorvastatin) is a multi-billion dollar blockbuster drug -- it fucking works. And I, for one, am thankful, because I've got family members taking these drugs. :)

[forummm]

@amberfocus:

Yes, your point about saturated fat fits my understanding as well, although I didn't point it out specifically. Total fat is what I meant.

Perhaps you're closer to the literature on statins -> LDL -> CVD than I am. I know that statins -> LDL and that generally LDL -> CVD (although there is some debate), but my understanding is that it is somewhat unclear whether statin-influenced LDL reduction is what's reducing CVD risk the same way naturally low LDL levels do (perhaps because naturally low LDL is associated with other factors associated with lower CVD risk; or perhaps because statins are influencing other non-LDL factors that are reducing CVD risk). In fact the NEJM article I was just reading on Friday (http://www.nejm.org/doi/full/10.1056/NEJMe1507041) discusses a debate around the "LDL hypothesis" itself. There is another new article in the journal this week that provides further evidence for the viewpoint you are espousing.

Despite this body of evidence, there has been a long-standing argument that the beneficial effects of statins are not adequately explained by their effects on LDL cholesterol. Statins have a complex array of biologic effects — including amelioration of endothelial dysfunction, increased nitric oxide bioavailability, antioxidant properties, and inhibition of inflammation — that are unrelated to their lipid-lowering effect and that are sometimes called “pleiotropic effects.”2 It has been argued that such effects may account for at least some of the benefit of statin therapy in preventing cardiovascular events. This alternative theory is sometimes referred to as the “statin hypothesis” — the idea that statins have a unique efficacy in atherosclerotic vascular disease that is not shared by other lipid-modifying agents and that reduction in LDL cholesterol levels is not the only basis for the beneficial effect of statins

Reading back on my initial words, I can see how the meaning was ambiguous. Thanks for helping to advance the discussion :)

[dungoofed]

Ancel Keys's seminal Seven Countries Study, that shows the correlation between percent calories from saturated fat and cardiovascular events

https://en.wikipedia.org/wiki/Seven_Countries_Study#Criticism

Keys has no shortage of critics. I'd be concerned about the criticism that he engaged in curve-fitting/cherry-picking when choosing the countries for the study. There were many more than seven countries.

[Cressida]

For anyone interested in the topic of diet, cholesterol, and heart disease, check this out:

http://thebigfatsurprise.com/

The author argues that neither total cholesterol nor LDL-cholesterol is a reliable indicator of heart disease, and posits that carbohydrates, not fat, are the main dietary cause of heart disease.

Obviously I did not check her work personally, but it struck me as well-argued, and it's certainly a great read.

If amberfocus has heard of this book, I'm guessing s/he's probably now going to write a long response explaining why the book is BS. I don't have a response to that, but I can tell you that the book thoroughly addresses most of the points amberfocus has raised so far (at least regarding diet; the book doesn't discuss statins much). Whether it does so successfully isn't something I can answer.

[edit: clarity]

[amberfocus]

Perhaps you're closer to the literature on statins -> LDL -> CVD than I am. I know that statins -> LDL and that generally LDL -> CVD (although there is some debate), but my understanding is that it is somewhat unclear whether statin-influenced LDL reduction is what's reducing CVD risk the same way naturally low LDL levels do (perhaps because naturally low LDL is associated with other factors associated with lower CVD risk; or perhaps because statins are influencing other non-LDL factors that are reducing CVD risk).

So you're right that there's the LDL hypothesis camp, and the statin hypothesis camp, and they differ in how to frame the analysis. Both have evidence that support their positions -- statins do have pleiotropic effects; and different LDL-lowering mechanisms are additive in effect.

The positions are also not mutually exclusive. :) I happen to lean LDL hypothesis, but then again, PCSK9 is a pet target of mine. When I first started working in this field, we didn't even know the mechanism of action for that gene. We've come a long way since then.

Ancel Keys's seminal Seven Countries Study, that shows the correlation between percent calories from saturated fat and cardiovascular events

https://en.wikipedia.org/wiki/Seven_Countries_Study#Criticism

Keys has no shortage of critics. I'd be concerned about the criticism that he engaged in curve-fitting/cherry-picking when choosing the countries for the study. There were many more than seven countries.

Ah, the Wikipedia citation. :) Let me just say that while I haven't looked into the specific critique that you've highlighted and can't comment on it, I *have* done a bit of research into the cholesterol denialism movement (just for funsies), and I see the biggest names in that movement (e.g. Uffe Ravnskov) listed and described in that Wikipedia section as if they have real credibility. It's a bit frustrating, to say the least, to have what are essentially crackpot conspiracy theorists, given equal time.

The relationship between saturated fat, LDL-C, and CVD is not in question in modern science. There might be some outlier studies or quibbling in the margins, but the heart of the hypothesis stands. If you look at actual treatment guidelines used by medical professionals, the TLC (therapeutic lifestyle changes) for cholesterol control focuses on the following:

1. Lowering saturated fat and cholesterol intake
2. Increasing fiber intake
3. Weight management
4. Physical activity

Item #1 reflects the known role that saturated fat plays in LDL-C levels. Item #3 reflects that fact that overweight and obesity are another risk factor -- and this is where cutting carbs, calories, and such can help. When it comes to CVD, you can't really single out a single nutritional "boogieman", where if you do A (or don't do B), you're "safe".

If amberfocus has heard of this book, I'm guessing s/he's probably now going to write a long response explaining why the book is BS. I don't have a response to that, but I can tell you that the book thoroughly addresses most of the points amberfocus has raised so far (at least regarding diet; the book doesn't discuss statins much). Whether it does so successfully isn't something I can answer.

*sigh* I can't tell you what to believe or how to live your life. After all, I'm just some random schmuck on a personal finance forum. :P What I am gonna say is -- talk to your doctors. Follow their advice. And most importantly, do what makes you happy. If you are in good health, then god bless -- that's what really matters. I have no personal interest in taking away your Philly cheesesteak. :)

ETA: Sometimes I feel like the "live below your means" mantra in personal finance is equivalent to the "diet and exercise" mantra in health. It may be common sense and it definitely does work*, but no one wants to hear it because it's hella-boring, and it's not fun or sexy advice. You don't necessarily have to take it to an extreme, but it's good to find your own personal balance between prudence and indulgence.

*For the vast majority of people. Obviously there are edge cases where it doesn't.

[Cressida]

If amberfocus has heard of this book, I'm guessing s/he's probably now going to write a long response explaining why the book is BS. I don't have a response to that, but I can tell you that the book thoroughly addresses most of the points amberfocus has raised so far (at least regarding diet; the book doesn't discuss statins much). Whether it does so successfully isn't something I can answer.

*sigh* I can't tell you what to believe or how to live your life. After all, I'm just some random schmuck on a personal finance forum. :P What I am gonna say is -- talk to your doctors. Follow their advice. And most importantly, do what makes you happy. If you are in good health, then god bless -- that's what really matters. I have no personal interest in taking away your Philly cheesesteak. :)

To be clear, I should say that my interest in this topic is based solely in my desire to know the truth and not in my desire to partake in an indulgent diet. My BMI is 18, my cholesterol is 162 total / 49 triglyceride / 77 HDL / 75 LDL, and I LOVE carbs. If the traditional low-fat food-pyramid diet truly is better for health than "Philly cheesesteaks and hold the bread," that would actually align better with my preferred diet. But if it's not, then I want to know that and I want to know why. So I await further research in this area.

[forummm]

Ancel Keys's seminal Seven Countries Study, that shows the correlation between percent calories from saturated fat and cardiovascular events

https://en.wikipedia.org/wiki/Seven_Countries_Study#Criticism

Keys has no shortage of critics. I'd be concerned about the criticism that he engaged in curve-fitting/cherry-picking when choosing the countries for the study. There were many more than seven countries.

Yeah, I had forgotten that this study has so much controversy around it. There is definitely controversy among medical experts around this and not just those cited in the wiki. Controversy doesn't mean it's disproven of course. Here are 3 interviews that include discussion of it (even if not by name in the Sci Fri one). You can hear the disagreement among the two guests in the Sci Fri one.

http://www.econtalk.org/archives/2011/11/taubes_on_fat_s.html
http://www.econtalk.org/archives/2012/07/taubes_on_why_w.html
http://www.sciencefriday.com/segment/02/27/2015/after-decades-of-dietary-warnings-eggs-make-a-comeback.html

I've read one of Taubes' books. I buy about 90% of what he says. I think his book is too anti-carb. I agree that refined carbs are to be avoided. But I think it's OK for most people to have carbs in vegetables, rice, oats, reasonable portions of whole fruits, and other whole grains. Once you pulverize things (flour, bread, etc) you start heading towards the sugar end of the spectrum. I still eat pasta and some bread and some fruit. I think something like the 40/30/30 caloric ratio of the Zone diet is a reasonable target to aim for, with the carbs being as complex as possible.

@amberfocus, you mention lower dietary cholesterol as being common physician advice. And it is true, unfortunately, that this is common advice. However, the evidence has shown for a long time that this has essentially no bearing on blood cholesterol levels and health outcomes in general. Even the USDA recommendations have finally come out and said that. It's frustrating that it takes medicine so long to correct their mistakes. Go ahead and eat eggs if you want--they're generally OK for you. If you want lower blood cholesterol, stop eating sugar.

[forummm]

Robert Lustig is another MD that talks about the harms of the western high-sugar diet.
http://www.sciencefriday.com/segment/01/11/2013/the-fallacies-of-fat.html
http://www.sciencefriday.com/segment/02/17/2012/should-sugar-be-regulated-like-alcohol.html

[Bob W]

Ancel Keys's seminal Seven Countries Study, that shows the correlation between percent calories from saturated fat and cardiovascular events

https://en.wikipedia.org/wiki/Seven_Countries_Study#Criticism

Keys has no shortage of critics. I'd be concerned about the criticism that he engaged in curve-fitting/cherry-picking when choosing the countries for the study. There were many more than seven countries.

Yeah, I had forgotten that this study has so much controversy around it. There is definitely controversy among medical experts around this and not just those cited in the wiki. Controversy doesn't mean it's disproven of course. Here are 3 interviews that include discussion of it (even if not by name in the Sci Fri one). You can hear the disagreement among the two guests in the Sci Fri one.

http://www.econtalk.org/archives/2011/11/taubes_on_fat_s.html
http://www.econtalk.org/archives/2012/07/taubes_on_why_w.html
http://www.sciencefriday.com/segment/02/27/2015/after-decades-of-dietary-warnings-eggs-make-a-comeback.html

I've read one of Taubes' books. I buy about 90% of what he says. I think his book is too anti-carb. I agree that refined carbs are to be avoided. But I think it's OK for most people to have carbs in vegetables, rice, oats, reasonable portions of whole fruits, and other whole grains. Once you pulverize things (flour, bread, etc) you start heading towards the sugar end of the spectrum. I still eat pasta and some bread and some fruit. I think something like the 40/30/30 caloric ratio of the Zone diet is a reasonable target to aim for, with the carbs being as complex as possible.

@amberfocus, you mention lower dietary cholesterol as being common physician advice. And it is true, unfortunately, that this is common advice. However, the evidence has shown for a long time that this has essentially no bearing on blood cholesterol levels and health outcomes in general. Even the USDA recommendations have finally come out and said that. It's frustrating that it takes medicine so long to correct their mistakes. Go ahead and eat eggs if you want--they're generally OK for you. If you want lower blood cholesterol, stop eating sugar.

Thanks for that --

The Ancel Keys 7 Countries (oh wait it was really 22) study is an indicator of  bad methodology and pretty much fraud.   

Your recommendations are spot on but don't forget the Vitamin B everyone.   

Here is a link that gives some long term sobering metadata on statin drugs -  http://chriskresser.com/the-diet-heart-myth-statins-dont-save-lives-in-people-without-heart-disease/

I'm not disputing that cholesterol is an interesting thing to look at.

[Helvegen]

I had a non-fasting screening done the other day at work. Total cholesterol was 169, HDL was 77. I'll have to update it in a few weeks when I have my yearly labs done for my physical. I don't eat a sneuxflake diet. I do have a normal BMI and exercise 5-6 days a week for 45-60 minutes.