How do I lower my cholesterol?

Iristxo

Transform wrote: »

its not really a riddle at all you just need to do a bit more reading - this will help -

http://thepaleodiet.blogspot.com/2010/03/paleo-diet-q-saturated-fat.html[/url]

But I don't understand. In that blog Maelan states that "consumption of saturated fatty acids is not an issue if we control several other factors such as those mentioned before" refering to "Lectins and low-grade chronic inflammation". Meaning that if someone is not doing the diet right and for whatever the reason does have low grade chronic inflamation then the SAFAs might prove very harmful! Furthermore the paper that he links to by Dr Cordain basically recommends lower consumption of SFAs in favour of MUFAs for example. Quote:

"− n-3 PUFAs, especially long-chain n-3 PUFAs, reduce CHD risk.
Increasing intake is unlikely to cause harm.
− Industrially produced TFAs increase CHD risk. Restricting or eliminating
TFA intake is unlikely to cause harm.
− MUFAs possibly reduce CHD risk. Substituting MUFAs for TFAs or
SFAs, especially palmitate, is unlikely to cause harm.
− High consumption of palmitate may increase CHD risk. The relationship
of stearate, laurate, and myristate to CHD is less clear.
Partial substitution of MUFAs for palmitate, and perhaps other SFAs,
may reduce CHD risk and is unlikely to cause harm.
− Optimal n-6 LA intake for CHD prevention is a matter of controversy.
US health promotion agencies recommend high LA consumption
[39••] despite the fact that 1) modern Western LA intake is unnaturally
high by evolutionary, historical, and global standards, and 2)
populations with very low CHD risk have uniformly low LA intakes.
CHD risk declined markedly in the sole long-term randomized trial in
which LA was lowered as part of a Mediterranean diet, indicating that
high LA intake is not a requirement for CHD risk reduction. Controlled
trials and observational studies comparing high with very high
LA intakes are insuffi cient for drawing conclusions regarding optimal LA intake. In light of current guidelines urging high LA intake, the
CHD impact of lowering LA to preindustrial levels is an issue of major
public health importance. For now, the replacement of LA-rich oils
with MUFA-rich oils (eg, olive oil) may provide considerable cardiometabolic
benefi ts and is unlikely to do harm."

From Dr Cordain's paper. Essentially he reccomends to limit consumption of mostly, grainf-fed animal meats and dairy.

Also, the paleo diet mostly recommends no dairy? I presume for the same reason as Dr Cordain's, mainly? And heavily supplementing with Omega-3 when consuming a diet rich in animal products? Would it not be better to consume less animal products to begin with, rather than relying to heavily in supplementation?

Iristxo

Ok, I am starting to see how this works. Every single diet will have its big flaw. For raw-foodism is the lack of control over blood sugar levels. For Paleo, the likely raise in cholesterol levels. It is a matter of choosing the least of a few evils, really, isn't it?

Macha

I just went onto the Irish Heart Foundation website and saw that they advocate the exact opposite of a healthy heart diet. How on earth do we combat something as widespread as this?

http://www.irishheart.ie/iopen24/good-eating-t-7_20_82.html

brianthebard

Iristxo wrote: »

Ok, I am starting to see how this works. Every single diet will have its big flaw. For raw-foodism is the lack of control over blood sugar levels. For Paleo, the likely raise in cholesterol levels. It is a matter of choosing the least of a few evils, really, isn't it?

That is part of it but also one should consider the limits of a particular practitioner or science, in this case TG has shown that your blood tests have proven you to be very healthy but your doctor is getting hung up on one number out of the whole, probably because that's what they were taught to do. Eating Paleo or low carb goes against the food pyramid which is still in vogue, so this and its side effects will be considered a flaw by the mainstream, but to those who follow those plans its either not a flaw or its a positive.

El_Dangeroso

Iristxo wrote: »

Ok, I am starting to see how this works. Every single diet will have its big flaw. For raw-foodism is the lack of control over blood sugar levels. For Paleo, the likely raise in cholesterol levels. It is a matter of choosing the least of a few evils, really, isn't it?

Seriously, you don't even know you have high LDL, the formula used to calculate it is inappropriate given your low trigs. You also don't know what type of LDL you have. Big fluffy LDL is heart-protective (this is the kind that sat fat increases), small dense LDL and oxidised LDL is the type that ends up forming arterial plaque.

I'm not for a second suggesting you go against your doctor's advice, but your doctor doesn't have all the information at the moment. Can you ask for a NMR cholesterol test? It's more expensive but they actually measure LDL and its size rather than calculate it.

BTW, eggs have very little sat fat (~1.5g), the reason they were cautioned against is because they contain dietary cholesterol, which has long since been proven to have no effect on blood cholesterol.

Also Cordain's estimation of sat fat consumption is way off, he's using modern game as a measurement but he leaves out internal organs and the fact that we hunted big massive fatty game to extinction during the paleolithic. How he can even come up with a such a specific macronutrient percentage given the wide range of saturated fat consumption amongst modern hunter gatherers (which runs from 20-50%) is laughable tbh. Cordain is subtley trying to backtrack on the sat fat issue without admitting he was wrong on the 10% figure.

Iristxo

Temple_Grandin wrote: »

Seriously, you don't even know you have high LDL, the formula used to calculate it is inappropriate given your low trigs. You also don't know what type of LDL you have. Big fluffy LDL is heart-protective (this is the kind that sat fat increases), small dense LDL and oxidised LDL is the type that ends up forming arterial plaque.

I'm not for a second suggesting you go against your doctor's advice, but your doctor doesn't have all the information at the moment. Can you ask for a NMR cholesterol test? It's more expensive but they actually measure LDL and its size rather than calculate it.

I see what you mean and all research point out in that direction but unless my doctor agrees, it will be no use. I see if i can find somewhere where they do that kind of NMR test. If they do it and they find out the LDL is not to worry about will they stop worrying about the total cholesterol figures? Thanks very much for that

El_Dangeroso

Actually, I stand corrected. The NMR will give you the accurate LDL particle count, but only the VAP test will give you the sub-particle breakdown.

Best of luck!

El_Dangeroso

OK, so I recalculated your LDL from the formula for low triglecerides as outlined in this paper

LDL = TC/1.19 + TG/1.9 - HDL/1.1 - 38 (this is for mg/dl not mmol/l like your results so I converted to mg/dl and converted back in the end)

LDL = 261/1.19 + 7/1.9 - 75/1.1 - 38
LDL = 219 + 3.7 - 68 - 38
LDL = 116mg/dl
LDL = 3mmol/l (I think I've got my maths right! Get your doctor to try this formula of course to double check)

3mmol/l LDL is defined by the American Heart association as 'near optimal' LDL. Not 4.6 which is defined as 'very high'.

Your trigs are so low as to be almost non-existant, as great as that is I'd get a re-test as it's artificially inflating your LDL measurement.

EileenG

Iristxo wrote: »

Well that's the thing, my trigs are very good and so is my HDL. I am going to visit my doctor again on Monday but I am sure he will just go with "total cholesterol not being good etc.". And if he pushes the issue, and he pushes the statins, I really am not confident enough about the whole issue to go against doctor's advise.

In the end, you are responsible for your health. You have to give due weight to your doctor's opinion, but it is you who will have to suffer the side-effects and reactions if a medication not the right one for you.

You owe it to yourself to be an educated consumer. At the very least, ask
"What is the benefit if I take this medication?"
"What makes me a candidate for it?"
"What are the common side-effects?"
"What is the Number Needed to Treat?" (this is the number of people to have to take a drug for one person to get a positive result. For statins, the number is extremely high)
"What will happen if I don't take it?"
"What are the alternatives?"

El_Dangeroso

EileenG wrote: »

"What is the Number Needed to Treat?" (this is the number of people to have to take a drug for one person to get a positive result. For statins, the number is extremely high)

*Puts hand up* Miss! Miss! I know Miss!:)

90 people need to take a statin for 5 years to prevent one single heart attack, and then, it only prevents heart attacks in a very small subset of the population, namely men, under the age of 65, that have diagnosed heart disease.

Never mind the inconvenient fact that (cheap and unpatentable) niacin supplementation kicks the ass of statins when compared in clinical trials. (as in niacin actually prevents the build up of arterial plaque, statins seem to do diddly in comparison). Vitamin D also does wonderful things to cholesterol and doesn't cost a fraction of the price.

Iristxo

Eileeen that's a good suggestion. Temple, thanks for doing those numbers for me. Everybody thanks for your time regarding this, specially Temple. I am going to talk to my doctor tomorrow and see what he has to say. If the ldl was calculated as opposed to measured, I will ask to see if it can be measured and see if they can do they type of test to measure the type of cholesterol. I am also going to try to find out if there is someone else out there in Ireland/Dublin who is up to date with more current developments regarding cholesterol. I will keep yous updated!

Thanks again

EileenG

I was reading today about an article in the BMJ which wasn't picked up by the mass media which showed that for every person who doesn't get a heart attack as a result of taking statins, two or more get serious liver or kidney damage.

This is one drug I would be very wary about unless you were completely happy it was right for you. Don't let yourself be bullied into anything. Be confident that you are doing the right thing for your own health.

brianthebard

That's crazy, I remember reading an article in the National Geographic a few years ago on the heart, heart disease, etc and doctors then were praising it as a wonder drug and some were taking it preventatively like a multivit! Funny to think how quickly the science can change.

El_Dangeroso

brianthebard wrote: »

That's crazy, I remember reading an article in the National Geographic a few years ago on the heart, heart disease, etc and doctors then were praising it as a wonder drug and some were taking it preventatively like a multivit! Funny to think how quickly the science can change.

Yep, some scientist proposed it be put in the water.. *shudder*. Luckily he was ignored. Statins definitely have their place and are effective in some instances (men, <65 years with existing heart disease), but never seen a shred of solid evidence that they are effective on women. It's a triumph of marketing over science IMO.

Luckily the patent runs out in 2013, so there will be no money in them after that.

EileenG

brianthebard wrote: »

That's crazy, I remember reading an article in the National Geographic a few years ago on the heart, heart disease, etc and doctors then were praising it as a wonder drug and some were taking it preventatively like a multivit! Funny to think how quickly the science can change.

It wasn't that long ago that HRT was being prescribed for all women over 50, just on the basis of how all round wonderful it was. Sometimes it takes time for all the nasty sides to show themselves.

Iristxo

So guys i went to another doctor and she said that since I have no other markers for risk for CVD and also the numbers on the cholesterol weren't too bad she said it was fine and we would monitor it but not do anything drastic for a few years anyway unless it gets worse. Phew! This thing had me tied myself in knots for the whole weekend. Anyways feeling better now.

Again, thanks everyone for your help. At least i learnt something, it seems that I have a genetic tendency towards high cholesterol or a metabolic disorder of some kind (doctor agreed that normally the amount of SAFAs that I ingest would not be enough to raise my cholesterol significantly). Suppose it's just a matter of keep monitoring it regularly from now.

El_Dangeroso

That's brilliant news Iris! Delighted your doc reassured you!

EileenG

Delighted to hear that. Good move on checking with another doctor.

Iristxo

As you guys said before, one has to be responsible for one's own health...