The cholesterol debate

[Billy T]

I´m to lazy to remove the Portugues, but want to give a very valuable index of coronary risk (Blue text below with my data displayed in calculation):
Exame: COLESTEROL FRAÇÃO HDL – SORO Amostra: 01 OS: 4732514 Coletado em 01/11/12 (that is 1 November 2012)
HDL Colesterol: 68 mg/dl VR: Desejáveis: > 40 (Desejáveis: > 45 diabéticos) Metodologia: Direto Automatizado
Exame: COLESTEROL FRAÇÃO LDL – SORO Amostra: 01 OS: 4732514 Coletado em 01/11/12
LDL Colesterol: 115 mg/dl Metodologia: Cálculo Friedewald VR: desejáveis Pac. baixo risco: < 160
Pac. médio risco: < 130 &para Pac. alto risco : < 100
Exame: TRIGLICÉRIDES – SORO Amostra: 01 OS: 4732514 Coletado em 01/11/12
Triglicérides: 56 mg/dl VR: Desejáveis: < 150 Metodologia: Glicerol Peroxidase Automatizado
Total Colesterol, TC = LDL + (Tri.G /5) + HDL = 115 + 11.2 + 68 = 194.2 Thus, TC/HDL = 194.2 / 68 = 2.86
(Valor de 3.4 is half the average risk coronary heart disease; 4.4 is average risk and; 7.1 is twice average risk.)
Data from: “Population at Risk” Am. J. Medicine. 1986, Vol. 80 (Sup. A2) by W.P. Castelli, & K. Anderson

I have recently completed (all for free) a very extensive general health exam. My first ever: 4 or 5 different types of echo and Doppler cardiograms (including adominal and neck regions also), exams of more than 30 different blood chemistry tests, stool exams, tomography, first ever colostomy, X-rays Stress EKG, etc. Above was copied from my summary.

PS to Syzgys: Was your Total Cholesterol actually measured? Or calculated from equation I gave in Blue, which is what is usually done. (too lazy to calculate your TC with your other data). Any way your ratio TC/HDL = 227/63 = 3.60 which is good but not as good as my 2.86 - You have slightly more than half the average risk of coronary heart disease.

 

[Syzygys]

I am not sure how they did it. I specially asked for VLDL, but the nurse said who gave me the report that they don't do that. So it is possible the TC was also just calculated.

I was reading cholesterol related threads on Reddit and people on the keto diet lower their numbers significantly. And that is rather interesting because there is not supposed to be much correlation between dietary and blood level cholesterol.

 

[Billy T]

I am not sure how they did it. ... So it is possible the TC was also just calculated. ...

OK lets calculate your TC via:
Total Colesterol, TC = LDL + (Tri.G /5) + HDL = 137 + (135/5) + 63 =137 + 27 + 63 = 137+ 90 = 227 exactly what they told you, so yes they calculated, not measured it, as is almost always the case.

BTW, I Googled the ref in my post 41 and found it has been cited 310 times in other papers! - It is an important paper still, it seems. I have calculated my TC/ HLD ratio with this formulae for more than two decades and it has always been very good but never been quite as good as it is now.

I still exercise, but not nearly as much as when younger. I very rarely eat red meat, mainly fish or chicken (and some beans) for protein for last 15+ years. One thing unusual I do eat every day for breakfast is one banana, microwaved for one minute, covered with a coffee scoop full of raw oats and at least two table spoons of soy oil, all smashed up with a little skimmed milk (plus two cups of not strong coffee). I think having some liquid oil every day* helps keep blood vessels clean and boost HLD while lowering LDL.

* I ingest very little sugar and avoid all fats (butter included) that don´t pour at room temperature but use liquid ones freely. At least half my calories do come from whole grain breads, rice or potatoes or pasta, fruits and vegetables, which are cheap with great variety in Brazil all year long.

 

[kwhilborn]

Doctor Oz just profiled two doctors who published their evidence that Cholesterol does not matter. They pointed at build ups in the blood stream being derived in the same methods, but due to sugars compromising the travel safety of Cholesterol.

Dr. Oz did not seem to advocate for or against, but if I was in ill health I would look at this more.

These guys seemed to be American Surgeons, and am unaware if they are the same guys as mentioned in the OP.

For any not in North America: Dr. Oz is a popular health television show that has cures ranging from science to myth.

 

[rodereve]

Thanks for the informative post Cris. But I was more concerned about your last statements, if you think that low fat and high complex carb diet is bad, then what would you suggest otherwise. I thought that was the ideal diet haha

 

[Billy T]

Thanks for the informative post Cris. But I was more concerned about your last statements, if you think that low fat and high complex carb diet is bad, then what would you suggest otherwise. I thought that was the ideal diet haha

I thank you as I had not read Cris´s post but now have. I think he has it nearly 100% correct. My only "correction" is to note the blue text reference in post 41. Although a high ratio of HDL/LDL is certainly desirable, what correlates better with low risk of coronary problems is a low ratio of TC/HDL, where TC is Total Cholesterol, TC = LDL + (Tri.G /5) + HDL and rarely measured but calculated by this formulae.

Best POV as Cris noted, is that coronary problems start with inflammation. Cholesterol is then deposited on the inflamed areas as a natural protective measure. I don´t do it, but should take a “baby aspirin” every day to retard formation of coronary inflammation. I don´t think that is much of a problem for me. I had extensive set of health tests* recently (first time ever) and Doppler cardiograms of heart and neck blood velocities were measured. Mine were well below normal and that indicates little constriction in the vessels. (Blood does not need to speed up thru constricted area.)

Yes Cris correctly told why high carb diet is bad. It is slow increase of your sugar in take, not nearly as bad as high sugar intake. Sugar, other than honey, is part of man´s food for less than 300 years. Human have an insulin system well designed to cope with slow release of sugars as carbs are digested, but NOT with ingestion of this less than 300 year old drastic modification of diets. Sugar make an abnormal surge up in insulin production which then remains in the system for hours after it has help burn up the sugar. IMO sugar is a slow acting poison that will subtract many years from you life, via several sugar induced diseases, that are a rapidly growing problem for societies that have a "sweet tooth."

* All free in Brazil, and as wife was a professor at USP, the best university in all of South America, they were done at the teaching hospital clinic of USP. Usually for free services, you need to got to your nearest center, and not all are good.

 

[Billy T]

I am exploring the subject, because I don't really want to take Lipitor, as my doctor recommended. Adverse reactions and such... Apparently, Red Fungus Grain has similar cholesterol-reducing effect, without dangerous part results, in addition to less expensive.

If you are less than 50 years old, total cholesterol is an independent predictor of your risk, but not after that age. More important than cholesterol, for all ages, is the ratio of total cholesterol to HDL. If this ratio is 3.4 a male has half the average risk of coronary heart disease. Less is even better. My TC/HDL ratio about a year ago was only 2.86. If ratio is 4.4 your risk is average for males. If it is 7.1 your risk is twice the average of males.

This data is based on huge (5,127 people mostly men - 50% of the town´s population) long-term (started in 1949) study of most males living in an English town (Framingham). The paper giving results has more than 300 citations by other reserachers. The study, briefly called "population at risk" or "the Framingham study" was published here:
Am. J. Medicine. 1986 vol. 80 (sup A2) by W.P.Castelli & K. Anderson. If you have serious concerns, read this most important study. It gives effects of age, and many other factors, including blood presure, also. -Lots of graphs.

BTW, Total Cholesterol, TC, is almost always computed from: TC = LDL + (Tri.G / 5) +HDL instead of measured directly.

 

[WillNever]

Dr. Oz is a known sell-out. He is paid to promote those stupid raspberry ketone pills and drops that cost around sixty dollars per bottle: another stupid miracle weight loss supplement.

 

[arauca]

If you are less than 50 years old, total cholesterol is an independent predictor of your risk, but not after that age. More important than cholesterol, for all ages, is the ratio of total cholesterol to HDL. If this ratio is 3.4 a male has half the average risk of coronary heart disease. Less is even better. My TC/HDL ratio about a year ago was only 2.86. If ratio is 4.4 your risk is average for males. If it is 7.1 your risk is twice the average of males.

This data is based on huge (5,127 people mostly men - 50% of the town´s population) long-term (started in 1949) study of most males living in an English town (Framingham). The paper giving results has more than 300 citations by other reserachers. The study, briefly called "population at risk" or "the Framingham study" was published here:
Am. J. Medicine. 1986 vol. 80 (sup A2) by W.P.Castelli & K. Anderson. If you have serious concerns, read this most important study. It gives effects of age, and many other factors, including blood presure, also. -Lots of graphs.

BTW, Total Cholesterol, TC, is almost always computed from: TC = LDL + (Tri.G / 5) +HDL instead of measured directly.

The paper, which analyzes decades of peer-reviewed science, reports that low magnesium levels—not cholesterol or saturated fat—is the leading predictor of heart disease. The paper argues that medical research took “an early wrong turn” by ignoring studies dating back to 1957 showing that lack of this essential mineral may actually cause plaque buildup in arteries.

“This means we have been chasing our tails all of these years going after cholesterol and the high saturated-fat diet, when the true culprit was and still is low magnesium,” study author Andrea Rosanoff, Ph.D., Director of Research & Science Information Outreach Center for Magnesium Education & Research, in Pahoa, Hawaii, contends in a statement.

http://health.yahoo.net/experts/dayi...save-your-life

 

[Billy T]

... the true culprit was and still is low magnesium,” study author Andrea Rosanoff, Ph.D., Director of Research & Science Information Outreach Center for Magnesium Education & Research, in Pahoa, Hawaii, contends in a statement.
http://health.yahoo.net/experts/dayi...save-your-life

You, don´t suppose that center could have any pro-magnesium biases do you?
Anyway Yahoo health has removed his paper, for reasons not stated, but I can guess. Here is all they say:
"We're sorry, but the page you are looking for no longer exists."

I searched here: http://www.ncbi.nlm.nih.gov/pubmed/?term=magnesium+deficiency to see if there is any support for the guy ´s theory. (He is not even with medical education!)

Heart problem were not mentioned in the first 40 papers listed except one noted excessive dietary suppliment of magnesium does shorten the interval in parts of the fetal EKG. Most papers related to effect on bones or psychological problems. Perhaps this guy has some of them as has been taking massive does of Magnesium?

 

[arauca]

You, don´t suppose that center could have any pro-magnesium biases do you?
Anyway Yahoo health has removed his paper, for reasons not stated, but I can guess. Here is all they say:
"We're sorry, but the page you are looking for no longer exists."

I searched here: http://www.ncbi.nlm.nih.gov/pubmed/?term=magnesium+deficiency to see if there is any support for the guy ´s theory. (He is not even with medical education!)

Heart problem were not mentioned in the first 40 papers listed except one noted excessive dietary suppliment of magnesium does shorten the interval in parts of the fetal EKG. Most papers related to effect on bones or psychological problems. Perhaps this guy has some of them as has been taking massive does of Magnesium?

I thank you for your reference was enlightening . I see there is a lot of publishing in order to promote the sponsoring industry, but there is good that there are critical people like you who make us stop from embarrassing, new publication.

 

[Billy T]

I think cholesterol necessary for human body

Probably as the body makes it.
I see you are making quick one line post in many threads - probably plannin some spam link - If so I´ll see you quickly get a permanet ban.

 

[Rav]

FYI that Yahoo Health article on magnesium hasn't been deleted, arauca just posted a truncated link. Here it is: http://health.yahoo.net/experts/dayinhealth/mineral-could-save-your-life

 

[Billy T]

FYI that Yahoo Health article on magnesium hasn't been deleted, arauca just posted a truncated link. Here it is: http://health.yahoo.net/experts/dayinhealth/mineral-could-save-your-life

Thanks. There does seem to be some correlation for men with low Mg removal by their urine, but no correlation with the Mg levels in the blood. Here is part of the abstract and the full conclusion:

Previous studies on dietary magnesium and risk of ischemic heart disease (IHD) have yielded inconsistent results, in part because of a lack of direct measures of actual magnesium uptake. Urinary excretion of magnesium, an indicator of dietary magnesium uptake, might provide more consistent results. ... The lowest sex-specific quintile (men: <2.93 mmol/24 h; women: <2.45 mmol/24 h) had an increased risk of fatal and nonfatal IHD (multivariable HR: 1.60; 95% CI: 1.28, 2.00) compared with the upper 4 quintiles of urinary magnesium excretion. A similar increase in risk of the lowest quintile was observed for mortality related to IHD ... No associations were observed between circulating magnesium and risk of IHD.

Conclusions: Low urinary magnesium excretion was independently associated with a higher risk of IHD incidence. An increased dietary intake of magnesium, particularly in those with the lowest urinary magnesium, could reduce the risk of IHD.

I.e. if you are in the 20% with the lowest Mg urine removal, increased dietary Mg may be a benefit, I say "may" as it is strange that Mg concentration in the blood is not a factor. (Crudely: How does the heart know much Mg is in your piss?) Perhaps what is more important is how well your kidneys function. - Not removing Mg from the blood like the average rate may be the real correlation. I do note that these "low urine Mg is danger for IHD" studies are relatively recent. Perhaps more main line medical researches will be prompted to investigate.

 

[arauca]

Thanks. There does seem to be some correlation for men with low Mg removal by their urine, but no correlation with the Mg levels in the blood. Here is part of the abstract and the full conclusion:



I.e. if you are in the 20% with the lowest Mg urine removal, increased dietary Mg may be a benefit, I say "may" as it is strange that Mg concentration in the blood is not a factor. (Crudely: How does the heart know much Mg is in your piss?) Perhaps what is more important is how well your kidneys function. - Not removing Mg from the blood like the average rate may be the real correlation. I do note that these "low urine Mg is danger for IHD" studies are relatively recent. Perhaps more main line medical researches will be prompted to investigate.

Whatever Magnesium does or not do according to " scientific data I get " Charle Horse " at night while a sleep , After I take a magnesium oxide pill it removes my problem for a few days then Have to take again .

 

[Cris]

An update on more recent developments.

While the discovery of different LDL sizes was promising and still gives some good indications of risk, by far the best indication now is LDL count, referred to as LDL-P. This is the count of LDL particles regardless of size. To be contrasted with LDL-C which is the total quantity of cholesterol.

In a diet with high carbohydrates significant insulin is released to clear the blood of glucose, or at least to target the steady state goal of about 5g (about a spoonful). This is the primary purpose of insulin since higher glucose levels become toxic. The glucose is either pushed into cells to be burnt for energy or is converted to triglycerides for fat storage. While insulin levels are high, fats cannot be used for energy, i.e. insulin inhibits lipolysis, the action of breaking triglycerides into free fatty acids suitable for energy. If intake of glucose is excess of energy needs then that raises serum triglycerides and if fats are also ingested then that further adds to the triglyceride load. Trigs are transported in the blood within LDL so if we see a rise in trigs, and at the same time the demand for cholesterol remains the same then both the cholesterol and trigs will share an increased number of particles to cater for the increased trig load. It turns out it doesn't really matter whether the particles are large or small, it is the total number that correlates the best with CVD risk.

The greater the number of particles then the greater the risk that one or more will crash into arterial walls and begin an inflammatory cascade.

The solutions -

1. Reduce serum cholesterol. Statins will do this, along with some very nasty side effects. We can see this approach can very well reduce the LDL-P since less cholesterol will need to be transported and hence fewer LDL particles needed. So problem solved? Well no. You actually need all that cholesterol for a healthy life, it is the major part of the membrane of every cell in your body, it is a major part of your brain, it is the critical foundation for vitamin D, it is the basis for bile needed for efficient digestion, etc, etc. Reducing the cholesterol that your body knows it needs simply makes you sick long term. And cholesterol was never the cause of the problem in the first place.

2. Use a low fat diet and keep glucose needs low enough to not cause excess that would normally converted into trigs. This is the official recommendations - high carb and low fat. The result is the current obesity, diabetes, cancer, and Alzheimer epidemics. High carbs mean more insulin is needed and the pancreas only has a very few cells that produce insulin. The high demand causes some or all of these cells to become exhausted and they die - diabetes. In addition the constant pushing of glucose into cells for energy causes cells to become resistant to insulin and hence causes a greater demand for more insulin to do the same job - a cascade reaction leading to diabetes again. The other major downside is that our bodies need a significant amount of fat for long term health. Fats are used in many ways - the brain is primarily made from fat, vitamins, A, D, E, and K are all fat soluble. Fat is needed for bone and skin health. Fat is required to allow calcium to build bones, etc. Reducing fat, a vital resource for long term health is counter productive, as we see from actual mortality results.

3. Keep carbs low and increase fat intake to be used as the primary fuel source. The low carbs avoid the cancer and diabetes risks and the excess that would otherwise convert to trigs. The fats instead of circulating in LDL particles are used for energy and hence LDL-P stays low and CVD is avoided. When fat is burnt for fuel then ketones are produced which are the optimum fuel for the brain, this then further decreases the need for glucose. The brain can operate on about 95% ketones as the best estimate I have seen, some say less than that.

Try these links -

The simplest and most concise to follow - http://www.youtube.com/watch?feature=player_embedded&v=LUlJE2Rqs0w

More detailed, longer, and scientific - http://www.youtube.com/watch?feature=player_embedded&v=8GDx5sObceI

 

[Billy T]

An update on more recent developments. ... The solutions

1. Reduce serum cholesterol....
2. Use a low fat diet and keep glucose needs low enough to not cause excess that would normally converted into trigs. ... Reducing fat, a vital resource for long term health is counter productive, as we see from actual mortality results.
3. Keep carbs low and increase fat intake to be used as the primary fuel source. ...
Try these links -

The simplest and most concise to follow - http://www.youtube.com/watch?feature=player_embedded&v=LUlJE2Rqs0w
More detailed, longer, and scientific - http://www.youtube.com/watch?feature=player_embedded&v=8GDx5sObceI

Thanks. I only had time for the second link and need to hear again, but tend to agree; however neither you nor he distinguish between fats. I think this very important.

Never, if you can avoid it, eat fat that is solid at room temperature - Trim any meat with great care and don't eat ground meat - like hamburgers. The best liquid fats are olive and canola oils, but they are relatively expensive. I sometimes use soy oil as it may help with a low level prostate problem removal of my prostate did not fully cure. I take at least a table full spoon of oil each day.

Don't jump to the conclusion I say this as arteries are constricted by solid fat like substances. Not the reason at all. I learned about a decade ago populations that do use a lot of olive oil have low CV problems, so started my diet change to include this oil daily. By the referenced index of my post 48, my risk of CV problems is only abour 20% of the average for a male. That very extensive, long-term, large* study is one of the few I am nearly certain gives a correct index of your CV risk. They don't tell what to eat etc. just how to measure your risk. I am convenced, just adding a table spoon of good oil per day to my diet is why my risk fell so low.

* BTW one of the great benefits of "socalized medicine" (in addition to half the cost to society complated to US's for profit system and a few years more life expectance) is the research potential. I.e. the health records basicaly from birth to death of 10s of thousand of people are available at one center, with one data format for computers. Not in 500 different doctor's hand written notes stored in filing cabinets until he throws them out as the partient has not been back for a few years as in the US.

 

[Cris]

Billy,

Never, if you can avoid it, eat fat that is solid at room temperature

Any good reason why not? Many saturated fats are solid at room temperature, but there is nothing wrong with saturated fats.

Trim any meat with great care..

If you do then make sure you eat the important parts - the fat. Eat the meat if you want although or you could just feed it to your dog instead.

and don't eat ground meat - like hamburgers.

Unless it is from grass fed meats and make sure it has the highest fat content.

The best liquid fats are olive and canola oils, but they are relatively expensive.

Olive oil is primarily monounsaturated and while we can use that for energy it doesn't give much else in the way of health. Canola oil is an artificial man made disaster - the chemicals and the manufacturing process used to create this are quite offensive - something very much to be avoided.

sometimes use soy oil as it may help with a low level prostate problem removal of my prostate did not fully cure. I take at least a table full spoon of oil each day.

Soy is something else that should always be avoided. It has a high omega-6 load and heavy in phytic acid - an anti-nutrient.

So the fats to consume and avoid -

1. Saturated fats to about some 50% of total food intake. These have a range of chain lengths that each convey a large variety of individual health benefits. There is absolutely nothing wrong with saturated fats, they should never be avoided. They are the foundation of human health.

2. Omega-3 polyunsaturated fats from wild caught salmon and similar fish. These types of O3 are in the form of DHA and EPA - we need a fair amount of these essential fatty acids. Plant based O3 like flax seeds only provide ALA and we only need trace amounts of that. High quality fish oils can provide this need - it is just safer and better to eat appropriate fish. O3 is very heart and brain healthy and is primarily anti-inflammatory.

3. Omega -6 - we need some of this in about the same proportion as omega-3 or a just a little more. Both are critical to normal health, however, o6 is extremely prevalent in western foods and it is highly inflammatory - many experts say it is one of the leading causes of CVD.

4. Monounsaturated fats and some others, make up the rest. Most animal fats will contain about the right ratios of this and O3, O6, and SAFA. Butter for example as well as lard or tallow.

5. Trans fats. These are man made fats and are poisonous and have been banned in many places in the world. Some margarine still use these - never eat these whatever else you might eat.

6. Avoid nearly all vegetable oils - they are nearly all very high in O6 and rarely have a good mix of other fats.

7. Coconut oil is an excellent source of fats and contain medium chain fats (8 and 10 carbon chains) that are minimally processed in human digestion and result in instant energy and are great for ketone production.

Total fats should make up some 65% to 80% of food intake with about 15%-20% from protein and the remainder from mainly non-starchy vegetables.

 

[Billy T]

Billy, Any good reason why not? Many saturated fats are solid at room temperature, but there is nothing wrong with saturated fats. ...

Yes dozens of "good reasons" in the peer-reviewed literature. - I doubt you an find even one CLINICAL STUDY, telling "there is nothing wrong with saturated fats" - That they are as OK to eat as monounsaturated are.

I.e. I don’t agree with your claim nor does Harvard School of Public Health nor the Mayo Clinic in their 2011 link quoted in small part below Harvard’s and dozens of others who do clinical studies, instead of complex speculative molecular dynamics theory – such as your longer “more scientific” article reports.

What really matters is the type of fat you eat.
“Good” fats—monounsaturated and polyunsaturated fats—lower disease risk. “Bad” fats—saturated and, especially, trans fats—increase disease risk. Foods high in good fats include vegetable oils (such as olive, canola, sunflower, soy, and corn), nuts, seeds, and fish. Foods high in bad fats include red meat, butter, cheese, and ice cream, as well as processed foods made with trans fat from partially hydrogenated oil.

And a growing body of research suggests that when it comes to dietary fat, you should focus on eating healthy fats and avoiding unhealthy fats.
The two main types of potentially harmful dietary fat:
• Saturated fat. This is a type of fat that comes mainly from animal sources of food. Saturated fat raises total blood cholesterol levels and low-density lipoprotein (LDL) cholesterol levels, which can increase your risk of cardiovascular disease. Saturated fat may also increase your risk of type 2 diabetes.
• Trans fat. This is a type of fat that occurs naturally in some foods, especially foods from animals. But most trans fats are made during food processing through partial hydrogenation of unsaturated fats. This process creates fats that are easier to cook with and less likely to spoil than are naturally occurring oils. …
• Most fats that have a high percentage of saturated fat or trans fat are solid at room temperature.

• The two main types of potentially helpful dietary fat:
• Monounsaturated fat. This is a type of fat found in a variety of foods and oils. Studies show that eating foods rich in monounsaturated fats (MUFAs) improves blood cholesterol levels, which can decrease your risk of heart disease. Research also shows that MUFAs may benefit insulin levels and blood sugar control, which can be especially helpful if you have type 2 diabetes.
• Polyunsaturated fat. This is a type of fat found mostly in plant-based foods and oils. Evidence shows that eating foods rich in polyunsaturated fats (PUFAs) improves blood cholesterol levels, which can decrease your risk of heart disease. PUFAs may also help decrease the risk of type 2 diabetes. …
• Foods made up mostly of monounsaturated and polyunsaturated fats are liquid at room temperature, such as olive oil, safflower oil, peanut oil and corn oil.

It always seemed strange to me, but only missing one potential H atom is more beneficial than missing several. Several studies said this some years ago.

 

[Syzygys]

Alright. I have just had the 6 months follow up blood check. I generally took 2 Lovaza (high quality fish pill) but I upped it to 3 and had a big eggs dinner before the check up.

OK, the results are in and I have pretty much passed with almost flying colors:

Total cholesterol: 227 (last year was 288)
LDL : 137 (186 last year)
HDL : 63 (same as last year)
Tryg : 135 (last year 208)

And the latest numbers are:

Total: 201
LDL: 122
HDL: 64
Tryg: 74
So in a year using fish oil I lowered my total number by 30%, mostly by getting the dangerous tryg number down by 60%.... I eat everything I want but I do exercise...