Cholesterol

hoodlisa1979 wrote: »

Has anyone successfully reduced their cholesterol through diet and exercise? I'm currently at 6 and I'm hoping to improve it within 8 weeks

You're at 6 what? Yes, I have reduced my cholesterol and one of my good friends reduced her cholesterol. I have familial high cholesterol. My friend and I both lowered our cholesterol by cutting out meat. She went whole food plant based, I cut out red meat. All the saturated fat deniers hate that answer though.

neanderthin wrote: »

Yes it will. However the jury is still out whether low overall cholesterol is better.


Total cholesterol and all-cause mortality by sex and age: a prospective cohort study among 12.8 million adults

https://nature.com/articles/s41598-018-38461-y?language=de

The basic jist of this graph shows a hazard ratio/risk against total cholesterol levels.

The base is at 1.0 and if you look at the people with the highest cholesterol levels on the x axis it's showing a risk/hazard ratio to be 30%

If you look at the people on the same x axis with the least amount of total cholesterol it's showing a risk/hazard ratio of 230% increasing risk of mortality 8 fold.

There's a little confusion going on and it appears from the research that what is more important, is particle size and total particle numbers within the actual LDL lipoprotein.

I agree, total cholesterol is not the issue, LDL cholesterol is. But let's not throw the baby out with the bathwater. High LDL cholesterol levels do matter. Alot. I'm at a much higher risk of death from cardiovascular disease because my body cannot adequately get rid of LDL cholesterol, so I keep it down myself.

"Second, other lipid measures, such as low-density lipoprotein and high-density lipoprotein cholesterol levels, were unavailable. Recent dyslipidemia management guidelines are more closely focused on these sub-fractions of cholesterol, so the direct application of our findings to individual patient care might be somewhat limited. " (from the study).

6 is in mmol/l. A range of 5.18-6.16 is considered high which is 200=239 mg/dl.

peggy_polenta wrote: »

sollyn23l2 wrote: »

hoodlisa1979 wrote: »

Has anyone successfully reduced their cholesterol through diet and exercise? I'm currently at 6 and I'm hoping to improve it within 8 weeks

You're at 6 what? Yes, I have reduced my cholesterol and one of my good friends reduced her cholesterol. I have familial high cholesterol. My friend and I both lowered our cholesterol by cutting out meat. She went whole food plant based, I cut out red meat. All the saturated fat deniers hate that answer though.

i have reduced my cholesterol by reducing carb intake to <50 per day and eating fat and protein. but all the all calories arent equal deniers hate that answer.

I know you're just echoing the phrasing from the PP, but actually all calories are equal, just like all miles are the same length. For sure, though, calories aren't all that matters about food choices, when it comes to health!

The nutrition that comes along with those calories, from different food choices, does make a difference when it comes to health issues like cholesterol levels, absolutely. Saturated fat intake is a somewhat hot debate in that respect lately, seems like, and others know more about that than I. Carb intake IMU can be relevant to blood cholesterol levels (and triglyceride levels), so carb reduction may be helpful.

I'm not going to argue the merits of low carb or very low carb, which is a great thing for some people. It's certainly compatible with cholesterol reduction, and could be important depending on starting point.

Experientially, without AFAIK familial hypercholesterolemia in the picture, my cholesterol dropped with weight loss even while I was eating 150g+ carbs most days (and stays fine while eating 225g+ carbs daily in maintenance), but those carbs tended to be sourced mostly from veggies, fruits, low/no fat dairy, and other whole or lightly processed foods. This makes me suspect that low carb isn't universally necessary in order to lower blood cholesterol, but I can't speak to different circumstances where it's more and less important: Just don't know. As an aside, I don't get a lot of sat fat, just something near the MFP default goal (which I'd consider moderate), but that's kind of a coincidence, so I don't know what the effect would be if I did eat more (or less).

When folks find that fully plant based eating (sometimes imprecisely known as veganism) has helped them get to a good cholesterol level (sometimes even with familial hypercholesterolemia), my suspicion would be that most of them are probably getting moderate to higher carbs. Low carb fully plant based is a thing, but it's fairly difficult, so not what I'd assume when someone says vegan or fully plant based unless they also say low carb.

My point is really that OP may have multiple options to try, some of them more likely to pay off in certain scenarios than others (like the genetic variation implications). It may be helpful if we can be clear about what worked for each of us and what our individual circumstances are/were, so s/he can evaluate what to try.

hoodlisa1979 wrote: »

Has anyone successfully reduced their cholesterol through diet and exercise? I'm currently at 6 and I'm hoping to improve it within 8 weeks

Yes; sort of.

I think my total cholesterol actually went UP after weight loss and increased exercise between 2017 and 2020. It is technically high, but my doctor isn't the least bit worried. My "good" cholesterol increased significantly and is definitely high. My "bad" cholesterol decreased from "borderline" to "near optimal." These markers are still in those categories. My blood pressure also improved from borderline to pretty damn good. If my "good" cholesterol wasn't so darn high, my total would be well in the normal range. Doctor thinks this is fine.

In the years between 2013 and 2017, I made lame attempts at improving diet and exercise. My doctor suggested meds more than once, but allowed me to continue working on diet and exercise. Something changed around 2017, and I got serious. It worked.

I don't think you'll see drastic improvements in eight weeks, but I may be totally wrong. Irrespective of the timeline to improve, the very VERY best time to start is RIGHT NOW!

hoodlisa1979 wrote: »

Many thanks everyone for your replies, I don't know how to reply directly to individual posts, I've hopefully attached my current test results, can anyone clarify what optimal levels are for LDL if possible, I'm already on BP medication which I'm hoping better living will sort, I don't want to take statins as well, I'm female but the familial high cholesterol is in the male side, the doctors have never mentioned it to me despite my dad passing at 42 from heart disease

Optimal LDL levels are less than 100 mg/dl. I lowered mine with diet and exercise and losing weight...my guess would be that the losing weight part had the most impact. You can see progress with your numbers in 8 weeks, but it's not likely you will be in the optimal range in 8 weeks. It takes awhile to lower. It took me about 6 months to get into the optimal range and I had lost a good 30 Lbs or so at that point.

Diet wise I just paid a lot more attention to my nutrition...more veg and fruit, more whole foods and home cooking, less eating out and almost no fast food. I started eating fatty fish like tuna or salmon 3x per week or more and in general started eating more lean meats like chicken thighs ( I don't do breasts), pork tenderloin and pork chops, and lean cuts of beef rather than my previously more typical short ribs or rib eye steaks. I also started doing some form of exercise most days for at least 30 minutes and up to an hour.

The confusion around cholesterol is not surprising, especially now when in 2015 the Dietary Guidelines Advisory Committee said it was no longer a nutrient of concern.

Dietary cholesterol is hydrophobic, basically it doesn't mix with water and therefore doesn't just enter the blood stream and why it has no effect on serum levels and it's the liver the manufactures cholesterol which has nothing to do with the cholesterol we eat, and this has been well known for 40 years or so and I suspect that the Advisory Board could no longer ignore this factoid. Basically cholesterol is just cholesterol in the context of metabolization.

Every single cell in the human body is capable of manufacturing it's own cholesterol, that is how important cholesterol is and why vegans don't need to be concerned and depending on the individual there may be times where more cholesterol is needed and that is were the liver come in, it's our factory to produce and distribute cholesterol and this is where HDL and LDL is produced. The liver makes lipoproteins, actual containers, that will then take the cholesterol it manufactures and distribute that cargo to the body. The liver will fill these lipoproteins with other nutrients as well. For example, triglycerides, which are hydrophobic as well will take up most of the room in an LDL lipoprotein as well as vit. E, CoQ10 and a few other nutrients including cholesterol.

What kind of cholesterol is the liver manufacturing and are they all the same. Depending on a persons lifestyle and diet that will effect the type of cholesterol and can and does produced oxidized cholesterol which is basically damaged cholesterol. Short answer. So, basically there are types of LDL cholesterol (sub fractions) that are less and more atherogenic and oxidized cholesterol, the small dense ones, that gets further oxidized and get stuck in the lining of the arteries, and it's these small dense ones that fit between cells and not the larger more buoyant ones, generally speaking and these LDL remnants are what actually contribute to atherosclerosis.

How do we know we have oxidized LDL cholesterol, is the real question. The best way of course to to address it directly with a coronary artery calcium score CT scan which will actually tell you how much plaque you have and your risk going forward. You only need to ask your PCP, but I suspect there will be a cost, it cost me, but I'm in Canada.

Other than doing that, certain markers will generally dictate oxidized cholesterol. Early on, 40 years ago it was just LDL levels in general but science around this has progressed, and back 20 years ago or so, if I remember correctly the correlation with low HDL and elevated triglycerides was evident in people that were omitted with heart related problems and consequently that combination was found to be a good indicator. Since then particle size and the number of particles is now the better predictor.

Basically there's 2 groups pattern A and pattern B. Pattern B are the small dense particles that easily pierce the endothelium and these are oxidized. Size again is important. Basically the small dense oxidized cholesterol will also have higher numbers in group B. Lets say our LDL is 100 but if we have a predominance of small dense particles that make up the 100mg/l there could be a problem and probably is. Getting a NMR Lipoprofile – separates LDL particles into A (large, fluffy, buoyant) or B (small, dense) and for particle size it's Vertical Auto Profile-11, or a Quantimetrix Lipoprint LDL System or tube gel electrophoresis – analyzes lipoprotein sizes and assigns either a normal (less than 5.5), intermediate risk (5.5 to 8.5), or atherogenic all of these can be had through a blood panel and you can ask your PCP to be tested and hopefully your Dr. doesn't have that deer and a headlight look when you ask them.


Of course saturated fat didn't get off as lightly and they doubled down and reduced it even further and considering cholesterol is only found in animal products it kind of makes you wonder why. If dietary cholesterol is ok what's wrong with saturated fat? Science and politics doesn't mix any better than cholesterol and water.

Anyway, if we consume saturated fat with carbohydrates, LDL is elevated and everyone gets their pants in a bunch obviously, but when we look at the science it shows that when we replace mostly the refined carbohydrates with saturated fat then particle numbers reduce and the particle sizes get bigger, basically less atherogenic, and when we replace carbs with animal protein triglycerides are reduced and HDL is elevated, not something your going to hear in main stream media very much or ever. And if I personally look at this logically and more critically then when you consider France the basic home of too much saturated fat and have pretty much the lowest incident of heart disease on the planet as well as Hong Kong who consume if not the highest amount of meat on the planet also live the longest and if I look at it in an evolutionary lens, then why would our physiology only have made it a problem in the last 50 years. None of this makes any sense.

Basically it doesn't matter if your a vegan, a vegetarian, a carnivore if your consuming a whole food diet and are not sedentary and exercise to any degree, the chances that we need to worry is probably a low priority. If a person is obese, diabetic, hypertension, smoke and other comorbidities of MetS then you might want to think about that low LDL or ideal LDL number because the vast majority in this demographic have low HDL, elevated triglycerides, elevated C-reactive protein, kind of the perfect storm, and when you consider 50% of the first heart attach are fatal it's probably a good idea to have an understanding that is a little more comprehensive than your doctor tells you or what the media says....Cheers

PAV8888 wrote: »

So how do you get these tests ordered in Canada if your NP doesn't really think you need them since she's only known you as normal weight / normal results and doesn't seem to be interested in getting your previous history from your retired doctor's files?

Not sure. Also not sure that "really doesn't think you need them" qualifies as a diagnosis for the state of the calcium in your arteries, but who knows, some Doctors know everything.

Well @neanderthin ... this would be under the "guidelines do not indicate any such test is necessary at this time"... the part where all past history is erased once your doctor retired during COVID and you start from scratch even though that history IS available to be pulled... I'm still trying to figure that out...

hoodlisa1979 wrote: »

Many thanks everyone for your replies, I don't know how to reply directly to individual posts, I've hopefully attached my current test results, can anyone clarify what optimal levels are for LDL if possible, I'm already on BP medication which I'm hoping better living will sort, I don't want to take statins as well, I'm female but the familial high cholesterol is in the male side, the doctors have never mentioned it to me despite my dad passing at 42 from heart disease

Nope, nothing attached.

Let me add I had a cardiac CT, that had showed 19 percent calcification. This is what prompted me to change. My cardiologist is all for exercise, lifestyle and supports my plant based life. I do my own research but self observation for us each on our personal level is the best way to figure out what works for you

hoodlisa1979 wrote: »

Just dropping in to update, I did have the repeat tests done at the 8 week mark but it takes forever to get results back, my cholesterol has gone up to 7.4, my HDL has reduced slightly and my LDL has also slightly reduced, I was gutted to say the least, despite following the NHS guides re foods to increase HDL it hasn't improved but worsened, I have lost 18lb now and I've read that levels can raise during weight loss but will have to wait a couple of weeks to speak to the doctor to check if thats the case, I suspect that they may just want me to take the medication, also just a note I'm in the UK and here we have to be practically dead for any referral for anything other than the basics in testing

How did they justify those results considering both your HDL and LDL went down?

The standard blood test for cholesterol doesn't specifically test for LDL-C. What they look at is HDL-C then whatever is left is considered LDL-C. Sub fractions of LDL are never tested (small dense or large buoyant and large buoyant are considered less atherogenic) but again generally speaking when HDL is higher it's a good bet a persons triglycerides are reduced or reducing which then translates to a better CRP (C-reactive protein) which is an inflammatory marker for inflammation and calcium in arteries that form plaques and why higher HDL and lower trigs are considered less atherogenic, but not always. Cheers