Elevated Cholesterol & Lean Mass Hyper Responders Paper

(Bacon is a many-splendoured thing) #21

Well, given that we have strong data to show what damage elevated serum glucose and serum insulin can cause, but the only evidence against cholesterol is weak and ambiguous, and most of the evidence points to a protective effect from higher cholesterol, I’d vote for worrying about the former, not the latter.

We know that our ancestors ate almost exclusively meat, and they weren’t dropping like flies from heart attacks. On the other hand, the diabetes and heart attack epidemics began a couple of decades after cheap sugar hit the market, and refined seed oils were increasing their market share. It’s correlation, but there are plausible causative mechanisms, so . . . .

(Robin) #22

Hi Denise, you have come such a long way and made so much progress! If it weren’t for your diabetes, the answer would be so simple. Must be maddening. Living with “The Numbers” when the rest of the world disagrees is so hard.

After new heart and stroke issues, I recently gave in and now take a statin. (Gasp! Horrors!) My lipid numbers are now in line with what my docs want, while I changed nothing about my diet. My weight and strength have have not fluctuated. I know many (most?) on here will not approve. But we also preach You do You! It’s all so very individual, isn’t it?

Go with your heart. You got this.

#23

I ended up having an LDL fractionation test (?) ordered by my dietician who has a doctorate. Think that is what it was called…which showed pattern A , no increased risk at all… so I was able to wave the paper around and everyone backed off from insisting I was going to die imminently of a heart attack if I didn’t get my LDL levels down.

It’s painful to have to jump through hoops but I felt it was to my advantage to get more information. Once done, if it shows your LDl is pattern A there is no increased danger whatsoever.

Hope I am not too off topic.

(Bob M) #24

That’s the most important one. It’s the only (easily available, cheap) test that tells you actual atherosclerosis. The one I got was $100.

@robintemplin The problem with statins for you is that LDL is important to your immune system. Women, in particular, with high LDL live longer, because they have better immune system. See this, for instance:

Now, this is David Diamond and Uffe Ravnskov, both of which I’m sure the lipophobes hate. But a study is a study.

Another one, this one finding low LDL is bad:

https://www.nature.com/articles/s41598-021-01738-w

Anyway, not to belittle your use of statins, but just to say your doctor probably isn’t correct.

#25

Regarding second paper, the lowest risk across categories is 130-159 LDL, so not exactly reassuring to us LMHRs…

(Bacon is a many-splendoured thing) #26

Two questions to ask: (1) what are the relative risk factors? and (2) what are the actual disease rates in the various groups?

Austin Bradford Hill pointed out, years ago, that if the relative risk ratio is not at least 2.0, there is no way to distinguish any effect from noise in the data.

Then there is the question of whether the statistical analysis managed to deal with all possible counfounders to the observed association.

(Luke) #27

Cholesterol numbers scare me to be honest , I’ve had my bloods done once since eating keto and they were ok not great , but had come down on the previous test , like a year before. I seem to take what my doctor tells me as gospel, but I saw on a documentary and can’t remember which one , but a certain doctor in favour of the keto diet was saying it doesn’t matter what your cholesterol numbers are as long as the body is free of inflammation. He said all cholesterol was good , as long as your arteries were not inflamed, and we needed the bad cholesterol as much as the so called good cholesterol to survive.

(Chuck) #28

If you want to.make most doctors go nuts then school them on the triglyceride/HDL rato, and tell them that LDL isn’t that important… My doctor’s NP almost has a heart attack when I explained that my only concern was the rate of triglycerides/HDL and not the total cholesterol or LDL.

(Bacon is a many-splendoured thing) #29

This is true. Cholesterol is an essential component of the wall of every cell in our body. It makes up a surprisingly high percentage of the fat in our brain, and our brains contain a lot of fat. Cholesterol forms part of the myelin sheaths of our nerves and is essential for properly transmitting brain and nerve impulses. Cholesterol is the precursor of Vitamin D and the sex hormones testosterone and progesterone. It helps fight off bacterial infections, as well as playing other roles in the immune system. It helps heal arterial damage by participating in plaque formation.

So cholesterol is nothing to be afraid of. Given that there is no evidence to show that cholesterol causes cardiovascular disease, and there is plenty of evidence to show that low cholesterol damages the body in many ways, I vote for not worrying about it. As long as your ratio of triglycerides to HDL is low enough, your cardiovascular risk is minimal.

(Edith) #30

50 grams of carbs is really not that much. It could be that for you eating an extra 30 grams a day (on top of the keto suggestion of 20 g) won’t really make that much of a difference? That extra 30 grams is a medium baked potato or a half cup of raspberries… Also, I remember you mentioning you are exercising a fair bit. If you eat your extra carbs after your workout, they should have minimal impact on your blood sugar but may still be enough to shift your LDL down a bit. I would suggest doing some experimenting and blood sugar testing. Experimenting will also help you feel like you are doing something proactive and make you even more sure about the direction you feel you need to go.

(Joey) #31

So, in effect what you’re saying is that your keto increased the risk of heart attack … in your doctor’s Nurse Practitioner?

Aha, clear proof of the dangers of carb restriction!!

(KM) #32

I’m rereading Benjamin Bikman’s ‘Why We Get Sick’. He’s definitely a proponent of the idea that higher LDL is not necessarily bad and in fact may be linked with reduced risk of death, especially when it shows up in someone who is older.

(Bacon is a many-splendoured thing) #33

There are several large, well-funded studies that have shown that association, of low cholesterol with worse health outcomes, over the years, including Ancl Keys’s own Minnesota Coronary Survey. What we can definitely say is that, while our various cholesterol levels might possibly be an indicator of coronary risk, cholesterol does not cause arterial damage. Its presence in arterial plaque is as part of the healing process.

Manipulating a marker of a disease does nothing towards curing the actual disease itself. It’s like taking the thermometer out of your mouth and putting it in a glass of ice water, in an attempt to lower your fever.

#34

I’m happy I’ve found this thread back!

I have a few questions: on the OP article, the authors use BMI. Anywhere else in this forum that’s enough to raise alarm bells. BMI is said to represent nothing. When does it become accepted to use BMI as a metric of anything?

Other questions: what was the measure of good health? BMI and Tg/hdl? It doesn’t mean you’re healthy! Being thin doesn’t mean you’re healthy and having low TG/HDL neither. I have a friend, 40 years old, brain tumor. Low TG/HDL. Thin. No smoker and sportive.

And what is the paper about? That high LDL can exist with low BMI and low TG/HDL? Ok. So what? And if you eat carbs LDL goes back down. So what? And it was about people reporting things themselves, mostly?

The nature article: the lowest LDL was associated with highest all cause mortality, etc. But the curve seems to go back up after coming down. So, the sky doesn’t seem to be the limit. Unfortunately, they didn’t discuss very high LDL.

Also, in the references cited there are many papers where the conclusion seems to point to high LDL being bad. Why is this paper “better” than the others?

I also ask myself when I read this kind of paper: could it be that the high-ish LDL people had a good outcome, because after their LDL was considered high, they were put on statins? I didn’t read the whole paper. Did they check for it?

#35

It’s not true. Extreme numbers show something is wrong. But more or less normal numbers alone say nothing, it’s the case where we shouldn’t care much about it - but if it’s extreme because the one in question is 30kg or 300kg for a normal height and having all limbs (obviously the “BMI” for someone with missing limbs is useless too), it’s quite visible without calculating anything so yeah, I don’t know why BMI is used. Yes it’s a number, people love numbers and they are easier to write down but when it’s about health and an individual and visual cues are totally there… Pretty useless. I never cared about mine, I look at myself and see if I am fat or muscular (sadly the former at this point but I am working on it :wink: ).

WHY people look at perfectly good looking, muscular, even pretty lean, dry ones and tell them they are overweight/obese according to BMI so need to lose weight, I can imagine. It’s some weird cognitive problem or something? I can’t wrap my head around that and I heard about such cases… I would think using our eyes is good enough for the vague evaluation… And if we want to be specific, we should measure body fat percentage… What’s wrong with muscles? :smiley:
BMI surely has little to do with health. One can’t be healthy with extreme numbers and that’s it. Normal BMI means nothing here just like low-cal foods aren’t automatically healthy, who started that idiotic thought I don’t know but it’s annoying…