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Cholesterol - A Primer (Attempt 2)

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    Isn't this post a sticky yet???

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    • Originally posted by DesertRain View Post
      I converted the OP to kindle format if anyone wants to read and re-read it from the beach
      Thanks, DesertRain - did you get both the post and the first comment into the file?
      Primal eating in a nutshell: If you are hungry, eat Primal food until you are satisfied (not stuffed). Then stop. Wait until you're hungry again. Repeat.

      Looking for my Cholesterol Primer? Here it is: http://www.marksdailyapple.com/forum...mer-(Attempt-2)


      Ditch the scale!: http://www.marksdailyapple.com/forum/thread33283.html

      My Success Story: http://www.marksdailyapple.com/forum/thread30615.html

      Comment


      • Yup, they're both in there.

        Two questions for ya...

        1. When getting a VAP, is it necessary to do the Iranian calculation if trigs are under 100, since it's a direct measurement?

        2. Multiple times in this thread I've read that higher LDL can be due to saturated fat and protein doing repair work in the body, and that LDL may normalize after said repair work is done. This is very intuitive and I'm inclined to just believe it straight away, but would really love to see some research validating or mentioning it. Anyone have some links handy?

        My VAP results after 5 months paleo/primal:

        Total: 304
        LDL (Iranian): 212
        HDL: 69
        Trigs: 90

        Total/HDL: 4.41 (<5)
        Trig/HDL: 1.30 (<2)
        LDL/HDL: 3.07 (<4.3)

        Comment


        • How do you reconcile your picture:

          Your body uses cholesterol to make a "patch" over cell walls that need to be repaired, but if we don't give it the proper amount of raw materials (saturated fat and protein) to repair them with, the patch will stay there, and like any old bandage, eventually start to peel off. In the absence of the proper raw materials, the body slaps another layer of cholesterol over them to make sure that the patch doesn't break. This is where cholesterol buildup, or plaque, in the arteries comes from. The longer the body has to go without the right raw materials, the worse the problem gets, and these plaques can eventually break off, just like a scab on the outside of your body does, and block up the arteries, causing a heart attack or a stroke. The technical term used for "increases risk of heart disease" is "atherosclerotic," which, translated out of its non-English roots, means "athero" (artery) "sclerotic" (hardening).
          ...with the one in Robb Wolf's Paleo Solution:

          LDL plays opposite HDL in the process of distributing lipid (fat) substances throughout the body. The energy we need to run our muscles, the raw material for our cell membranes, the omega-3 fats that make up our brain, are all shuttled around with the help of LDL (and chylomicrons for you geeks).
          It appears the type of LDL particle is of significantly greater importance than the amount. The type B profile, for example, appears to be particularly bad as the small, dense LDL particles get trapped in the nooks and crannies of the blood vessels. Our immune system is not used to seeing things get stuck in the gaps between cells in our blood vessels. Our immune system mistakes the small/dense LDL particles for a foreign invader and attacks them. This is the beginning of an atherosclerotic plaque, which can narrow key arteries such as the carotid artery.
          and Chris Masterjohn at The Daily Lipid:

          As in arterial plaques, this cholesterol comes from the accumulation of oxidized LDL into macrophages (immune cells), which is a phenomenon mediated not by the cholesterol but by the oxidation of the polyunsaturated fatty acids (PUFAs) in the LDL membrane, which in turn damages the protein in the membrane, leading the immune system to mop it up before it wreaks havoc on every cell it encounters.
          Later experiments, as described in my article linked to above, showed that it was oxidized derivatives of linoleic acid, mainly derived from dietary vegetable oils, that were the key constituents of the LDL particle that could turn on the genes in the macrophage that would cause it to turn into a foam cell.

          It is these macrophages and foam cells that populate atherosclerotic plaques, initiating the inflammatory process, eventually degrading the fibrous cap and increasing the chances of rupture, and committing suicide, leaving cellular debris and large pools of oxidized lipid -- that is, a giant mess of toxic waste -- in the center of the plaque.
          and Chris Masterjohn at the Weston A. Price Foundation blog:

          Also, oxidative stress, which is promoted by intake of polyunsaturated fatty acids and is protected against by intake of saturated fatty acids and to some extent by monounsaturated fatty acids (and wihch is also influenced by many other factors, such as toxins and heavy metals), decreases LDL-receptor function.
          In any case, experimental evidence has shown in humans that saturated fats protect against in vivo LDL oxidation. You can see this by looking at the rightward most column in this graph: Dietary Fat and LDL Oxidation.
          My reading of that stuff is that plaques have nothing to do with cholesterol, but rather with oxidized lipoproteins and the immune response that follows.
          Last edited by DesertRain; 01-08-2011, 09:36 PM. Reason: Added another quote

          Comment


          • Originally posted by DesertRain View Post
            Yup, they're both in there.

            Two questions for ya...

            1. When getting a VAP, is it necessary to do the Iranian calculation if trigs are under 100, since it's a direct measurement?
            Shouldn't be. The VAP does, as you say, a direct measurement. The Iranian calculation is designed to compensate for the flaws in the Friedewald equation.

            2. Multiple times in this thread I've read that higher LDL can be due to saturated fat and protein doing repair work in the body, and that LDL may normalize after said repair work is done. This is very intuitive and I'm inclined to just believe it straight away, but would really love to see some research validating or mentioning it. Anyone have some links handy?
            I wish I did. To me, that's just intuitive as well, but I'm not a nutrition researcher (that's not my field) so I'll have to see if I can get in touch with some folks in the know and get some references. I'd think that Colpo probably has some, but right now I can't put my hands on his book (I own it, I just put it down somewhere and can't find it!).
            Primal eating in a nutshell: If you are hungry, eat Primal food until you are satisfied (not stuffed). Then stop. Wait until you're hungry again. Repeat.

            Looking for my Cholesterol Primer? Here it is: http://www.marksdailyapple.com/forum...mer-(Attempt-2)


            Ditch the scale!: http://www.marksdailyapple.com/forum/thread33283.html

            My Success Story: http://www.marksdailyapple.com/forum/thread30615.html

            Comment


            • UK/Canada etc to US Conversions

              Excellent online calculator for making the two different Cholesterol and Trigs conversions into US measurement:

              http://www.spacedoc.net/converters.html

              (Dr. Duane Graveline's site - astronaut and MD who has now written several books on why statins are bad - starting from his own personal experience!)


              The different conversion confused the heck out of me until I finally realised that moles are not like grams. In a sense they differ depending on what substance is being measured and Cholesterol and Trigs are not the same "weight" in moles.

              And Griff - huge thanks for giving me the information I needed to tell the nurse who was marginally concerned at my numbers why, precisely, I was not!

              Comment


              • Originally posted by DesertRain View Post
                I converted the OP to kindle format if anyone wants to read and re-read it from the beach
                THANK YOU!!! I have the kindle app on my iphone, so I can have it with me when I go to the doc's

                Comment


                • Just had to share ...

                  Previously:
                  45 year old female, 6'2", 260 lbs, years of grains, grain flours, trans-fat and industrial seed oils.

                  Current
                  46-year old female, 6'2" 201 lbs, 5-6 months of diet modifications: low-carb, low-fat July - Oct 2010, Primal Oct 2010 - Dec 20, 2010 (date of test)

                  Total (2009: 220) 184
                  HDL (2009: 50) 53
                  Triglycerides (2009: 123) 51!!! Hooray... I make the cut to use the Iranian equation!
                  LDL (Iranian) : 95 (2009: 145)

                  Total:HDL (2009: 4.4) 3.47
                  tri:HDL (2009: 2.45) 0.97
                  LDL:HDL (2009: 2.89) 1.81

                  Can't wait till next year after having increased HDL by adding moving slowly more frequently, and incorporating occasional sprinting and lifting heavy things!
                  Last edited by svelting; 01-10-2011, 08:29 PM. Reason: to correct arithmetic in the ratios, and umm, spelling!
                  My journal

                  Comment


                  • Warning about Iranian vs Friedewald calculation

                    I posted my blood lipid results a few months ago. Here are the numbers:

                    219: Total cholesterol
                    84: HDL
                    27: Triglycerides
                    119: LDL

                    I had read all about the supposed inaccuracies of the Friedewald equation for estimating LDL, so I plugged my numbers into one of the online calculators (http://homepages.slingshot.co.nz/~geoff36/LDL_mg.htm) to get the Iranian vs Friedewald results. Here's what I got:

                    130: Friedewald
                    84: Iranian

                    I remember being a little confused that the LDL reported on my lab sheet was not 130, but I didn't give it much thought afterward.

                    Today I came across my lab results again, and I noticed that the LDL was a direct measurement, not a calculated value. It actually says: "LDL, DIRECT". I don't know how I missed it before.

                    The upshot is that in my case, the Friedewald equation did in fact overestimate my LDL by about 11 mg/dL, a 9% overestimation , but the Iranian equation fared even worse, underestimating it by 35 points -- a whopping 30% underestimation..

                    I don't know what to make of this. Did I use the calculator incorrectly (anyone can check my numbers quickly enough)? Does the Iranian equation start to fall apart for very low triglycerides, much like the Friedewald equation falls apart for lowish and very high triglycerides? Is my lab report lying, and they didn't actually do a direct measurement? Is there a typo on my lab report?

                    This information seems relevant on a thread where many are easing their worries about high LDL by using the Iranian equation to get a lower LDL number. I will try to verify that the lab used by my doctor did in fact use a direct LDL measurement.

                    Comment


                    • Originally posted by The Big L View Post
                      I remember being a little confused that the LDL reported on my lab sheet was not 130, but I didn't give it much thought afterward.

                      Today I came across my lab results again, and I noticed that the LDL was a direct measurement, not a calculated value. It actually says: "LDL, DIRECT". I don't know how I missed it before.

                      The upshot is that in my case, the Friedewald equation did in fact overestimate my LDL by about 11 mg/dL, a 9% overestimation , but the Iranian equation fared even worse, underestimating it by 35 points -- a whopping 30% underestimation..

                      I don't know what to make of this. Did I use the calculator incorrectly (anyone can check my numbers quickly enough)?
                      No, the calculator's right, but why does it matter? Your LDL is normal. Look at your ratios, not at your absolute numbers.

                      Your Total/HDL is 2.6 where the lowest danger level is 4.4 for a woman and 5.0 for a man.
                      Your Trig/LDL is 0.3 where the "great!" is 2 and below for any gender.
                      Your LDL/HDL is 1.4 where the lowest danger level is 4.4 (and goes up from there).

                      So why are you worried? The Iranian equation was created precisely to counteract the problems with calculated LDL where trigs are below 100. Your LDL wasn't calculated, so you don't need the Iranian calculation.
                      Primal eating in a nutshell: If you are hungry, eat Primal food until you are satisfied (not stuffed). Then stop. Wait until you're hungry again. Repeat.

                      Looking for my Cholesterol Primer? Here it is: http://www.marksdailyapple.com/forum...mer-(Attempt-2)


                      Ditch the scale!: http://www.marksdailyapple.com/forum/thread33283.html

                      My Success Story: http://www.marksdailyapple.com/forum/thread30615.html

                      Comment


                      • Originally posted by Griff View Post
                        No, the calculator's right, but why does it matter? Your LDL is normal. Look at your ratios, not at your absolute numbers.

                        Your Total/HDL is 2.6 where the lowest danger level is 4.4 for a woman and 5.0 for a man.
                        Your Trig/LDL is 0.3 where the "great!" is 2 and below for any gender.
                        Your LDL/HDL is 1.4 where the lowest danger level is 4.4 (and goes up from there).

                        So why are you worried?
                        Thanks for your response. I'm not worried about my own cholesterol numbers.

                        The Iranian equation was created precisely to counteract the problems with calculated LDL where trigs are below 100.
                        That is exactly my point: if the Iranian equation was created to be more accurate than Friedewald with trigs < 100, then why does it do so poorly compared to Friedewald with my 27 trig reading? (btw, I don't expect you or anyone else to have the answer to that question. It's just some food for thought).

                        Your LDL wasn't calculated, so you don't need the Iranian calculation.
                        Whatever method the lab employed to come up with my LDL number is irrelevant to the validity of the Iranian calculation.

                        I've seen many posts on this forum where people treat results from the Friedewald calculation as suspect and those from the Iranian calculation as gospel. What I think we have here is a case of confirmation bias.

                        I just thought this information might be interesting for those with an open mind. And for the rest, I don't mind being the catalyst for a little cognitive dissonance.

                        Comment


                        • Griff -- mind helping me interpret my numbers?

                          CHOLESTEROL 318
                          TRIGLYCERIDE 88
                          HDL CHOLESTEROL 34
                          CHOL/HDL 9.4
                          LDL CHOLESTEROL 266

                          Doc wants to put me on statins... of course.

                          Comment


                          • I already posted this on another thread (I know its bad forum manners but maybe somebody will get something out of this):

                            Ya wanna really freak...my stats: (8 months pastoral diet ala Kurt Harris)

                            TC 393
                            LDL-C 260
                            HDL 85
                            Tri 72
                            Solid Pattern A

                            Here is the really fun part:

                            CRP .1

                            Apparently my CRP is so radically low I am eligible to be included in studies of unusually low CRP...almost no trace of inflammation anywhere in my body.

                            So, my HDL is excellent; TG very good (could be a bit better), TG/HDL ratio superb, Pattern A, and my CRP says I should live to be a million. Also, I am 60 so even what associations there are with bad impacts of high TC/LDL start to become irrelevant as I move into the "elderly" category. I feel better than I ever have (migraines and IBS gone), have a ton of energy, and people constantly think I am 5-15 years younger than I am. Oh yeah, my BMI is 20.

                            Still, I gotta live with the emotional impact of having a TC of almost 400 and I can help it, it still bugs me and I never tell anybody...stupid but what can you do? Either I will live forever or I will keel over any minute.

                            If I don't post again within the next six months, assume that I am dead.

                            additional note:

                            Let me add to his here....Dr. Kurt Harris asks a relevant question which is if we don't believe in the "Diet-Heart Hypothesis" which are we all a bit obsessed (me included) about checking our cholesterol numbers? Seems to me we want it both ways- not to believe in the idea that cholesterol causes heart disease and to have either "normal" cholesterol or the magic factor de jour (particle size, particle number, hdl, whatever) that will make us exempt from any problems with high LDL. If we don't believe in the original premise, why can't we simply eat the way we believe is the best and forget the rest? Are any of us going to go back to a high carb, industrial seed oil, etc, etc-based diet as a result of a cholesterol test?

                            Dr. Harris suggests a one-time test (before going paleo, low carb, etc I presume) to check for familial hypercholestermia (which actually if it hasn't killed you by adulthood probably won't) and then to forget about it from then on. Excellent advice which I will try hard to follow and wish I actually had followed. Now I am stuck with the almost 400 TC in my mind which, on an emotional level, just sucks but I still think its kind of nuts to try and find this "trump card" to allow us not to have anxiety about the issue.

                            Another interesting question for me is given how many people who have been on low carb or paleo diet lifestyles, has anybody heard about somebody who developed sudden heart problems that were blamed on the diet? I would guess this would be big news in the nutrition world but I haven't come across such a case in over a year of researching these issues.

                            Comment


                            • after 2 months panu, results almost cloned from sgmiller:

                              TC 374
                              HDL 123
                              LDL235
                              TG 105

                              CRP 0.0 (repeat test: still 0.0)

                              (lipids can fluctuate a bit, two weeks earlier, it was TC 324, HDL 131, LDL184, TG 92)

                              (I wonder if apoB: 2.00 (.5-1.00) apoA1:2.41 (1.1-1.6) adds much to this picture beyond confirming it. A year ago it was ApoB 1.26, ApoA1: 1.95 on low cal low fat diet) Comments welcome!

                              Comment


                              • sorry, a misprint: "two weeks earlier, it was TC 324, HDL 121, LDL184, TG 92"

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