We got our VAP results-good m page

[Momto3]

Good news and bad news

My results of being primal for 4 months were great!
TC 215
LDL 134
HDL 69
VLDL 13
TG 59
LDL+VLDL 147
apoB100 93
LDL-R 117 *
Lp (a) 12 *
IDL 5
IDL + VLDL3 13
HDL-2 15
HDL-3 53
VLDL-3 8
LDL Density Pattern A

Very happy with this!

My husband-not good news
We have been eating the same. Strict primal, regular primal exercise...

His results:

* means high

LDL 239 *
HDL 55
VLDL 22 *
Total C 317*
Triglyceride 99
LDL+vldl 261*
Apob100 175*
LDL-r 226*
lp(a) 0.0
Idl 13
Idl+ vldl3 25
Hdl-2 12
Hdl-3 43
Vldl-3 12*
LDL density pattern B

His grandfathers on both sides died of heart attack or heart issues. Uncles on both sides have had heart attacks, his dad is currently battling high cholesterol, high blood pressure.
My husband is ReadyToGrok if you want to look at his journal
Right now our plan is to add on Coqu10 maybe niacin? Please comment. If you have family history of heart disease is primal diet not right? We don't want to go back to grains. What do we do?

[Mollymoe]

I'm not an expert but thought I'd bump to allow people who know what they are talking about to advise.

One thing I would ask is do you have any previous numbers to compare these to? Is it possible that although your husband's numbers may not look that great they are actually an improvement on what he had before?

You might also want to take a look at Griff's thread on cholesterol - http://www.marksdailyapple.com/forum...mer-(Attempt-2

[john_e_turner_ii]

Wow, this has me scared to see my NMR results I am waiting on. You can modify the PB diet and still not eat grains to accomplish your goals. I would think reducing the saturated fats might help. However, first look at the carb intake. Is your husband eating a lot of carbs, even though they are primal?

Coqu10 is not a bad idea, so start that as well. What about Vitamin D levels? Fish oil?

[Momto3]

Here are his past numbers:
4/30/09 6/6/10 10/4/10
TC 267 229 305
TRI 125 100 102
HDL 53 44 55
LDL 189 165 230

TC/HDL 5.03 5.2 5.55
TRI/HDL 2.36 2.27 1.85
LDL/HDL 3.57 3.0 4.18

At age 28 (10 years ago) he was diagnosed with high cholesterol. we tried the low fat, whole grain diet plus exercise, but that didn't have effect. So he started on a very low dose of statins. It brought the numbers into the "normal" range. We don't have the data about the ratios though. fast forward to April 2009. He had run out of statins and was off of them for awhile. Got cholesterol tested....put back on statins.June 2010 was on statins and right before going off of them and starting PB. Oct 2010 is after 4 months of strict primal. Supplements include fish oil, vitamin D, vit a min E, multi and probiotics. We have fully embraced the primal lifestyle. He is 6' 180lbs so not grossly overweight. He has 20% body fat.

We are starting to look into genetic small LDL as Dr. Davis talks about on his Heart Scan Blog. He will start the CoQu10 and I think we'll pick up ome niacin.

Please, please, if you have history of heart disease in your family, don't rely on the TG/HDL ratio. ReadyToGrok's ratios have been fine .....but the VAP shows a different story.

[Momto3]

[QUOTE=john_e_turner_ii;236341]Wow, this has me scared to see my NMR results I am waiting on.[QUOTE] Do you have history of heart disease in your family? I hope your numbers are great....like mine were. We have been eating essentially the same thing. Maybe he hasn't eaten as much nuts as me....but he's been even more strict with sugar than I have. I think there is something genetic going on. We plan to give this another 3 months and retest to see how he's doing. With a grandfather dying at age 45 from heart attack and all the other family history, we just don't want to play around with it for too long...and yet we are not a believer in statins.....we have really like the PB. If we cut the saturated fat we risk him not making enough HDL.....maybe cut back on saturated fat and load up on olive oil and nut oil???

[piano-doctor-lady]

In your place, I'd be sure his Vitamin D status is good, and especially magnesium. He could use "magnesium oil", a brine which you rub on your skin. It absorbs more easily than by mouth, and avoids gut problems which magnesium often causes.

He should take ubiquinol, which is a more usable form of CoQ10, and he should take a lot of it, since statins work against it. Statins are such bad news!

[cillakat]

LDL 239 *
Apob100 175*

Davis:
http://heartscanblog.blogspot.com/20...glycation.html

Younis et al have documented an extraordinary variation in glycatability between large and small LDL, with small LDL showing an 8-fold increased potential.

It may be interesting to buy a cheap blood sugar monitor and see how his post prandial blood sugars are. It'll be in everyone's best interest to be sure that Apob isn't glycating.


Davis on testing post prandial blood glucose:
http://heartscanblog.blogspot.com/20...ur-finger.html

Regarding his lp(a) - lipoprotein a - status:
This, at least, is good news.
http://heartscanblog.blogspot.com/20...y-to-your.html

If you have lipoprotein(a), Lp(a) ....
Lp(a) is a "cleanly" inherited genetic pattern: If either parent has it, there's a 50% chance that you have it. If you have it, then there's a 50% likelihood that each of your children has it...
The atherogenicity (plaque-causing potential) of Lp(a) also tends to get transmitted. In other words, if your Dad had a heart attack at age 50 due to Lp(a) and you share Lp(a), then you likely share a similar magnitude of risk as your Dad. If your Mom had Lp(a), though passed quietly at age 89 without any overt evidence of heart disease, then you are likely to share the relatively benign form of Lp(a).

For most of us with Lp(a), however, it is best to assume that it has at least some potential for causing heart disease, being the most aggressive cause known. (That is, until we have the ability in everyday clinical practice to characterize Lp(a) by assessing such factors as the size of the apoprotein(a) molecule, the number of kringle "repeats" on the tail, etc. Until then, we need to rely on the crude, though helpful, observation of family history.)

Regarding the rest:

He really needs to shed the excess weight. For him, it's very important.
Tweaking his fat/protein/cal ratios might also not be a bad idea.

http://heartscanblog.blogspot.com/20...r-dummies.html

To raise HDL powerfully--not to 40 mg/dl for males or 50 mg/dl for females, but to 60, 70 or 80 mg/dl--think about the following strategies:

--Eliminate wheat and cornstarch products. I have droned on endlessly about this concept, but it is enormously effective. While the weight loss that inevitably follows elimination of these foods adds to the HDL-raising effect, there is also an independent effect, as well.

--Fish oil--The omega-3 fatty acids in fish oil reduce triglycerides. Triglycerides accelerate the destruction of HDL. Remove triglycerides, HDL goes up. (Though krill oil may share, even surpass this effect, we need more data than the single manufacturer-sponsored study.) Of course, this requires real doses, not the namby-pamby doses you often read about.

--Vitamin D--Achieving normal levels of 25(OH) vitamin D raises HDL with power I have never witnessed from any other strategy before, barring weight loss of 30+ lbs. Readers of the Heart Scan Blog know that just taking vitamin D is not enough. Verification with blood levels is an absolute necessity, particularly if raising HDL maximally is among your goals.

--Adding back saturated fat. I say "adding back" since most of us (including myself) went too far down the "saturated fat is bad" path over the past few years. While I do not advocate a carte blanche approach to saturated fat, I believe that adding back eggs (preferably free-range and/or omega-3 rich), lean meats, and hard cheeses is a good idea. The saturated fat in these foods raise HDL 5 or more mg/dl.

--Dark chocolate--Or other cocoa prepartions. What a cool way to raise HDL! Reach for the lowest-sugar, highest cocoa preparations.

--Alcoholic beverages--I am partial to the red wine/flavonoid-rich concept, being a wine drinker. Although all alcoholic beverages raise HDL due to the ethanol content, for benefits beyond alcohol (as well as to avoid wheat-based drinks like beer), I do believe that the bulk of data argue for flavonoid-rich red wines from southern France, Italy, and California.

--Achieve ideal weight--

Davis on complex familial hyperlipidemias:
http://heartscanblog.blogspot.com/20...d-and-hdl.html

At first, I thought it was attributable to other factors. In real life, most people don't modify one factor at a time.

They reduce
processed carbohydrates/eliminate wheat and cornstarch
lose weight
add or increase omega-3 fatty acids from fish oil
begin niacin
increase exercise and physical activity

All these efforts also impact on HDL.

Among the many things I do, I consult on complex lipid (cholesterol) disorders (complex hyperlipidemias) in my office. A substantial number of these people carry a diagnosis of hypoalphalipoproteinemia, a mouthful that simply means these people are unable to manufacture much apoprotein A1, the principal protein of HDL cholesterol particles. As a result, people with hypoalphalipoproteinemia have HDL cholesterol levels in the neighborhood of 20-30 mg/dl--very low. They are also at high risk for heart disease and stroke.

Encourage these people to exercise, attain ideal weight, eliminate wheat and cornstarch: HDL increases 5 mg/dl or so.

Add niacin, HDL increases another 5-10 mg/dl.

Perhaps we're now sitting somewhere around an HDL of 35-40 mg/dl--better, but hardly great.

Add vitamin D to achieve our target serum level . . . HDL jumps to 50, 60, 70, even 90 mg/dl.

The first few times this occurred, I thought it was an error or fluke. But now that I've witnessed this effect many dozens of time, I am convinced that it is real. Just today, I saw a 40-year old man whose starting HDL was 25 mg/dl increase to 87 mg/dl.

Responses like this are supposed to be impossible. Before vitamin D, I had never witnessed increases of this magnitude.

How much D is he taking? Why the E? What kind of multi? Can you send me links for what he's taking? When are supps being taken?

Even though he's already taking fish oil, I'd track diet for a few days to assess his Ω3:Ω6 ratio and supplement as needed to bring ratios to 1:1.

On triglycerides - nothing new but to have it all in one spot:
http://heartscanblog.blogspot.com/20...de-buster.html

wrt Pattern B - modifying small LDL, it doesn't sound like there is anything revolutinary yet. It sounds to me like Davis is saying once you achieve an ideal weight/body fat, exercise, have eliminated grains/sugar, are taking niacin, have optimal D levels that small LDL pretty much just 'is what it is'. At this point, from what he's saying, it doesn't even appear to be of benefit to take statins if this is the only remaining issue....though currently, it's not his only issue

Contrary to the response, LDL particle size assays are quite reliable and accurate. I've performed many thousands of lipoprotein assays and they yield reproducible and clinically believable results. For example, eliminate wheat, oats, cornstarch, and sugars and small LDL drops from 2400 nmol/L to 893 nmol/L (NMR)--huge drops. If repeated within a short period of time, the second measure will correspond quite closely.

The data are also quite clear: Small LDL particles (i.e., "pattern B") are a potent predictor of cardiovascular events. What we lack are the treatment trials that show that reduction of small LDL results in reduced cardiovascular events. The reason for this is that small LDL research is not well-funded, since there is no prescription drug to treat small LDL, only nutritional means. Niacin (as Niaspan) is as close as it comes for a "drug" to reduce small LDL. But diet is far more effective.

Given the questioner's fairly favorable BMI of 25.1 and his history of aggressive heart disease, it is virtually certain that he has what I call "genetic small LDL," i.e., small LDL that occur on a genetically-determined basis (likely due to variants of the cholesteryl-ester transfer protein, or CETP, or of hepatic lipase and others).

Ignoring this man's small LDL will, without a doubt, consign him to a future of more heart attacks, stents, and bypass. Maybe by that time the data supporting the treatment of small LDL will become available.

[cillakat]

2nd PDL's recommendations for Niacin, CoQ10, and mag. The Q10 won't affect numbers but is still protective.

Here is my google bookmark list of magnesium posts - a bunch by pdl, me and more. There is info on the kind of mag I use and magnesium oil. Fwiw, the Jigsaw Health doesn't cause digestive distress like other forms can. Yay!
http://goo.gl/lists/HwSn

I haven't tried mag oil yet but I keep meaning to.

[cillakat]

Here is Davis' post on Niacin v. Niacinamide. It matters a great deal for heart health:
http://heartscanblog.blogspot.com/20...cin-scams.html

Magnesium:
http://www.jigsawhealth.com/supplements/magnesium

CoQ10:
Jarrow Formulas, QH-absorb, 200 mg, 30 Softgels$34.97


When possible, I buy my supps at iherb.com. No one beats them for cost, shipping speed or customer service. Even when vitacost or luckyvitamin looks like they have a lower price, the total is always less at iherb.com due to an additional 10% off that comes at checkout.

Best,
Katherine

[Momto3]

Wow! THANK YOU, Katherine. I will be reading through all that you posted. Thank you.