Chris Masterjohn on Cholesterol page 2

[Artbuc]

"It's called math."

Hey wise guy, I would wager I have forgotten more about math than you will ever know. If you read my post, you would understand my point that HDL-C is very difficult to change whereas TC can be changed dramatically with statins.

"Never was mentioned 5 is better than 3."

Griff's primer, which is what I referred to, says 5 is "ideal". Masterjohn says 3 should be the target. I am just guessing here, but if Chris Masterjohn thought 5 was better than 3 he probably would have said so. My question remains, does 3 represent a lower risk of CVD than 5? If yes, I would say 5 is NOT ideal.

[Dirlot]

It is a numbers game designed to get HDL up, TG down and LDL big and fluffy. A ratio of 5:1 is good start, 3:1 should be better because it indicates a higher amount HDL in the blood.

[Artbuc]

Why do you think your TG are up?

I said I am guessing my TC is up because I have dramatically increased dietary saturated fat. My assumption is, based on the experiences of others, that my TC is up disproportionately compared to my HDL-C, ie my TC/HDL-C ratio is now quite possibly much higher than 5. Now, if 5 really is ideal as Griff says, maybe no problem. But it I should be shooting for 3, I am concerned.

[Artbuc]

Here we go. I listened to this a couple months ago and had not recalled how detailed it was in the discussion of TC/HDL-C ratio. Masterjohn sees atherosclerosis as a leptin signaling/thyroid function/LDL receptor issue whereby LDL stays in the bloodstream too long and starts to oxidize. He does not believe increasing or decreasing the ratio is necessarily good or bad.

http://chriskresser.com/the-healthy-...ast-episode-11

[magicmerl]

That's not entirely true. Jimmy moore has a large particle size yet his LDL-P is sky high. Granted he is following a very extreme diet with this "nutritional ketosis". I read Dayspring saying he may have to cut right back on his saturated fat content if things don't change.

Right, so for the corner cases of people on 'extreme' diets, I don't think that the science is definitive with regards to discordant LDL-C and LDL-P. Peter Attia definitely thinks that LDL-P is the cause, but I am still agnostic. Given the underlying mechanism (small particles passing through the arterial wall that would normally not be able to fit between the gaps if they are normally sized, or large and puffy) I think that it's premature to write off small LDL particle size as being a factor in CVD.

And LDL particle size is definitely something we know we can influence, by decreasing our Trig/HDL ratio.

I have read your primer but not recently.

Thanks, but I didn't write the primer. Griff did.

I will re-read it today. How can you say CW is wrong to drive down TC if you agree that the ratio of TC/HDL-C is the best predictor of CVD?

I don't think that TC/HDL is the best predictor of CVD. I think that the RATIOS are the key metrics to look at, not the absolute values. So it's ok for you TC to go up as long as your TC/HDL ratio goes in the right direction. Basically, TC is irrelevant as an isolated variable. It's the ratio that counts. And actually, I think that Trig/HDL is really the most important ratio to focus on.

There isn't very much you can do to increase HDL-C but you can take statins to substantially reduce TC.

Yes there is. Eat animal fats, particularly dairy. That will increase your HDL. And since HDL is the denominator in all three ratios, increasing HDL makes ALL of your ratios better.

Also, I think it is wrong to tell people to eat as much dietary cholesterol as they want because only 15% gets absorbed (unless you are a hyper-absorber). If you already have a TC/HDL-C ratio of 5, adding more dietary cholesterol doesn't seem like a very good idea.

You seem to think that Cholesterol is bad. It isn't. Cholesterol is very very good and is vital to our bodily functions. Oxidised particles in our arteries are likely to cause inflammation and from there, CVD. THAT is what you should focus on if you want to prevent heart attacks.

I agree that Peter Attia is just reguritating stuff he has read on the Internet. However, lipidologists like Dayspring, Cromwell and Dall seem like very well educated people with outstanding professional credentials and positions. I don't trust Chris Kresser especially since he just starting marketing his $149 cholesterol action plan.

I agree with you that it's a good idea to be suspicious of people who are very earnest about selling you things. But I have a lot of respect for Chris Kresser and the freely available articles of his I've read I thought were excellent. I'd be astonished if his paywall content was junk given the high quality of his free content.

Please explain why you say the desired TC/HDL-C ratio is 5 whereas CM says 3. That is a big difference! Thanks.

By 'you', I presume you mean Griff's primer? I would guess that both he and CM are basing it off recent research, although the primer is probably a bit more dated than CM. But really, the takeaway is that you want the ratio to be lower rather than higher. So you eat in a way that will lower the ratio.

I said I am guessing my TC is up because I have dramatically increased dietary saturated fat. My assumption is, based on the experiences of others, that my TC is up disproportionately compared to my HDL-C

I'm not sure that that is a reasonable assumption to make. Because saturated fats also increases HDL as well. If you are worried about it, why not get a test done? Then you will know what your ratios are.

[peril]

"It's called math."

Hey wise guy, I would wager I have forgotten more about math than you will ever know. If you read my post, you would understand my point that HDL-C is very difficult to change whereas TC can be changed dramatically with statins.

"Never was mentioned 5 is better than 3."

Griff's primer, which is what I referred to, says 5 is "ideal". Masterjohn says 3 should be the target. I am just guessing here, but if Chris Masterjohn thought 5 was better than 3 he probably would have said so. My question remains, does 3 represent a lower risk of CVD than 5? If yes, I would say 5 is NOT ideal.

HDL is not difficult to increase. Increased consumption of saturated fats will drive up both HDL and TC, with a reduction in the TC/HDL ratio. (LDL will also increase and TG decrease markedly if reducing carbs but the HDL increase will more than cancel the influence of the LDL increase on the ratio). As a maths savant I'm sure you can work this out.

Low TC is associated with increased death from cancer, increased mental illness, increased injury and death from violence, ... It is also associated with chronic infection - see Paul Jaminet's blog for more on this

[Dirlot]

I said I am guessing my TC is up because I have dramatically increased dietary saturated fat. My assumption is, based on the experiences of others, that my TC is up disproportionately compared to my HDL-C, ie my TC/HDL-C ratio is now quite possibly much higher than 5. Now, if 5 really is ideal as Griff says, maybe no problem. But it I should be shooting for 3, I am concerned.

I have been Primal over a year, I eat fish, grass fed meat, vegetables, I cook with butter, coconut oil and lard. I eat a three egg cheese omelette every morning with 2 pieces of bacon. I don't have per-primal numbers but my recent test had
TC 172.9
Tri 57
HDL 78
LDL 83 Framingham
LDL 66 Iranian
Low Tri High HDL, my numbers are good even by CW standards and my TC/HDL-C = 2.2

If you are worried get tested.

[Annika]

I have the same lipid pattern as Jimmy Moore: high TC (304), high HDL (95), high LDL (209), high LDL-P (in my cape, apo-B was tested which correlates well with LDL-P), and very low triglycerides (23). All my ratios indicate I'm at the very lowest risk, but my apo-B of 163 says I'm at very high risk! Dr. Dayspring has gotten me a bit freaked out, and the wildly divergent numbers have me quite confused. I started taking kelp tablets (iodine) to boost my thyroid function - the minimal thyroid testing I had was normal, but I think I may have a mild subclinical hypothyroidism. I'm going to eventually get an NMR test. There seem to be quite a lot of people in the paleo community with very similar lipid profile - I'm looking forward to more solid information about it. It seems to be a rapidly evolving science with lots of disagreement.

[Artbuc]

I have the same lipid pattern as Jimmy Moore: high TC (304), high HDL (95), high LDL (209), high LDL-P (in my cape, apo-B was tested which correlates well with LDL-P), and very low triglycerides (23). All my ratios indicate I'm at the very lowest risk, but my apo-B of 163 says I'm at very high risk! Dr. Dayspring has gotten me a bit freaked out, and the wildly divergent numbers have me quite confused. I started taking kelp tablets (iodine) to boost my thyroid function - the minimal thyroid testing I had was normal, but I think I may have a mild subclinical hypothyroidism. I'm going to eventually get an NMR test. There seem to be quite a lot of people in the paleo community with very similar lipid profile - I'm looking forward to more solid information about it. It seems to be a rapidly evolving science with lots of disagreement.

If you supplement with iodine, make sure you also take the right amount of selenium. Masterjohn and Kresser talk about this.

[Artbuc]

As a maths savant I'm sure you can work this out.

I appreciate your help but this comment was uncalled for. My " math" comment was a response to an incredibly condescending remark from another poster.