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    Chris Masterjohn on Cholesterol

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    I just came across this interview with Jimmy Moore:

    6: All Things Lipids (Cholesterol 101) | Chris Masterjohn | Jimmy Moore Presents: Ask The Low-Carb Experts

    About 15 mins in CM says the best predictor of CVD is the ratio of TC to HDL-C. He does not believe enough work has been done to standardize LDL particle size testing and does not even mention LDL-P. I was flabbergasted to hear this after listening to pre-eminent folks like Thomas Dayspring, Lara Dall and Peter Attiia make strong and unequivocal assertions that the only number that matters is LDL-P. The TC/HDL-C ratio has been around for decades and CM says the target should be 3 which is also a very CW notion. So, after throwing so many stones at my doctor and many others I perceived to be stuck in obsolete thinking about cholesterol, CM is saying that CW is still the best, at least as far as CVD risk factors are concerned. CM goes on to say that trig numbers do not add any additional info to the TC/HDL-C ratio although they may be helpful in identifying IGT.

    This scares the crap out of me because my ratio was 5 before I started a VLC, high saturated fat diet. My primary objective is to control BG but I bet my TC is up substantially which, according to CM, means my risk of CVD is also up substantially.

    Do you think Chris Masterjohn has more cred than Attia, Dayspring and Dall?

    How can so many lipid experts be all hyped up about LDL particle size and particle count when someone like Masterjohn says the standard lipid profile and conventional TC/HDL-C ratio is the only thing that matters?

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    masterjohn is one of the brightest and best for this stuff, and is an actual scientist and researcher, unlike many of the bloviating web types. check his blog cholesterol and health, and all his writing for weston price. the interview above may be out of date, i've not listened to it, but his take on LDL particle size is absolutely correct, and i believe that mark has acknowledged as much on his blog.

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    Quote Originally Posted by Artbuc View Post
    I just came across this interview with Jimmy Moore:

    6: All Things Lipids (Cholesterol 101) | Chris Masterjohn | Jimmy Moore Presents: Ask The Low-Carb Experts

    About 15 mins in CM says the best predictor of CVD is the ratio of TC to HDL-C.
    Yep.

    Quote Originally Posted by Artbuc View Post
    He does not believe enough work has been done to standardize LDL particle size testing and does not even mention LDL-P.
    LDP-P is kinda related to LDL particle size. If all your LDL is the large puffy good kind, then your LDL-P will be low. Put another way, the at risk people are the people with the small, dense, oxidised LDL. And they have to have a correspondingly larger LDL-P.

    Quote Originally Posted by Artbuc View Post
    I was flabbergasted to hear this after listening to pre-eminent folks like Thomas Dayspring, Lara Dall and Peter Attiia make strong and unequivocal assertions that the only number that matters is LDL-P.
    The question is, what's the science behind the LDL-P stuff? As far as I know, there's only one (unreproduced) study that shows that LDL-P matters irregardless of LDL particle size.

    Quote Originally Posted by Artbuc View Post
    The TC/HDL-C ratio has been around for decades and CM says the target should be 3 which is also a very CW notion. So, after throwing so many stones at my doctor and many others I perceived to be stuck in obsolete thinking about cholesterol, CM is saying that CW is still the best, at least as far as CVD risk factors are concerned.
    Absolutely, 100% not. CW is completely wrong with it's misplaced focus on lowering total cholesterol and LDL.

    CW says that Total Cholesterol is bad, and should be as low as possible. This is rubbish. CW says that LDL should be as low as possible. This also is rubbish. CW says Trigs should be low. This is TRUE. CW says HDL should be high. This is true also.

    The concept of TC/HDL, Trig/HDL and LDL/HDL are mainstream markers (or at least they are becoming so).

    Quote Originally Posted by Artbuc View Post
    CM goes on to say that trig numbers do not add any additional info to the TC/HDL-C ratio although they may be helpful in identifying IGT.

    This scares the crap out of me because my ratio was 5 before I started a VLC, high saturated fat diet. My primary objective is to control BG but I bet my TC is up substantially which, according to CM, means my risk of CVD is also up substantially.
    No, only the ratio. Please read through the primer in my sig if you havn't seen it before.

    Quote Originally Posted by Artbuc View Post
    Do you think Chris Masterjohn has more cred than Attia, Dayspring and Dall?
    Every day of the week and twice on Sundays.

    Quote Originally Posted by Artbuc View Post
    How can so many lipid experts be all hyped up about LDL particle size and particle count when someone like Masterjohn says the standard lipid profile and conventional TC/HDL-C ratio is the only thing that matters?
    Because the LDL-P stuff is 'breaking news'. When subsequent studies are done, they might fail to reproduce the previous study, in which case LDL-P will quietly shivel up in the corner. Or they might reproduce it and show the effect is dependant on LDL particle size. Or they might confirm the effect as being independant of particle size. In which case Attia et al's viewpoint will become the consensus one.
    Last edited by magicmerl; 11-08-2012 at 04:29 PM.
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    Quote Originally Posted by magicmerl View Post
    Yep.


    LDP-P is kinda related to LDL particle size. If all your LDL is the large puffy good kind, then your LDL-P will be low. Put another way, the at risk people are the people with the small, dense, oxidised LDL. And they have to have a correspondingly larger LDL-P.

    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.

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    Quote Originally Posted by magicmerl View Post
    Absolutely, 100% not. CW is completely wrong with it's misplaced focus on lowering total cholesterol and LDL. CW says that Total Cholesterol is bad, and should be as low as possible. This is rubbish. CW says that LDL should be as low as possible. This also is rubbish. CW says Trigs should be low. This is TRUE. CW says HDL should be high. This is true also. The concept of TC/HDL, Trig/HDL and LDL/HDL are mainstream markers (or at least they are becoming so). No, only the ratio. Please read through the primer in my sig if you havn't seen it before.
    I have read your primer but not recently. 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? There isn't very much you can do to increase HDL-C but you can take statins to substantially reduce TC. 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. 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.

    Please explain why you say the desired TC/HDL-C ratio is 5 whereas CM says 3. That is a big difference! Thanks.
    Last edited by Artbuc; 11-09-2012 at 02:12 AM.

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    Quote Originally Posted by Artbuc View Post
    Please explain why you say the desired TC/HDL-C ratio is 5 whereas CM says 3. That is a big difference! Thanks.
    I found this link which may answer my question - it is a matter of risk.

    Blood Cholesterol

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    What is CM, triglycerides?

    Quote Originally Posted by Artbuc View Post
    I just came across this interview with Jimmy Moore:

    6: All Things Lipids (Cholesterol 101) | Chris Masterjohn | Jimmy Moore Presents: Ask The Low-Carb Experts

    About 15 mins in CM says the best predictor of CVD is the ratio of TC to HDL-C. He does not believe enough work has been done to standardize LDL particle size testing and does not even mention LDL-P. I was flabbergasted to hear this after listening to pre-eminent folks like Thomas Dayspring, Lara Dall and Peter Attiia make strong and unequivocal assertions that the only number that matters is LDL-P. The TC/HDL-C ratio has been around for decades and CM says the target should be 3 which is also a very CW notion. So, after throwing so many stones at my doctor and many others I perceived to be stuck in obsolete thinking about cholesterol, CM is saying that CW is still the best, at least as far as CVD risk factors are concerned. CM goes on to say that trig numbers do not add any additional info to the TC/HDL-C ratio although they may be helpful in identifying IGT.

    This scares the crap out of me because my ratio was 5 before I started a VLC, high saturated fat diet. My primary objective is to control BG but I bet my TC is up substantially which, according to CM, means my risk of CVD is also up substantially.

    Do you think Chris Masterjohn has more cred than Attia, Dayspring and Dall?

    How can so many lipid experts be all hyped up about LDL particle size and particle count when someone like Masterjohn says the standard lipid profile and conventional TC/HDL-C ratio is the only thing that matters?
    An optimist is someone who falls off the Empire State Building, and after 50 floors says, 'So far so good!'
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    CM =Chris Masterjohn

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    Why do you think your TG are up?
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    Quote Originally Posted by Artbuc View Post
    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?

    It's called math.

    If; TC=180 HDL=60

    180/60 = 3

    but; TC=250 HDL=100

    250/100 = 2.5

    So if your ratios are good then TC should not matter.


    Quote Originally Posted by Artbuc View Post
    Please explain why you say the desired TC/HDL-C ratio is 5 whereas CM says 3. That is a big difference! Thanks.
    Never was mentioned 5 is better than 3. It was mentioned that ratios matter more than the perception of "high" TC (see above as to why) In other words if you have a "high" TC of 250 your doc may want you on statins even though your ratios may be better that the CW of 3. Which we think is BS since people die of CVD even with low TC. This is why ratios are used. I think that is the point CM is trying to get across.

    Looking at the role of cholesteral plays I would say having high TC but a good ratio means your body is healing or has the capacity to heal rather than a degenerative state presented by a higher ratio.
    Last edited by chima_p; 11-11-2012 at 07:42 AM.

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