CHOLESTEROL and RELATED ISSUES

[cugila]

Just lately we have seen more and more discussion about how much Cholesterol is good or bad for you. Now there are many conflicting views about this and the discussion can sometimes get quite heated ! Hopefully we can talk about the subject here without anybody behaving like a TROLL or insulting other Members.

It's up to you folks.......keep it Civil, factual, and do please try and avoid talking in scientific Language if at all possible. Not everybody is a Chemist, Endocrinologist or a Scientist. Try to keep things as much as possible in laymans terms so everybody can understand.

If you quote anything, give the source of that quote and make sure it is clearly displayed as a quote with the source. If you are asked by a Monitor to produce a source for the quote and it is not provided we may well delete that post with no reference to the Member concerned on the board.
A Pm will be sent advising them of the reason.

So, if you have something to say about the subject........this is the place, not in other threads which then get totally derailed.

Forum Monitor's

[cugila]

Let us see information from Medical sources, reputable websites, research about the Western Diet. We don't need anecdotal evidence such as "my old Gran told me fat was good for me !" Let's hear something we can get our teeth into.

Here's a starter.......

Eating a lot of saturated fat can increase the cholesterol in your blood. High levels of cholesterol can increase your risk of:

• a heart attack,
• stroke, and
• narrowed arteries (atherosclerosis).
Cholesterol is a type of fat that your liver makes from the fatty food that you eat.

Is all fat bad for me ?
Your body needs small amounts of fat to help it work normally. However, some types of fat are healthier than others. There are two main types of fat in food:

• saturated fat, and
• unsaturated fat.
It’s a good idea to eat less saturated fat, to reduce the health risks linked with high cholesterol levels.

http://www.nhs.uk/chq/Pages/1124.aspx?C ... goryID=167

[Hobs]

I enjoy saturated fats like butter (I'm not men with it either) on my slice of wholemeal toast for my 2 fried eggs (no salt) and beef dripping to roast my 2 small quartered spuds in (again no salt) but I do not have furred up blood vessels according to my cardiologist and being that my latest C-test was 3.4 and my Hb1Ac was 6.1% I'm not about to change my life style. My very first C-teat some years ago was dead on 5 but was advised to consider a low dose statin which I did and still do take a 5mg tablet every 2nd day, mainly to comply and avoid a lecture about the right triglyceride balance
What I am prone to is a food related cardiac arrhythmia and have to watch out for MSG, but that is another subject.
There was a time when guide lines were different and I cut back on everything I was advised to, including all of the above, but since being told everything is now back on my menu I eat what I like and when I like but in moderation mainly to keep my weight in check.

Looking back over the years we have all been advised to cut out A and ease back on B while eating more C, but then as time progressed the advice was changed or modified which I'm sure confused more than just a few people.

[noblehead]

Well for what's its worth I am a great believer that diet plays a important role in maintaining good cholesterol numbers. My own method is to ensure that I eat foods high in fibre such as fruit and vegetables, pulses and wheat-bran, I also eat oily fish at least twice a week and take a cod liver oil supplement each and every day.

Twenty-plus years ago I was by my then gp that garlic was one of the best foods in maintaining good cholesterol levels and promoting cardiovascular health, so I often use garlic in my cooking and have taken a garlic supplement daily ever since.

I don't eat a lot of red meat or processed meats and cut back even more after reading the health risks and its association with cancer last year, but when I do I choose lean meats with the fat removed and also opt for low-fat diary every-time. The highest my cholesterol has been in recent years was 4.8, and at present it is 4.3 with good lipoprotein levels which pleases my gp.

I must stress that the above is only my own view and anyone contemplating changing their diet or taking supplements would do well to speak with their gp first.

Nigel

[ally5555]

it is an interesting thread .

Have you ever looked at the DRV for sat fat - 10% of calories should come from sat fat out of the 30-35% calorie from fat . The last review of DRV was done in 1991 - might be worth a read as it does give the current dietary guidelines - they were not thrown together!
Dietary reference Values for food , energy and nutients for the UK - 1991 - Dept of Health.

Some are being updated by the SACN meetings - they are reviewing several nutrients and have expert committes on most nutrients.

In practice what does this mean - you can eat 2-3 portions a day of protein - yes meat , fish, eggs, cheese plus milk. Plus the fat you get in butter / marg. My guess is that is what most of us eat in practice!

I think it is important that you realise that no one has said not to eat these foods daily - however the portion size is important.

The problem with sat fat is where it comes from - some people are consuming vast quantities from the junk that they eat - so yes it is a problem. What we need to do is look at where the sat fat is coming from.

There are also probelms with people who have a genetic hyperlididaemia - there are several of these and sat fat will be a consideration.

Ally

[robertconroy]

I've been really studying this topic for the last 11 years so here is my opinion from the many books, articles, and drug studies I've read:

60% of heart attacks are in people with normal or low choesterol. Something else must be at play here. The real culprit is silent inflamation, not cholesterol. Eating too much saturated fat can put you at higher risk for diabetes. Mortality by heart disease is shown to be somewhat (but just one factor) related to having too high cholesterol. There is also a mortality risk related to having too low cholesterol. Stress is actually more highly associated with heart attack. Drugs that lower cholesterol can put you at higher risk of other diseases and death.

Cholesterol is protective for every cell in your body and if it gets too low, below a certain point, it puts you at inversly higher risk for cancer. Anotherwords, the lower your cholesterol gets below that point, the higher risk you have of developing terminal cancer. Cholesterol lowering drugs (Statins) have shown to cause cancer in laboratory animals at the equivalent of a human prescription dose.

Statin drugs have never shown to reduce mortality. Fish oil is much more effective at protecting your heart, especially after having one heart attack. A lowfat diet does not prevent heart disease. In fact, eating lower fat may result in higher consumption of high glycemic carbohydrates, which can raise your risk of diabetes, stroke, heart attack, cancer, osteoporosis, obesity, hyperinsulemia, etc., etc. Researchers are now saying eat more protein, more fat, more fiber, and less complex carbohydrates that raises your insulin levels, and your blood sugar. High insulin levels causes all types of problems including insulin resistance (prediabetes), type II diabetes, metabolic syndome, and heart disease just to name a few.

Now when a person walks into a doctors office with a big tummy, rather than checking their cholesterol, the doctor should be checking their insulin levels. Which is currently hardly ever done.

[cugila]

UK medical circles viewpoint is somewhat different. This from HeartUK website about Statins. I could give you much anecdotal 'evidence' to support this but this all says it better than I.

The effectiveness of statins in decreasing heart attacks and prolonging life has been shown in research studies. A study was conducted in Scandinavia (known as the 4S study) that involved over 4000 men and women aged 50-70 years who had coronary heart disease (2). People were given either a statin drug or a placebo and the outcome was compared over five years. Results indicated that people receiving the statin notably lived longer and also showed a 37% reduction in their risk of undergoing angioplasty or coronary artery bypass surgery.

The 4S study has been closely followed by the WOSCOPS, CARE, LIPID and HPS studies that have all demonstrated reduced mortality and morbidity in people taking these drugs after - even before - a coronary event. Statins are now recommended for all patients with established coronary disease. And for those at high risk of developing heart disease (particularly those with diabetes, high blood pressure or a family history of premature death from heart disease) whose total cholesterol level exceeds 5 mmol/l and LDL cholesterol level is above 3mmol/l.

http://www.heartuk.org.uk/images/upload ... tatins.pdf

[Patch]

I've just come back from an appointment at the Lipid Clinic at my hospital - picked up a couple of interesting points. These came directly from the Dr. - not from a dietition or a diabeties specialist nurse:

1) Around 2/3 of the Cholesterol (LDL/HDL) in your system is created BY your system. Only 1/3 of it comes from the food you eat.

2) Triglycerides come directly from the food you eat - but it is very common for people to have a genetic disposition to elevated triglycerides.

Point 1) was very interesting to me - I'd always known that a lot of the cholesterol in your system was created by the system, but I didn't know it was as high as 2/3 of the total cholesterol. So,theoretically, a person with a TC level of 6, can realistically only reduce it to 4 by diet modification only.

[ally5555]

Sounds like one of my consultations patch - exactly what I discuss.

TG are an interesting one - studies from years ago showed that they were effected by refined carbs and alcohol and you usually see a dramatic reduction in most people by reducing these! a dietary analysis of many pts does show a diet high in sugar and fat ( the bad stuff!)

One imporatnt point about the TG is that they must be done on a fasting level - I always check with pts that they are!

If you use a porfolio approach that also uses steols you can get a 30% reduction - virtually the same as a statin.

Allyx

[Froobes]

What would every determine to be good/normal/okay Cholestrol levels? Mine's at 5.3 at the moment so could be better! Although the Diabetic Nurse and Diabetic Doctor have very different opinions on statins, the Doctor saying I absolutely do not need them and the Nurse the opposite

[cugila]

Here is a link to Cholesterol information from the NHS.

http://www.nhs.uk/conditions/Cholestero ... ction.aspx

The government recommends that cholesterol levels should be less than 5mmol/L.

In the UK, two out of three adults have a total cholesterol level of 5mmol/L or above. On average, men in England have a cholesterol level of 5.5mmol/L and women have a level of 5.6mmol/L.

The UK population has one of the highest average cholesterol concentrations in the world.

You also need to consider all the other risk factors......it isn't just about Diabetes......

High cholesterol levels are as serious as high blood pressure, whether you are diabetic or non-diabetic.

http://www.diabetes.co.uk/Diabetes-and-cholesterol.html

There are those who think those sort of higher levels are fine, you will often read about 'The Great Cholesterol Con' or similar........your choice if you believe it all, bearing in mind the Author is trying to sell books ! Anything that is controversial is a good way to make money.

Me personally I have a TC level of 3.2, all other levels HDL/LDL etc are all within targets.......my choice.

As for Statin's there are those that say they are evil, have had major problems with at least one of them, usually Simvastatin, the cheapest of them all.....then there are those that say they are good, I am in the latter camp. Once I found a Statin that did not have any side effects all the problems I had on Simvastatin disappeared like magic. Only problem is that the one I am now on is £30+ per 28 days as opposed to Simvastatin at around couple of pounds for 28 days ! Cost has a huge bearing on what you get prescribed sometimes.

There is also the Statin Questions and Answers thread in Diabetes Medication and Drugs section

[Elc1112]

Hi froobes,

The national average is around 5.5-5.6. This is above the recommended level. The recommended level is 5.0 total cholesterol with 3.0 LDL (bad cholesterol). More and more doctors are now saying that you should aim for 4.0 with an LDL of 2.0 or less. I have always been told that, being diabetic, it is better to aim for 4.0/2.0.

This can be difficult to achieve for a lot of people. Your levels are good, but you may be able to lower it further by making a few simple changes.

It is a bit confusing as different health care professionals so seem to quote slightly different figures. My last reading was 4.2 and one doctor told me I had to get it down, another told me it was an excellent level!

E

[anniep]

As I understand it the reccomemned cholesterol levels are lower for people who are diabetic.

I had a normal level until I was diagnosed, and then my doctor said it was too high! It is becasue of problems that diabetics can get with cardio vascular events, and so it is reccomemded that our cholesterol is lower, than peopel with normal BG.

Just more of the unfairness ot this dratted disease.

[viviennem]

This is one of those subjects that needs a lot of research and then make your own mind up - only my opinion, of course

I always ask for a print-out of the breakdown of my cholesterol tests. The figures I work towards, which I must have picked up from somewhere (NICE?) in 2004, are as follows:

Total cholesterol target: below 5.18
HDL (good) target: above 1.04
Triglycerides (the real baddies) target: below 1.7 and the lower the better
LDL (bad) less than 3
Total cholesterol:HDL ratio: 4.5 or lower

My best-ever results were after 18 months on the Atkins diet and lots of Wolfhound-walking, which were as follows:

Total: 5.4
HDL: 1.65
Triglycerides: 0.65
LDL wasn't calculated, or at least, I don't have the figure. Must ask.
Total:HDL ratio: 3.3

So even though my total cholesterol would have been considered too high, my HDL and triclycerides were excellent! Also my total:HDL ratio.

Incidentally, all my readings were worse on statins than on Atkins - leaving aside the side-effects of the statins. Also, my latest total reading was the lowest I've ever had - 5.0 - but all the others were heading towards the wrong side of the target range. Can anyone explain that, please?

Actually, I can, when I think about it - my levels WERE coming down, all except triglycerides, which get released into the blood as the system begins to burn fat for energy (ketosis). My next triclycerides should be lower.

I sometimes wonder whether the figures that associate diabetes with higher cardio-vascular risk aren't really telling us something about the life-styles of the badly controlled diabetics who died of heart disease? Statistics again - based on a few decades of results, going backwards in time. Things have improved since then, I hope and trust! If we control our blood glucose levels, eat a good diet and keep active, are we really at more risk of CVD than anyone else?

I would recommend to anyone to take a bit of time to read around on all sides of the argument, and do what you feel is best - paying due attention to what your HCP is saying.

Viv

[janeislay]

I don't think the people writing books like the "Cholesterol Con" and several others, are doing it for money - having corresponded with a number of them. They sincerely want to get the facts out and to help people keep healthy. They know, as I do, that pharmaceutical companies conduct much of the research (or pay scientists to do so) and only publish the bits that help THEM sell their drugs.

Did you know that drug companies used to pay newspapers for "reprints" in return for that newspaper not pubishing anything untoward about statins ?

If you're really interested in fats and cholesterol, go to the THINCS website (The International Network of Cholesterol Skeptics) at http://www.thincs.org

I've been diagnosed Type 2 for eight years, have an overall cholesterol level of over 10. I had peripheral artery disease and have heart failure, apparently, but have never felt better and have absolutely no symptoms whatever - thanks largely to my high fat diet

(And by the way, statins cause muscle degeneration in many people. Your heart is a muscle; hence heart failure.) They also cause depression, impotence, memory loss and much more - but don't let me put you off