Cholesterol

[CrazyCatLady2693]

I bought some Benecol and some of Tesco's cholesterol reducing yoghurt drinks because my cholesterol is borderline high.. My doctor didn't want to try statins yet because I'm on a lot of other medication for various conditions. I agreed and I thought I'll give Benecol/yoghurt drinks a go as it can't hurt.. but I've just had a thought - do they lower all cholesterol including the 'good'/HDL? Because that's been under 1mmol/L for years.. LDL/'bad' was at 4.35mmol/L last time it was checked so it's not abysmal but I thought getting these products would be productive, but now I'm wondering if I've shot myself in the foot here and it could lower my HDL even more.. if anyone has any wisdom to share on this topic I'd really appreciate it!

 

[HairySmurf]

No the plant sterols in Benecol and similar won't significantly effect your HDL levels. Plant sterols work by 'jamming' the pathways through which cholesterol is absorbed from the intestine. Not exactly, but as the mechanism that absorbs cholesterol in the gut can't distinguish between plant sterols and what we call dietary cholesterol it ends up absorbing a lot of the plant sterols in place of cholesterol. The body then dumps the plant sterol as a waste product. This 'jamming' makes cholesterol a slightly more precious resource as far as the liver is concerned. Much of the cholesterol that is taken in from the intestine was actually put there further up the intestine via bile acids created by the liver - that cholesterol is largely recycled and supplemented by cholesterol in food. Plant sterols inhibit that recycling mechanism and the uptake of cholesterol from food a little bit, increasing the demand for cholesterol in the liver which needs it to create more bile acids. This causes the liver to start taking up more LDL cholesterol particles from the blood to meet that demand - the liver compensates for reduced supply from the intestine and the result is lower LDL levels. HDL levels are not affected much, if at all. The effect of plant sterols is quite small though and foods containing plant sterol are quite expensive. If you have weight to lose the single most effective thing you can do to reduce cholesterol in the blood is to lose weight.

 

[Melgar]

Interesting @HairySmurf . I too have high LDL Cholesterol. My Triglycerides are very low 0.54. I eat little to no fat. I have had problems with fats for many years, now I cannot tolerate fat at all. I am having problems with my gallbladder and pancreas with bouts of inflammation. Scans show no gall stones are present. It seems my liver is determined to produce cholesterol in the absence of fat in my diet. I am lean and fit. So I am now on statins.
So does the liver make cholesterol regardless of whether one eats fats in their diet or not? It’s a question in my own head. Do you have a source for your plant sterols “'jamming' the pathways through which cholesterol is absorbed from the intestine”. I’m interested as it is an issue for me at the moment.

 

[HairySmurf]

Interesting @HairySmurf . I too have high LDL Cholesterol. My Triglycerides are very low 0.54. I eat little to no fat. I have had problems with fats for many years, now I cannot tolerate fat at all. I am having problems with my gallbladder and pancreas with bouts of inflammation. Scans show no gall stones are present. It seems my liver is determined to produce cholesterol in the absence of fat in my diet. I am lean and fit. So I am now on statins.
So does the liver make cholesterol regardless of whether one eats fats in their diet or not? It’s a question in my own head. Do you have a source for your plant sterols “'jamming' the pathways through which cholesterol is absorbed from the intestine”. I’m interested as it is an issue for me at the moment.

Yes the liver will and must make cholesterol in order to 'manufacture' bile acids which is important for how our digestive system works. Every cell in the body can and does manufacture its own cholesterol but the liver has a very high demand for it in order to create bile acids. Manufacturing cholesterol inside the liver is 'expensive' though, it's a precious resource that the body doesn't like to waste much like everything else that's useful. All cholesterol interventions/medications work by influencing the uptake of LDL particles from the blood by the liver, a ready source of cholesterol that it can draw on, either by affecting how 'precious' cholesterol is as a resource in the body, how scare or how hard it is to manufacture basically, or by directly interfering with the rate at which the liver takes up LDL particles, which is how the newest medications work. Those new medications don't affect cholesterol supply in the body at all, just the receptors on the liver, 'forcing' it to take up more LDL particles from the blood. Those medications are expensive though and will continue to be for many years.

High fat intake doesn't affect cholesterol directly though specific fat molecules, trans fats and a subset of saturated fats, influence the number of receptors on the liver which pull in LDL particles, if there is high intake of these specific fats over time.

Most of the information about cholesterol came from this series of interviews with lipidologist Dr. Thomas Dayspring - Link - links to the interviews as podcasts or on Youtube on that page. Interview 1 of the 3 contains the information on the mechanism by which the body takes in cholesterol from the intestine and how plant sterols mess with it. He does not go into fats much in those interviews. This article lists the specific saturated fat molecules that can influence LDL particles - Link. As far as I know all trans fat molecules do it too but I never looked that up. Other kinds of fats - monounsaturated, polyunsaturated etc. do not mess with the LDL receptors in the liver directly as far as I know.

Your situation appears to be unusual though - lean and fit with low trigs and high LDL while not eating a lot of trans or saturated fats. I suspect the typical advice that might apply well to the average person might not suit you. One thing to investigate might be the profile of the cholesterol 'hyper-absorber' - mentioned in the video interviews. Some people are genetically setup to absorb a lot of cholesterol from the intestine. These people are affected by the cholesterol in eggs for example while most of us aren't. Those people respond much better to ezetimibe than to statins I believe and around around 1 in 20 of the population, if I recall correctly. They're one example of how some people can vary widely in what influences their cholesterol levels. I believe Dayspring does talk about a specific test for hyperabsorption in one of the videos and talks about signs of other unusual circumstances. Maybe something in there might provide clues?

 

[Melgar]

@CrazyCatLady2693 , I seemed to have exhausted my attempts at lowering my LDL cholesterol, although unlike you my HDL numbers are okay. As I mentioned to @HairySmurf I have a problem with my gall bladder, and my pancreas, not wishing to miss out, seems to be involved too. I cannot tolerate any foods with fats in. This Inability to tolerate fats now includes plant based fats. Even the mere thought of fat turns my stomach. My forced little to no fat diet has made no difference to my high LDL figures. There are many discussions around the pros and cons of high LDL’s. Some trains of thought say high LDL’s are not a big deal, especially when Triglycerides are normal. You might want to read Malcolm Kendrick’s books on his views around LDLs. They make for very interesting reading.

I do not have much wisdom to share, only that my virtually no fat diet has made little or no difference to my LDL numbers. This maybe down to my own body situation.

ed spelling

 

[Melgar]

Thanks @HairySmurf I’ll check those links out . Ha, you mention eggs, strange, I am unable to eat eggs either without feeling nauseous . Interesting.

 

[KennyA]

You might also want to have a read of some research (attached below) that throws a different complexion on what is "high" cholesterol and whether that is a problem.

https://www.sciencedirect.com/scien...tm_medium=referral&utm_campaign=the-arrow-188


Journal of the American College of Cardiology 2019:
•Several foods relatively rich in SFAs, such as whole-fat dairy, dark chocolate, and unprocessed meat, are not associated with increased CVD or diabetes risk.
•There is no robust evidence that current population-wide arbitrary upper limits on saturated fat consumption in the United States will prevent CVD or reduce mortality.

Total cholesterol and all-cause mortality by sex and age: a prospective cohort study among 12.8 million adults - Scientific Reports

No simple conclusion from this huge Korean study - U-curve associations between TC levels and mortality were found in both men and women. The TC range associated with the lowest mortality was 210–249 mg/dL (5.4- 6.4mmol/l). When age was further considered, U-curve associations were observed regardless of sex or age, and the optimal TC range for survival was 210–249 mg/dL (5.4- 6.4mmol/l) for each age-sex group, except for men at 18–34 years (180–219 mg/dL or 4.6-5.6 mmol/l ) and for women at 18–34 years (160–199 mg/dL or 4.1-5.1 mmol/l) and at 35–44 years (180–219 mg/dL or 4.6-5.6 mmol/l)

Re-evaluation of the traditional diet-heart hypothesis: analysis of recovered data from Minnesota Coronary Experiment (1968-73)

Conclusion: Available evidence from randomized controlled trials shows that replacement of saturated fat in the diet with linoleic acid effectively lowers serum cholesterol but does not support the hypothesis that this translates to a lower risk of death from coronary heart disease or all causes. Findings from the Minnesota Coronary Experiment add to growing evidence that incomplete publication has contributed to overestimation of the benefits of replacing saturated fat with vegetable oils rich in linoleic acid.

Is the use of cholesterol in mortality risk algorithms in clinical guidelines valid? Ten years prospective data from the Norwegian HUNT 2 study

Conclusion: ".....If our findings are generalizable, clinical and public health recommendations regarding the ‘dangers’ of cholesterol should be revised. This is especially true for women, for whom moderately elevated cholesterol (by current standards) may prove to be not only harmless but even beneficial."

 

[Hopeful34]

I've had to give up eating eggs too @Melgar as they have the same effect on me.

 

[Melgar]

I've had to give up eating eggs too @Melgar as they have the same effect on me.

I was able to eat eggs @Hopeful34 but since the fat thing I can’t eat those either !

 

[Chris24Main]

Everyone please read the reports that @KennyA links to - low cholesterol is, and only ever has been linked with poorer health - particularly for women.

I agree with @HairySmurf also - except that cholesterol is much more important than even he is suggesting - it's a vital nutrient.

To me, the most damming piece of evidence is the Minnesota trial, which funnily enough, I was reading about at the weekend. It's absolutely shameful, and if it had been published at the time we would not be even discussing whether eggs are a good thing or not.