So what's the truth about Cholesterol

[RoyG]

"The association with IHD mortality (HR: 1.07; 95% CI: 0.92–1.24) was not linear but seemed to follow a ‘U-shaped’ curve, with the highest mortality <5.0 and ≥7.0 mmol L−1. Among men, the association of cholesterol with mortality from CVD (HR: 1.06; 95% CI: 0.98–1.15) and in total (HR: 0.98; 95% CI: 0.93–1.03) followed a ‘U-shaped’ pattern." My bold.

I'm in the sweet spot of <5.0 and ≥7.0 (where most of the UK is by the way) so I'm happy with that. My other lipids are excellent; i.e. trigs and HDL/total cholesterol ratio.

The "U" shaped thing worries me, because I have very low-cholesterol (3.6 momol/l). However,

I think that it's wrong though. Cochrane says this:

There has been some concern that low levels of blood cholesterol increase the risk of mortality from causes other than coronary heart disease, including cancer, respiratory disease, liver disease and accidental/violent death. Several studies have now demonstrated that this is mostly, or entirely, due to the fact that people with low cholesterol levels include a disproportionate number whose cholesterol has been reduced by illness - early cancer, respiratory disease, gastrointestinal disease and alcoholism, among others (Iribarren 1997; Jacobs 1997). Thus it appears to be the pre-existing disease which causes both the low cholesterol and raised mortality (Davey Smith 1992).

Unless of course I have a pre-existing disease that is causing it.

According to the American Heart Association in 1994, only total cholesterol levels below 160 mg/dL or 4.1 mmol/l are to be classified as "hypocholesterolemia" However, this is not agreed on universally and some put the level lower. so is your cholesterol lower because of diet alone? as your figure is very low.

 

[borofergie]

According to the American Heart Association in 1994, only total cholesterol levels below 160 mg/dL or 4.1 mmol/l are to be classified as "hypocholesterolemia" However, this is not agreed on universally and some put the level lower. so is your cholesterol lower because of diet alone? as your figure is very low.

I think it must be genetic Roy. I've had it measured three times, the first about 15 years ago, pre-diabetes when the nurse said to me "you cholesterol is a bit on the low side, but don't try and fix it or you'll kill yourself".

It was "OK" on diagnosis, according to the Doc, because of which I didn't note the numbers.

I'm eating an 80% fat diet, with as much as possible from saturated fats, so it just goes to show that fat in your mouth, doesn't equal fat in your blood plasma. It's not like I could eat any more fat to try and increase my levels.

It's slightly worrying because low-cholesterol is associated with an increased risk of cancer, and both my parents died of cancer in their early 60s.

 

[RoyG]

It's slightly worrying because low-cholesterol is associated with an increased risk of cancer, and both my parents died of cancer in their early 60s.

Quite likely not Stephen, I did highlight the bit where it states it's not fully agreed. and would lean more to the genetic cause rather than underlying illness If you have no symptoms and are healthy. I would just keep an eye on it, and get regular check up's.

 

[Dillinger]

Try addressing the science for a change, and not resorting to slanderous insults.

Borofergie! That is outrageous; I'm shocked, shocked I tell you.

As well you know 'slander is what we hear with our ear, libel is what we see with our eye-ball'.

Please edit your statement to say 'libellous insults'.

Best

Dillinger

 

[viviennem]

Here goes for a really unscientific question:

I understand that most of our brain functions (do I mean 'synapses'?) are based on cholesterol - ie, without cholesterol our brains just don't work.

Do statins affect brain cholesterol?

Does anyone know whether lowering blood cholesterol affects the level of cholesterol in our brains? And if so, what is the effect of low blood cholesterol on brain function?

No effect whatsoever, in Borofergie's case :lol:

There is also the fact (is it a fact? I've heard it said, anyway) that the cholesterol in the fat under our skin is vital in the conversion of sunlight into Vitamin D. What effect does lowering blood cholesterol have on subcutaneous cholesterol and therefore Vitamin D levels?

I personally believe, on no evidence whatsoever, that most of the stats on progressive diabetes and the incidence of complications and therefore CVD and strokes, etc, are based on information from previous decades of badly-controlled diabetics. We now have a much better chance of controlling our diabetes. I'd like to see some statistics based well-controlled diabetics, for a change.

Viv 8)

A friend of mine who had been Type 1 for 50+ years following gestational diabetes, has recently died in her mid 90s - peacefully in her sleep, with full eyesight, kidneys and legs & feet intact. Her son, diagnosed in his forties, died in his early 50s because he would not take control. The statistics are only as good as the people they are based on.

 

[noblehead]

I'm eating an 80% fat diet, with as much as possible from saturated fats, so it just goes to show that fat in your mouth, doesn't equal fat in your blood plasma. It's not like I could eat any more fat to try and increase my levels.

It's slightly worrying because low-cholesterol is associated with an increased risk of cancer, and both my parents died of cancer in their early 60s.

Hope you don't mind me asking you a few questions Stephen but how many years have you been eating a 80% fat diet, also the rise in cholesterol levels in Sweden has been put down to the high consumption of diary products since they caught on to low-carb diets, how do you explain that or is it that they are still eating moderate carbs as well. Also Dillinger has been on a LCHF diet for several years now but unlike you and Wiflib has very high cholesterol (hope you don't mind me saying so Dillinger) why is it that some achieve successful cholesterol results and others don't?

Just one more, I wasn't aware that low-cholesterol is associated with an increase risk of cancer, do you have a link so that I can read it as I've not come across this before when reading about cholesterol.

Many thanks!

 

[Anonymous]

Can I also add to those questions..

Why, on a high fat diet, would you concentrate on saturated fat? (I just know I've missed a lesson somewhere )

 

[jopar]

There is or has been some research into links between Altzhimers (sp) and cholesterol..

Apparently lowering the cholesterol helps protect to Altzhimers disease!

Now I don't know what this research is based on, as the information was provided by hubby, who recently attended a dementia course (latest one of many courses he's attended) and this was one of the snippets of information from their lecturer!

 

[Dillinger]

Also Dillinger has been on a LCHF diet for several years now but unlike you and Wiflib has very high cholesterol (hope you don't mind me saying so Dillinger)

Er, my last total cholesterol was 6.1 mmol/l the average total cholesterol level in the UK is 5.5mmol/l for men and 5.6mmol/l for women. So, I don't agree that I have 'very high cholesterol'. Also my lipid profile as of December last year is excellent; the desired ratio for TC/HDL ratio is 4.5 or less - mine is 2.6. HDL should be above 1.2 mmol/L, mine is 2.3 mmol/L. LDL should be 3.0 mmol/L or less mine is 3.6 mmol/L (so slightly elevated). For Triglycerides you should have less than 1.69 mmol/l mine are 0.7 mmol/l.

So yes, I do mind that being classified as 'very high'.

Best

Dillinger

 

[noblehead]

Why, on a high fat diet, would you concentrate on saturated fat? (I just know I've missed a lesson somewhere )

You don't have too, the mediterranean diet is considered high fat but discourages saturated fats, Ancel Keys followed a mediteranean diet and he died days before his 101st birthday and his wife (who followed the same diet) died age 97.

 

[noblehead]

Er, my last total cholesterol was 6.1 mmol/l the average total cholesterol level in the UK is 5.5mmol/l for men and 5.6mmol/l for women. So, I don't agree that I have 'very high cholesterol'. Also my lipid profile as of December last year is excellent; the desired ratio for TC/HDL ratio is 4.5 or less - mine is 2.6. HDL should be above 1.2 mmol/L, mine is 2.3 mmol/L. LDL should be 3.0 mmol/L or less mine is 3.6 mmol/L (so slightly elevated). For Triglycerides you should have less than 1.69 mmol/l mine are 0.7 mmol/l.

So yes, I do mind that being classified as 'very high'.

Didn't mean to offend Dillinger as we were discussing cholesterol only a few weeks ago and you said then that you didn't mind discussing your cholesterol levels on the open forum, if I have offended you then I do apologize as that wasn't my intention!

 

[borofergie]

Hope you don't mind me asking you a few questions Stephen but how many years have you been eating a 80% fat diet, also the rise in cholesterol levels in Sweden has been put down to the high consumption of diary products since they caught on to low-carb diets, how do you explain that or is it that they are still eating moderate carbs as well.

Nigel, I started VLCing (for the second time) 4 months ago (after a period of being on around 60-80g of carbs a day). For the past 4 months I've been eating 70-80% a day, including lots of dairy. It's very hard to get up to 80% without cream or cheese, because most of the meat we eat is too lean (without eating brain and bone marrow).

On the Swedish study the average carb intake was 44% (by energy), so in reality it was a high-carb/high-fat diet, which is the worst of all. The Swedish study doesn't show any data about what happens to the cholesterol of people on low-carb diets.

All the data I've seen suggests that low-carbing:

1. Decreases Blood Trigs
2. Increases "good" HDL cholesterol
3. Increases the quality, but not the quality of "bad" LDL cholesterol

My LDL and trigs are low (which is great), but my HDL is also low (which is unexpected on my diet). Some people suggest that LDL and HDL numbers don't matter very much, as long as your trigs are OK.

Also Dillinger has been on a LCHF diet for several years now but unlike you and Wiflib has very high cholesterol (hope you don't mind me saying so Dillinger) why is it that some achieve successful cholesterol results and others don't?

As you know from your brother, there is a strong genetic component here.

I doubt that my low-cholesterol is attributable to low-carbing; as I said above, it was flagged as "low" before I ever caught diabetes. However, I can say for sure, that eating an 80% fat diet doesn't send your cholesterol through the roof. I wish I coud make mine a bit higher, but I'm already doing everything that should make it high.

I'd humbly suggest that Dillinger's cholesterol is healthier than mine.

Just one more, I wasn't aware that low-cholesterol is associated with an increase risk of cancer, do you have a link so that I can read it as I've not come across this before when reading about cholesterol.

There is a very scary Total Cholesterol vs Mortality Chart, here, which suggests that I would be better off having high cholesterol. However, chart includes both developed and undeveloped countries, which is misleading because undeveloped countries have low cholesterol but high mortality primarily due to infectious diseases, not because their cholesterol levels are too low:
http://renegadewellness.files.wordpress ... -chart.pdf

Here is a slightly better one:

These are both in American units, so you have to multiply your Total Cholesterol by 39. Mine is 139mg/dl, which is on the extreme left hand side of both curves.

The data is pretty sketchy, and there is some suggestion that low-cholesterol is caused by some fatal diseases (rather than the other way around).

http://en.wikipedia.org/wiki/Hypocholesterolemia

 

[noblehead]

Thanks Stephen, I have to get back to work now but will have a good read later and give you my thoughts!

 

[borofergie]

Why, on a high fat diet, would you concentrate on saturated fat? (I just know I've missed a lesson somewhere )

You don't have too, the mediterranean diet is considered high fat but discourages saturated fats, Ancel Keys followed a mediteranean diet and he died days before his 101st birthday and his wife (who followed the same diet) died age 97.

There is no question that you evolved to get the majority of your energy from saturated animal fats, rather than mechanically processed vegetable oils.

Monounsaturated oils (such as olive oil) are better than mechanically recovered polyunsaturated fats (such as sunflower and seed oils). Both are very high in Omega6 oils which are unhealthy in large quanities. Most western diets have an Omega 6 to Omega 3 ratio of over 10:1, which is very unhealthy. The only way that you can counter this, is by removing vegetable oils from your diet.

All vegetable oils are neolithic inventions. You didn't evolve to eat them, and they are harmful if you eat them in large quanities. Saturated fat it your body's preferred energy storage medium. How could it possibly be unhealthy?

Here is what happened to the UK consumption of Animal vs Vegetable Fats during the obesity epidemic:

 

[SouthernGeneral6512]

The only point is life expectancy was probably less than it is today during the pre-neolithic times when we lived on saturated fat although I don't know if that would be because of the diet or the hard life?

 

[borofergie]

The only point is life expectancy was probably less than it is today during the pre-neolithic times when we lived on saturated fat although I don't know if that would be because of the diet or the hard life?

Only because of non-dietary factors. Mortality was high (due to infection and getting eaten by things), but if you survived those then you could expect to live a long and healthy life. People certainly weren't dying of obesity related diseases.

There is no reason at all to suggest that your body is better off running on man-made vegetable oils rather than on the largely saturated animal fats. Body fat is largely saturated, why do you think that is?

 

[xyzzy]

Thanks for some brilliant info again Stephen.

I am waiting for a 6 month post diagnosis lipids result which I should get next week. The 3 month one on LCHF dramatically reduced my cholesterol levels back to normal so I'm waiting to see what will happen another 3 months on. I do take 40mg Simvastatin as I believed even prior to T2 diagnosis my levels were too high, at one point they had exceeded a total level of 8. A lot of this seems to be genetic in component as far as I'm concerned as my two brothers and my sister have all suffered high cholesterol regardless of our respective weights and life styles.

My attitude has been to take the statin until my levels normalised and my current plan will be to halve my dose over the coming 3 months assuming next weeks results are ok. I don't see that an immediate reaction is necessary in any of this.

To me it is plain risk management so I accept there are proven risks in taking statins but still think having too high bad cholesterol and / or trigs is more of a risk than the statin if you aren't experiencing any noticeable side effects. I score 148 on your chart so that would imply my level is slightly too low!

 

[SouthernGeneral6512]

The only point is life expectancy was probably less than it is today during the pre-neolithic times when we lived on saturated fat although I don't know if that would be because of the diet or the hard life?

Only because of non-dietary factors. Mortality was high (due to infection and getting eaten by things), but if you survived those then you could expect to live a long and healthy life. People certainly weren't dying of obesity related diseases.

There is no reason at all to suggest that your body is better off running on man-made vegetable oils rather than on the largely saturated animal fats. Body fat is largely saturated, why do you think that is?

Suppose it's just very hard in middle age to start to believe that everythign you know is wrong ... I'm sure most people would flip at the idea of 80% saturated fats despite what the truth of the matter is

 

[borofergie]

To me it is plain risk management so I accept there are proven risks in taking statins but still think having too high bad cholesterol and / or trigs is more of a risk than the statin if you aren't experiencing any noticeable side effects. I score 148 on your chart so that would imply my level is slightly too low!

Hmmmm. So your TC isn't much higher than mine. I'd think very carefully about staying on them, if I was you:

There has been some concern that low levels of blood cholesterol increase the risk of mortality from causes other than coronary heart disease, including cancer, respiratory disease, liver disease and accidental/violent death. Several studies have now demonstrated that this is mostly, or entirely, due to the fact that people with low cholesterol levels include a disproportionate number whose cholesterol has been reduced by illness - early cancer, respiratory disease, gastrointestinal disease and alcoholism, among others (Iribarren 1997; Jacobs 1997). Thus it appears to be the pre-existing disease which causes both the low cholesterol and raised mortality (Davey Smith 1992).

The potential adverse effects of statins among people at low risk of CVD are poorly reported and unclear (Jackson 2001) but, among those with pre-existing CVD, the evidence suggests that any possible hazards are far outweighed by the benefits of treatment.

http://summaries.cochrane.org/CD004816/ ... ar-disease

 

[borofergie]

The only point is life expectancy was probably less than it is today during the pre-neolithic times when we lived on saturated fat although I don't know if that would be because of the diet or the hard life?

Only because of non-dietary factors. Mortality was high (due to infection and getting eaten by things), but if you survived those then you could expect to live a long and healthy life. People certainly weren't dying of obesity related diseases.

There is no reason at all to suggest that your body is better off running on man-made vegetable oils rather than on the largely saturated animal fats. Body fat is largely saturated, why do you think that is?

Suppose it's just very hard in middle age to start to believe that everythign you know is wrong ... I'm sure most people would flip at the idea of 80% saturated fats despite what the truth of the matter is

I should be clear here, that I'm talking about dietary fat in the context of a low-carbohydrate diet. Most of what you have been told about fat is related to a high-carb/high-fat diet. Eating more fat (of any type) on a high-carb diet is a very bad idea.

I'm not sure how old you are, but I'm sure your Grandparents would have laughed at "sunflower oil", and (if they are English) would have preferred butter, lard and dripping over olive oil.