cholesterol numbers and confusion/frustration

[seekingsimplicity]

I am a 50 year old fit male (6'1" 175 lbs). Exercise 4-5 days per week. Had my chol checked for the first time in Jan 07 and results were: LDL = 166, HDL = 74, TrG = 121. Read "Protein Power" and in mid-May '07 started following the Phase I Intervention (low carb 30g per day) plan and stepped up my exercise regimen. I went from 185lbs to 175lbs in 8 weeks and I feel great.

Just had a re-check after appx. 8 weeks on Phase I Intervention plan and results were extremely disappointing to me. LDL = 245, HDL = 70, TrG = 73. Any advice on where I go from here?

[Omlette]

I don't have any suggestions as to why your LDL's went up, but I would suggest getting a lipid profile that shows the size of the lipid paricles. If the partices are large, then you are okay. If they are small, then there is a danger.

[Mitra]

I can't remember where (if you search for something like triglycerides or LDL on Dr Mike's blog, it should be in there somewhere), but I think I remember Dr Mike saying low triglycerides are associated with the "good" kind of LDL.

[seekingsimplicity]

is there a moderator here who can shed some more light on my situation?

Thank you.

[Mitra]

The moderators here don't have any medical qualifications. Gabe is a biochemist, but is in the throes of moving house at the moment, so doesn't manage to get over here as often as we'd like. Other than that, I'm afraid we don't have more knowledge than other interested amateurs.

From what I've seen other people post, triglycerides seem to respond the fastest to dietary changes - and generally fall, as yours have, when carbs are reduced. The other components can take months, and the changes seem much more variable. The older you are, the slower the response, in general. There's a graph in Life Without Bread, that shows no change in total cholesterol for those over 60 adopting a low carb diet, a very slight reduction for those between 40 and 60, and significant reduction for those younger than 40. (The graph was based on 263 people over two years.)

I'm afraid that personally, I don't put much faith in the whole lipid hypothesis, so I don't think cholesterol measurements on their own are a very useful way to assess someone's health - but, I have no medical qualifications, and that's purely a personal opinion.

Sorry I can't just give you a nice straightforward interpretation of the numbers.

I don't know if you followed up my earlier suggestion to check out Dr Mike's blog?

This was from an article he wrote on a comparative study of different diets (http://www.proteinpower.com/drmike/?p=551) (it's a quote from the study, not Dr Mike's words):
Many concerns have been expressed that low-carbohydrate weight-loss diets, high in total and saturated fat, will adversely affect blood lipid levels and cardiovascular risk. These concerns have not been substantiated in recent weight-loss diet trials. The recent trials, like the current study, have consistently reported that triglycerides, HDL-C, blood pressure, and measures of insulin resistance either were not significantly different or were more favorable for the very-low-carbohydrate groups. [My italics]

The exception to this pattern has been LDL-C concentrations. Two of the most consistent findings in recent trials of low-carbohydrate vs low-fat diets have been higher LDL-C concentrations and lower triglyceride concentrations in the low-carbohydrate diets. Although a higher LDL-C concentration would appear to be an adverse effect, this may not be the case under these study conditions. The triglyceride-lowering effect of a low-carbohydrate diet leads to an increase in LDL particle size, which is known to decrease LDL atherogenicity. In the current study, at 2 months, mean LDL-C concentrations increased by 2% and mean triglyceride concentrations decreased by 30% in the Atkins group. These findings are consistent with a beneficial increase in LDL particle size, although LDL particle size was not assessed in our study. In addition, we examined non–HDL-C concentrations as an alternate indicator of atherogenic lipoproteins—a variable not substantially influenced by changes in triglyceride concentrations—and observed no significant differences among groups at any time point.

Therefore, we interpret these findings to suggest that there were no adverse effects on the lipid variables for women following the Atkins diet compared with the other diets and, furthermore, no adverse effects were observed on any weight-related variable measured in this study at any time point for the Atkins group. Further examination of the dietary effects on lipid variables would benefit from analyses of lipoprotein particle subfractions and follow-up of longer than 12 months.

I'll let Dr (Mike) Eades have the last word (from a reply to a comment on his blog about Malcolm Kendrick's book, The Great Cholesterol Con (http://www.proteinpower.com/drmike/?p=646)): Remember, the whole idea that cholesterol has anything to do with heart disease is an hypothesis, not established fact. That means that there is NO definitive evidence that cholesterol levels mean squat, no matter how much some ill-informed people blather on about them.

Cheers–

MRE

[LowCHO]

I got a new doc and he told me to get this book, "The New 8-Week Cholesterol Cure" and come back and see him in 4 weeks. My cholesterol was 140, LDL's 80 and HDL's 47 after following what the book said, mainly exercise, limiting saturated fats and eating oat bran... oh yeh, limiting calories to around 1800/day.
The author also advocates lowering carbs as a way to loose weight (fat).
Saturated fats are known to increase cholesterol. I lowered my saturated fats to no more than 15 grams per day and ate oat bran which limits the amount of cholesterol the liver produces. I also took CholestOff.
I hope this helps. You know how important it is don't you?