Question about dietary fats/cholesterol...

[Reinventing Myself]

Hi!
I have a question regarding dietary fat intake (amount and types of fats) and their affect of cholesterol.

This past week I had an episode of hypertension lasting several days, along with migraine headaches. At my doctor's appointment on Monday, the triage nurse mentioned that my cholesterol was "very high," (This test was from last summer sometime) and that along with my hypertension, I should do something about that "very high" cholesterol. At this moment, I can't access the server with my results on it, but total cholesterol was around 179, and LDL was 158 or so. The LDL was the value that seemed to concern her.

I have been reading about cholesterol trying to understand it better both here on this site and in my PPLP book, but somehow I don't fully get it. Now the doctor wants me to eat a vegan (Yikes!!) diet with no saturated fats. He says the only ways to bring down the LDL are exercise and statin drugs. I don't want the drugs... the body should be moving more anyways :rolleyes:. I now find myself afraid to enjoy cream in my coffee, full fatted Greek yogurt, meat, etc... hence the nature of my question.

I think I understand the link between insulin levels and triglycerides and total cholesterol... but is there a reason to consume less or no saturated fats in the diet in order to further control cholesterol? Should fats be limited to only the "healthy fats" (olive oil, nuts, etc)? Or does it really matter?

Thanks, RM

[Gaelen]

RM, take a look at Dr. Mike's blog from Feb. 13, 2006 "Who would have thought it?" (http://www.proteinpower.com/drmike/archives/2006/02/who_would_have.html). It might clear up some of your concerns about the immediate effects of that cream in your coffee.

I do tend to focus on getting as many healthy oils (extra virgin olive oil, nuts, oils from fatty fishes and coconut oils) as I can. But I don't worry about the amounts of saturated fats I get from butter, eggs, dairy and the occasional poultry or other meats that I eat. "Total cholesterol" is relatively meaningless without the context of the LDL, HDL and Triglyceride numbers and the ratios the four numbers create (including total cholesterol/HDL and LDL/HDL). And exercise plus a statin isn't always the only way to improve an LDL number (or more importantly, the type of cholesterol that number is monitoring--packed (bad) or fluffly molecules (good)). Hope this helps...

[Gabriel Guzman]

This past week I had an episode of hypertension lasting several days, along with migraine headaches. At my doctor's appointment on Monday, the triage nurse mentioned that my cholesterol was "very high," (This test was from last summer sometime) and that along with my hypertension, I should do something about that "very high" cholesterol. At this moment, I can't access the server with my results on it, but total cholesterol was around 179, and LDL was 158 or so. The LDL was the value that seemed to concern her.


As explained by Gaelen, those numbes tell very little, if anything, if taken out of the context of the other parameters, such as triglycerides and HDL. Moreover, since LDL is calculated out of a formula and not directly measured, we don't even know the actual LDL particle size that dominates your LDL profile.

At a glance, a total cholesterol level of 179 doesn't look high at all but it's hard to say anything without knowing about the other parameters.


I have been reading about cholesterol trying to understand it better both here on this site and in my PPLP book, but somehow I don't fully get it. Now the doctor wants me to eat a vegan (Yikes!!) diet with no saturated fats.


A vegan diet won't do anything for cholesterol levels. Lowering cholesterol levels doesn't always translate to better health. More important, a vegan diet won't do anything for HDL levels since it has been shown that not only an adequate amount of protein is needed but also adequate fat intake.


He says the only ways to bring down the LDL are exercise and statin drugs. I don't want the drugs...


Well, he's quite wrong. That is not the only way. Actually, it's not about lowering levels of LDL but about recomposing the type of LDL particles that are more abundant. Lowering LDL levels accomplishes nothing if most of the particles are the dense, atherogenic ones. Likewise, lowering LDL levels accomplishes nothing if triglyceride levels are unchanged. Your doctor needs to read and educate himself a bit more about the dynamics of cholesterol.


...the body should be moving more anyways :rolleyes:. I now find myself afraid to enjoy cream in my coffee, full fatted Greek yogurt, meat, etc... hence the nature of my question.


Exercise will benefit you in many ways but particularly about cholesterol, exercise will improve your HDL levels. Not all types of exercise, though, but resistance exercise. Controlling carbohydrates will have a dramatic effect on your lipid profile as it will lower triglyceride levels while favoring a recomposition of the LDL profile. If your doctor really wants to have a critical view at the whole picture, he should be more interested in checking how your LDL profile looks like before making any suggestions/decisions about taking statins. In fact, it would be interesting to see which study would he cite as 'the study' that shows a cause-effect situation between saturated fats and cholesterol. The studies that show no effect or the complete situation keep piling up. In other words, the evidence that saturated fat increase cholesterol levels and cause any kind of heart disease doesn't hold any water.


I think I understand the link between insulin levels and triglycerides and total cholesterol... but is there a reason to consume less or no saturated fats in the diet in order to further control cholesterol? Should fats be limited to only the "healthy fats" (olive oil, nuts, etc)? Or does it really matter?

Thanks, RM

With respect to heart disease of high cholesterol problems, no, there is no reason. Eating healthy fats is an effort we should all try to make all the time, followed by an extra effort to stop thinking of saturated fats as 'unhealthy' for they're not. In my opinion, the only unhealthy type of fats are first the trans fats and then 'rancid' oils.

[mcsblues]

In my opinion, the only unhealthy type of fats are first the trans fats and then 'rancid' oils.Wouldn't you say that all vegetable oils with a high percentage of omega 6 (like safflower) would be unhealthy regardless of whether processing has made them rancid? (as someone pointed out to me recently you can get cold pressed organic safflower oil) Wouldn't this be especially the case for someone suffering from hypertension who could do without the inflammatory eicosanoid response to a poor omega 6 : omega 3 ratio - which consuming high omega 6 oils would contribute to?

[Gabriel Guzman]

Wouldn't you say that all vegetable oils with a high percentage of omega 6 (like safflower) would be unhealthy regardless of whether processing has made them rancid? (as someone pointed out to me recently you can get cold pressed organic safflower oil) Wouldn't this be especially the case for someone suffering from hypertension who could do without the inflammatory eicosanoid response to a poor omega 6 : omega 3 ratio - which consuming high omega 6 oils would contribute to?


There is nothing unhealthy about omega-6 fats per se. What you are referring to is the ratio omega-6/omega-3 fats, but strictly speaking, there is nothing inherently wrong with omega-6 fats from the point of view of their chemical structure. Just because omega-3 fats are precursors of anti-inflammatory eicosanoids and pretty much do the opposite to omega-6 fats, doesen't make them 'healthier' than omega-6 fats. In an optimum or close to uptimum ratio omega-6/omega-3, everything is fine. In other words, the 'unhealthiness' of omega-6 fats is related to their ratio to omega-3 fats. The unhealthiness of trans-fats is related to their actual chemical structure.

[mcsblues]

Yes it was the ratio that I referred to and I agree in principle ,,, but in practice we need to minimise omega 6 consumption as much as is practicable in order to even approach the sort of ideal ratio the Eades talk about - so that makes high omega 6 vegetable oils something to avoid, as even if they are not inherently 'bad' or 'unhealthy' consuming them on top of all the other omega 6 we get in our diet from meat and dairy, would be unhealthy for us.

[Gabriel Guzman]

Yes it was the ratio that I referred to and I agree in principle ,,, but in practice we need to minimise omega 6 consumption as much as is practicable in order to even approach the sort of ideal ratio the Eades talk about - so that makes high omega 6 vegetable oils something to avoid, as even if they are not inherently 'bad' or 'unhealthy' consuming them on top of all the other omega 6 we get in our diet from meat and dairy, would be unhealthy for us.

Minimizing the intake of omega-6 without increasing intake of omega-3 isn't likely to work either. The main problem is the deficiency in omega-3 fats and the excess of omega-6. If the ratio is what matters, then whatever approach that makes that ratio closer to the optiman is likely to be favorably. Decreasing intake of omega-6 fats only without makeing sure a good intake of omega-3 doesn't change the ratio between the types of fats. Sometimes, just be increasing the amount of fish one eats helps to bring that ratio closer to an ideal one. So, the 'as much as possible' part is quite relative.

[mcsblues]

The only way that reducing omega 6 intake wouldn't change the ratio .. is if you weren't getting any omega 3 at all!:) Yes I agree that eating more fish and other omega 3 sources as well as supplementing fish oils is a good idea, but I don't think anyone is suggesting you should make this the primary method of correcting the ratio, certainly not the Eades. From what they say in PP and PPLP, the main emphasis is cutting down the consumption of vegetable oils and processed foods which contain them as well as seeking grass fed meat sources where possible.