My Numbers Are In...

[Nam]

and my doctor says "Clean up your diet and we'll check you again in 3 months." Sigh. Here are my numbers...

2007 - Total Cholesterol - 224
HDL - 49
LDL - 150
Tri - 99

2008 - Total Cholesterol - 242
HDL - 61
LDL - 161.4
Tri - 98

2009 - Total Cholesterol - 252
HDL - 78
LDL - 153.8
Tri - 101

Oh yes, last year he told me he "doesn't believe" in fluffy LDL's.
Every way I figure my ratios they seem fine to me.

Comments welcome. I am 72.5 years old, 5 feet 4 inches, 148 pounds, and have no aches or pains. I go to the gym three or four times a week.

[Frank Hagan]

It sounds like you are in generally good health, so I don't think there's anything really alarming about your blood test numbers. Your doctor may disagree based on your personal health risk factors like prior heart disease, family history, etc. What does the doctor say specifically? Is he worried about the LDL?

The traditional "goals" for a lipid profile are:

Total: under 200
HDL: 40 or above
LDL: 130 or below
Triglycerides: 150 or below


You have very good HDL levels that are moving in the right direction. Your triglycerides are steady over the three year period and are very good, well below the "max". I suspect your fasting blood sugar is 100 or below.

Your doctor may be concerned about the LDL number, and perhaps that's why he said "clean up your diet".

If you are low carbing, eating only 30-40g per day of carbs, and producing ketones, your LDL may be raised slightly; the studies of epilepsy patients on ketogenic diets seems to support this idea. You might try increasing your carb count until you are out of ketosis for a few weeks before the blood test. Oatmeal has also worked to lower LDL for a lot of people; 1/2 cup of plain oatmeal has about 13g of carbs, so you might try adding that to your diet.

For those of us without heart disease as a risk factor, stroke and cancer are much greater risks. I have very little heart disease in my family, so my focus is on avoiding the things I'm actually at risk for: diabetes and cancer. Doctors should focus on individual risk factors rather than overall societal goals, but often they emphasize what everyone else is emphasizing, especially when it comes to "general health".

[Nam]

Thanks for your reply. I actually like oatmeal so that's a good idea. Yes. I got my fasting glucose down to 90 the lowest in years. Diabetes is a big risk factor in my genetic profile, so I was very pleased with that reading.

[mcsblues]

Originally Posted by Frank Hagan

The traditional "goals" for a lipid profile are ...

Doctors should focus on individual risk factors rather than overall societal goals ...

Frank, I'd just like to point out that these goals are certainly not 'traditional', nor are they 'societal'. What they represent is the moving ever lower targets, essentially set by drug companies and charlatan 'scientists' in their employ, and the motivation for doing this has nothing to do with 'general health'.

Nam, if the research into cholesterol tells us anything, it is that higher cholesterol levels in the elderly (hope you don't mind me using that term!) are protective. If you want my 2 cents, I'd lose the oatmeal and concentrate on keeping your blood sugar as low as possible, with a low carb diet which is the very best thing for your health on all fronts.

[Nam]

Well, I am elderly even though I don't look or feel it. Thanks for all input. I'm lovin' it.

[S Bear]

Most of the research seems to show that the ratios are most important to health, and, as you mention, you look great in that regard.

Your doctor needs a refresher course.

[maxlharris]

Hrm. Let's look at the numbers in isolation:
Trig: 99 - 98 - 101 (essentially flat)
LDL: 150 - 161.4 - 158.3 (slight trend up, but essentially flat)
HDL: 49 - 61 - 78 (trending up)

So, the change in the total is mostly change in HDL. Ratios are better each year. Triglycerides are stable in a very healthy space. The HDL, traditionally the good stuff, is trending up, which is good.

You're doing fine and your doc is maybe a tad lazy on keeping up with his journals.

[Frank Hagan]

Originally Posted by mcsblues

Frank, I'd just like to point out that these goals are certainly not 'traditional', nor are they 'societal'. What they represent is the moving ever lower targets, essentially set by drug companies and charlatan 'scientists' in their employ, and the motivation for doing this has nothing to do with 'general health'.

"Traditional" was probably a poor choice, even though I think it communicated my original idea pretty well. "Overwhelming medical consensus", "American Heart Assoc. Guidelines", etc. might be better terms.

But I'll stand by "societal goals", as the history in the US is that our standard low fat diet recommendations are intended to set a standard for society and provide overall better health, even if it is harmful for some individuals. In this country, the first low-fat dietary guidelines were promulgated by our US Senate in the 1970s in an honest attempt to improve the health of the country. These were not evil people, they were just wrong.

I don't take the view that doctors are in collusion with drug companies, or that there's a grand conspiracy afoot. The low-fat diet advice started in this country long before statins or other cholesterol-lowering drugs were on the market. It is the failure of that diet to produce lower cholesterol that prompted the drug companies to invest and provide drugs to do what many people wanted ... lower cholesterol numbers. When the doctor advises you to take statins, he isn't doing so because he likes the drug company representative; he does so because he really thinks it is the best thing for you. It is the consensus view. The doctor, drug company reps, and the scientists are not evil. They are just wrong.

[mcsblues]

I didn't suggest McGovern et al were "evil" in fact I didn't mention them at all - but yes they were certainly wrong, and it is not as if they weren't provided with appropriate advice (so not wrong through ignorance, so that makes them ...?). They chose to ignore science, and when they needed someone to push their agenda they specifically chose someone who would toe the line, without a science background. Conspiracy? Well that line was significantly influenced, as were the succession of pyramids that followed it, by agricultural lobby groups. Science didn't, and really never has got a look in.

When it comes to "societal goals" I was inferring that you meant the goals of society. But as you have now clarified that you mean the goals or recommendations for society, just where do they come from? The come from drug companies and/or 'research' funded by drug companies. There is no need for a giant conspiracy between them and your doctor. Because again, where does his advice come from? Either direct from the drug company rep, or if he actually reads the drug company trials, its highly likely he reads the abstract at best, or if he does read the paper does he read it critically? (he isn't trained to). Alternatively he gets his advice from the representative bodies, the AHA, or his years of medical training ... the only difference is there is an extra step ... the source is still the same.

If any of the links in that chain actually looked at the evidence they would see that statins are a dangerous class of unnecessary, expensive drugs which provide a minuscule and ultimately questionable benefit to a tiny subset of the millions that are prescribed them each and every year. Conspiracy? Evil? ... I prefer the term criminal malpractice, but to each his own.

Coming back to your advice to Nam to eat oatmeal to get his (what used to be) normal cholesterol level lower. Perhaps you should be providing him with some evidence as to why that would be a good idea?

[maxlharris]

Not to sound too tin-foil hat, but you have dietary guidelines promulgated by the USDA. You have large amounts of money going to subsidize corn and grain growing. You have large political donations from the grain science companies, like ConAgra and Monsanto. You can follow the money on who wins with the low fat diet. The US Congress has a streak of altruism, but each member has voters to woo and donors to appease (key example: Joe Lieberman on the public option... )

As to drug companies and doctors: Again, the money. Who funds the studies suggesting what drugs are good? Who defunds studies that run counter to the party line? Who publishes the specialist journals? Who refuses to publish papers against the party line? Big Pharma. Big Pharma has a streak of altruism Big Pharma also has shareholders who demand quarterly numbers.



No, actually, it's just everyone doing what is in their interest, and occasionally the interests align.