As a part of her early morning paper-reading ritual my wife always sees fit to alert me to my horoscope, which, today, in our local paper was:
A closed mouth gathers no foot. Big ambitions may be bandied about, but when push comes to shove it’s the guy who does the actual work that gets the glory.
Typically I about half listen to her read these things because I’m usually busy pouring over my own newspapers, but today it got my attention. I had finished all my newspaper reading and was reviewing a recent medical paper from the American Heart Journal entitled The independent correlation between high-density lipoprotein cholesterol and subsequent major adverse coronary events, and what caught my ear in the horoscope reading was the line “a closed mouth gathers no foot.” In view of this medical article it made me think of Dean Ornish and his idiotic analogy of HDL-cholesterol as a garbage truck that I wrote about a few days ago. It made me wonder if Dr. Ornish had read this same paper I was reading, and if so, did he feel like he had put his foot in his mouth?
The paper is not particularly brilliant but it contains much valuable information. Researchers from Indiana University School of Medicine identified a group of about 7000 patients who had been seen in a huge outpatient care facility and who had had two lipid measurements (lipids are blood fats including cholesterol. Today a typical lipid profile lab test contains the following blood levels: total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglycerides) taken between the years 1985 and 1997. The researchers compared the starting lipid values to the lipid values years later on these subjects and correlated them with any heart disease that might have developed.
Subjects having a lower HDL-cholesterol level at the first or second test were more prone to develop heart disease. Subjects whose HDL-cholesterol levels fell between the first and second tests were even more prone to develop heart disease. And those subjects whose HDL-cholesterol levels went up between the first and second test seemed to incur some protection against developing heart disease. As the authors of the study report:
The level of risk reduction was nontrivial: every 1 mg/dl higher baseline HDL-C was associated with about 1% lower in cardiac risk. Comparably, for every 1 mg/dl increase in HDL-C change over the average 2.6 year measurement interval, cardiac risk was 0.7% lower.
None of the other lipid parameters showed a significant correlation with the development of heart disease.
We were surprised that, contrary to prior research, LDL-C and its change were not associated with subsequent cardiovascular risk.
I would be surprised if they weren’t surprised. Researchers are always surprised when LDL-cholesterol isn’t shown to be bad in some way.
This study, along with a lot of others, does seem to show, despite any Dean Ornish HDL-cholesterol-is-a-garbage-truck gibberish to the contrary, that HDL-cholesterol may be protective against heart disease. But if HDL-cholesterol is ever conclusively shown to be a protective factor against heart disease, I would be willing to bet that it will be due to its anti-inflammatory properties, not its cholesterol transport properties.
In either case, if you want to get your HDL-cholesterol levels up, you have to eat fat. Fat intake drives HDL-cholesterol levels up; decreasing fat in the diet–as Dean Ornish has discovered to his chagrin–drops HDL-cholesterol levels.
So, if you want to raise your HDL-cholesterol level by putting something other than your foot in your mouth, try a cheeseburger, hold the bun, hold the fries. It’s a lot tastier.
I wonder if Dean Ornish is a Gemini?