April 13

My morning horoscope and HDL

4  comments

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?


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  1. Woohoo! Thanks for the information! I learn so much reading here.
    That does help explain (besides the exercise I did) why my HDL skyrocketed on the Atkins diet – my fat intake was fairly high. My HDL went from 45 to 74, driving my total cholesterol up a bit because the LDL dropped by less than the HDL rose.
    If fat drives HDL up, what is it about exercise that also raises it?

  2. Did you notice the results of the RUTH study that were announced today? http://www.medadnews.com/News/index.cfm?articleid=330933
    “EVISTA did not increase or decrease the combined endpoint of non-fatal heart attack, fatal heart attack, and hospitalized acute coronary syndrome compared to placebo.”
    As Evista was previously found to lower total cholesterol by 7% and the dreaded LDL by 11%, Eli Lilly spent huge sums to prove that it would lower heart risk. It ends up showing (again) that lowering LDL does NOT reduce heart risk, despite all propaganda that low LDL is the magic cure.

  3. You all suck because a good diet is not exclusive to fat and carbs I think the way food is cooked, how it is prepared, and even what it is served with makes up a “truly” good diet. If the medical experts have it with HDL levels and their correlation to high fat foods my husband would have dropped dead on the worksite as an aquaintance did two weeks ago, who is significantly thinner than my husband and probably had a meager diet. I follow the food pyramid and if I cut anything out ; the processed canned goods go first. They say less this and less that but in actuality your’e getting more of something else or alot of nothing.
    I think you should all rub my feet.
    Hello
    You wrote:

    “…a good diet is not exclusive to fat and carbs I think the way food is cooked, how it is prepared, and even what it is served with makes up a “truly” good diet.”

    And this is based on what research? What training? What reading of the medical literature? Or maybe you’ve taken care of thousands of patients on diets, that’s it, right?
    Or is it just your opinion based on the fact that you just feel that way?
    If so, thanks for sharing.
    MRE

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