Cholesterol

[kustard]

So I had to go get a blood test as part of now being over 40 and the results whilst good said I have elevated cholesterol as part of a genetic trait (thanks a lot parental units!).

Anyway, I have to say good bye to full cream milk :( The doctor said skim but I might start with light milk instead of that while coloured water called skim...

Cholesterol is quite common so I was wondering what kind of diet regimes do people follow in order to keep their levels down.

[Screwdriverone]

Hi Simon,

That's a bugger....sorry, I don't have any tips for you.

Does that mean you will have to change your screen name too....?

It all helps I s'pose...;)

Cheers

Chris

[kustard]

Hahaha, I hope virtual online projections are non-fattening ;) The doc also said I'll need to do some *gasp* exercise! Of all the things to say!

[jjjnettie]

Try the UHT skim milk. It has more flavour than the fresh.

[pgc hunter]

My cholesterol is off the charts. Genetic and had a very unhealthy diet and used to eat heavily right up until midnight. Maybe cut down on snacks / soft drink/ meats if you eat alot of those, but not sure if that would help. No late night binges, that's for sure - you'l want to give your body time to digest the food.

One thing I won't ever give up is full cream milk. Skim milk is not milk, it's more like liquified pecker-cheese that tastes like water mixed with a curdled egg that someone spat on.

[tonybarry]

Simon, you may wish to try the Flora ProActive (butter replacement). It does work. Not Magic, but worthwhile. Dropped my cholesterol from 7.2 to 5.7. No other changes in diet or behaviour.

Regards,
Tony Barry

[Screwdriverone]

:lol:

Don't hold back now, tell us what you really think!

You paint a.....well......quite awful picture, thanks......:(

Cheers

Chris

[Waxing_Gibbous]

:rofl::rofl::rofl:

Too true!
IF you drink a lot of milk or eat tons of dairy (I don't) you should probably switch to "liquified pecker cheese" and stear clear of high-fat, stuff.
However, I managed to drag out of my Cardiologist (a skinny nervous guy who's hands shook), that taking 1/2 an aspirin, eating more veggies and doing regular, sweaty exercise, will help counter-act the effects of serum cholesterol.
I smoke, I drink, I eat crap, I have type II diabetes, damn near everyone in my family has croaked because of one of the above, yet every time I go for a physical, my arteries are clear, my ECG is spot-on, I have the lungs of a 30 year-old marathon runner, my pulse is 50 bpm and my BP is 110/60 ( thank God!!!).
I also do about 4-6 hours of hard labour a day.
We are animals. We are very physically able and adapted - we can run further than any other creature on the planet - and using that ability is the main way to keep us healthy.
Break a sweat for an hour or more a day, stear clear of Mars bars and you should stay pretty sound.

[MrB]

And that there is the 'secret'

[multiweb]

If it's hereditary you'll likely need medication... Yeah drop the full cream milk. You'll get used to skim anyway. Bit of Olive oil, lots of fish, bit of wine in moderation, exercise, sensible diet and watch your weight. Nothing new you'll say just common sense. :P

[gregbradley]

I get very good results with red rice yeast. Its a natural product but is the raw material statin drugs are made from.

I was told you can't take it all the time as it can affect your liver. I believe that is the same situation with statin drugs or at least the liver needs to be checked from time to time to see how it is coping with it.

More salads, less fatty food like dairy, fatty meats -, drink more water, more exercise, lose weight etc etc. The normal usual health advice.
As Marc said more fish (of the right type, some types of fish can increase mercury, predator fish have higher levels as they pick it up from their prey and it accumulates).

Greg.

[ZeroID]

Go the veges, reduce the meat. We buy better quality ( less fat ) but eat smaller portions. A more mediterranean diet is the answer. Salads can be very flavoursome with balsamic and Haloumi, nuts, roasted capsicums. oven roast chips and veges. Plenty of options. I've actually found more variety going towards a heathier life style than on the 'mandiet'. Doesn't stop me enjoying a good beer or three, good wine, dining out. In fact I look for wide options than I used to and you appreciate good cooking more. Japanese cuisine is excellent. Stir fries on the BBQ.

Don't look at it as a problem, it's actually an opportunity to find new dishes.

[Barrykgerdes]

I haven't met anyone yet who has had that blood test and not been over the recomended level. The medication supplied under prescription I believe is the worlds biggest seller to the pharmaceutical companies.

My parents and grand parents etc some fat some thin all lived into their 90's without knowing what their cholesterol level was. Some were vegetarians some were omniverous and some were gluttons. It did not seem to have affected their life spans or well being.

Incidently I take medication for it but that is only to keep the doctor happy!

Barry

[kustard]

Good advice guys :)

I've grabbed some low fat options from the shops today and like a few people have said, it's pretty much common sense.

[CraigS]

To the best of my knowledge, no reputable study has ever come anywhere near to proving that serum cholesterol is the direct cause of artherosclerosis.

Within 'normal' lifestyles, ingested cholesterol has little to zero direct effect on serum cholesterol. Where it seems to have an indirect effect is on the calculation of the LDL (or so-called 'bad cholesterol'), figure. Serum triglycerides are usually factored into the formula used to calculate LDL. To the best of my knowledge, (others may be able to confirm this), the LDL figure pathologists report, is rarely a directly measured figure. As a result, if your triglycerides are up, due eating saturated fatty foods, your LDL 'figure' will go up in a way defined by the formula. This doesn't necessarily mean that your LDL has increased.

Exercise reduces the triglycerides and thereby, shows up in a reduction in the LDL figure.

Remember, for those without diagnosed artherosclerosis, 'elevated' cholesterol is only one of about five or six 'risk factors. In my case, I've found that GPs rarely consider the other factors, before reaching for the prescription pad.

It is still possible that 'elevated' cholesterol is a symptom of artherosclerosis but not necessarily, the cause. Statin therapy would then only be an attempt at treating the symptom .. and it carries risk.

If you have a confirmed, diagnosed case of artherosclerosis, or have other risk factors going against you (genetics, high blood pressure, diabetes, low measured HDL, high percentage body fat, etc), then the risk of statin therapy is probably outweighed .. so take the pills.

Statin therapy should be considered alongside the other risk factors and should not be the single dependent factor. I recommend having a careful look at the reputable information you can get your hands on eg: National Heart & Kidney foundation reports, etc .. before making the decision.

I have found numerous GPs, who don't seem to be following the wording of the NHF NKF, etc recommendations/material, in detail.

(My 2 Cents worth).

Cheers

[AdrianF]

Chia seeds. High levels of omega3 and cholesterol lowering ability. You can buy the seeds from health food shops and some bakeries are now adding to some of their breads.
I am over weight my diet is atrocious but my cholesterol is 5.1 when last checked.

Adrian

[blindman]

How high is your cholesterol?
Garlic helps, also Cinnamon also helps.
Level of normal cholesterol levels has been deliberately lowered to make more profit for pharmaceutical companies.
With medication you will most probably stuff your memory, make some research on internet.
You mention drinking milk? Why would someone drink milk, if not sick? :-)
Milk diluted with water (what they sell here) should be banned as product.
Cheers Nev

[Spanrz]

Add my 2 cents.

For 2-3 years, my doc said my Cholesterol was climbing, and threatened to put me on Lipitor.
I watched my diet and all, I suppose it wasn't the best, but it wasn't the worst.
My wife has very good results with Cholesterol, it's kinda weird, cause she can eat worse than me and still have a low reading (around 4)
Mine was creeping from a 5 to a 6.8 to 7

I changed my diet in to 3 levels, in other words, I ate healthier then healthier again, for a while and it just kept skyrocketing up...WTH
I was eating porridge with 2% or less fat Milk, and fruit during this time.
Doc "never" believed me that I was eating healthier.
So I changed my diet again and was put on lipitor. Small dose. Then a few months after another test, came back higher, so she kept me on Lipitor and upp'd the dose to 80mg (by memory?)
I was WTH and the Doc still never believed me I was eating healthier, the wife had to come and give evidence to prove I was eating different stuff. Crazy I tell you.
I read what Lipitor can do to you and I went off it. (My preference)

Anyway, I got the ****s. And said not doing testing for a while, I'll prove it to the doc.
After a year, I got sick bad enough for a visit to the Doc. I was told, no test for a long time, naughty boy, said I got the poops with your "non-believer" attitude.
So I did the test, results came back down to 5.5..... Lol and my diet hadn't changed since the last test. And no Lipitor pills either.
She asked me what I changed, and I said nothing major, maybe minor things, but had this diet for 2 odd years. She was gobsmaked to say the least.

The biggest thing I changed, was my milk. From normal milk to the 1-2% fat stuff. Normal Milk carries 4% fats, so I halved my intake of milk fats and vola.
My butter/margarine has been "olive grove classic" for over 3 years. I did used to have butter (oooohhh that western star stuff), but hadn't had real butter in many years.

After a while, the doc believed me and started to realise that I may have a hereditary cholesterol, which I do know of some high readings in the family. Only took 2-3 years for the Doc to realise, that I was obeying her orders.

So, before you go hammer and tongs on Lipitor, read about it. Blood tests need to be done after starting Lipitor, to check for damage or the medicine to affect the liver (something about the enzyimes).

And start using the less than 2% milk for a long time. It will take about 6 months for things to change.

[DavidTrap]

It may seem like common sense, but my best advice would be too see a dietician. They know far more about food that most doctors (and I say that as a doctor). I saw one a couple of years ago on the advice of my GP when I wanted to lose some weight. When I followed her suggestions, the weight fell off. It seemed like I was eating more, but it was in the right proportions. She was very clever at making menu plans around my lifestyle & work. The advice they can give you about the right foods to eat is gold.

Ask your GP for a referral to a dietician.

DT

[CraigS]

Folks;

I have recorded 11 cholesterol readings over some 20 years of 'normal' and intentionally strict cholesterol diet controlled living.
Yes, that's right .. I've been pursued by GPs for over 20 years about this issue and I've never had any even near cardiac events nor a single high blood pressure reading.

My cholesterol readings have been all over the place, from 5.6 to 8.0, and there's never been any correlation between my readings and dietary changes. Neither has any doctor been able to establish one. I've been through all these cutbacks on milk, butter, fatty meats, etc, etc. I have never taken pills for it.

No dietary change, no matter how severe, (yep .. been there, too), has had any effect, whatsoever.

And, as I said in my prior post, no reputable double blind, clinically controlled, medical trials have ever established to any statistical significance, a cause/effect relationship between ingested (eaten) cholesterol and blood serum cholesterol.

Talk to your GP. All the honest ones I've had, confirm that dieting has virtually no effect on blood cholesterol. Any correlations you may observe between your readings, and your diet, are pure chance, or are simply a result of the way they calculate the LDL (bad cholesterol) figure.

Don't believe me. Research it for yourselves. Read the clinical trial papers and their results. Read the reputable institution recommendations. You'll see what I mean.

Cheers

[DavidTrap]

CraigS,

I hadn't read your previous post before replying to the original poster.

LDL is a measured variable - whilst at Uni, I worked in a pathology lab and spent one summer working in the department that did that particular test. I think the Medicare Schedule requires the pathology lab to "measure" the variable rather than "calculate" it before they pay for the test.

I'm not sure where you evidence comes from, but elevated cholesterol is a well established risk factor for atherosclerosis. The role of LDL vs HDL cholesterol is something that has only come out in the last couple of years.

Cholesterol is a complex thing, but one of the reasons that dieting probably fails is that most people don't follow strict diets for long enough periods of time. They might think they do, but human nature causes them to return to bad habits or they are not eating the "right" diet (hence my advice to see a dietician).

Statins don't just lower cholesterol, but also "stabilises" the plaques via anti-inflammatory effects. Yes, there are side-effects to statins, but not everyone experiences those effects - like everything you do in life it is a risk-benefit analysis.

I don't claim to have all the answers.

DT

[gregbradley]

You can slam it down in 4 days. I did it once. Doctors couldn't believe it and wanted to know what I did. They said change your diet etc etc and it takes 6 weeks to notice any change. Mine was only slightly elevated.

Red rice yeast capsules, lots of water, exercise (walks on the beach nothing strenuous), salads maybe some tuna, organic lecithin twice a day, niacin (opens up the blood vessels).

Dropped something like 25%. So I disagree, diet and exercise can affect it but probably the main item was the red rice yeast.

The Naturopaths say there is no problem with higher cholesterol and its not a proven theory. Doctors don't get everything right and I agree dieticians would know more about food however they also get a lot of things right and I wouldn't go against them unless it were in an area I knew they were weak on. However is chlolesterol really a subject they are weak on? Hmm - plenty of dead people who ate lots of MacDonalds and KFC I reckon shows they are pretty close to the truth.

Greg.

[DavidTrap]

I won't disagree that the pharmaceutical companies make lots of dollars from statins, but they wouldn't be subsidised on the Pharmaceutical Benefit Scheme by the Federal Government if there wasn't good evidence.

I anaesthetise patients for cardiac surgery - I certainly agree that we see lots of people who have indulged in too much fast-food. Unfortunately we see some without any risk factors who look to be clean living people - usually they have chosen their parents poorly. You can't change the hand you've been dealt, but (most of the time) you can decide how it's played. One thing I have definitely observed - 99% of the 80+ year olds we see are NOT fat - the fat ones are already dead.

DT

[MrB]

David,
Slightly off-topic but still on the dietary theme..
What is your personal opinion on high-protien low-carb diets like BodyTrim(if you are familiar with it?)
Ketosis seems to be a concern?
Last thing I want is Acetone breath! (and other more serious ketosis effects)

[CraigS]

Would appreciate some first hand confirmation on whether the labs actually routinely do this for all screened samples. Happy to be corrected on this point. It wasn't always so.

LDL can be measured, but the last advice I had from a pathology lab, was that it was still calculated using the Friedewald equation. All of my historical LDL figures are within 0.5% of the calculated figure. It also varies precisely with the variance in the triglyceride figures, (which, as I mentioned, is factored into the Friedewald equation).



Can you forward me the clinical trial reference papers which establish this with statistical significance?
Cholesterol is a clear risk factor for cardiac events and strokes.
Its causative role in atherosclerosis is constantly being researched. I am interested to know if any reputable trial has firmly established such a causative role.
Once again .. happy to be corrected.




Can you forward me the clinical trial reference papers supporting the assertion that there has been a direct causal relationship established within statistical significance, between diet and serum cholesterol ? There are many so-called 'paradoxes' in this area, which support the contrary view.
Once again .. happy to be corrected in the light of quality evidence.


Agreed that statins act as anti-inflammatory agents.
Which is why is why I said:


Cheers

[CraigS]

David, with respect, there are many generalisations and sweeping statements you're making here.

The topic is complex, and I fully respect your professional role.

I'm happy to open my mind to the possibility that I have mis-stated something or I am way out of whack. I am fully prepared to make public apologies for any misrepresentations I've made.

However, I assure you, there is much research, deliberation and validity behind my words.

Perhaps it is not appropriate to continue in a low-rigor forum.
I am happy to call it quits at this point, if necessary.

Cheers

[DavidTrap]

Craig,

I won't deny I'm making sweeping statements - basically because I feel the association between cholesterol and atherosclerosis is well established.

I'm not intending to get into an argument quoting papers. I found one whilst you were sending your most recent post, so I'll post it anyway. It's a bit old (1998), but is from the New England Journal of Medicine - reasonably well respected peer-reviewed journal. I found it in a quick google search, and I've only read the abstract, but it was pretty definite about an association (and this was an autopsy study of young people):

Association between Multiple Cardiovascular Risk Factors and Atherosclerosis in Children and Young Adults
Gerald S. Berenson, M.D., Sathanur R. Srinivasan, Ph.D., Weihang Bao, Ph.D., William P. Newman, M.D., Richard E. Tracy, M.D., Ph.D., and Wendy A. Wattigney, M.S. for the Bogalusa Heart Study
N Engl J Med 1998; 338:1650-1656June 4, 1998

Abstract can be read here (http://www.nejm.org/doi/full/10.1056/NEJM199806043382302)

Happy to bring this discussion to an end. :thumbsup:

As to MrB's questions about low-carb diets, if you're referring to VLCD (Very Low Carbohydrate Diets) or shake diets - there is good evidence you can drop a significant amount of weight quickly (good if you need to lose weight before elective surgery), but most people rebound when they stop.

DT

[Liz]

As a senior nurse in a Coronary Care Unit, I will chuck in my 2 cents worth. ;)
Our cardiologists like the cholesterol level to be below 4.5, so patients with heart disease and high cholesterol are treated quite aggressively with high doses of good old Lipitor. As David says, Lipitor also has other heart friendly effects.
Cholesterol is one of the risk factors for heart disease, so if you can decrease it either by diet and/or medication, then thats great. Our docs dont reccommend the low carb/high protein diet, though I reckon its good. :D I lost weight 10 years ago, and dropped my cholesterol from 7ish to 4 ish by doing this. You need carbs to absorb fat.
Not everyone with a high cholesterol will get heart disease, but combined with other risk factors of blood pressure/smoking/family history/stress/weight etc., it can be a worry.
As others have said, a combination of diet and exercise normally brings it down Ok, others need different approaches per their GP.
Take care all, otherwise I will see you in CCU. ;)

[CraigS]

Hi David;

Thanks for the link/paper. There are lots of 'ins and outs' behind this so perhaps, out of respect, and for the sake of bringing this to a quick end (for others), I am happy to let it be.

I am interested in reading more and this thread has spurred me along.

Thanks for your input.

Cheers & Rgds.

[CraigS]

Yep Liz … I agree.

All things in moderation, stay fit eat healthily, get exercise and stay away from smoking.

Statin therapy is appropriate for some who fit the risk profile.

Many things are still unknown, when it comes to the medical research behind the causes.

Cheers

[DavidTrap]

Sorry if my last post seemed short or curt - my wife was giving me "the look" about the need to get the children up and into the bath...

Liz - I think the same when I look at my patients, ie I don't want to end up where they are. Then again - pork chops taste good...

DT