Reduce Cholesterol or Inflammation is the big question?
This week end I have been very busy reading about inflammation and cholesterol!
Lots and lots of information available. Do we look at reducing cholesterol or reducing implementation?
Did the researchers got is all wrong? Please advise.
bigleg/Bala
And interesting question and response. However I think we need to be careful in coming to an answer. There are two "BIG" questions:
1) Is 'current' wisdom as to how cholesterol becomes raised correct?
and
2) Is raised cholesterol a health concern at all?
I'm not sure which part, bigleg, your responding to? All the quote is on number 1 but you seem to imply to number 2 also.
In my opinion (based on a degree in a nutrition and a subsequent Masters - and then working in the field ever since) the answer to the first question is categorical. There is no question that the caused of raised cholesterol was misidentified as "fat" and even later narrowing in on "saturated fat" has worsened the situation. Again, in my opinion (but based on extensive studies on clinical data - as well as my own practice experience), refined carbohydrates is to blame.
Question 2 is far trickier. There is evidence to show some protective effect of higher cholesterol levels in certain populations but it is hard to interpret against individual differences. If there was a direct straight line link anyone with FH would drop dead - fortunately this is not the case. I am quite sure that giving a set upper limit (in the UK 5 but in France 6 so whose to say what this should be any way) is far too over simplified.
For me there is no coincidence that when you eat healthier (and exercise) your LDL and perhaps more importantly your VLDL reduce - so I would not way don't worry so much about your total cholesterol number (or eating healthily) I would say worry about the type.
And in answer to Bala's question these liproproteins are deemed to be inflammatory - so perhaps we should not be talking two different things - cholesterol and inflammation?
Finally. I wouldn't be so quick to think the guys writing the books are always right. At the end of the day they have books to sell and therefore need an angle. From my professional experience (reading clinical studies) I see these mis-interpreted (or at least interpreted to support an argument) as much by these 'rougue doctors' as by others - but normally in the direct opposite fashion. Extremism is seldom good in any guise, but middle of the road books don't sell.
Professionally speaking proper scientists spend their whole year in a field - they know how to interpret data and more worryingly how to build a study that give best chance of showing a positive result. Doctors spend little to no time on nutrition and this is very often outdated - hence we still for the most part get 'low fat' advice. One hopes those writing the books spend a little more time learning the area. As an aside naming no names, but the most well known (or at least they were) nutritional doctor in the UK was a Gynaecologist?!
BetaBalance
Too add to my marathon post above.
The reduction of refined carbohydrates will also reduce inflammation markers too.
So all in all I'm agreeing, but not pretending to know the whole answer.
The interactions between the body are extremely complex so I don't know if it is possible (or beneficial) to isolate one marker. If inflammation was all bad - we should promptly stop all exercise!
BetaBalance.
Hi Bala,
Cholesterol and inflammation levels appear to be linked - rather like Bonnie & Clyde.
The much maligned satins reduce our mortality risk by 19% - irrespective of whether they do so by reducing cholesterol or inflammation levels. Yes, statins reduce inflammation levels.
On the other side of the coin, carbohydrates and saturated fats raise both inflammation and LDL.
So until they finally work out the precise mechanics for the cause of CVD, we should tackle one or the other or both. It shouldn't matter.
I must confess to being utterly confused.
Having only recently entered the high cholesterol world (diagnosed FH a month ago), I am still researching and learning about cholesterol, statins, what I can and can't eat etc.
Thank you bigleg for the link to the article. Extremely interesting, written by a professional without an obvious gain to be made and as such very believable.
Is my high cholesterol a problem or not?
Does my research now shift from 'which statin should I take' to 'should i be taking them at all' ?
And what can and should I eat? if cholesterol is not the issue can I have some butter on my toast? or is it not the butter but the bread that is the problem?
I really would like to know the answer to these questions. Betabalance, can you point me to a sensible article and or diet which gives information on the correct kind of diet I should be following or at least considering?
Well, either high cholesterol is a problem, or it's a consequence of another problem (inflammation in this claim), so I feel we probably should do something about it.
Much as I'd love to blame evil factory bread for causing the problem, it seems unlikely to me - I've been eating a measured amount of oat-laden craft bread for a year or two now and it's only made a slight reduction. And don't forget, butter is unnatural too: cows don't churn their own milk.
We'd all really like to know the answers, but they've not yet been discovered and I feel the only people who claim certainty aren't trustworthy enough. There are a few hypothesis and the lipid hypothesis is supported by most people, so I continue with that for now, but try not to do anything too harmful in general (I'm probably taking a lower dose of an older statin than some medics would like) and try to stay on the "right side" of most other hypotheses.
There are several studies which have found that the lipid hypothesis is incorrect. Why these have not been widely publicised I do not know. Some people would suggest that there is no money to be made from telling us about this. This study is a summary of evidence.
ajcn.nutrition.org/content/...
It is possible that eating any bread will keep your cholesterol high, as it is processed carbohydrate.
Evening amandac,
Sorry - bit of a cop out. But really most people in my situation always want to give advice tailored to the individual. As it depends on goals, weight, activity levels, BMR and more..
As a general rule I tend to recommend - not withstanding special requirements:
1) high (relatively) protein
2) Medium cabohydrate (from high fibre complex sources)
3) Medium fat
Carb choices should be fibrous.
5 meals per day (or 3 meals and 2 snacks) - each with a source of protein carbs and healthy fat in. As this reduced postprandial glucose response.
For cholesterol lowering in particular, I favour an increased soluble fibre intake - vegetables, pulses and lots of oats (in various forms).
I'm not against elements of diets such as paleo, zone, atkins (parts thereof), Dukan etc... but as with books (see earlier rant above) commercial diets/eating plans always err on extremism so they take a good idea and take it too far. Making it difficult to comply (or in other words stick to it). Would rather have a little moderation and make positive changes for life - then see a change for a couple of weeks and then falling of the wagon.
Sorry if that's not the response you wanted, but I hope it is at least a little useful.
Happy to answer any other questions.
BetaBalance
As someone who was diagnosed with high cholesterol and written off as having hereditary high cholesterol based on little evidence... Then told i MUST take statins to avoid a stroke or heart attack and being bullied every time i went to the GP to take them... My Gp even had a talk to me about how she likes to feel she is doing a good job that the work she does is making a positive diffrence- to i which replied' we cant always have what we want'. I was told there is no way i can bring my chol down from so high and quick enough. Yet when i cut out cakes,biscuits,sweets,chocolates, manufactured milk shakes and added more veg,fruit,fish i got my chol down to an exceptable level- which suprised my gp.
Im not saying this is the same for everyone, but that with an already suspicious mind based on the 'evils' of statins,previous allergic reactions to medication( to which the gp told me i cant be having a reaction as its an anti-inflammatory with no side effects- i ignored gp's advice stopped taking and got better),my grandfathers allergic reaction to the heart medication( top Surgeon at the hospital gave him a lecture, but my grand dad refused, then once left hosptial, got hold of medical journals and compiled evidence to support his case and wrote a letter to the Surgeon pointing out the symptoms he was having is medical fact that he did the right thing stopping taking it) but also that that there is alot of commercial investment in high Cholesterol.
The diagnosis for me was : 3 blood tests,2 blood pressure tests(normal healthy level) ,one physical checkup- no signs of high chol slightly overwieght, one urine sample taken -diagnosis given minutes after that and then one more blood test after being diagnosed!. Sooo im very skeptical.
I dont take the cholesterol could be a reaction to inflammation as the truth, but i dont dismiss it either as its a little more plausible than high chol is genetic and must be forced down via medication.
Hi,
Thanks for your input. My GP, (NHS) similar to your GP's response. GP cannot understand how I am able to reduce the HbA1c teats results by life style change and going to gym and the cholesterol has not come down, even alcohol free for three months. I gave in and I am on the 4th week on Statin!
Only time will tell, next blood test is at the end of June this year.
One interesting book on the subject by Robert Lustig, an American childhood obesity specialist, looks at the effect our diets have on our health. He writes about the damage done to our health by low fat diets, and by processed, fibre less food full of sugar. He writes about metabolic syndrome, which includes high BP, and the science behind it. It may be an American book but the problem is world wide.
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