Hi All, I am new here and have recently had a health check at the doctors surgery and it looks as though my cholesterol and triglyceride readings are high. My total cholesterol was 6.51, my HDL was 1.44, my non-HDL was 5.07, my Chol/HDL was 4.5 and my triglycerides were 4.80 mmol/L. I am a 42 year old male.
The nurse didn't mention seeing the doctor so apart from cleaning up my diet and exercising more should I look at going back to discuss medication? I would prefer not to take medication if this can be addressed through lifestyle choices alone.
Any help would be greatly appreciated.
Written by
RoboDollars
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First of all, bear in mind that cholesterol is only a diagnostic tool, and not a very good one at that. Cholesterol does not cause heart disease, which is why statins don't reduce your heart disease risk even though they reliably decrease total cholesterol and LDL.
Exercise is probably the single best thing you can do to reduce your risk of CVD ... independently of whatever your cholesterol readings might be. Having a high VO2max is the single best predictor of a low risk of heart disease, by a long chalk. In fact it correlates much better than HDL:TG ratio (which is currently accepted as the most useful risk marker from your blood lipid panel).
I remember my first year sixth form physics being told afresh about measuring volts amps etc. If I remember correctly the point being made was that these devices are designed to use laws that predict what you expect to see, and therefore are prejudiced in favour of the results you want to show.
V2OMAX has a similar design flaw. Research into V2Omax is often in very fit people doing a lot of cardio. So what result would you expect from a test that measures good cardio.?
More pertinently, surely, is looking at how cardiovascular disease actually occurs. My point is that someone can have 90% arterial blockage and still not have a heart attack. Most heart attacks occur in blockages above 90%.
So what is going on with people who exercise hard and yet have increasing arterial blockages? What happens is the body develops capillary tubes to carry the blood as the main arteries clog up.
This means that people can exercise hard for many years. Only when the arteries are truly blocked does the whole thing collapse, and death is often the result.
>> these devices are designed to use laws that predict what you expect to see, and therefore are prejudiced in favour of the results you want to show.
Good grief Andy. I'm glad I didn't have your physics teacher, or I'd still be washing dishes in a hotel kitchen for a living. This sort of "the laws of physics are prejudiced and subjective and Ohm's Law is a tool of thuh patriarchy" stuff I would expect in current year, but in 1972..? Well, I guess history does tend to go in cycles.
Ohm's Law emerges from the underlying physical reality of the universe. It is not "reality" itself, but it describes reality well enough to predict that if you grasp a 3kV powerline, several amps of current will flow through your body, regardless of your "expectations", and various other physical theories will predict the consequences.
Likewise with VO2max, which represents the maximum power output of your body in terms of oxygen uptake. There is no "design flaw". It is a precisely-defined parameter that describes the physical reality of the conversion of fats and carbohydrates to heat and mechanical work. Of course there may be errors in measurement (and even bigger errors in estimation) but that doesn't alter the fundamental reality of what VO2max is.
A body with 90% arterial blockage cannot simultaneously have a VO2max of 60mL/kg·min because there is nowhere for that oxygen to go. Likewise, a body with a VO2max of 10 is clearly in a parlous state. VO2max is a very good indication of the state of your cardiovascular system. This isn't just theory - it's also been borne out by experiment. VO2max is the single best predictor of your future CVD prospects. Doctors prefer to use cholesterol tests - even though they're vastly inferior - because (a) the government is only interested in cholesterol reduction, not disease reduction and (b) cholesterol tests are simpler and can be safely administered to dangerously-unfit individuals.
>> What happens is the body develops capillary tubes to carry the blood as the main arteries clog up.
Where on earth did you get this from? Capillaries and arteries have different functions. Your body doesn't magically grow extra capillaries to bypass arteries. I think you are referring to capillary growth that happens around tissues that are starved of blood due to advanced disease processes, but these are the last-ditch attempts of a dying body to keep itself alive, not routine adaptations that pass unnoticed.
>> To put it bluntly you cannot outrun a bad diet.
Maybe not, but RoboDollars was interested in the relative merits of a limited number of possible interventions. Exercise works. Statins don't. In fact the statin mechanism of action blocks a crucial metabolic pathway involved in cellular repair, thus ensuring that the outcome of exercise is likely to be muscle pain and fatigue (or, in rare cases, death by rhabdomyolysis) instead of an improvement in fitness. Statins thus prevent you from taking actions which would heal you.
I was also going to mention - as Praveen55 did - that an effective dietary intervention would be to drop dietary carbs (which are the usual culprit behind elevated serum triglycerides) and start eating proper food. But few people can accept this in the face of mainstream dietary advice, so I figured it was better to stick with one thing at a time
Welcome to the Healthy Eating forum. There is also an HU forum called 'Cholesterol Support' where you could also post, to get more replies - if you want to. I can pop back with the link in a moment.
Here's the link to the Cholesterol Support forum (on HU):
I assume the blood sample for the test was taken after 8 - 10 hrs of fast ( typically, overnight fast). Your TG number is very high making TG:HDL ratio in significantly high risk category for CVD. You are most likely overweight and have insulin resistance which can be confirmed by getting blood test done for fasting insulin level and glucose.
Action: For medication, discuss with your Doctor. As you are in high risk category, it makes sense to improve the numbers using medicines at least in the short term.
Long term strategy: Dietary intervention is the most important step forward. Avoid all processed food. Consider following low carb ketogenic diet which has improved lipid profile for many people. It will help you lose weight fast and will be sustainable. Learn about this diet. You should be doing regular exercise also. However, I will suggest you should take medically supervised TMT ( Treadmill test) before undertaking any strenuous workout. Talk to your GP about this.
I have a history of high Cholesterol readings - latest 7.7 - but never been on medication as my "good" values are high, too. On doctor's advice I have been drinking plant stenol drinks (Benecol or Tesco do an own brand, too) after my evening meal - haven't had my values retested, as I like the taste anyway. (Advice came after an old person's health check). Good luck - and don't fret too much.
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