by shadykiller on 2/12/21, 3:30 PM with 142 comments
by elhudy on 2/12/21, 5:06 PM
I am thinking...is this really the modern answer to someone's high cholesterol if they consistently exercise, are nearly underweight, and rarely eat animal products to begin with? It doesn't add up to me.
It's amazing how little we still know about heart disease - the #1 killer in the US. As someone who will inevitably inherit chronic high-cholesterol as well, I'm excited to read and share this ongoing research. Thank you for posting this.
by superqd on 2/12/21, 7:32 PM
"There is little doubt that people with high cholesterol have an increased risk of disease."
It's just as valid to say that people with heart disease are more likely to have high cholesterol. When all you have is correlation, there is a heart disease group, and a high cholesterol group, and all you shown with correlation is that there is a third overlapping group of people with both. With only correlation, you don't know how/why, or even if, members of one group transform into the other. Which is partly the underpinning of the article.
It's possible that high cholesterol is a result of underlying heart disease (which the article says is possible), rather than a cause. But what shocks me is that people, even researchers, seem surprised to realize such possibilities.
by sradman on 2/12/21, 5:43 PM
ANSWER #1: Serum cholesterol is transferred back-and-forth between the blood and cell membranes to maintain a constant cell rigidity; normal behavior
PROBLEM #2: High serum cholesterol correlated to cardiovascular disease
ANSWER #2: Chronic inflammation associated with metabolic disorders upsets the various regulatory systems
I find the second answer unsatisfactory. Any chronic condition that damages arteries leads to plaque and this, in my opinion, accounts for all the other associations. The arterial wall damage can be due to excess blood sugar, oxidation, or pathogens (SARS-CoV-2?). The damage causes an inflammatory response and extra serum cholesterol is needed to repair the damage (forms the plaque). The chronic plaque formation reduces the arterial cross-section and reduces elasticity which both increase blood pressure.
The underlying cause is arterial wall damage. This can be measured non-intrusively using the Ankle-Brachial Pressure Index:
by flowerlad on 2/12/21, 6:59 PM
Also see collection of links at bottom of this article: https://medium.com/@petilon/cholesterol-and-statins-e7d9d8ee...
Cholesterol reduction is big business. Pfizer’s Lipitor alone raked in $125 billion between 1996 to 2012. This amount of money can be very corrupting. It’s almost impossible to find experts who are not influenced by money from industry.
by chihuahua on 2/12/21, 5:29 PM
It reminds me of my own experience earlier this week where I needed to call a certain service. The API has 2 parameters. I thought that one was required and one was optional. But whenever I called the service with 1 parameter, it failed. Eventually I thought "maybe both parameters are required" and called the service with 2 parameters, and it worked. So I concluded "both parameters are required". But later I discovered that the service was just flaky and it was a coincidence that it started working just at the moment when I added the second parameter. After that experience it's difficult to know what to trust, when everything could be due to randomness and unreliability.
by ncmncm on 2/12/21, 9:01 PM
Fred Kummerow spent his whole working life getting trans fats out of the US food pipeline. He proved trans fat was poison in 1957, and finally in 2009, under compulsion of a lawsuit, the FDA declared it toxic. Then, they issued no regulations restricting their use until forced by another lawsuit, in 2014. Then, they gave vendors 3 more years to put poison in stuff being sold as if it were food. In 2018 it was supposed to be illegal to sell trans fats as food, but a number of companies still do, under waivers.
He died in 2017, at age 102. He spent the final two years of his life working on Parkinson's, which had taken his wife, since trans fats had (he thought) finally been outlawed. He was a great hero of experimentally-grounded health science.
https://www.drmirkin.com/histories-and-mysteries/fred-kummer...
India and Brazil are still struggling to get it outlawed. The big corporations have resisted because selling poison as if it were food remains profitable.
We are still confused about fats. But a takeaway should be that nobody has ever found any evidence of harm from eating saturated fat, or benefit from eating unsaturated fat, despite decades trying.
by Geee on 2/12/21, 7:06 PM
by basicplus2 on 2/13/21, 12:45 AM
Cholesterol is used by the body to patch damaged arterial walls which can cause clogging if the there is excessive damage to the arteries.
The problem is high sugar levels in the blood by eating high sugar content foods and high glycemic index foods like highly processed carbohydrates which turn to sugar quickly raising blood suggar levels.
High sugar levels cause damage to the arterial walls and bodies response is to patch the damage.
https://www.adwdiabetes.com/articles/repeated-sugar-spikes-d...
Other issues interfere with the ability of lipids entering the wall properly in the repair process and cause the atherosclerosis exaserbated by ldl presence also caused by high sugar levels amongst others
https://pubmed.ncbi.nlm.nih.f gov/1222702/
Unfortunately all these issues get conflated together to produce misunderstanding and alot of misunderstanding
by mrkeen on 2/12/21, 10:17 PM
A: saturated fats
B: LDL cholesterol
C: heart disease
A => B
C => B
A => B /\ B => C
You don't say?
by josefresco on 2/12/21, 5:39 PM
Before my disease I ate like an average American (sugar, meat, dairy etc.) and my LDL cholesterol was high. I was diagnosed, changed my diet and my LDL dropped to healthy levels. Later I started a new medication (JAK inhibitor) and it jumped back up, but my diet did not change.
I read this article twice and have no idea how it applies to my situation.
by PragmaticPulp on 2/12/21, 5:51 PM
The ambiguities and unknowns have opened the door for fitness gurus and health product grifters to turn this into a sort of holy war. It’s sad to see how many people have been convinced they are “healthy” because they follow a couple out of context fragments of the overall health picture.
I know too many people who think they are doing everything right because they avoid gluten, or don’t eat dairy products, or minimize saturated fat. Yet they go on to consume excessive amounts of sugar, or drink copious amounts of alcohol, or eat 4000+ calories per day of their chosen healthy foods.
by chiefalchemist on 2/12/21, 6:32 PM
The point being, much of collective knowledge on this subject is based on misleading / false assumptions. That is, you're going to struggle to find results that align with conventional wisdom because that wisdom is flawed.
by qw3rty01 on 2/12/21, 5:49 PM
by hpoe on 2/12/21, 4:58 PM
It seems like every decade we find out everything we did last decade was bad and wrong but now we've finally for sure got it figured out, and this time we know we are right because we have fancier gadgets and more citations in our name.
From Frued to the Food Pyramid it seems that the experts always have just finally figured it out.
by j16sdiz on 2/12/21, 6:11 PM
Most pop science articles just dont have it
by ve55 on 2/12/21, 6:29 PM
I think it's likely the case that sometimes high LDL is good, and sometimes it is bad, and this may depend on many other factors related to yourself and your diet. But disentangling these cases is very difficult, and the food supply of nations has changed so much that we keep seeing very misleading correlations. These misleading correlations are why we sometimes hop onto bandwagons like 'fat is bad for you', 'high salt is bad for you', or 'animal products/red meat are bad for you', and then after more research and RCTs, we realize that this is not the case (if the press would stop reporting correlations to everyone as important research that you need to act on right now, that would certainly be nice).
I'm looking forward to more progress here, but until then I don't mind eating saturated fats myself, although I do avoid certain sources of them, such as in fried oils high in linoleic acid. I also don't focus a ton on LDL precisely, but rather some other related measures (different types of cholesterol, low inflammation, and coronary calcium scans if possible)
by blakesterz on 2/12/21, 5:20 PM
The homeoviscous adaptation to dietary lipids (HADL) model explains controversies over saturated fat, cholesterol, and cardiovascular disease risk
https://academic.oup.com/ajcn/article-abstract/113/2/277/610...
"Corresponding with the model, we suggest alternative contributing factors to the association between elevated LDL cholesterol concentrations and ASCVD, involving dietary factors beyond SFAs, such as an increased endotoxin load from diet–gut microbiome interactions and subsequent chronic low-grade inflammation that interferes with fine-tuned signaling pathways."
by troll_v_bridge on 2/13/21, 12:11 AM
by didibus on 2/12/21, 6:44 PM
I still don't understand this. I thought the cause and effect had never been proven, but only the correlation.
Like people who have heart disease often have high cholesterol.
But was it shown that if they lower their level of cholesterol they can revert their condition?
Or was it shown that it was the increase which led to heart disease?
by wuwuno on 2/13/21, 3:55 AM
The claim is that cholesterol is so sticky that is clogs up the largest arteries of the body, is almost laughable.
If cholesterol is as truly sticky as claimed then it should be clogging up the tiny capillary vessels in the lungs, but it doesn't do that.
Linus Pauling discovered the basis for heart disease, but his theory has been 'discredited' by scientists who have bought and paid for by big pharma.
by twic on 2/13/21, 1:29 PM
That seems like an absolutely wild idea to me. So the cell just grabs whatever lipids arrive from the diet and turns them into phospholipids and puts them in the membrane? I know nothing about this process, but my biochemist's intuition tells me to be skeptical. Is there research on this?
by rafaelero on 2/12/21, 6:57 PM
by dcolkitt on 2/12/21, 6:33 PM
by hammock on 2/13/21, 12:10 AM
by Syzygies on 2/13/21, 12:51 AM
I had been taking Clemastine and vitamin D. I asked a former student now a doctor at the center of the COVID response whether these would interfere with my vaccine. She said to stop Clemastine on the off chance that one study was on to something, but there was no reason to take or stop taking vitamin D.
by andybak on 2/13/21, 12:18 AM
The obvious and constant advice to date is: drink less alcohol, exercise more and eat less saturated fat.
Tackling all three at once is quite a challenge so it would be lovely if someone threw me a bone here. ;-)
by wtetzner on 2/12/21, 5:40 PM
It seems more likely that the supposedly "heart healthy" seed oils are causing heart disease.
The Carnivore Code has some very good insights (at least in my opinion) [1]
And this talk on how seed oils are destroying our health is also pretty interesting: https://www.youtube.com/watch?v=7kGnfXXIKZM
[1] https://www.amazon.com/Carnivore-Code-Unlocking-Returning-An...
by known on 2/13/21, 1:53 PM
If you want a general guide of how healthy your cholesterol levels are, find out your total cholesterol-to-HDL ratio
To find this, take your total cholesterol figure and divide it by your HDL figure. A result of less than four is healthy
by doganengin on 2/12/21, 3:43 PM