The FastDay Forum

I started 5:2 back in March. I had recently fallen into the overweight BMI category, a big shock, and my cholesterol was much too high. So it was time for a change. Seven months later, I've lost about 16 pounds and am 3/4 of the way to my goal weight. I look better and feel great.

But the disappointing part is that in August I had blood tests done and saw my doctor. My cholesterol hasn't budged. I have a very healthy diet - no red meat, no fast food or junk food to speak of, lots of vegetables. And I've always eaten this way. So it's a genetic condition, and that's all there is to it. My doc says that the only way I'm likely to be able to lower the numbers is by going on a really extreme diet - virtually no carbs, lots of good oil, piles of fruit and vegetables, no animal protein, that sort of thing. I'm too much of a foodie to do that unless there was no other way.

And the other way is a statin. But the doctor says I can wait till I'm 60 (soon, I'm afraid) and have a heart scan. Based on the state of my heart, I might or might not need the statin. Side note - my doctor, who is 71 and about to retire - is in the same boat, but did have heart scans and is not worried about her high cholesterol because of those heart scan results.

Anybody out there identify with this story?

What is your number for LDL-P (should be on your NMR LipoProfile)? LDL-P, or ApoB, is one number indicator for the risk of coronary artery disease (CAD). If the LDL-P is high, you can then look at particle size.

Triglycerides, Ratio of Total cholesterol to HDL, Total HDL levels, etc. on their own are not more accurate predictors of the risk of CAD than LDL-P.

LDL-C is not the same as LDL-P.




Edited to add information.

Hi Wendyjane,

I can't say yet what has happened with my cholesterol. Mine has been high and I was being treated with Lipitor. I told my Dr I didn't want to take a statin and she let me take nothing for 3 months. I am due back to see the results are since doing 5:2. I'm curious. Where do you live? I didn't want to take a statin since I had read that it isn't good for women. But, you can find info to support almost anything on the internet.

[Debs]

Absolutely Maryjane. I found mine was 8.8 several years ago but was unable to get it down to an acceptable level with diet and exercise alone. Mine is genetic and, therefore, frustrating so I have ended up on stains for the last few years which brought it down to just over three.
I hate having to take drugs continually am and going to see if the fasting helps at all so I am having some time out from taking them and then getting tested.
(And yes, I am aware of LDL/HDL ratios etc.!)

Debs

[carorees]

There's some good info on cholesterol in this thread: progress-f4/topic5145-15.html#p59051 (the link takes you to the start of the discussion about cholesterol). There does seem to be evidence that lowering carbs reduces high density LDL.

Hi there, I too have genetically high cholesterol. My doctor here in Britain did not believe me as I have been a vegetarian/pescarian since the age of 11, have never been overweight, and eat a super healthy diet and get tons of exercise. I was 7.4. My ratio was good though and it was suggested that I reduce/change certain things in my diet. Well I did that and got it down to a 6.0 after a few months. I started 5:2 January 2013. The weight has been coming of slow and steady. I decided to get my cholesterol tested in August and was really hoping that I would see a decline as Dr.Moseley had in his book. Well I was really disappointed when I was told it was now 7.2. I sat down with my doctor and we went over it and I told her about the fasting, etc. Anyway she took me online to punch in my info to a site that tests one's cholesterol risks. She told me not to worry as my ratio was really good and all of my lifestyle factors were really good so I was not in a "high risk" category. I told her that there was no way in hell I would ever go on Statins knowing the risks associated with them. My mother who also has genetically high cholesterol was put on statins in the USA and she felt so rotten on them that she stopped taking them. So maybe see if your doctor can tell you or direct you to the website to see what your risk is? Anyway good luck and I would avoid statins. Oh and my mom is almost 70.

What is your number for LDL-P (should be on your NMR LipoProfile)? LDL-P, or ApoB, is one number indicator for the risk of coronary artery disease (CAD). If the LDL-P is high, you can then look at particle size.

Triglycerides, Ratio of Total cholesterol to HDL, Total HDL levels, etc. on their own are not more accurate predictors of the risk of CAD than LDL-P.

LDL-C is not the same as LDL-P.




Edited to add information.

I'm guessing my numbers won't mean much to you, Lady Muck, since I'm guessing you are British, and the rest of the world measures cholesterol differently than we do in the US (it figures!).
However, here they are for what it's worth. (Note: Dr. Mosley says there's no direct translation of the American cholesterol scale with everyone else's... not sure how that could be, but I believe him).

In August 2012 I had an NMR LipoProfile test (which my nasty American insurance company wouldn't cover, BTW).
LDL-P 1821 (High)
LDL-C 146 (Borderline-High)

In August 2013 I had a plain old lipid panel.
LDL-C 168 (High)
HDL 48
Trig 90
Cholesterol 234

Blech!!!
PS Are you a doctor?

[carorees]

I've been having a look at cholesterol levels and risk, and as you might expect it's very complicated and no-one has really pinned down exactly what the best lipid profile might be!

Some interesting things I found though are:
In the Leiden Longevity Study, while LDL particle sizes were associated with male longevity (increase in log odds ratio (OR) per unit = 0.21; p = 0.023), it was triglyceride levels (decrease OR per unit = 0.22; p = 0.01), but not LDL particle size, that were associated with female longevity.

In the Framingham Offspring Study, LDL-P was a more sensitive indicator of low cardiovascular risk than either LDL-C or non-HDL-C.

According to a recent review of studies about lipids and cardiovascular risk:

The Emerging Risk Factor Collaboration, a large prospective participant level analysis, a meta-analysis of statin clinical trials, and the Heart Protection Study have each reported that apoB does not add significantly to the cholesterol markers as indices of cardiovascular risk. By contrast, a meta-analysis of published prospective studies demonstrated that non-HDL-C was superior to LDL-C, and apoB was superior to non-HDL-C. As well, three studies using discordance analysis each demonstrated that apoB and LDL-P were superior to the cholesterol markers. Two approaches to resolve these differences are brought to bear in this article: first, which results are credible and second, how does taking the known differences in LDL composition into account, help resolve them. The best identification of individuals at risk of coronary artery disease or with coronary artery disease allows the most efficacious treatment of elevated LDL-P and will permit a more extensive use of some of the more novel LDL-lowering agents.

Much of the controversy vanishes once the physiologically driven differences in the composition of the apoB lipoprotein particles are taken into account, illustrating that epidemiology, not directed by physiology, is like shooting without aiming.

The paper reporting on the meta-analysis mentioned in the review opens with a very interesting introduction describing the debate on the relevance of different lipid measurements to cardiovascular risk. The discussion suggests a target levels for non-HDL-C (if apoB levels are not available) might be <130mg/dl while LDL-C should be <100mg/dl. While a high-risk level would be >190mg/dl for non-HDL-C and >160mg/dl for LDL-C.

I presume your values represent mg/dl? If so, your non-HDL-C level (total minus HDL) is 186mg/dl putting you in an increased risk category.

Your focus should be on lowering non-HDL and raising HDL levels. So I looked for studies documenting the effects of diet etc on HDL/non-HDL levels.

I found that a diet high in carbohydrates caused increased triglycerides and lowered HDL in postmenopausal women: http://www.ncbi.nlm.nih.gov/pubmed/10837283
Adopting a paleo diet (pproximately 30% of energy from protein, 40% from fat and 30% from carbohydrate) caused a decrease in waist and hip circumference, waist/hip ratio and abdominal diameter, as did diastolic blood pressure (mean -7 mmHg), levels of fasting serum glucose, cholesterol, triglycerides, LDL/HDL cholesterol, apolipoprotein B (ApoB) and apolipoprotein A1 (ApoA1), urinary C-peptide and HOMA indices: http://www.ncbi.nlm.nih.gov/pubmed/23414424
Advice to increase carbs and lower fat resulted in a significant increase in fasting triglyceride concentrations after 1 week (p < 0.05), and the high-density lipoprotein (HDL) cholesterol concentration was significantly decreased (p < 0.05) after 1 and 4 weeks in post-menopausal women: http://www.ncbi.nlm.nih.gov/pubmed/19339775

Vitamin B3 (niacin/nicotinic acid) seems to be accepted as a means to raise HDL. It is recommended to use it in combination with statins, but I don't see why you couldn't try increasing your niacin intake to see what happens!

Niacin-rich foods include: mushrooms, chicken, turkey, beef, lamb, salmon, halibut, sardines. Interesting how the richest sources are in meat...I wonder if the benefit of the paleo diet partly comes from increasing meat content as well as decreasing carbohydrate content of the diet?!

And, of course, fasting has been shown to improve apoB and LDL particle size, so do keep on fasting!

Hope this helps!

Where do you live? I didn't want to take a statin since I had read that it isn't good for women. But, you can find info to support almost anything on the internet.

I live in Colorado, land of the Great Flood. My doctor says that women's risk doesn't increase till much later than men's - so she was recommending a statin COULD be taken starting in my early 60s, depending on the state of my heart.

What weird medical conditions I have - I also have low thyroid. I take thyroxine, and the doctor has asked if I feel better on it. All I can say is, I felt fine to begin with. Same thing with cholesterol, I feel FINE, damn it!

Niacin-rich foods include: mushrooms, chicken, turkey, beef, lamb, salmon, halibut, sardines. Interesting how the richest sources are in meat...I wonder if the benefit of the paleo diet partly comes from increasing meat content as well as decreasing carbohydrate content of the diet?!

And, of course, fasting has been shown to improve apoB and LDL particle size, so do keep on fasting!

Hope this helps!

Thanks, Caroline. I love all those foods (except beef and lamb - don't eat red meat).

True confessions: Another thing that could lower my cholesterol is more exercise. Once I get to my goal weight (aiming for sometime in November) "Phase 2" of my health improvement plan involves exactly that. Somehow, regular, more intense exercise is harder for me than not eating. I know lots of folks have the opposite reacton.

wendyjane, I hope the floods didn't affect you. The pictures look terrible.

I was reading that there are studies that say that women taking statins increase their chances of diabetes but I don't know how valid the studies were. I had also read that statins don't really help reduce the death rate from CAD unless you already have heart disease when you start taking it.

I have been curious about the particle size testing too. I haven't checked to see if my insurance will cover it.

I asked my Dr about maybe taking Niacin and she said the latest info on it wasn't so good either which is why she suggested just doing the diet and exercise and recheck in 3 mo.

I, like you, have a hard time motivating myself on the exercise part of it. I did stick with HIIT for 2 months last year then injured myself. Now I am trying to at least get walks and yard/garden work in.

I also take Lexothytoxine.

I don't believe that high colesterol is bad.
Many researches shows that it is not the main reason for heart desease

Hi, all my life everybody told me that high cholesterol is the main reason for heart disease. Due to that, I struggled lowering my high cholesterol for all my life. It's running genetically in my family. I tried anything - all kind of low fat diets, sports, natural supplements but nothing helped. 2 years ago I gave up and started taking statin. It helped lowering my cholesterol but I felt bad - I hate taking drugs and there are all the researches that say that statin is bad. So a year ago I came across with this site - http://bit.ly/19DmhsC . I studied the material and I decided to give it a try - and the results are amazing!!! I stopped taking any medication and followed the instructions and in the past 9 months my health is great, my cholesterol is perfectly normal and in the first time in my life I eat the stuff I love!!! This is never happened to me in any other method! I really recommend to all people that wants to live healthy and enjoyable life – try this http://bit.ly/19DmhsC

[carorees]

@theshark This site you link to is just advertising for an expensive book! Please can you replace your links with links to the research material so I can judge whether there is any merit to the guy's claims.

I agree that the cholesterol story is a lot more complicated than people think but we need to see the scientific rationale behind new claims just as much as for discrediting the old claims!

There is already plenty of evidence that it is the particle size of the cholesterol "packets" that is important and that HDL is the one to worry about increasing rather than reducing LDL.

I was reading that there are studies that say that women taking statins increase their chances of diabetes but I don't know how valid the studies were.

Hopefully that isn't the case as my mum had type 2 diabetes and high cholesterol (she's 66) - the doctor prescribed statins two years ago and she refused to take them, hoping to get her cholesterol levels down. She couldn't do it on her own and gave in a year ago. Her cholesterol dropped dramatically to healthy levels and she's just had her regular blood test to check her sugar levels and been told she is no longer diabetic.

I understand the need to not take drugs if there is another way to lower cholesterol levels - but only if it works.