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Thread: High bad cholesterol

  1. #1
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    Default High bad cholesterol

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    Robert, in your experience, do doctors ever suggest eating less carbs as one measure to reduce high bad cholesterol? I ask because that's one of the things my doctor said after mine came back at 130-something, after bloodwork from a routine physical.

    I am 56, 6'0", 194 pounds, bodyfat percentage higher than I'd like (23-24% as measured by FitBit scale). I train 3 times weekly, which I told her. She also suggested "increasing exercise to 2 1/2 hours per week".

    I'd rather base the amount of carbs I eat on fueling training performance. But I'm curious as to why she would suggest less. Is it just a knee jerk response, or is this perhaps her way of recommending a calorie deficit?

    I appreciate your hard work on this forum and all the content you share. Thank you.

  2. #2
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    You should get a second opinion. The only reason I would think to suggest that is if fat was already restricted and you needed to pull carbohydrates to lose more weight. Now a high sugar diet can elevate your triglycerides because if you eat excessive carbohydrates they can be converted to triglycerides in the liver via denovo lipogenesis, with release into the bloodstream and adipose tissue. This effect seems to be more pronounced in individuals with higher body fat and the theory is that it is related to reductions in insulin sensitivity commonly observed with high body fat. We are talking about a diet that is very high in carbohydrate, low in fat, and high in calories. That combination requires effort that most people won't put in. Generally, it is recommended that you get fat calories down first along with sugar and go from there. What were you exact lab values?

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    Quote Originally Posted by Robert Santana View Post
    You should get a second opinion. The only reason I would think to suggest that is if fat was already restricted and you needed to pull carbohydrates to lose more weight. Now a high sugar diet can elevate your triglycerides because if you eat excessive carbohydrates they can be converted to triglycerides in the liver via denovo lipogenesis, with release into the bloodstream and adipose tissue. This effect seems to be more pronounced in individuals with higher body fat and the theory is that it is related to reductions in insulin sensitivity commonly observed with high body fat. We are talking about a diet that is very high in carbohydrate, low in fat, and high in calories. That combination requires effort that most people won't put in. Generally, it is recommended that you get fat calories down first along with sugar and go from there. What were you exact lab values?
    Thank you for this detail. The lab values were given to me over the phone, while I was in my car, so I will follow up for the exact numbers.

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    Yep get the actual value and report back!

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    Quote Originally Posted by Robert Santana View Post
    Yep get the actual value and report back!
    HDL cholesterol: 56 mg/dL
    Triglycerides: 133 mg/dL
    Cholesterol, total: 212 mg/dL
    CHOL/HDLC ratio: 3.8 (calc.)
    LDL-Cholesterol: 131
    Non HDL cholesterol: 156

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    Quote Originally Posted by Charlocity2 View Post
    HDL cholesterol: 56 mg/dL
    Triglycerides: 133 mg/dL
    Cholesterol, total: 212 mg/dL
    CHOL/HDLC ratio: 3.8 (calc.)
    LDL-Cholesterol: 131
    Non HDL cholesterol: 156
    I would worry more about the Triglycerides than the LDL. All are welcome to correct me, but I believe the evidence of high Triglycerides being bad is much stronger than the evidence of high LDL being bad. Neither your Tris or your LDL are atrocious, though. Your HDL is pretty good.

    My total Chol. is about where yours is, but I look more at the Trig./LDL ratio. I like this study:
    High Ratio of Triglycerides to HDL-Cholesterol Predicts Extensive Coronary Disease
    (though bear in mind it looked at people who had various risk factors for heart disease, not just high cholesterol).
    In this study, LDL and total cholesterol didn't predict coronary disease very well, but low HDL, high Tris, and high Tri/HDL did.

    Also bear in mind you can pick and choose studies to tell the cholesterol story you want, like the story I'm telling you now.
    Good news is exercise improves HDL and Trigylcerides, so do the program.
    More good news: I ain't a doctor, so you can ignore this post if you want.

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    Quote Originally Posted by Slow Uncle Joe View Post
    I would worry more about the Triglycerides than the LDL. All are welcome to correct me, but I believe the evidence of high Triglycerides being bad is much stronger than the evidence of high LDL being bad. Neither your Tris or your LDL are atrocious, though. Your HDL is pretty good.

    My total Chol. is about where yours is, but I look more at the Trig./LDL ratio. I like this study:
    High Ratio of Triglycerides to HDL-Cholesterol Predicts Extensive Coronary Disease
    (though bear in mind it looked at people who had various risk factors for heart disease, not just high cholesterol).
    In this study, LDL and total cholesterol didn't predict coronary disease very well, but low HDL, high Tris, and high Tri/HDL did.

    Also bear in mind you can pick and choose studies to tell the cholesterol story you want, like the story I'm telling you now.
    Good news is exercise improves HDL and Trigylcerides, so do the program.
    More good news: I ain't a doctor, so you can ignore this post if you want.
    Thanks for weighing in. Your point is well taken. When they gave me these numbers over the phone, what I remembered was "130 [something]...needs to be under 100". Since both triglycerides and LDL cholesterol were 130-something, it's possible I confused the two.

    They also asked me to come back in 3 months for repeat bloodwork.

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    LDL needs to be under 100 mg/dL and Trigs should be under 150 mg/dL. Sounds like your LDL was on the high side. I don't see how this isn't something you can remedy by cleaning up your sugar and fat intake and training.

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    Quote Originally Posted by Robert Santana View Post
    LDL needs to be under 100 mg/dL and Trigs should be under 150 mg/dL. Sounds like your LDL was on the high side. I don't see how this isn't something you can remedy by cleaning up your sugar and fat intake and training.
    Thank you, sir. I'll do just that. I'll track my macros and schedule the appointment for that 3 month follow up bloodwork. That will make it feel like I'm training for a meet!

  10. #10
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    If you want to plug your numbers into the American Heart Associations Risk Calculator, here it is:
    2018 Prevention Guidelines Tool CV Risk Calculator

    I'm not convinced LDL is a very good risk indicator, there are studies now that associate higher total cholesterol with lower mortality rates among older populations. I'll post links if anyone is interested.
    I live dangerously and don't worry much about LDL and total Chol., but if you're not a daredevil like me, you can use the AHA's risk assessment linked above.

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