LDL, HDL, VLDL, OMG!

Cholesterol. 

One of the most common questions that comes up by people paleo-curious, or who have jumped right on in with both feet and are enjoying the way they are looking, feeling and performing is this one: “What will eating all this meat and all these eggs do to my cholesterol?” 

Let’s chat a bit about this.

Firstly, I am not a doctor, nor would I ever play one on TV. This post is not to be taken as medical advice, rather, I am hoping that it gives you some food for thought, things to discuss with your doctor, and geek out on if you so choose. I’m not saying all docs are right, or wrong, I’m saying that there are a LOT of things that go into the full cholesterol story and you ABSOLUTELY should talk to your doctor or health practitioner about any and all of these things.

Griff, a senior member over at Mark’s Daily Apple, did an awesome write-up on cholesterol basics, what the total cholesterol is a count of, then defines LDL (low-density lipoprotein – or “bad” cholesterol as many call it), HDL (high-density lipoprotein – or “healthy” cholesterol), triglycerides and VLDL (very  low-density lipoproteins – or the carriers of your triglycerides). What was enlightening to me was the take on how the numbers are derived, and how different formulas might paint a very different picture. Yes, it's a long post. Read it!

Now, I'm pressed for time, so I don't have several hours to devote to summarizing all the info that's on the web concerning cholesterol. Just know that I'm now empowering YOU to go geek out on this stuff. That's right, links and links some more that might prove useful for you in understanding these numbers, cholesterol in general, etc.

So here we go:

• Gary Taubes wrote this piece in the New York Times that I thought was pretty enlightening.
• Robb Wolf has this to say about cholesterol.
• Chris Kresser, aka "The Health Skeptic" provides all kinds of information, along with more links than you can shake a stick at, here and here.
• This study, out of Texas A&M (along with collaborating researchers), talks about VLDL maybe not being as bad as we think it is.
• Mark Sisson at Mark's Daily Apple weighs in here.
• Chris Masterjohn has a wealth of information here and cites a lot of publications, other links and resources that may be of interest (such as explaining the difference between the diet-heart hypothesis and the lipid hypothesis).
• Very often you'll hear talk about "particle size" or "pattern A" or "pattern B" LDL cholesterol. Here's some more info on that and LDL in general from Wikipedia. Though most doctor's offices don't delineate these, there's an important differentiation to be made. This is an interesting study on low fat/high carb diets and heart disease risk. Then some more info here on those "small dense" guys.

So what's the right answer? What should we aspire to in our blood panels? What is "normal" (and if "normal" is as it relates to society at large, is that something we really want for ourselves?).

I wish I had all the answers. What I can tell you is this: In 2005, $19.7 BILLION was spent on outpatient statin prescriptions (that's up from $7.7 BILLION in 2000). When are statins prescribed? When your cholesterol is "high" according to your doctor's office. As you've read in the links above, there are some very real, very valid questions about what cholesterol numbers mean, and are we even testing the right thing to know if there's an issue (that is, should we be looking at particle size more to see if in fact that has a stronger correlation to heart disease, because it seems to be of more and more interest)? 

It's hard to know who to trust/who to believe these days and what is "right." Those of us who used to be devout food pyramid followers might be among the greatest skeptics out there. However, if you have a family history of cardiac events, you need to do your own due dilligence to figure out what is right for you, and seek out specialists who can help you to make the best decision for you. Talk with your medical professional, not this blog!

I will say this: there are a lot of people who would rather take a pill to fix something, than figure out ways to prevent it. We see this with weight loss all the time. The scary thing is that this is now being handed down to kids in today's world. Take a look at this article here in Time Magazine. Statins for obese kids? OMG.  

I am hoping that somewhere in here, there's a nugget of info that is in the slightest bit helpful. Again, NONE of this is medical advice and if you take it as such Melissa will make you do 4982 burpees. Right now.

Got something to say on cholesterol? How were your numbers? Anyone who has done paleo and gotten blood tests, how did those undisputedly good HDL numbers look?

Comments

[Vinings Charles]

Hi...my name is Charles. "Hello Charles" And I have high cholesterol. Interestingy enough, my cholesterol is high for two reasons:

1) My HDL is way above normal. HDL is the good kind and my doctor didn't hardly mention this in my last blood panel.

2) My LDL is slightly high (based on current standards). VLDL was extremely low.

I had them test my partical size for the blood work and I came back Type A. For those that haven't geeked out yet, Type A are large and puffy. In other words...the don't stick to anything. This seems to be the biggest line in the sand for those that support the notion that total cholesterol isn't the whole story. If the LDL is big and puffy...it isn't supposed to stick to anything. If this is true, then my high LDL count isn't as big of a concern.

Needless to say, I tried to talk about this with the doc...he just wanted me on meds. At this point, I'm willing to take the chance that any issues I have (according to the doc) would benefit greatly from healthy eating.

[Catherine]

Oh!I understand! -new Tom Ford glasses Thank you for sharing this