Breaking Down the Numbers

The lipid profile will include numbers on the following:

• Low-density lipoprotein cholesterol (LDL)
• High-density lipoprotein cholesterol (HDL)
• Triglycerides
• Total cholesterol

Your LDL cholesterol is the “bad.” HDL is the “good.” Triglycerides are fat obtained from dietary intake. Total cholesterol is those two combined, plus other lipid components.

Why are the levels of these important? Being a reader of this website, you’re most likely a healthy and fit specimen. But you might have a family history of heart disease, high blood pressure, diabetes, or some other issue. So, you need to watch your numbers on a regular basis. As they say, it’s better to be safe than sorry.

“If you have a family history of high LDL and exercise and diet are not helping, then cholesterol medications may be the answer.“

The risk of heart disease increases if your levels of LDL cholesterol are high. LDL can build up on the walls of your arteries and blood vessels in the form of plaque and decrease potential blood flow. HDL – the good cholesterol – can help decrease this bad cholesterol buildup.

Triglycerides are another type of circulating fat that can lead to narrowing of the arteries and vessels. Over-consuming calories can lead to greater amounts of triglycerides. As with LDL cholesterol, high triglyceride levels increase the risk of having a coronary event.

Low-density lipoproteins can form the arterial plaque that is generally associated with cholesterol.

What Does Healthy Look Like?

When it comes to LDL levels, the lower the better:

• Less than 100 mg/dl (milligrams per deciliter) = optimal
• 101-129 mg/dl = near optimal
• 130-159 mg/dl = borderline high risk
• 160-189 mg/dl = high risk
• More than 190 mg/dl = very high risk

But when it comes to HDL levels, the higher the better. You have a greater risk of heart disease if you are:

• A male and have less than 40 mg/dl of HDL
• A female and have less than 50 mg/dl of HDL
• Male or female, you have a lesser chance of heart disease with HDL levels more than 60mg/dl

“[Y]ou might have a family history of heart disease, high blood pressure, diabetes, or some other issue. So, you need to watch your numbers on a regular basis.”

Here’s where you should aim when it comes to triglycerides:

• Less than 150 mg/dl = normal
• 151 – 199 mg/dl = borderline high
• 200 – 499mg/dl = high
• More than 500 mg/dl = very high

Your total cholesterol is the sum of your HDL, LDL, and triglyceride levels. Determine your triglyceride sum factor by multiplying it by .2. That is, if your triglyceride level is 135, the sum factor would be 27 (135 x .2).

• Less than 200 mg/dl = optimal
• 201 – 239 mg/dl = borderline high-risk
• More than 240 mg/dl = high risk

Example – Female:

• LDL = 116 – near optimal
• HDL = 68 – good
• Triglycerides = 36 (180 level x .2) – borderline high
• Total cholesterol = 220 – borderline high-risk

Example – Male:

• LDL = 158 – border-line high risk
• HDL = 60 – good
• Triglycerides = 19.6 (98 level x .2) – normal
• Total cholesterol = 237.6 – borderline high-risk

How to Get Your Numbers in the Healthy Range

If you are already an avid trainee who eats well, but you have undesirable cholesterol levels, then you should seek out a reputable physician for help. If you have a family history of high LDL and exercise and diet are not helping, then cholesterol medications may be the answer.

If you don’t exercise and you do practice a poor diet, you need to:

1. Begin a sensible exercise regimen.
2. Shore up your food consumption habits.
3. Get tested again when you’ve improved your lifestyle.

Check out these related articles:

• Is the Government Reversing Its Stance On Cholesterol?
• What Is Healthy Eating? Turning the Pyramid Upside Down
• Study – High Protein Diets Result In Better Cholesterol Scores
• What’s New On Breaking Muscle Today?

References:

1. Fogoros, Richard N., M.D., “Cholesterol and Triglycerides – What You Need to Know,” About Health, accessed April 2, 2015.

2. Kahn, April, “High Blood Cholesterol and Triglycerides (Lipid Disorder),” Healthline, accessed April 1, 2015.

3. Shaw, Gina, “The Trouble with Triglycerides – Manage high triglycerides with tips from the pros,” WebMD Feature, accessed April 1, 2015.

Photos courtesy of Shutterstock.

The post Understanding Cholesterol: Good Health by the Numbers appeared first on Breaking Muscle.

At the time, heart disease was the leading killer among Americans and fixing this issue was at the forefront of research. Ancel Keys, an American scientist who studied diet and health, and his colleagues convinced Congress that saturated fat and cholesterol were the major culprits of this epidemic. This led to the United States Department of Agriculture recommending a high-carb and low-fat diet to the American people.

We were saved. Or were we?

An Increasing Risk of Heart Disease and Cancer

The government has been warning people of the dangers of cholesterol and saturated fat since 1961. Since then, our obesity rates have climbed, along with heart disease and cancer rates. Researchers and doctors expected to see a huge drop in heart disease by handing out new guidelines that recommended eating less cholesterol and saturated fat while increasing carbohydrate intake. When the results did not match their predictions, they thought, “We must lower cholesterol levels even more.” This gave birth to the massive push of cholesterol-lowering medication.

“The government has been warning people of the dangers of cholesterol and saturated fat since 1961. Since then, our obesity rates have climbed, along with heart disease and cancer rates.”

But even with these medications and a high-carb, low-fat diet, heart disease, cancer, and obesity rates continue to climb. After decades of failure, someone should have been questioning these methods. When results are not meeting expectations, we need to go back to the drawing board.

Poor Science Meets Government Do-Goodery

Cholesterol was condemned by Ancel Keys, but he cherry picked epidemiological data to match his hypothesis. Epidemiological research is the starting point, not the ending point, of research. In order for his epidemiological data to hold weight, it would have needed to show an inverse relationship between cholesterol and heart disease across the board.

Research during Keys’s time did not undoubtedly show that saturated fat and cholesterol led to heart disease. Conversely, a 2010 meta-analysis on saturated fat and heart disease risk concluded with this statement:

A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD. More data are needed to elucidate whether CVD risks are likely to be influenced by the specific nutrients used to replace saturated fat.¹

Why do we continue to push these nutritional policies when the evidence is pointing us in another direction?

Ancel Keys carefully selected which the data he would present and then presented this information to Congress. Poor science met government do-goodery and the “saturated fat and cholesterol are responsible for heart disease” mantra was born. (By the way, Gary Taubes has a great write up of this history in his book Good Calories, Bad Calories.)

Is the Government Changing Its Stance on Cholesterol?

Fast-forward to February 10, 2015, and the headline for a Washington Post blog read, The U.S. government is poised to withdraw longstanding warnings about cholesterol. Upon reading this, I immediately thought the government was reversing the stance they took over thirty years ago. I should have known better.

“Cholesterol has been found at the scene of clogged arteries in human subjects post mortem, but that does not mean it is the culprit.”

It seems the government is poised to remove the high-cholesterol warning label on foods such as eggs, shrimp, and lobster. The “experts” now believe that ingested cholesterol does not raise cholesterol levels in the blood for the majority of people. They believe the problem lies with too much consumption of highly saturated foods such as fatty meats, butter, and whole milk. They still caution against the high levels of LDL (“bad”) cholesterol in the blood.

I am not totally in disagreement that too much LDL is bad. If levels are high, it may be a symptom of something else going wrong. Cholesterol has been found at the scene of clogged arteries in human subjects post mortem, but that does not mean it is the culprit. Cholesterol may be there acting as an antioxidant.²

We cannot just look at LDL levels without looking at the bigger picture. HDL (“good”) cholesterol levels and triglycerides are also important factors. LDL-to-HDL ratio is a valuable tool of assessing heart disease risk.³ Most studies condemning fat intake only looked at LDL. But when we examine the relationship of LDL and HDL together, it turns out saturated fat intake raises both of them – which does not change heart disease risk.⁴

Changes in the Right Direction

As irritated as I was from reading this latest Washington Post piece, I took a step back and thought about it. The more I thought, the better I felt. Yes, the government is still missing the boat on a number of nutritional issues. Hopefully, they realize this before another forty years pass. But they are making changes in the right direction. We can’t expect them to change everything at once, especially when commercial interests are at stake.

“Yes, the government is still missing the boat on a number of nutritional issues. Hopefully, they realize this before another forty years pass.” 

The USDA’s dietary guidelines are updated every five years and they are currently under review. The last meeting to discuss the proposed guidelines was back in December, so now we just sit and wait to hear. Some other topics proposed for discussion were sugar intake, omega-3 fatty acids, salt, red meat, and saturated fat. It will be interesting to see the changes that are made.

Are you optimistic that the government will move our policies on nutrition in the right direction? Share your thoughts in the comments below.

References:

1. Siri-Tarino, PW, et.al., “Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease.” American Journal of Clinical Nutrition (2010). Retrieved on February 12, 2015.

2. Girao, Henrique, et.al., “Cholesterol may act as antioxidant in lens membrane.” Current Eye Research (1999). Retrieved on February 12, 2015. 

3. Fernandez, ML and D Webb. “The LDL to HDL cholesterol ratio as a valuable tool to evaluate coronary heart disease risk.” Journal of the American College of Nutrition (2008). Retrieved on February 12, 2015. 

4. Mensink, RP, et.al., “Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials.” American Journal of Clinical Nutrition (2003). Retrieved on February 12, 2015. 

5. Whoriskey, P., “The U.S. government is poised to withdraw longstanding warnings about cholesterol.” The Washington Post 2015. Retrieved on February 12, 2015.

Photos 2 & 3 courtesy of Shutterstock.

The post Is the Government Reversing Its Stance on Cholesterol? appeared first on Breaking Muscle.