Cholesterol question

I believe the cholesterol you eat is largely passed undigested. It's a myth that high cholesterol foods cause high cholesterol directly- it's more of a side effect. Also, check what they're actually measuring as there isn't really 'good' or 'bad' cholesterol and some other measurement that I've forgotten the details of (apoB) is actually what's important.

Stick some Peter Attia cholesterol episodes in your ears and get up to speed 😀

I had a similar 10 year risk. GP seemed to think it was nothing to worry about, so I've just decided to try and beat the system 10 years at a time.

My simplistic take is to just avoid the sugary stuff - e.g. have the bagel with bacon / mackerel / etc, rather than the cake/brownie.

This is based off the idea that a (simple) sugar-filled diet causes your liver to make more ldl cholesterol, the bad type, and less hdl cholesterol, i.e. the good kind.  That's simple added sugar as opposed to sugars delivered via veg / grains / etc.  Lots of articles around on this if you have a quick google.

Dr says I have a 3.8% chance of a heart attack in next 10 years which she seemed to think was low.

You need to look at the half full glass - you have a 96.2% chance of not having a heart attack in the next 10 years, which is very high.

Increase those chances further by not worrying! 😉

But also cut out unhealthy foods.

My LDL's were the ones that are high 😟

To be honest I'm not that worried, I was just hoping that I could still happily have cake at the cafe on a bike ride! Having said that my father didn't make 40 due to lung cancer (keen smoker) and my brother only just managed 40 (keen drinker, although the alcohol didn't directly kill him , what did dependents in how much you trust the Police in Baku) so I am keen to see my son grow up and know this is not a given!

But also cut out unhealthy foods.

😰😰😰😰

Your doctor is/possibly is an idiot. High cholesterol can be genetic, certainly is in our house. I take a low dose of statins. All the checks came back exceptionally low for heart attack, but there wasn't really anything I could do to change my diet. Low dose of statins had everything in range. Both my folks are on statins.

By all means change your diet, then get tested. If it hasn't moved much it's genes !

I've a a bit longer than you, of my dad's family:

Grandad (heavy drinker)  heart attack from clogged arteries @ 67

Uncle (heavy drinker & smoker) heart attack from clogged arteries @ 71

Aunt (overweight & diabetic) heart attack from clogged arteries @ 69

Dad sweet tooth but not overweight heart attack from clogged arteries @ 69

so I've got 14-16 years to go.

Have had generally low cholesterol, but c 3 years ago it was up a bit (still in ok range) & I was overweight. Thanks to chub club I've dropped 14kg so need to sort out another cholesterol test to see if there has been any improvement.  While statins may help you drop the cholesterol level,  what happens to the fat that's been laid down in your arteries if it has been high previously?

In the family cases above, it was bits breaking off & causing blockages that caused the problem.

My sister lives in Spain-  when she went home after Dad's funeral & discussed this with her GP, she was sent for loads of tests including the stress test on a bike, plugged into machines, oxygen mask etc & pedal like mad till exhaustion and has had 2 follow ups in the 10 years since.

A little of what you fancy...

Is what my doc told me 15 years ago after my heart attack. 12 years later I'm still here, despite not having the healthiest of lifestiles, now reformed due to a TRA or two and the possible onset of diabetes.

High Cholesterol runs in my family, and I possibly have a high chance of having anoither Heart Attack, but it ain't a bad way to go... Could be much worse...

As a general rule both doctors and patients are pretty shit at understanding percentages and risks.

what inputs did they use to determine the % risk?  Was it just your age and lipid levels? Perhaps gender?  Was your activity level, your weight/height, or any other risk factor part of the calculation?  did they say having a heart attack (bad) or dying from a heart attack (more bad).  Did they say what the risk would be if you could manage to significantly reduce the level (say by 30% which would be a big change).  Did they say what the confidence interval was on 3.8%?

id hazard a guess (without having any actual stats or your details in front of me) that you are more likely to die from a heart attack in the next 10 yrs if you reduce your cholesterol by enough that your doctor makes encouraging noises, but stop exercise than if you keep doing exactly what you do just now.  If cake is your motivation for exercise (or social interaction with friends, or various other things which affect morbidity) then I’d think carefully before chasing the 3.8%…

FB-ATB - a vitamin K2 supplement may help you. Plenty of info on the web, I like to listen to this cardiologist

it’s a fat soluble vitamin, so take it with some fat.

Low fat diets eh?

I'm in the same boat (I started another thread somewhere on here about it) - for the past 2 weeks I've avoided all cake, biscuits, crisps, cheese, fast food etc, and am trying to eat as healthy as possible. A side effect is I've lost just over a kg - down to 83.5kg.

My parents have both had TIA's, which has an impact on the docs calculations on how much of a risk it is for me to have one too. They're both on statins, so it's likely I'll also be given them (regardless of if I need them or not).

I run three times a week, cycle at the weekends, walk the dogs every day and generally run about the house after our children. Yet mine is still up at around 7.1

I plan on being around to see my grandkids, so making some changes now for the better.

anything Less than 4 % risk is totally normal for someone well into middle age and not something to be worried about is saythat said if your cholesterol is high then cutting down on the saturated fat (keep to around 10g per day, easier said than done if you enjoy your food) plus increase the good hdl makes a difference I went from well over 6 total cholesterol to less than 3 through that approach. Lots of avocados seemed to help. I also take a low does statin, but should be noted I got to below 3 before I started taking them.cardiologist told me that if you can get your ldl below 1.6 you can actually reverse heart disease to some degree. but as pointed out above, some folks just have high cholesterol no matter what you eat, so if that’s the case a low dose statin may be in order. Also apparently helps stabilize existing plaques, which is why I take them.

Sorry wrong link above. Try this

what inputs did they use to determine the % risk?  Was it just your age and lipid levels? Perhaps gender?  Was your activity level, your weight/height, or any other risk factor part of the calculation?

From what I gather it involved age, weight, height (or maybe BMI) and blood pressure which was taken recently.

No confidence intervals were given, due to the fact she was bumbling on about good cholesterol and bad I didn't think it appropriate to enquire about the type of analysis that was done either although I used to do a reasonable amount of multivariate statistics myself.

id hazard a guess (without having any actual stats or your details in front of me) that you are more likely to die from a heart attack in the next 10 yrs if you reduce your cholesterol by enough that your doctor makes encouraging noises, but stop exercise than if you keep doing exactly what you do just now.  If cake is your motivation for exercise (or social interaction with friends, or various other things which affect morbidity) then I’d think carefully before chasing the 3.8%

Whilst I like that thinking, I reckon it might be possible for me to stop at a cafe and not eat cake 🤔🤔😄😄

U can always make your own cake and cut down on the nasty stuff, I am just making a banana bread and cut right down on the sugar, add some dates to make it less bland.

're 3.8% I would be highly sceptical of such a precise percentage, unless it came from an actuary.

I have annual cholesterol  checks, 1st one is really a snapshot, subsequent ones establish a pattern.  Doc always says u have to look at other markers too, height, weight, lifestyle, age, other blood markers like cell count, can't remember if it's red or white.

What are the numbers?

4% chance of a heart attack in 10y for a middle aged man is chuff all really I’d settle for those odds and I’m running marathons regularly (at a decent pace too). I’d file it under nothing to worry about.

4% chance of a heart attack in 10y for a middle aged man is chuff all really I’d settle for those odds

You are assuming it's an accurate model

for the past 2 weeks I’ve avoided all cake, biscuits, crisps, cheese, fast food etc, and am trying to eat as healthy as possible. A side effect is I’ve lost just over a kg – down to 83.5kg.

If I don't ride my bike for a fortnight but keep the same diet I tend to lose about a kilo as the muscle in my legs disappears. 😀

I’m not sure why you need to stop your mid-ride cake 🤷🏻‍♂️

What are you scared of in there? We’ve already established that dietary cholesterol is irrelevant to incidences of heart disease so it’s not the eggs.
In which case it must be the sugar but we know that is treated differently during exercise too. Your glute 4 transporters will be rippling with excitement from smashing all those hills- so the sugar in the cake will be into your muscles in no time at all (not spiking your insulin and causing fatty liver disease etc).

The best thing you can do is to get fitter. Raise that Z2 power and get those mitochondria healthy 😃

@edward2000

thanks for the link. Interesting stuff

The best thing you can do is to get fitter.

Race you up a hill 😜😜

Not on flat though 😄😄😄😄

We’ve already established that dietary cholesterol is irrelevant to incidences of heart disease

Have we?

I’ve got Peter Attia’s book and interestingly, he says the main shift in his thinking since he set out to write it is that diet is almost irrelevant to health. There’s literally not enough facts to back up the inclusion or exclusion of anything in particular and is wildly unique.
And exercise that he thought was a side note at the beginning is in fact the almost powerful way to stay healthy.
He talks about imagining you are training for the centarian Olympics. We know predictably how much aerobic, anaerobic and strength fitness declines with age so to be that world beating 90 year old, you need to get as fit as possible now!!

There’s some technical bits I ignore but I’d highly recommend the book. (Outlive).

Have we?

Well I have because I read the link I posted 🤣

is that diet is almost irrelevant to health. There’s literally not enough facts to back up the inclusion or exclusion of anything

Pretty sure that a similar arguement was made that smoking wasnt bad for you.

Well I have because I read the link I posted

I got bored pretty quickly!!!

My understanding was that if you were genetically prone to high cholesterol then actually diet was more important, which sounds a bit back to front but is true

Cholesterol isn’t even the issue is it. It’s the fact that it gets dumped out in your arteries by the low density and very low density lipoprotein transporters as they gouge into the walls.
The ‘good’ and ‘bad’ lipoproteins have the exact same cholesterol inside of them.

And your liver regulates what you produce (some cells make their own, some get it from the liver). That’s partly the issue with being metabolically dysfunctional.

Most cholesterol we eat literally cannot get through our gut transporters into the blood stream anyway. As I say- we poop it out.

What you describe with smoking is what happened already with cholesterol. The cholesterol at the blockages was assumed to be the culprit. But of course it wasn’t that simple.

As Peter says regularly in his cholesterol episodes- if anyone you are discussing your health with starts mentioning ‘good’ and ‘bad’ cholesterol then they literally have nothing of use to tell you- they are the exact same cholesterol being transported in two different ways. (Cholesterol is an oil which repels water so can’t move through your blood stream without being wrapped in a lipoprotein case).

Anyway- cake isn’t an issue but I guess I’m done in this thread 😀

As Peter says regularly in his cholesterol episodes- if anyone you are discussing your health with starts mentioning ‘good’ and ‘bad’ cholesterol then they literally have nothing of use to tell you- they are the exact same cholesterol being transported in two different ways. (Cholesterol is an oil which repels water so can’t move through your blood stream without being wrapped in a lipoprotein case).

It depends on whether the person is talking about good/bad to dumb it down for you as most won't see the relevance of how it's transported.

... I reckon it might be possible for me to stop at a cafe and not eat cake 🤔🤔😄😄

Did she factor in the fact you appear not to be human in her calculations. 😉

I would be highly sceptical of such a precise percentage, unless it came from an actuary.

That was the point I was getting at.  She didn't intend it to cause alarm.   I wonder if she had said, "in general your health is good and when combined your overall risk is <5%" if the OP would have been worried enough to start the thread.  Instead, she's given a very specific number, suggesting it's more than reasoned guesswork or reading off a couple of graphs, and left him thinking, well 38 out of every 1000 people my age with my cholesterol have a heart attack in the next 10 years - which sounds scary.  What she didn't do was point out that as a relatively healthy middle-aged white man in the UK your likelihood of surviving that is somewhere approaching 90%.

I've spent a surprising amount of my life in meetings about how outcomes of tests like that are presented to users, and things like the colour of the text/background and font/capitalisation of words etc has an impact on how we perceive the meaning in the number.  It can be as much of a challenge in the opposite direction - making sure that someone takes action as doesn't overreact.  Its often the worst-funded and poorest thought-out bit of any research project around some new health initiative.

You are assuming it’s an accurate model

I don't have enough expertise in the field to have any particular reason to doubt it. If you've found sufficient research to challenge it, fair enough.

It depends on whether the person is talking about good/bad to dumb it down for you as most won’t see the relevance of how it’s transported.

There's no need to lie about it to the extent that people associate mid-ride cake with death 😉

<p style="text-align: left;">We’ve already established that dietary cholesterol is irrelevant to incidences of heart disease

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total cholesterol is expressed as a combo of ldl and hdl plus triglycerides. The ldl/hdl ratio is important

Ldl is bad according to pretty much every expert I’ve spoken to (2x cardiologists plus  professor of clinical pharmacology)

all that said, I refer to my earlier post. Whilst you probably want to try to get your ldl down a bit, 3.8 % risk will be absolutely no worse than anyone else your age. And on a positive note, if its 4% chance of a heart attack, it’s probably a 1% chance of dying from a heart attack! I’d bite your hand off for those odds over the next 10 years!

The point is, LDL and HDL contain the exact same cholesterol. You could lower your cholesterol intake all you like but if your liver is making more than you need you’re in the same boat.
You can’t exist without cholesterol- it’s part of every cell. The idea isn’t to eliminate it but to stop your LDL’s dumping their load into your artery walls.

Total cholesterol doesn’t include what you eat because most of that goes straight out the back door 😀

Any improvements dietary restriction in the name of ‘lowering cholesterol intake’ makes to your total cholesterol is almost certainly a byproduct of being healthier via lowering your weight and your blood pressure and improving your metabolic health.

Eating cake mid-exercise remains a non issue 🍰 😋

That was the point I was getting at.  She didn’t intend it to cause alarm.   I wonder if she had said, “in general your health is good and when combined your overall risk is <5%” if the OP would have been worried enough to start the thread.

It didn't alarm me. Any number presented to 1/10 of a percent regarding something as complex as thisisnt worth worrying about. (This also answers the captain's question). What worried me was the fact that a Dr called me up to tell me I have high cholesterol when I eat a very low fat high fibre diet, don't drink much, don't smoke and am not overweight. Which combined with cycling to work everyday in top of two or 3 other rides a week means I don't have much "fat' to trim as far as improving this goes

Any improvements dietary restriction in the name of ‘lowering cholesterol intake’ makes to your total cholesterol is almost certainly a byproduct of being healthier via lowering your weight and your blood pressure and improving your metabolic health.

eating less saturated fat and more healthy eating has lowered my ldl massively. Without a significant change in weight or bmi. No 2 ways about it. So unless you are a doctor of some description I’d be more trusting of the advice of folks who are paid to know about this stuff and all have told me that diet plays a part in cardiovascular health.

feel free to do as you please obviously, but unless you are a doctor I don’t think it’s particularly appropriate to be handing out advice on diet in relation to heart disease on a public forum when it flies in face of what most experts agree on.

Reduce your sugar/carb/ultra processed food intake. Sugar is the killer

a_a was she testing for a particular reason? Or have you just reached an age where they do this for fun?

I haven’t given any advice other than to be aware of what is actually happening in your body.

Same as low fat diets can help you lose weight even though you can get fat without eating fat- healthier, low cholesterol diets will lower your ldl despite the fact the problem was the cholesterol you were making, not eating.

a_a was she testing for a particular reason? Or have you just reached an age where they do this for fun?

Age, pushing 50 that and I finally went to see Dr about something else and had been ingnorring all the messages about blood pressure and blood tests!!

Reduce your sugar/carb/ultra processed food intake

If I reduce my carb intake I'd feel shit on the bike, can't see how that's linked to cholesterol.

eating less saturated fat and more healthy eating has lowered my ldl massively.

That is interesting. My GP strongly believes that altering your diet makes little difference to your cholesterol levels. He claims that your cholesterol levels are almost all down to what your own body produces and that only losing weight is likely to have a significant effect.