Gambling...? Gawwds, no...got no pokerface... (Lady Gaga)
Tell me your labs. (Or show me ur abs...j/k)
You'll get a reaction.
Yeah, you thought... I was... e a s y. *ahhhaa*
When I hear an HDL cholesterol is off the charts, like triple-digit-over-100 mg/dl... you my dear have my full attention.
HDL Cholesterol: The Higher, The HOTTER
The goal for health optimization for HDL-cholesterol is 60 mg/dl or higher. Studies like the Four Prospective American Studies by Castelli WP et al found "A 1-mg/dl increment in HDL-C was associated with a significant coronary heart disease risk decrement of 2% in men (Framingham/FHS, CPPT, and MRFIT) and 3% in women (FHS)."
According to master cardiologist Dr. Castelli (who has successfully escaped premature family hx of CAD), if one's baseline HDLs are 30's and one increases this to 80's, this may represent a 100% reduction in relative risk for a coronary event. For girls, if one increases from HDLs 50's to 80's, then also a 100% coronary risk reduction could be relied upon.
Sounds excellent to me!
It is not difficult to raise HDLs.
This is observed all over in the evolutionary/paleo blogosphere, at Bernstein's diabetes, Protein Power Drs.Eades blog, at TYP in only those on high sat fat and/or [no or low-statin+wt-loss] and in clinical practice ALL THE TIME.
Eliminating wheat/d*mn-dirty-GRAINS/carbs, adding some vitamin D, omega-3s, Taurine, and Slo-Niacin 1-2 grams/day. Throwing away the Mazola and any packaged food items. Oh yeah, and add some fat. Individuals may continue their EVO (but not too much b/c it cranks up hepatic lipase, see HERE) but they increase eggs 2-6 daily, add some (organic nitrate-free preferably) bacon and some coconut oil.
And...reduce their statin (if even taking).
I know, s a c r i l e g e . . .
Consider the value of not over-statinating.
Over-statinating stagnates the formation of large particles. wtf. This is observed on the TYP forum frequently in over-statinators -- and easily corrected. The statin or fibrate is withheld or severely dose-reduced (TYPically, I advise 'licking the tablet' and that is a clinical term). See below medscape cases as well.
Yes, statins and fibrates LOWER HDLs ('good chol') for many individuals. Lipitor is the worse. Drugs appear to cause a 'ceiling' effect for HDLs and small dense LDL. Marginally on paper these may improve, however iatrogenically they fail to improve FURTHER beyond the ceiling.
Esp if low sat fat.
Esp additionally if you are an apo E2 carrier (you have lower TC LDL HDLs compared to the general pop). Or... if you eat low fat, low cholesterol, low saturated fatty acids. The interaction is hypothesized to be related to a statin-and/or-fibrate-related apo A1 reduction in activity (and because you are chol/saturated-fatty-acid-deficient).
Please, Ladies and Gents... what nicely raises cardioprotective HDLs (and apoA1) and lowers TOXIC small LDL and Lp(a) ?Saturated fat and C H O L E S T E R O L.
Yeah, even if you are moderately high carb, smoke, and had an event already. We'll go over some post-CAD event trials in the near future to describe yet again some interesting paradoxes. Eat fat to lower body fat. Eat fat to lower bad fat, the sdLDL. Eat fat to raise 'happy' good HDL cholesterol. Hhhhmmm... provocative? Our Paleo experiences and the medical literature will tell us.o Paradoxical Decrease in HDL-Cholesterol With Statin and Fenofibrate Combo: S E V E N Case Reports (medscape.com)
o Castelli WP, et al. High density lipoprotein as a protective factor against coronary heart disease. The Framingham Study. Am J Med. 1977 May;62(5):707–714.
o Castelli WP, et al. High-density lipoprotein cholesterol and cardiovascular disease. Four prospective American studies. Circulation. 1989 Jan;79(1):8-15.
----> If you'd like to amuse yourself and see how cardio-stat-idiots attempt to debate themselves out of the above clinical findings, read THIS. "We found no significant association of change in HDL cholesterol with the log risk ratio in any model after adjustment for changes in LDL cholesterol." wtf? Note their funding... 'unrestricted grant from... Pfizer.'
Paleo Maximizes/Magnifies HDLs
Below are my Paleo peeps who have ROCKIN' ghetto-FAB lipoproteins with Paleo (or semi-Paleo) (units are mg/dl):
)Mr. Stephan Guyenet (almost-Paleo)
Real LDL (n/a)
Calc LDL 131 (wrong, but who cares)
Mr. Scott Miller (BF 9% -- nukem, dude, awesome! Lives the ultimate Paleo expanded lifespan plan...lots of coconut oil/70% dark chocolate, some HIIT 3 min/wk that mimics evo-behavior/hunting...zen-like martial arts. He smokes out his friends on 3hr-vigorous mountain bike rides w/minimal effort.)
HDL 98 (baseline: 38-ish and BF 26%)
Real LDL (n/a)
Calc LDL 125
Mrs. Anna (Against the Grain GRRRLL! )
TC 230 (2007, still transitioning to sat fat/grain-free)
HDL 72 (from 60's)
Calc LDL 146
Ms. Anne (Paleo and grain-free)
Real LDL (n/a)
Calc LDL 154
Mr. Jimmy Moore
Diet: La-Vida-low carb/70%-high-fat
Small-LDL: nearly big PHAT zero on NMR
Large-LDL: ALL per interview with Dr. Davis
Family hx of premature CAD: YES
EBT score: wish I knew... wanna wager 'zero'? Bummer, said I didn't gamble... right? *ha*
6/2009 (on coconut oil, Paleo, [25OHD]=50 ng/ml)
Real LDL 125
Calc LDL 130 (wrong by 4% but, again, who's counting)
12/2008 (Paleo/Xfit+15#muscle, [25OHD]=60 ng/ml)
Calc LDL 124
2/2008 ([25OHD]=80 ng/ml; started X-fit)
Calc LDL 99
10/2007 (vit D deficient [25OHD]=20 ng/ml)TC 170
TG 51HDL 71Calc LDL 90
TYP Hall Of Fame (Statins Optional)
Many others have HDLs to provoke tremendous envy at the TYP forum:
Mr. 'O' (brilliant brain who understands HORMONES, like the powerful hormonal effects of Sat Fat w/the line 'the AHA low fat diet...will kill your HDL...and eventually kill you as well!' *haa* HDL 65 w/niacin IR 1g/d, 6g/d EPA DHA and small amounts of coconut oil; NO STATINS)
Mr. 'D' (EBT regression 5% w/in only 8mos by adding 1-3 Tbs virgin coconut oil, 4 cage-free eggs/d, niacin 1g/day; Large-HDL tripled from 3.2 to 9 umol/L; ABSOLUTELY NO STATINS)
Mr. 'LindyBill' (EBT regression 33.6% in one year and 21% HDL increase from 38 to 46 mg/dl with major weight loss of several inches off the abdomen which accounts for 5-7% Body Fat recomposition (eg, utilization of stored 25-30# Sat Fat) via walking/ball-rm-dancing/ swimming daily and low carb diet; stopped simva 20/d a while ago due to aches but no updated labs; READ, NO STATINS)
Mr. 'H' in the UK (EBT regression 30.2% in one year by walking 1hr per day fast, 3 g/d EPA DHA, niacin 1.5/d, vitamin D, burning 2.5 stone (=5 kgs or 10#) *saturated fatty acids* off the body, Wt Watchers but unlimited (I read: high fat) treats on holiday, high dose vitamin 'O' and... btw... NO HINT OF STATINS)
Dr. 'K' (HDL 68 Feb but probably higher now; reduction in 100% sd-LDL to only 11% by eating COCONUTS and high sat fat, eggs-n-butter, steak, krill-omelets, gamey duck; 9.0 g/d EPA+DHA doesn't hurt for 100% sucky-sd-LDL-baselines...STATIN-FREE)
Mr.&Mrs. 'A' (low carb, high sat fat -- dramatic reductions in Lp(a) by 38%, raising Large-HDL 11 to 22.4 umol/L, raising HDL 63 to 78 mg/dl, and lowering sd-LDL... STATIN-FREE)
Mr. 'C' (Italian Ferrari w/HDL incr from 50 to 79 and now 'zero' Small-LDL (on VAP; on NMR 3.7% LDL-IVb)! Regressive HDL2b from 10 to 43% or 34 mg/dl... Twenty pound body fat loss... yeah btw NO STATIN and SloNiacin 1 g/d, 8 g/d EPA+DHA, krill oil, kelp...low carb, mod Sat Fat, unlimited vegetables, unlimited EVOO, eggs (organic free range plus omega 3), cheese, avocados, red wine, coconut milk (for smoothie), no or limited fruit, cinnamon,unsweetened natural alkaline free cocoa powder; meditation; IF irregular/ unpredictable cycle; lost 20# BF13%)
Mrs. 'M' (HDL=92 mg/dl and teaches me much about omega-3, bless ur heart...STATIN-FREE? undoubtedly!!! on virgin coconut oil + niacin 500mg/d which also dropped sd-LDL despite major hormone imbalances)
Mr. 'P' petroleum engineer ('Unrestricted fats', low carb, Lp(a) reduction of 80% from 70 to 14 mg/dl; niacin 1.5g/am, dhea, 3 g/d EPA DHA, Pauling protocol (L P C), and low dose Crestor)
Mr. 'PBG' (HDL 71 mg/dl, Lp(a) reduced 76% from 83 to 20 mg/dl; sd-LDL reduced to 23% from 56%; statin-free of course)
Mr. 'J' (27# wt loss! on low carb; HDL 61 from 43 mg/dl in a few mos! 42% HDL increase after being statin-free several wks prior to lab testing)
Mr. 'N' (semi-off-not-really-wheat/ carbs, 'mod Sat Fat/pufa' diet; semi-fasts 'perpetually hungry' long 15-20 days every 2mos; 66# wt loss; Lp(a) dropped 85% from 123 to 18 mg/dl; HDL 49 mg/dl who admits when he takes 'lipitor-10mg/d-free holidays' his energy/ mood/ brain brighten)
Dr. 'R' for regression (young endurance triathlete; HDL incr from undetectable b/c TGs 400s to HDL 64 mg/dl; with a low carb Paleo diet with 6kg wt loss and imminst.org antioxidants; simva reduced from 40mg/d to 20mg/d w/the plan to stop after 3mos d/t leg heaviness; I hypothesize astronomical improvements in Lp(a) and EBT but no baselines to report)
Mr. 'R' (elite athlete stud HDL2b 35% and HDLs 115 mg/dl ~200% increase from 60's wow with lower carb etc...mmmm... (still low sat fat) no further comments at this time)
Mr. 'CP' (you ROCK!! HDL 71 from 57 mg/dl and definitely statin-less; 33% sd-LDL% after remarkable 67% drop previous baseline after only 3 mos...how? 'more butter, more eggs, more meat...' despite a lotta back pain)
Mr. 'H' (my favorite hunter and tracker in PA -- 200% increase to HDL 76 from lipitor-low-31 to 40 mg/dl with a Paleo, low carb diet; HEEYYGGE 94.9% sdLDL reduction to nothing 3.4% for sdLDL% that resembles centenarian phenotypes consume ...statin-free? bummer no but low dose and no longer LDL-suppression from effects lipitor 10-20/d or previous low fat diet as evidenced by how the LDLs bounced up from 48 to now. . . PHAT fluffy . . . 90)
And...many others my ADHD memory fails to recall!
They all eat a Paleo, semi-Paleo, or Paleo+dairy (eg, Protein Power) or some version of these.
With no fear of fats.
Esp some Sat Fats and Cholesterol (egg yolks).
And oh by the way mainly statin-free.
Esp in the cases with the grossest, most spectacular lipoprotein outcomes (high HDL, low sd-LDL%, lower Lp(a)).
@The Heart of Darkness Dot Org
At a cardiologist forum where I used to pimp TYP/lurk (when I'm thoroughly bored and want to entertain myself with the latest, greatest thoughts of cardio-geniuses), some silly physicians attempted to persuade Mr. Carey (see below) with FH (familial hypercholesterolemia - high LDLs, low HDLs) to give up Paleo/ meat/ no-grains/ no-legumes and adopt the heart-healthy whole-grains WHOLE-DISEASE Mediterrean diet and... reconsider re-statinating himself . . . *wicked laugh*:
"Mediterranean diet was not enough for me. As an FH with a TC of 340, I followed the Mediterranean diet approach (high fiber vegan + salmon +sardines) for over 12 years, while I was on 40mg Pravastatin (TC= 220, HDL = 35, LDL = 130), but after severe plantar fasciitis and muscle wasting set in from the Prav. (even on a dosage reduction to 2mg from 40mg), I stopped rx and tested all the other statins and more without success.
The Paleo diet has changed my ability to metabolize fats, reduced my blood glucose levels, and dramatically increased my HDLs (84). On the same daily running and biking regimen, my body fat % dropped from 15.5% to 8% during the last 6 months. I eat huge quantities of non-cereal, non-grain foods all day and continue to lose weight while feeling far more energetic. As an added benefit, at the age of 44, I recently ran a road race at a pace I have not been able to match since I was on the high school track team.I loved to eat legumes and healthy grains, but I have seen such a dramatic improvement that I will never go back."
His lipoprotein results with Paleo:
"Paleo diet + exercise + psyllium TRIPLED my HDL to 84. I am a slim FH patient who tried and failed to raise my HDL levels above 40 using a low-fat vegetarian, high exercise lifestyle (My LDL was 240). I could not tolerate ANY statin or Welchol. Now, I eat only lean meat, vegetables, fruits and raw nuts while avoiding all sugar, cereals, grains and legumes. With my unchanged intense exercise regimen, I have lost 10 pounds over 6 months, yet grown stronger and faster. I have reduced my LDLs to 202, while raising my HDLs to 84 from as low as 35.
At 44, I feel like I have turned the clock back st least a decade. "
A M E N brother!