Cholesterol Study: Low HDL May Not Be So Bad

[chee]

http://www.webmd.com/cholesterol-man...src=RSS_PUBLIC
Very Low LDL 'Bad' Cholesterol May Cut Heart Risk Even if HDL 'Good'
Cholesterol Is Also Low

[Alan S]

On Fri, 23 Jul 2010 03:23:15 -0500, chee wrote:

>http://www.webmd.com/cholesterol-man...src=RSS_PUBLIC
>Very Low LDL 'Bad' Cholesterol May Cut Heart Risk Even if HDL 'Good'
>Cholesterol Is Also Low

The way I read the paper was that stains diminish the benefits of
higher HDL.

Cheers, Alan, T2, Australia.
--
d&e, metformin 1000 mg
Everything in Moderation - Except Laughter.
http://loraldiabetes.blogspot.com (I'm Type 2! What Should I Eat?)
http://loraltravel.blogspot.com (Iguassu Falls - Movies)

[Alan S]

On Sat, 24 Jul 2010 07:56:00 +1000, Alan S
<[email protected]> wrote:

>On Fri, 23 Jul 2010 03:23:15 -0500, chee wrote:
>
>>http://www.webmd.com/cholesterol-man...src=RSS_PUBLIC
>>Very Low LDL 'Bad' Cholesterol May Cut Heart Risk Even if HDL 'Good'
>>Cholesterol Is Also Low
>
>The way I read the paper was that stains diminish the benefits of
>higher HDL.
>
>Cheers, Alan, T2, Australia.

Oops -statins, not stains.

More here: http://www.theheart.org/article/1103731.do
Registration is free and spam-free.

"Little evidence that HDL is predictive of risk when LDL very low"

In my lay opinion, make that "when LDL is forced unnaturally low by a
statin".

Note that they also write:

"But some data do suggest HDL still predictive at low LDL levels

But in their comment, Hausenloy, Opie, and Yellon say the data are
conflicting on whether HDL is predictive of risk in the face of low
LDL levels. Although they agree that some secondary-prevention statin
trials have illustrated null data for HDL and residual risk, they cite
other studies in which HDL was predictive of risk even in patients
with quite low LDL levels (ranging from 1.6 to 2.0 mmol/L).

It possible that at "very low" LDL levels, other lipid measures will
provide more accurate prediction of cardiovascular risk than HDL
concentrations, they note.

"Studies of secondary prevention of cardiovascular disease are needed
to confirm whether the predictive value of HDL-cholesterol
concentrations for cardiovascular risk are diminished in the presence
of very low LDL cholesterol, and whether other lipid measurements
might offer greater predictive accuracy of cardiovascular risk," they
conclude.

Ridker et al agree: "Randomized trials of potent
HDL-cholesterol-raising agents will be needed to definitively test
this clinically important hypothesis." "

I wonder if they have considered dietary fats and exercise as potent
HDL-cholesterol-raising agents?

Cheers, Alan, T2, Australia.
--
d&e, metformin 1000 mg
Everything in Moderation - Except Laughter.
http://loraldiabetes.blogspot.com (I'm Type 2! What Should I Eat?)
http://loraltravel.blogspot.com (Iguassu Falls - Movies)

[Susan]

x-no-archive: yes

On 7/23/2010 5:56 PM, Alan S wrote:

> The way I read the paper was that stains diminish the benefits of
> higher HDL.

They've tried and failed to come up with a drug to raise HDL, so now
they have to condemn it.

Susan

[[email protected]]

Alan Wrote:
" In my lay opinion, make that "when LDL is forced unnaturally low by
a
statin".

Paleo man (even the few true paleo populations that have been studied)
would seem to have ldl levels in this range. What's more natural than
that?

Regards
Randy

[Alan S]

On Fri, 23 Jul 2010 16:03:45 -0700 (PDT), "[email protected]"
<[email protected]> wrote:

>Alan Wrote:
>" In my lay opinion, make that "when LDL is forced unnaturally low by
>a
> statin".
>
>Paleo man (even the few true paleo populations that have been studied)
>would seem to have ldl levels in this range. What's more natural than
>that?
>
>Regards
>Randy

They do? Which range? The <100 pushed by big pharma for the general
population or the <70 pushed for type 2s?

Supporting cites for that statement please. I'm afraid I don't believe
it.


Cheers, Alan, T2, Australia.
--
d&e, metformin 1000 mg
Everything in Moderation - Except Laughter.
http://loraldiabetes.blogspot.com (I'm Type 2! What Should I Eat?)
http://loraltravel.blogspot.com (Iguassu Falls - Movies)

[[email protected]]

Randy Wrote:
> >Paleo man (even the few true paleo populations that have been studied)
> >would seem to have ldl levels in this range. What's more natural than
> >that?

Alan Wrote:
> They do? Which range? The <100 pushed by big pharma for the general
> population or the <70 pushed for type 2s?

Here's the reference, refer to Figure 3:
http://www.thepaleodiet.com/articles...ych%202005.pdf

Regards
Randy

[outsider]

On 7/23/2010 6:03 PM, [email protected] wrote:
> Alan Wrote:
> " In my lay opinion, make that "when LDL is forced unnaturally low by
> a
> statin".
>
> Paleo man (even the few true paleo populations that have been studied)
> would seem to have ldl levels in this range. What's more natural than
> that?

It would be interesting to know what the incidence of diabetes
is among people living a paleo lifestyle. Diabetes was unknown
among American Indians till they were introduced to the white
man's diet. (time to recycle that discussion?)


--
It's never too late to have a happy childhood.

[Alan S]

On Fri, 23 Jul 2010 16:59:12 -0700 (PDT), "[email protected]"
<[email protected]> wrote:

>
>
>Randy Wrote:
>> >Paleo man (even the few true paleo populations that have been studied)
>> >would seem to have ldl levels in this range. What's more natural than
>> >that?
>
>Alan Wrote:
>> They do? Which range? The <100 pushed by big pharma for the general
>> population or the <70 pushed for type 2s?
>
>Here's the reference, refer to Figure 3:
>http://www.thepaleodiet.com/articles...ych%202005.pdf
>
>Regards
>Randy

The humans total cholesterol, based on a visual perusal of that chart,
are as follows:

Hazda: 112
Inuit: 144
Kung: 122
Pygmy: 108
San: 122

The figure legend claims that equates to LDL of 35 to 70; I'm off to
read the Eades original paper - if I can find it - to see if that is
true. That also implies extraordinarily low trigs or rather high HDL.

Interesting that Inuits are included; I presume you're aware of the
paradox that adds to your discussion?

To be honest, I have never heard of the Hazda, Kung or San; obviously
my anthropological education was lacking. One wonders whether their
menu may have been similar to the Inuit.

Thanks for the response.

Cheers, Alan, T2, Australia.
--
d&e, metformin 1000 mg
Everything in Moderation - Except Laughter.
http://loraldiabetes.blogspot.com (I'm Type 2! What Should I Eat?)
http://loraltravel.blogspot.com (Iguassu Falls - Movies)

[Alan S]

On Fri, 23 Jul 2010 21:24:34 -0500, outsider
<[email protected]> wrote:

>On 7/23/2010 6:03 PM, [email protected] wrote:
>> Alan Wrote:
>> " In my lay opinion, make that "when LDL is forced unnaturally low by
>> a
>> statin".
>>
>> Paleo man (even the few true paleo populations that have been studied)
>> would seem to have ldl levels in this range. What's more natural than
>> that?
>
>It would be interesting to know what the incidence of diabetes
>is among people living a paleo lifestyle. Diabetes was unknown
>among American Indians till they were introduced to the white
>man's diet. (time to recycle that discussion?)

True. Possibly the time is right.

My comment on "unnaturally low" was specifically related to use of
medications; not when un-medicated diet and exercise means are
employed to achieve good lipids.

As to what is "good" for LDL or even for total cholesterol, that can
be an individual number which is also affected by heredity. I believe
there is a J curve; you can go too low as well as too high. For
example:

http://www.ncbi.nlm.nih.gov/pubmed/18381649
This prospective study supports the hypothesis that low LDL-C is
associated with an increased risk of Parkinson's disease. Although
confirmation is required, the underlying mechanisms may be useful in
understanding key aspects of PD.

http://www.cmaj.ca/cgi/reprint/179/5/427
Among patients with type 2 diabetes, the association between LDL
cholesterol and cancer was V shaped, whereby both low and high levels
of LDL cholesterol were associated with elevated risk of cancer.

Cheers, Alan, T2, Australia.
--
d&e, metformin 1000 mg
Everything in Moderation - Except Laughter.
http://loraldiabetes.blogspot.com (I'm Type 2! What Should I Eat?)
http://loraltravel.blogspot.com (Iguassu Falls - Movies)

[Nicky]

On Sat, 24 Jul 2010 16:42:23 +1000, Alan S
<[email protected]> wrote:

>>Here's the reference, refer to Figure 3:
>>http://www.thepaleodiet.com/articles...ych%202005.pdf
>>
>>Regards
>>Randy
>
>The humans total cholesterol, based on a visual perusal of that chart,
>are as follows:
>
>Hazda: 112
>Inuit: 144
>Kung: 122
>Pygmy: 108
>San: 122
>
>The figure legend claims that equates to LDL of 35 to 70; I'm off to
>read the Eades original paper - if I can find it - to see if that is
>true. That also implies extraordinarily low trigs or rather high HDL.

The !Kung and San are what you might know as Bushmen, living in
semi-desert conditions in southern Africa - although originally their
range was much greater, they've been forced into the marginal lands by
incoming pastoral groups. Their diet is predominantly meat, with
high-carb binges occasionally in season - Tsamma melon is gorgeous,
and they have an arm-long yam-like root that's pretty good too. I
expect their HDL is also pretty good, due to the hunter-gatherer
exercise requirements - and I've never met a fat San.

Nicky.
T2 dx 05/04 + underactive thyroid
D&E, 150ug thyroxine
Last A1c 5.2% BMI 26

[Alan S]

On Sat, 24 Jul 2010 10:56:36 +0100, Nicky <[email protected]>
wrote:

>On Sat, 24 Jul 2010 16:42:23 +1000, Alan S
><[email protected]> wrote:
>
>>>Here's the reference, refer to Figure 3:
>>>http://www.thepaleodiet.com/articles...ych%202005.pdf
>>>
>>>Regards
>>>Randy
>>
>>The humans total cholesterol, based on a visual perusal of that chart,
>>are as follows:
>>
>>Hazda: 112
>>Inuit: 144
>>Kung: 122
>>Pygmy: 108
>>San: 122
>>
>>The figure legend claims that equates to LDL of 35 to 70; I'm off to
>>read the Eades original paper - if I can find it - to see if that is
>>true. That also implies extraordinarily low trigs or rather high HDL.
>
>The !Kung and San are what you might know as Bushmen, living in
>semi-desert conditions in southern Africa - although originally their
>range was much greater, they've been forced into the marginal lands by
>incoming pastoral groups. Their diet is predominantly meat, with
>high-carb binges occasionally in season - Tsamma melon is gorgeous,
>and they have an arm-long yam-like root that's pretty good too. I
>expect their HDL is also pretty good, due to the hunter-gatherer
>exercise requirements - and I've never met a fat San.
>
>Nicky.
>T2 dx 05/04 + underactive thyroid
>D&E, 150ug thyroxine
>Last A1c 5.2% BMI 26

Thanks Nicky.

Interesting choices, Randy.

Cheers, Alan, T2, Australia.
--
d&e, metformin 1000 mg
Everything in Moderation - Except Laughter.
http://loraldiabetes.blogspot.com (I'm Type 2! What Should I Eat?)
http://loraltravel.blogspot.com (Iguassu Falls - Movies)

[Chris Malcolm]

outsider <[email protected]> wrote:
> On 7/23/2010 6:03 PM, [email protected] wrote:
>> Alan Wrote:
>> " In my lay opinion, make that "when LDL is forced unnaturally low by
>> a
>> statin".
>>
>> Paleo man (even the few true paleo populations that have been studied)
>> would seem to have ldl levels in this range. What's more natural than
>> that?

> It would be interesting to know what the incidence of diabetes
> is among people living a paleo lifestyle. Diabetes was unknown
> among American Indians till they were introduced to the white
> man's diet. (time to recycle that discussion?)

And when they are introduced to the paleface diet, they're more
susceptible to diabetes than the palefaces -- more of them get it, and
more of them get it worse.

--
Chris Malcolm
Warning: none of the above is indisputable fact.

[[email protected]]

Alan Wrote:
" Interesting that Inuits are included; I presume you're aware of the
paradox that adds to your discussion?"

Not really. Although traditional Inuits diets are high in fat, its the
composition of that fat that's important.
Its seems to be much lower in saturated fat and much higher in monos,
and n-3s.

See:
http://www.medkb.com/Uwe/Forum.aspx/...-Inuit-paradox

Regards
Randy

[Trinkwasser]

On Sat, 24 Jul 2010 08:05:38 +1000, Alan S
<[email protected]> wrote:


>"Little evidence that HDL is predictive of risk when LDL very low"
>
>In my lay opinion, make that "when LDL is forced unnaturally low by a
>statin".

That figures. Lipid metabolism is so complex with multiple passes that
manipulating just one end result without looking at the rest of the
equation tends not to show the expected results.

Plus of course the lipids are probably not causal of anything, just
indicators of the processes that are.

>Note that they also write:
>
>"But some data do suggest HDL still predictive at low LDL levels
>
>But in their comment, Hausenloy, Opie, and Yellon say the data are
>conflicting on whether HDL is predictive of risk in the face of low
>LDL levels. Although they agree that some secondary-prevention statin
>trials have illustrated null data for HDL and residual risk, they cite
>other studies in which HDL was predictive of risk even in patients
>with quite low LDL levels (ranging from 1.6 to 2.0 mmol/L).

Did they look at the different subfractions of HDL like Krauss et al.
look at the subfractions of LDL? HDL particles of different sizes may
have different effects. Could well be that lowering LDL shifts the HDL
between HDL2 and HDL3

>It possible that at "very low" LDL levels, other lipid measures will
>provide more accurate prediction of cardiovascular risk than HDL
>concentrations, they note.
>
>"Studies of secondary prevention of cardiovascular disease are needed
>to confirm whether the predictive value of HDL-cholesterol
>concentrations for cardiovascular risk are diminished in the presence
>of very low LDL cholesterol, and whether other lipid measurements
>might offer greater predictive accuracy of cardiovascular risk," they
>conclude.
>
>Ridker et al agree: "Randomized trials of potent
>HDL-cholesterol-raising agents will be needed to definitively test
>this clinically important hypothesis." "
>
>I wonder if they have considered dietary fats and exercise as potent
>HDL-cholesterol-raising agents?

No profit in it.

[Trinkwasser]

On Sat, 24 Jul 2010 16:42:23 +1000, Alan S
<[email protected]> wrote:

>The figure legend claims that equates to LDL of 35 to 70; I'm off to
>read the Eades original paper - if I can find it - to see if that is
>true. That also implies extraordinarily low trigs or rather high HDL.

probably both, not uncommon in even Westerners eating Paleo type diets
and doing paleo type exercise