Cholesterol

[Guest]

I had a 40+ NHS healthcheck last week, expected to sail it... Unfortunately my cholesterol was very high (total 7.5, ratio 4.4, HDL 1.7, LDL 5.8)

The GP said my alcohol consumption was to blame, and I'm happy to admit I do like a drink. But I can't find a clear explanation of how alcohol causes it as my only tipples (red wine and beer) don't contain cholesterol. The articles I found on respected sites say it's to do with the mixers (i.e. Coca cola) which don't apply. Or they say alcohol causes excess triglycerides which then lower good cholesterol levels (mine are fine!).

So what's going on? I'm more than happy to sort myself out but I don't like blindly following advice without understanding it.

[reddog]

30 minutes ago, Grab_Some_Popcorn said:

I had a 40+ NHS healthcheck last week, expected to sail it... Unfortunately my cholesterol was very high (total 7.5, ratio 4.4, HDL 1.7, LDL 5.8)

The GP said my alcohol consumption was to blame, and I'm happy to admit I do like a drink. But I can't find a clear explanation of how alcohol causes it as my only tipples (red wine and beer) don't contain cholesterol. The articles I found on respected sites say it's to do with the mixers (i.e. Coca cola) which don't apply. Or they say alcohol causes excess triglycerides which then lower good cholesterol levels (mine are fine!).

So what's going on? I'm more than happy to sort myself out but I don't like blindly following advice without understanding it.

Is that really what the doctor said?  Sounds like rubbish to me, I thought the main cause of Cholesterol is eating a hi fat diet.

[sexton]

"A study in the journal Neurology suggests that high cholesterol levels in old age may reduce dementia risk.

Although people think of cholesterol as something that's bad for you, it is essential for many bodily functions, including the maintaining of proper brain functioning.The study included 392 men and women, all 70-year-old residents of Goteborg, Sweden. The participants of the study were followed over an 18-year period.Each had a series of assessments performed, including a physical, an EKG, a chest X-ray, a battery of blood tests and a neuropsychiatric examination.

The study found high total cholesterol levels were associated with a reduced risk of dementia between ages 75 and 79."

[Guest]

1 hour ago, reddog said:

Is that really what the doctor said?  Sounds like rubbish to me, I thought the main cause of Cholesterol is eating a hi fat diet.

She said it's not just the alcohol it's all the junk food you eat when you're drinking (um, I have a trashy dinner 2 nights a week).

I'm happy to admit my cholesterol is high (I'll assume the NHS target is sensible, but will dig into its basis at some point). But I want to know what in my lifestyle causes it. If it's alcohol so be it but the evidence is hard to come by.

I will track calories/saturated fat just out of interest, but I'm sure it's well within sensible limits.

[winkie]

Quote

 Alcohol may raise levels of good HDL cholesterol by as much as 5 to 15 percent, research shows — and red wine is particularly beneficial because its polyphenol antioxidants may also lower LDL levels. If you're not into vino, grape juice can provide some of the same heart-healthy benefits. Alcohol may raise levels of good HDL cholesterol by as much as 5 to 15 percent, research shows — and red wine is particularly beneficial because its polyphenol antioxidants may also lower LDL levels. If you're not into vino, grape juice can provide some of the same heart-healthy benefits.

The ratio means the 'good' cholesterol HDL of which red wine/grape juice is one of the foods that helps offset the 'bad' cholesterol LDL.

[Hail the Tripod]

4 hours ago, Grab_Some_Popcorn said:

I had a 40+ NHS healthcheck last week, expected to sail it... Unfortunately my cholesterol was very high (total 7.5, ratio 4.4, HDL 1.7, LDL 5.8)

The GP said my alcohol consumption was to blame, and I'm happy to admit I do like a drink. But I can't find a clear explanation of how alcohol causes it as my only tipples (red wine and beer) don't contain cholesterol. The articles I found on respected sites say it's to do with the mixers (i.e. Coca cola) which don't apply. Or they say alcohol causes excess triglycerides which then lower good cholesterol levels (mine are fine!).

So what's going on? I'm more than happy to sort myself out but I don't like blindly following advice without understanding it.

Last year mine was similar at around 7 (nuffield test came in at 7.2, while NHS gave 6.8) with a similar mildly negative ratio.

Alcohol (and fructose) are metabolised by your liver in a process called "de novo lipogenesis" into LDL cholesterol. This whole area of the relationship between diet and blood cholesterol levels and the consequential impact on health seems to be a very poorly understood set of relationships. It's a bit of a rabbit hole, frankly. Personally I came to the conclusion that there's too many factors that are too poorly understood to worry too much about it. There are definite benefits to maintaining a healthy weight and blood pressure, and so I only worry about that. Obviously if my cholesterol ratios were to veer off into wild extremes I would then be concerned. 

[Sledgehead]

2 hours ago, Hail the Tripod said:

 

Alcohol (and fructose) are metabolised by your liver in a process called "de novo lipogenesis" into LDL cholesterol. This whole area of the relationship between diet and blood cholesterol levels and the consequential impact on health seems to be a very poorly understood set of relationships. It's a bit of a rabbit hole, frankly.

Well, that's medicine for you.

I'm no expert, but seeing as the OP has already made the 'school-boy error' () of supposing dietary cholesterol has anything to do with blood serum cholesterol, perhaps we should also consider whether blood serum cholesterol (the measure of cholesterol we all talk about) has anything to do with arterial plaques, consequent atherosclerosis (narrowing) and arterial hardening (the effects that lead to heart attack and stroke).

As has been mentioned before, low levels of alcohol intake have been found to be protective against carotid atherosclerosis, tho high levels have been found to be worse than smoking in that regard.

Fine. So far, so mildly confusing.

But what of the relationship between serum cholesterol and atherosclerosis? One would have thought that atherosclerosis would harden arteries and thus result in high pulse pressure (pulse_pressure = systolic  - diastolic), as a hardened aorta etc is unable to absorb the shock waves of a beating heart (by the time the blood reaches capillaries its flow should not be exhibiting any of the pulsing created by ventricular contraction).

So why then does my elderly Mum (with raised cholesterol) have a lower pulse pressure than my elderly Dad (with low cholesterol)?

Well, maybe, just maybe, serum cholesterol is not the measure of imminent atherosclerosis we believe it to be. Maybe arteries that allow plaque creation are just super effective at removing serum cholesterol, luring the patient with low cholesterol measurements into a false sense of security?

 

2 hours ago, Hail the Tripod said:

Personally I came to the conclusion that there's too many factors that are too poorly understood to worry too much about it. There are definite benefits to maintaining a healthy weight and blood pressure, and so I only worry about that.

And I guess that is a measure that not only tells you things are amiss, but also makes some sense.

But like you say, it's not a field as well understood as we are made to believe.

[Byron]

Quote

 

All I can say is that over the years I have been put on 4 different Statins.

Each made me ill in different ways,

Joint pains, sleeplessness, sight disturbances, memory loss.

I gave them up 3 years ago and feel so much better.

I am still on Bendroflumethiazide which keeps my Blood Pressure correct.

The real truth seems to be that no-one knows much about high cholesterol, but apparently, the 'approved' figure of 5 was lowered to 3.5 without any scientific basis.

 My figure varies between 5 and 6, but I have given up worrying about it, also I no longer worry about my PSA figure either.

[Guest]

That link about alcohol says:

. Protection offered by alcohol consumption of <50 g/d appeared to act through inhibition of the injurious action of high levels of low-density lipoprotein (LDL) cholesterol. Excess risk of incident atherosclerosis observed among heavy alcohol consumers (> or =100 g/d) clearly surpassed the risk burden afforded by heavy smoking

How many g/d is a unit?

[rantnrave]

12 hours ago, Grab_Some_Popcorn said:

I had a 40+ NHS healthcheck last week, expected to sail it... Unfortunately my cholesterol was very high (total 7.5, ratio 4.4, HDL 1.7, LDL 5.8)

The GP said my alcohol consumption was to blame, and I'm happy to admit I do like a drink.

I'm teetotal and managed to get a cholesterol reading of 14 (one four) during my health check two years ago. Brought it down to 5.6 without having to resort to medication.

[LittlePig]

Would not recommend trying to interpret single random articles or epidemiological trials - epidemiological trials are unlikely to provide causality (see Bradford Hill) https://www.healthknowledge.org.uk/e-learning/epidemiology/practitioners/causation-epidemiology-association-causation

If you are interested in truth seeking behaviour, I would recommend systematic reviews that take into account all available evidence. The cochrane library would be a good place to research. e.g.

http://www.cochrane.org/CD011737/VASC_effect-of-cutting-down-on-the-saturated-fat-we-eat-on-our-risk-of-heart-disease

ACC guidelines on cholesterols - whilst aimed at statin treatment - are graded by evidence and possibly helpful.  http://circ.ahajournals.org/content/circulationaha/early/2013/11/11/01.cir.0000437738.63853.7a.full.pdf

 

[crashmonitor]

17 hours ago, rantnrave said:

I'm teetotal and managed to get a cholesterol reading of 14 (one four) during my health check two years ago. Brought it down to 5.6 without having to resort to medication.

I'm of the view that modest alcohol is good for cholesterol. I have occasionally paid to have a cholesterol test done at supermarkets and it's always on the high side (circa 6) but it would probably be a lot higher without it. The OP has a good GP,  I'm 53 and still waiting for my free well man check.

[rantnrave]

2 hours ago, crashmonitor said:

I'm of the view that modest alcohol is good for cholesterol. I have occasionally paid to have a cholesterol test done at supermarkets and it's always on the high side (circa 6) but it would probably be a lot higher without it. The OP has a good GP,  I'm 53 and still waiting for my free well man check.

Agreed - the lack of red wine was cited as a factor in the result I got.

My GP makes Fergus Wilson look slim. I am aware that when he tells me not to get too worried about cholesterol, he's preaching to himself. Get a second opinion when I can.

 

[Millaise]

The OP is a victim of the usual bad medicine and treatment by probabilities that is dished out to the public. The logic is daft and blunt.

The OP didn't even experience any symptoms, yet his GP went looking for something.  The OP is now worried. Result!

The pharmaceutical companies went looking for a drug they could give to well people for life. They found statins. Result!

If a man given statins lives to be 100, none of the medical establishment would be able to say whether the statin was responsible, or even whether it had done him any good, or even whether he would have lived to 102 had he not been given them. A doctor should not give treatment that is not necessary...I think I read a surgeon was jailed recently for unnecessary operations,  yet GPs have impunity. They are even given bonuses for how many people they can get on statins. Result!

The majority of cholesterol in the blood is synthesized in the liver.  The body manufactures it because it is needed by every cell in the body. It also lines the lumen of inflamed arteries in an effort to protect them from further damage.

A few people do have a heritable condition that involves sky-high cholestrol, so it is even deposited as nodules under the skin; they might genuinely want some treatment. For the rest, I know so many people who've had their lives impaired by going on statins "for their good", in one case, a friend's  muscle damage never recovered even when off them.

[winkie]

I am not saying some drugs are very useful, some can be life saving and necessary....the issue I have is most do not cure they only manage and once on them the body gets used to them, it can be very difficult to get off them, all drugs have side affects.....buyer beware....a customer for life if not careful, best to try and prevent taking them in other ways first if possible......a future health insurance warning.

[Guest]

On 10/11/2017 at 6:04 PM, rantnrave said:

I'm teetotal and managed to get a cholesterol reading of 14 (one four) during my health check two years ago. Brought it down to 5.6 without having to resort to medication.

What was your weight and diet like?

I'm skinny and eat loads of fruit and veg. Plus do 10hrs of brisk walking and hard cycling a week.

[rantnrave]

On 11/11/2017 at 6:26 PM, Grab_Some_Popcorn said:

What was your weight and diet like?

I'm skinny and eat loads of fruit and veg. Plus do 10hrs of brisk walking and hard cycling a week.

That's the weird thing. At the time, I had become a little podgy - BMI of about 26. It's not a perfect measure, but a yardstick that told me I was officially overweight and needed to do something. Photos show that it had mostly happened over the last five years. BMI is about 24 now, so 'normal'. At the time, colleagues / family etc were stunned because I was in no way approaching anything like obese (people seem to think cholesterol and body fat are one in the same thing).

Diet wise, I wouldn't have said terrible, by any means either. I have since become far wiser about what I am picking up at the supermarket though. The five little stats re salts, sugar, fat, sat fats etc are on everything and it has been a real education. In any situation, I would unknowingly chose a flavour / brand that had the most saturated fats. I was a bit of a cheese lover and we had been advised our young daughter should drink full fat milk, so we were all drinking that rather than buying separate ones. Bertolli came out with this amazing butter, which won some product of the year award, and I started eating bagels every morning to put that on (it's loaded with sats).

It was statins or do it the hard way. Didn't fancy statins. For three months I slashed all sat fats from my diet. Black coffee, benecol margarine, grilled fish and rice all the way No cheese or even milk for breakfast cereal. Ate walnuts and porridge (with water, not milk - cinnamon to make it palatable). Lunch was potato salad - leftover baked potatoes, loads of veg and fat free dressing. Grilled chicken, veg and pasta for dinner. Seemed to work. After 6 months the score of 14 was down to 8.1. Have carried on taking hot drinks without milk, eat porridge twice or three times a week. All cheese is now low fat. Red meat twice a week max - lean stuff with 5% fat. Pasties / pies completely gone - from my diet, so have noodles which are loaded with sat fats too. Yoghurt is only low fat varieties as well.

I should add that due to my initial test result, Mrs. Rave was advised to get her cholesterol checked. We eat the same lunch and dinner as it is. At the time, she came in at 3.9 - so no problems. I think I do have something non-dietary that's causing problems. Cholesterol was probably what finished my grandfather off (at 84 years old, so not a bad innings), but they weren't really checking for it back then. Got another test done at a Tesco health check place in October and am down to 5.6 now.

[Inoperational Bumblebee]

From the British Journal of Sports Medicine, a subsidiary of the British Medical Journal:

Saturated fat does not clog the arteries: coronary heart disease is a chronic inflammatory condition, the risk of which can be effectively reduced from healthy lifestyle interventions

http://bjsm.bmj.com/content/51/15/1111

 

[Errol]

Nothing wrong with cholesterol, as others have pointed out. It is in fact essential to numerous bodily functions. 

[sexton]

3 hours ago, Errol said:

Nothing wrong with cholesterol, as others have pointed out. It is in fact essential to numerous bodily functions. 

Testosterone is made from cholesterol. Does the proliferation of low fat everything account for the increase in girly men?

[Craig_]

3 minutes ago, sexton said:

Testosterone is made from cholesterol. Does the proliferation of low fat everything account for the increase in girly men?

Probably more likely due to hormones in the water supply from contraceptive pills, and possibly the oestrogenic effects of hops in beer...

[LittlePig]

8 hours ago, Inoperational Bumblebee said:

From the British Journal of Sports Medicine, a subsidiary of the British Medical Journal:

Saturated fat does not clog the arteries: coronary heart disease is a chronic inflammatory condition, the risk of which can be effectively reduced from healthy lifestyle interventions

http://bjsm.bmj.com/content/51/15/1111

 

Good article.

[MarkG]

Another one:

http://www.pharmaceutical-journal.com/20203046.article?clearcache=1

It's probably worth noting that one of the guys who discovered statins apparently refuses to take them. Can't find a link to the article I read on him a while back.

As usual, it seems that much of the advice given by doctors has been not only garbage, but actively harmful garbage.

[JoeDavola]

On 11/11/2017 at 1:37 PM, rantnrave said:

My GP makes Fergus Wilson look slim. I am aware that when he tells me not to get too worried about cholesterol, he's preaching to himself. Get a second opinion when I can.

Yep the majority of doctors I've known over the years have been either fat or obese. My Dad's doctor is fat and didn't inform him about how diabetes can be fixed using diet; he just gave him increasing amounts of meds as he got sicker and sicker. I have to spend about 2 years telling him to clean up his diet. When he did, he lost 3 stone and cut his meds in half.

[JoeDavola]

Oh and whilst I don't agree high cholestrol is a good thing, the research on Statins shows that they do NOT reduce the risk of death. Basically they don't do most people any good at all: