You’ve heard a million times that there is “good” cholesterol (HDL) and “bad” cholesterol (LDL). Recently I got my cholesterol measured. My LDL was 151 mg/dl. The test results were written on a form that said your LDL should be “Below 100 mg/dl. Below 70 mg/dl if High Risk.” The person who handed the results to me said, “These are not the best results . . . ”
How concerned should I be? A 2005 study in the Journal of the American Geriatric Society surveyed several thousand “elderly people [who] were recruited from a general Italian population, and mortality was monitored from 1983 to 1995.” The emphasis of the study was on whether LDL was good or bad.
People with more LDL lived longer. You read that correctly. For women, mortality was lowest at the highest level of LDL. For men, mortality was higher at the highest level of LDL (60 deaths/1000 patient years) than at the next highest (50), but still lower than at the lowest level of HDL (90). Going from the lowest to the highest levels of LDL is associated with a one-third decrease in mortality, in other words.
What should I make of my 151 mg/dl? To convert to the units of the paper (mmol/L), I needed to divide by 39. 151/39 = 3.9. Looking at the graph relating mortality to LDL, an LDL concentration of 3.9 mmol/L is where the mortality vs LDL function reaches a minimum — the lowest mortality. According to this study, my LDL is optimal.
Thanks to Joel Kauffman.
Seth, there are many kinds of LDL, and the LDL level handed to you was almost certainly not measured (as that’s expensive), but rather inferred from other results and then calculated (which is very inaccurate.) So you really have no idea what your LDL is, and you certainly don’t know your LDL particle size (which is crucial.)
Here are some posts that explain things:
https://heartscanblog.blogspot.com/search/label/LDL%20cholesterol
It’s optimal if you are “elderly.” It’s well known that “bad” cholesterol is a significant predictor of cardiovascular disease and mortality in middle aged men.
also, there’s different kinds of LDL, i.e., very lower density, which, as i recall, are the most dangerous. my guess is that if an elderly person survives with hi ldl, it’s probably not vlldl and probably there is some genetic reason the elderly person can deal with hi ldl, whereas many in middle age cannot.
Your seeming conclusion is (with all due respect) unscientific and dangerous.
These discrepancies and caveats underscore the need to look at LOTS of studies — epidemiological, human experimental, lab animal experimental — and in multiple categories — old, middle, and young aged; various ethnicities and both genders; and with various risk and environmental factors — in order to build a strong framework from which to derive testable hypotheses. This, I thought was one of the strengths of Gary Taubes book “Good calories, bad calories”.
It’s well known that “bad” cholesterol is a significant predictor of cardiovascular disease and mortality in middle aged men.
@David Marcus
It may be ‘well known’, rather, many believe it as such — but that certainly doesn’t prove that ‘bad’ cholesteol is any sort of predictor. Taubes and many others such as Eades and Kendrick have done some serious damage to the validity of the lipid hypothesis and its attendant correlaries and ostensible implications.
LDL levels may be a marker, but we really don’t know for what. We don’t don’t know if there is any optimal level of any sort of cholesterol. Kendrick thinks it may be for stress. See The Cholesterol Con and his take on the lipid hypothesis.
The low-fat and low-cholesterol myths-sum-informational cascades we have been drenched by prove absolutely nothing. The more and more research I do, the more and more I think those who have promoted the aforementioned have gotten it wrong.
What is ‘The Unifying Answer’ to cholesterol and diet and health? I dunno, but I think we are all better off admitting our ignorance than being swept away by these misinformational cascades….
BTW that is exactly why Taubes’ book is such a great one.
Triglicerides are a more telling marker of heart disease risk. LDL levles on their own don’t mean as much as the LDL:HDL ratio. I work in a medical lab.
Also the size of the LDL molecule is telling as well. VLDL or very dense molecules are stickier and are more likely to clog artery walls. They are associated with greater consumption of carbohydrates.
@Seth
Here is a pretty good summation of some of the myths of LDL, HDL etc etc
https://www.marksdailyapple.com/cholesterol/
For your next self-experiment, you might want to look at the relationship between inflammation and flax seed oil.
Varangy, that’s a good idea — about studying inflammation as a function of flaxseed oil. Any suggestions how to measure inflammation? I was thinking of measuring the redness of my gums, but that isn’t easy. Hard to quantify.
I believe you can get tests that will give a breakdown of your LDL particle size. As others have already written, this is much more useful information than is the total.
Yep. I was just thinking that. Dunno if you saw this post over at Art de Vany’s blog on evolutionary fitness — https://www.arthurdevany.com/?p=961
but the guy in the pictures, himself, references the inflammation in his face in the ‘before’ photo. Quite dramatic difference a year makes.
Two questions:
1) Is it really ‘inflammation’ not just excess body, in this case, facial fat?
2) If it is inflammation, what is an objective definition, and moreover, what is an objective measurement?
Here Mark Sisson talks about inflammation and reducing it, without really defining it. In the cholesterol post two comments above he had referred to biomarkers for inflammation without naming them.
https://www.marksdailyapple.com/naturally-reduce-inflammation/
I’ve been tracking the severity of my psoriasis using a cellphone camera. I take snapshots of left hand, open them in ImageReady (but any reasonable graphics program will do), take a colour sample of an affected area and copy the red-blue-green values into a spreadsheet. The most obvious variation is in the level of redness, which I expect has to do with underlying inflammation.
I’ve posted some October/November results here. The results are false-colour: the red really is reddish; the brown is my slightly swarthy caucasian skin tone. Displays best in Firefox.
Seth, you might see if there is a medical researcher at Berkeley or UCSF who is willing to run regular tests on your C-Reactive Protein…might be a good proxy for systemic inflammation. (Or they might be able to identify a better proxy.)
Would make an interesting research paper.
Possibly a rheumatologist?
Chris, that’s an intriguing idea, using the red-green-blue values of a photo as a way of measuring redness. Your psoriasis data is very impressive. Have you reached any conclusions from it?
Tom, there is no medical school at Berkeley; UCSF is an hour away. I want to make daily measurements for months. That would be too much travel.
Yes, my aim is to see how different factors affect my psoriasis. I’ve come to some provisional conclusions: (1) less redness in the morning, more in the evening; (2) less redness immediately after an acupuncture treatment; (3) strong redness after certain foods – red wine, aged cheeses, shellfish, for example. I’m continuing to experiment.