macro nutrient ratios

[Todd Allen]

On 5/5/2021 at 10:32 AM, Ron Put said:

It obviously works for you at an individual level, but I believe that the preponderance of the evidence still points to high cholesterol as a broad marker for CVD.

Atherogenic dyslipidemia: cardiovascular risk and dietary intervention

Quote

Atherogenic dyslipidemia comprises a triad of increased blood concentrations of small, dense low-density lipoprotein (LDL) particles, decreased high-density lipoprotein (HDL) particles, and increased triglycerides. A typical feature of obesity, the metabolic syndrome, insulin resistance, and type 2 diabetes mellitus, atherogenic dyslipidemia has emerged as an important risk factor for myocardial infarction and cardiovascular disease. A number of genes have now been linked to this pattern of lipoprotein changes. Low-carbohydrate diets appear to have beneficial lipoprotein effects in individuals with atherogenic dyslipidemia, compared to high-carbohydrate diets, whereas the content of total fat or saturated fat in the diet appears to have little effect.

My triglycerides are low, my HDL is high and my LDL particle count is moderate and strongly pattern A with large particles and few small ones.  Markers of oxidation and inflammation are very low.  The opposite of when I ate plant based HCLF.  I have not seen a study showing high LDL cholesterol is problematic in the absence of any other risk factors or signs of CVD. 

[Ron Put]

On 5/6/2021 at 10:48 AM, Todd Allen said:

I have not seen a study showing high LDL cholesterol is problematic in the absence of any other risk factors or signs of CVD. 

A high-fat diet may improve symptoms in people with a particular metabolic syndrome, just like it improves symptoms in some suffering from epilepsy.

But for most, my reading of the current evidence and plenty of good studies clearly show that plant-based diets, with complex carbohydrates, are considerably healthier in the long run. Of course, science constantly evolves based on new data and knowledge, but the general consensus appears to clearly be that "The lower your LDL, the lower your risk of having a heart attack."

See also this:

Long-term moderately elevated LDL-cholesterol and blood pressure and risk of coronary heart disease

Methods

Observational study using data from 2,714 adults in Framingham Offspring Study who were free of existing cardiovascular disease and aged <70 years at baseline (1987–1991). We used the parametric g-formula to estimate 16-year CHD risk under different levels and durations of exposure to LDL-cholesterol (low: <130 mg/dL, moderate: 130 to <160 mg/dL, high 160 to <190 mg/dL, and very high: ≥190 mg/dL) and systolic blood pressure (low: <120 mmHg, prehypertension: 120 to <140 mmHg, stage 1 hypertension: 140 to <160 mmHg, and stage 2 hypertension: ≥160 mmHg).

Results

The estimated 16-year CHD risk under exposure to low LDL was 8.2% (95% CI = 7.0–9.6). The 16-year CHD risk under exposure to moderate LDL was 8.9% (7.8–10.1) which was similar to CHD risk under 8 years of low LDL followed by 8 years of high LDL at 9.0% (7.7–10.3); and 12 years of low LDL followed by 4 years of very high LDL at 8.8% (7.6–10.1). The results for blood pressure were similar.

Conclusions

Long-term exposure to moderate levels of LDL-cholesterol and blood pressure had a similar impact on CHD risk as shorter exposures to levels considered ‘high’ per clinical guidelines.

[Todd Allen]

21 hours ago, Ron Put said:

See also this:

Long-term moderately elevated LDL-cholesterol and blood pressure and risk of coronary heart disease

From the study:

Quote

The estimated 16-year CHD risk under exposure to low LDL was 8.2% (95% CI = 7.0–9.6). The 16-year CHD risk under exposure to moderate LDL was 8.9% (7.8–10.1) which was similar to CHD risk under 8 years of low LDL followed by 8 years of high LDL at 9.0% (7.7–10.3); and 12 years of low LDL followed by 4 years of very high LDL at 8.8% (7.6–10.1).

Going from a CHD risk of 8.2% with low LDL to a risk of 9.0% with high LDL is only a 0.8% increase in CHD risk.  The population over the study period went from a mean BMI of 26 to 28.1 and from 2.7% to 12.3% being diabetic.  A significant percentage were smokers and alcohol drinkers.  They did not stratify the population for these or other known CHD risk factors beyond LDL and BP so we have no idea how much of the 0.8% increase in CHD seen with increasing LDL was within those smoking, drinking or becoming obese and diabetic.  Nor did they look at things such as particle counts, size distributions, OxLDL, and the degree to which those sorts of changes are responsible for the change in CHD risk with rising LDL.

Edited May 8, 2021 by Todd Allen