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Mike Lustgarten

LDL: What's Optimal For Health And Longevity?

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7 hours ago, Ron Put said:

...the significant drop in my TC, LDL, and inflammation values is unlikely to be because of an underlying disease or metabolic issue,

But that's not  the question here. 

The question is:   over the next twenty, thirty or forty plus years of your life,  would you better off having moderately low cholesterol levels rather than extremely low levels  so as to better protected against cancer, infectious diseases etc.?  (especially  since you do not have any cardiovascular risk factors, afaik.)  

That's is an open question.  

Cholesterol is a double-edged sword.

 

Edited by Sibiriak

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17 hours ago, Ron Put said:

Yep, but many of you here have been doing this for a long time and are probably better than me at it.  For me, it's a significant improvement and kind of surprising how quickly I adapted

You're doing well.

  --  Saul

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Arnold's cholesterol level dropped to 109 after he went vegan, and he says he never felt better

https://www.livekindly.co/arnold-schwarzenegger-beyond-meat-almond-milk/

and... BEYOND MEAT>. which has saturated fat too..

Also isn't low cholesterol associated with depression?  i mean clearly it isn't for ARNOLD

Edited by InquilineKea

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6 hours ago, InquilineKea said:

Arnold's cholesterol level dropped to 109 after he went vegan, and he says he never felt better

Do we know which cholesterol it is? Specifically, TC or LDL-C? If the former, it's very low, if the latter, it's not so low.

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On 2/13/2021 at 5:27 AM, mccoy said:

Do we know which cholesterol it is? Specifically, TC or LDL-C? If the former, it's very low, if the latter, it's not so low.

I just tried searching and all articles are based on the same "cholesterol at 109" quote, so I would guess it's total cholesterol, since that's the common use.  And that is very low, indeed. Who knows if it's too low, or optimum....

I thought this was an interesting presentation on cholesterol and cancer:
 

 

Edited by Ron Put

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I've had really low cholesterol from doing CR and I never felt any negative effects from it. 

The numbers were:

Total 2.8 (108mg/dl)
HDL: 1 (39mg/dl)
LDL 1.5 (58mg/dl)

 

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2 hours ago, Matt said:

I've had really low cholesterol from doing CR and I never felt any negative effects from it. 

The numbers were:

Total 2.8 (108mg/dl)
HDL: 1 (39mg/dl)
LDL 1.5 (58mg/dl)

 

I seriously doubt that Schwarzenegger is practicing CR, though. If I had to bet, I'd bet he refers to LDL cholesterol. I'm pretty curious at this point!

Edited by mccoy

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On 2/17/2021 at 2:19 AM, Sibiriak said:

Arnold's never felt better,  after multiple heart surgeries.

Right. It is not clear if they were due to steroid assumption, excessive training, congenital disease, or all of the above.

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Arnold successfully sued a doctor that stated his heart surgery was due to steroid use.

Arnold said that the doctor could not claim that without ever having examined him; Arnie claimed that the surgery was necessary due to some congenital defect.

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From MedicalXpress, Not all 'good' cholesterol is healthy

HDL cholesterol (high-density lipoprotein cholesterol), or "good cholesterol," is associated with a decreased risk of cardiovascular disease as it transports cholesterol deposited in the arteries to the liver to be eliminated. 

Although drugs that lower LDL cholesterol reduce cardiovascular risk, those that raise good cholesterol have not proven effective in reducing the risk of heart disease.

The conclusion is that genetic characteristics linked to the generation of large good cholesterol particles are directly associated with a higher risk of heart attack, while features linked to small good cholesterol particles are related to a lower risk of heart attack.

There is a positive causal relationship between the size of HDL cholesterol particles and the risk of heart attack, so although we have to increase the levels of good cholesterol in the blood, they must always be small particles

If we need to do something in relation to HDL, it is to increase the number of small particles, which are those that adequately perform the function of eliminating cholesterol, those that really move it to the liver for removal, and do not allow it to accumulate in the arteries and cause cardiovascular disease

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On 2/26/2021 at 9:15 AM, corybroo said:

There is a positive causal relationship between the size of HDL cholesterol particles and the risk of heart attack, so although we have to increase the levels of good cholesterol in the blood, they must always be small particles

Interesting. This made me take a look at my test.

Quest Diagnostics appears to suggest the opposite to be the optimal result, unless I am misunderstanding their footnote:

 

HDL LARGE: nmol/L

Risk: Optimal >6729; Moderate 6729-5353; High <5353

Edited by Ron Put

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My wife has modestly high cholesterol (TC 213 mg/dl, LDL 126 mg/dL, HDL 71mg/dL) despite having a pretty reasonable diet (pesco-vegetarian, lots of fruits and veggies). 

IMO, it's not quite high enough to warrant statins. Dr. Greger recently talked about Amla for cholesterol lowering, based on several studies, including this double blind, placebo controlled study [1] of 98 people with high cholesterol. It found 1000mg of dried amla power per day for 12 weeks resulted in a drop in total cholesterol from 231 to 177 mg/dL and a drop in LDL from 140 to 111 mg/dL.

I actually already add amla powder to my spice mix for its antioxidant content already so I consider it safe and generally healthy. Has anyone here considered or tried amla specifically for cholesterol reduction?

I think we're going to try it for my wife and see if it drops her cholesterol after a few months. 

--Dean

------------

[1] BMC Complement Altern Med. 2019 Jan 22;19(1):27.
doi: 10.1186/s12906-019-2430-y.

A randomized, double blind, placebo controlled, multicenter clinical trial to 
assess the efficacy and safety of Emblica officinalis extract in patients with 
dyslipidemia.

Upadya H(1), Prabhu S(2), Prasad A(3), Subramanian D(4), Gupta S(5), Goel A(6).

BACKGROUND: Dyslipidemia is one of the most frequently implicated risk factors 

for development of atherosclerosis. This study evaluated the efficacy of amla 
(Emblica officinalis) extract (composed of polyphenols, triterpenoids, oils etc. 
as found in the fresh wild amla fruit) in patients with dyslipidemia.
METHODS: A total of 98 dyslipidemic patients were enrolled and divided into amla 
and placebo groups. Amla extract (500 mg) or a matching placebo capsule was 
administered twice daily for 12 weeks to the respective group of patients. The 
patients were followed up for 12 weeks and efficacy of study medication was 
assessed by analyzing lipid profile. Other parameters evaluated were 
apolipoprotein B (Apo B), apolipoprotein A1 (Apo A1), Coenzyme Q10 (CoQ10), 
high-sensitive C-reactive protein (hsCRP), fasting blood sugar (FBS), 
homocysteine and thyroid stimulating hormone (TSH).
RESULTS: In 12 weeks, the major lipids such as total cholesterol (TC) 
(p = 0.0003), triglyceride (TG) (p = 0.0003), low density lipoprotein 
cholesterol (LDL-C) (p = 0.0064) and very low density lipoprotein cholesterol 
(VLDL-C) (p = 0.0001) were significantly lower in amla group as compared to 
placebo group. Additionally, a 39% reduction in atherogenic index of the plasma 
(AIP) (p = 0.0177) was also noted in amla group. The ratio of Apo B to Apo A1 
was reduced more (p = 0.0866) in the amla group as compared to the placebo. 
There was no significant change in CoQ10 level of amla (p = 0.2942) or placebo 
groups (p = 0.6744). Although there was a general trend of FBS reduction, the 
numbers of participants who may be classified as pre-diabetes and diabetes 
groups (FBS > 100 mg/dl) in the amla group were only 8. These results show that 
the amla extract used in the study is potentially a hypoglycaemic as well. 
However, this needs reconfirmation in a larger study.
CONCLUSIONS: The Amla extract has shown significant potential in reducing TC and 
TG levels as well as lipid ratios, AIP and apoB/apo A-I in dyslipidemic persons 
and thus has scope to treat general as well as diabetic dyslipidemia. A single 
agent to reduce cholesterol as well as TG is rare. Cholesterol reduction is 
achieved without concomitant reduction of Co Q10, in contrast to what is 
observed with statins.
TRIAL REGISTRATION: Registered with Clinical Trials Registry- India at 
www.ctri.nic.in (Registration number: CTRI/2015/04/005682 ) on 8 April 2015 
(retrospectively registered).

DOI: 10.1186/s12906-019-2430-y
PMCID: PMC6341673
PMID: 30670010 [Indexed for MEDLINE]

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On 5/24/2021 at 2:04 PM, Dean Pomerleau said:

My wife has modestly high cholesterol (TC 213 mg/dl, LDL 126 mg/dL, HDL 71mg/dL) despite having a pretty reasonable diet (pesco-vegetarian, lots of fruits and veggies). 

IMO, it's not quite high enough to warrant statins. Dr. Greger recently talked about Amla for cholesterol lowering, based on several studies, including this double blind, placebo controlled study [1] of 98 people with high cholesterol. It found 1000mg of dried amla power per day for 12 weeks resulted in a drop in total cholesterol from 231 to 177 mg/dL and a drop in LDL from 140 to 111 mg/dL.

I actually already add amla powder to my spice mix for its antioxidant content already so I consider it safe and generally healthy. Has anyone here considered or tried amla specifically for cholesterol reduction?

I think we're going to try it for my wife and see if it drops her cholesterol after a few months. 

--Dean

------------

[1] BMC Complement Altern Med. 2019 Jan 22;19(1):27.
doi: 10.1186/s12906-019-2430-y.

A randomized, double blind, placebo controlled, multicenter clinical trial to 
assess the efficacy and safety of Emblica officinalis extract in patients with 
dyslipidemia.

Upadya H(1), Prabhu S(2), Prasad A(3), Subramanian D(4), Gupta S(5), Goel A(6).

BACKGROUND: Dyslipidemia is one of the most frequently implicated risk factors 

for development of atherosclerosis. This study evaluated the efficacy of amla 
(Emblica officinalis) extract (composed of polyphenols, triterpenoids, oils etc. 
as found in the fresh wild amla fruit) in patients with dyslipidemia.
METHODS: A total of 98 dyslipidemic patients were enrolled and divided into amla 
and placebo groups. Amla extract (500 mg) or a matching placebo capsule was 
administered twice daily for 12 weeks to the respective group of patients. The 
patients were followed up for 12 weeks and efficacy of study medication was 
assessed by analyzing lipid profile. Other parameters evaluated were 
apolipoprotein B (Apo B), apolipoprotein A1 (Apo A1), Coenzyme Q10 (CoQ10), 
high-sensitive C-reactive protein (hsCRP), fasting blood sugar (FBS), 
homocysteine and thyroid stimulating hormone (TSH).
RESULTS: In 12 weeks, the major lipids such as total cholesterol (TC) 
(p = 0.0003), triglyceride (TG) (p = 0.0003), low density lipoprotein 
cholesterol (LDL-C) (p = 0.0064) and very low density lipoprotein cholesterol 
(VLDL-C) (p = 0.0001) were significantly lower in amla group as compared to 
placebo group. Additionally, a 39% reduction in atherogenic index of the plasma 
(AIP) (p = 0.0177) was also noted in amla group. The ratio of Apo B to Apo A1 
was reduced more (p = 0.0866) in the amla group as compared to the placebo. 
There was no significant change in CoQ10 level of amla (p = 0.2942) or placebo 
groups (p = 0.6744). Although there was a general trend of FBS reduction, the 
numbers of participants who may be classified as pre-diabetes and diabetes 
groups (FBS > 100 mg/dl) in the amla group were only 8. These results show that 
the amla extract used in the study is potentially a hypoglycaemic as well. 
However, this needs reconfirmation in a larger study.
CONCLUSIONS: The Amla extract has shown significant potential in reducing TC and 
TG levels as well as lipid ratios, AIP and apoB/apo A-I in dyslipidemic persons 
and thus has scope to treat general as well as diabetic dyslipidemia. A single 
agent to reduce cholesterol as well as TG is rare. Cholesterol reduction is 
achieved without concomitant reduction of Co Q10, in contrast to what is 
observed with statins.
TRIAL REGISTRATION: Registered with Clinical Trials Registry- India at 
www.ctri.nic.in (Registration number: CTRI/2015/04/005682 ) on 8 April 2015 
(retrospectively registered).

DOI: 10.1186/s12906-019-2430-y
PMCID: PMC6341673
PMID: 30670010 [Indexed for MEDLINE]

Share    
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
HealthyHey Nutrition Amla Extract 50:1 - Equivalent to 25g Amla Powder - Natural Vitamin C - 500mg - 60 Veg. Capsules

Dean Are extracts equivalent to the dried powders.  The above product claims quite a difference. If the extract in the study was similiar you would need 50 gms of powder!!

Edited by Mike41

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Here's a new presentation by Dave Feldman adding an interesting mechanistic detail to his lipid energy model which is an attempt to explain the phenomenon of "lean mass hyper responders" where a significant subset of those adopting low carb diets see dramatic increases in cholesterol proportional to the degree of carbohydrate restriction and perhaps surprisingly also proportional to ones leanness and physical fitness.  An interesting idea to me is the membranes of adipocytes like other cells are a phospholipid bilayer which incorporate a lot of cholesterol.  Adipocytes maintain a roughly spherical shape as they change in size and the membrane thickness, density and composition remains fairly constant and thus the membrane must incorporate or shed material as the adipocyte grows or shrinks.  The shells of lipoproteins are a phospholipid monolayer of similar composition and lipoproteins traffic not just the contents for the lipid droplet within adipocytes but also the phospholipids and cholesterol of the membranes.  When carbohydrates are ingested much of the daily energy flux is in the form of glycogen in the liver and muscles but a ketogenic diet shifts the energy flux to lipids in and out of adipocytes.  Those who are muscular and active have greater energy flux and the leaner one is and the smaller their adipocytes the greater the proportional change in size of adipocyte membrane to contents and thus the amount of cholesterol being trafficked by lipoproteins.

 

Edited by Todd Allen

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1 hour ago, Mike41 said:

Are extracts equivalent to the dried powders.  The above product claims quite a difference. If the extract in the study was similiar you would need 50 gms of powder!!

Good catch Mike!. No they aren't equivalent. I looked at the paper's supplemental material and it said:

The crude extract was purified and standardized to contain about 35% polyphenols, 8% triterpenoids and 10% amla oil.

The HealthyHey product you linked to doesn't appear to be available in the US. But I found this extract, which has 45% tannins (the major class of polyphenols in amla), so it looks to be about equivalent to the concentration used in the above study. It claims a 15:1 extraction ratio, and that each 1000mg daily serving is equivalent to about 8000mg of amla powder.

I odred it and will report back in a couple months if it worked to lower my wife's cholesterol.

--Dean

 

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We've always wondered why my wife's cholesterol is on the high side despite her pretty good diet and exercise routines. Unfortunately she is a carrier of one copy of the e4 allele of the apo gene (I. E. Apoe4), which has been shown to elevate LDL and total cholesterol in numerous studies, as can be seen in this graph from [1].

Screenshot_20210602-054244_Drive.jpg

 

As you can see, the e2 allele reduced total cholesterol by 15-20 mg/dL and the e4 allele raises it by around 5-10 mg/dl. According to the authors, no other common genetic variation impacts cholesterol as much (genes that cause familial hypercholesterolimia are rare in the general population). 

--Dean 

---

[1] Davignon J. Apolipoprotein E polymorphism and atherosclerosis. In: Born GVR, Schwartz CJ, eds. New Horizons in Coronary Heart Disease. London, England: Current Science; 1993:5.1-5.21.

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My mother is 92, never had heart issues or dementia. Her only problem is bad knees. She only takes blood pressure meds. Her cholesterol has Been around 250 ish for decades and she refused to take statins decades ago. She never drank or smoked. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6367420/

based on the above massive study total cholesterol levels between 210-249 were best.

In conclusion, U-curve relationships between TC and mortality were found, regardless of sex and age. TC ranges associated with the lowest mortality were 210–249 mg/dL in each sex-age subgroup, except for the youngest groups of men, aged 18–34 years (180–219 mg/dL), and women aged 18–34 years (160–199 mg/dL) and 35–44 years (180–219 mg/dL). Inverse associations in the range <200 mg/dL were more than 3-fold stronger than positive associations for cholesterol levels ≥200 mg/dL, except for the youngest adults. Positive associations in the upper TC range were strongest for youngest adults and weakened with advancing age. TC levels <200 mg/dL may not necessarily be a sign of good health. Identification and proper management of diseases associated with lower TC levels might improve survival.

Edited by Mike41

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Yeah, well.... I'd take all of these studies with a large grain of salt, given the preponderance of the evidence we have. The fact that for most people consuming a healthy diet results in a drop of total cholesterol, as well as blood pressure, diabetes risk, etc., would indicate that high cholesterol is not something to aspire to.

Of course, cholesterol is a piece of a puzzle, and for some, it may not be the most important one. Some who have high cholesterol may be protected by other factors. And some with low cholesterol may die of something unrelated. But the bottom line for me is that overall, lower cholesterol (within limits) is better for longevity than high cholesterol. Just like being thin, or not smoking is better (despite some population studies that say otherwise).

As to APOE E4, it's more complicated than that. There are variants in APOE E3 and elsewhere that act to counteract it, so it may, or may not mean much.

As to amla, I've been taking it for months now (as powder) and I haven't noticed a significant effect on cholesterol or anything else. In fact, most of my numbers went in the wrong direction, which I attribute to berberine, and amla didn't appear to counter it (or have a positive effect prior to that).

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On 6/2/2021 at 5:12 AM, Dean Pomerleau said:

For anyone following along at home and perhaps thinking about trying amla for high cholesterol, I've switched my wife to this amla supplement:

https://www.amazon.com/dp/B07XZB9DJ2/

Since it utilizes the same TRI-low formulation of amla extract from the same company whose supplement was used in the study I referenced above. 

--Dean 

Hi Dean thanks for this information. BTW how long is your wife going to take this before she gets tested for ldl? If it’s anything like a statin it should work quickly. 

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6 minutes ago, Mike41 said:

 Hi Dean thanks for this information. BTW how long is your wife going to take this before she gets tested for ldl? If it’s anything like a statin it should work quickly. 

We're targeting 90 day before LDL testing. She is half way there. Alma may kick in quickly (if it works at all that is), but in private communication with Tom (who is fine BTW, just very busy), he worried that it would be like the LDL-lowering effects of oats, which he said looked good in the short term but tapered off with time. If alma is working to lower her LDL at the end of 90 days, we figure that will indicate a long-lasting effect.

--Dean

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41 minutes ago, Dean Pomerleau said:

We're targeting 90 day before LDL testing. She is half way there. Alma may kick in quickly (if it works at all that is), but in private communication with Tom (who is fine BTW, just very busy), he worried that it would be like the LDL-lowering effects of oats, which he said looked good in the short term but tapered off with time. If alma is working to lower her LDL at the end of 90 days, we figure that will indicate a long-lasting effect.

--Dean

Oats and diet in my case are totally useless. My ldl is 100 even with 40 mg of Crestor the highest dose of the most potent statin. Anyway thanks for keeping us updated and I ordered your recommended product

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