Why is my LDL still so high and how do I fix it?
I have worked the body composition angle extensively this year. Back in May 2011, I weighed in at 159.7, with 24.4% Bodyfat on a BodPod, and a cholesterol level of 247, LDL=173, HDL=51, Triglycerides of 116. I used Lose It to track calories and emphasized a vegetarian during the day approach and some meat at night. Occassional pizza, etc. I still eat wheat, dairy, meat, etc; but try to get the highest quality of these things I can (like Greek Yogurt, lean meat). I am probably at about a 95% optimal diet. My breakdown from Lose It on a typical week is about 30% Fat, 55% Carbs, 15% Protein. Daily cholesterol intake around 150mg. Sat Fat around 24g. Protein 100g.
My weight has responded phenomenally, dropping down to 140 pounds and BF now around 15%. My BMI is 22.6. This has all been slow, steady loss due to calorie counting and working out. Fitness is at an all time high. In December (at a weight of about 147 at that time, I was showing good progress with Chol=207, LDL=149, HDL=64, Tri=48. So I was shocked yesterday after dropping 7-more pounds that my retest again showed Chol =239, LDL=157, HDL=59, Tri=88.
My selective CRP is a butt kicking 0.7, and my BP, HR, etc are all optimal so the cholesterol is my only achilles heel at this point, but one I would really like to get rid of. In December it seemed like I was really doing well and I had taken it as a foregone conclusion that yesterday's numbers were going to be pristine and I was more than a little unhappy that they weren't.
So . . .
I am interested in hearing from people who have personally dropped their cholesterol numbers and what they did that they felt made the difference. Others can chime in too, but the web is full of unverified 3rd person anecdotes of what works. I'm really interested in first person data.
Comments
I should add all the tests were done fasting and without any dietary indiscretion ahead of time. I am looking into getting a VAP test.
Also, remember that cholesterol, while the most well-known marker, is not a particularly good predictor of heart disease risk. LDL particle size test give the proportion of VLDL's, which have a much higher correlation with heart attacks. cRP is also thought to be a better measure, though somewhat controversial. Sounds like a good conversation to have with your cardiologist.
Soluble fiber is pretty good, but am going to up it a bit like you suggest. Waiting on the results of the VAP panel which will directly measure LDL and VLDL and give actual particle breakdown size. I'm going to go see a lipid specialist at our med center to try to sort this out. With my CRP so low and LDL really as my only risk factor, I'm not too concerned about risk today, more about accumulating risk if the numbers stay high for the next 20-years or so.
The kicker for me was compromising around training. Until a year ago, when I was only a runner, I would eat zone bars while training and not many calories at that. I was pretty wiped out after marathons. I have now compromised and have the sport drinks and recovery drinks, guided by the information in the Paleo Diet for Endurance athletes, and I feel better. I haven't tested since doing this and have the paperwork to do so (just haven't found a day where I can fast and get into the lab.). I am wondering if my numbers will change for the worse with the extra carbs-I'm thinking if you burn em off before your insulin levels rise you are ok.
If you are not already doing so, I would recommend you taking a quality fish oil, 2.5 gm per day of combined EPA/DHA (omega3 oil). Fish oil works by tipping your omega 6s (which we get plenty of in our diets) down the nonimflammatory pathway, so you do do not make the mediators that cause increased cholesterol, LDLs, hypertension.
Hope this helps.
Here is some of my dietary background and cholesterol numbers. Currently 50yrs old and dont have any data between 07-10 but was 45 yrs old in 07. The first 2 sets of numbers from 07 and 10 show low HDL and high LDL and high RISK. After changing to a Vegan diet for the last 18 months the numbers have been very stable with noticible improvements in HDL, LDL , and RISK. The TRI is interesting, seems to vary a bit more. I know there are alot of theories out there but it makes sense to me if you dont want any cholesterol dont put any in your mouth. FWIW my girlfriend's numbers improved so much that her doctor took her off her statin's. I feel great and I am faster than I have ever been. No its not the diet its the training. Very interested in your VAP test . Good luck,
10/07 Very fit and lean active rock climber. High protein diet of lowfat meats and dairy , lower fat and lower carb diet . Minimal processed foods.
TOT 213
TRI 96
HDL 57
LDL 130
RISK 3.7
10/10 Very fit and lean triathlete. High protein lowfat meats and dairy, lower fats and carbs. Minimal processed foods.
TOT 187
TRI 65
HDL 42
LDL 132
RISK 4.4
3/11 Vegan 6 months.
TOT 188
TRI 111
HDL 70
LDL 96
RISK 2.7
10/11 Vegan 1 year.
TOT 185
TRI 100
HDL 79
LDL 86
RISK 2.3
3/12 Vegan 18 months
TOT 173
TRI 69
HDL 67
LDL 92
RISK 2.6
Hey Kevin,
I saw your post to Kevin and his results. I am interested in learning more about the Vegan nutritional plan. Do you have suggested readings, websites or information you can direct me towards? I am very concerned about my LDL as my diabetes progresses.
I follow a combination of the American Heart Association meal plans and ADA plans, however my last LDL readings were ridiculously high and blood sugar readings are out of control regardless what I do. I haven't tried a vegan nutritional approach and am very interested.
THANKS!
Rich Miller
@Rich,
Above is a thread I started about 6 months ago which kinda explains how I got where I am going and what I believe nutritionally. In it there are some books, websites, and magazines that I like. I have several of those books and would be happy to give them to you . Send me a PM with your mailing address and I will ship them your way in a few days. If you have enough discipline to be here at EN training for an IM and have tried other nutritional directions that did not work then you certainly have the discipline to learn and try a plant based nutritional approach. Its not that difficult and I would bet that done correctly you will see the same results as Kevin.
Hopefully Kevin will chime in and give us a run down on his diet the last couple months and any educational materials he likes as well!
Tim,
For diet ideas and more inspiration, Engine2Diet by Rip Esseltyn; Thrive Diet by Brendan Brazier (both IM triathletes of note) are good. I also like the 21-day weightloss kickstart by Neal Bernard which is basically a 21-day intro to veganism. Dr. Bernard's book has a companion website and even iPhone app with 21-days of recipes to get started.
All 4 of these books are available as downloads from Amazon on Kindle.
Over the last year my diet has really evolved quite a bit and I've been a bit compulsive about tracking the changes. I went semi-vegetarian about a year ago or so (fish and diary okay with some very occassional chicken). Also started obsessively food logging. That approach really jump started my weight loss and pounds fell off. I dropped down from 159 to 145 and my cholesterol went from 255 to around 207. Interestingly, I then got more relaxed about the vegetarian thing, but kept the same close eye on calories. Weight continued to fall down to 141 or so, but cholesterol went back up to 239 as did LDL. So weight loss, while helpful, was clearly not the main story in terms of my serum lipid markers. Since my numbers were better when I semi-vegetarian, I decided to try pure veganism. At the time, I was pretty skeptical that I could do it for any length of time. I like meat, dairy, cheese, etc quite a bit really. I decided to do it religiously for 6-weeks and then recheck. If it made a big difference then I would be on board for the long haul, if not then I figured I would try Paleo or some other approach. As you can see, the improvement wasn't subtle! I am more than a bit shocked.
I can tell you that in terms of macronutrients, I consumed the exact same % of calories during the interval before and after veganism, namely 55% carbs, 30% fat, 15% protein. Total caloric intake also similar (I'm actually taking in more calories now than before to account for ramping up IM training and now approaching my goal weight want to be sure I don't lose lean muscle mass). Big differences were that cholesterol intake per-day is now zero where as before it was 150/day during my semi-veg phase and around 250/day during my looser period. I believe AHA allows 300mg/day, so like you I was very high despite being within AHA guidelines. The other equally big differences were a doubling of fiber from around 30g/day to 55-60g/day. (Be sure to drink extra water when you start). Also my % intake from saturated fats plummeted from around 10% to 3% or so.
I think the most interesting thing for me is that this "diet" is really quite easy. I'm frankly not really hungry for meat anymore. If anything I miss cheese more.
My basic tenets would be.
1) Food log compulsively. (I use LoseIt and do 99% of my logging via my smartphone).
2) Weigh in daily. (I use a Withings scale that automatically uploads to my LoseIt and TrainingPeaks accounts).
3) Make the switch to whole grains and away from refined foods as much as possible. (As I type this I am sitting in Starbucks with a decaf espresso and a package of almonds for a snack. Previously I would have gotten a cappucino and a baked good or cookie).
4) Start experimenting with the recipes from the books above. You will learn they taste pretty good.
5) Commit to experiment for 6-weeks and then reassess. The change will seem less daunting if you focus on short term goals.
I also have a cookbook at home, something like Vegan Cooking for Carnivores that has some good recipes too. Even Men's Health this month had an article on how to make homemade Vegan burgers (they were pretty good.)
While you are doing this for serious reasons related to your health, be sure to have fun doing it and experimenting with it.
Let me know how it goes.
Wow! THANK YOU Kevin for your input and guidance! I truly appreciate the time you took to lend a helping hand on my inquiry.
I'll have to get the 21 Day Weight Loss Kickstart by Neil Bernard. I like to experiment to meet my nutritional needs and make it taste good! In a warped sense, that is fun to me! Trying this Vegan approach for a short period of time and assessing progress sounds so easy. I especially liked your basic tenets. Adding the "compulsive" food log to my daily blood pressure readings and my daily blood sugar readings ( x 3 ) log shouldn't be a problem and Tenet 3 won't be a problem with a few adjustments.
Looking forward to trying this out! Again, THANK YOU for your help!
Rich Miller