Re: Cholesterol: How Low Should You Go?

[Guest guest]

> The optimum total cholesterol level in the blood is 100 mg/dl (2.6

> mM)? The WUSTL study CRers had levels of 158 versus the controls'

> 205 mg/dl. Mine was just above 100.

For non-CRers, optimal is 180 mg/dl, though the healthiest range is

180-220 mg/dl. Half of all heart attack victims have normal total

cholesterol levels and the lower your total cholesterol, the higher

your risk of dying from a stroke.

I vehemently disagree with having total cholesterol in non-CRers

below 180 mg/dl, particularly in the elderly-medicare-is-paying-for-

statins-guinea-pigs who desparately need cholesterol for hormone

synthesis. It is the oxidation of LDL specifically that is an

alleged cause for concern, not total cholesterol, HDL or LDL. Other

than the body using cholesterol to use as hormone substitutes (thus

pushing up the total level), the real underlying problem is not

arterial plaques (of which oxidized LDL is a small component), but

chronic inflammation brought about by sub-clinical Vitamin C

deficiency (required for collagen synthesis and repair of arteries).

Logan

[Guest guest]

Hi Logan:

Well data like the following do not seem to agree with your view

(stated below):

http://www.chd-taskforce.de/slidekit/kit4/slide2.htm

http://snipurl.com/7f2n

The data is from the large PROCAM study. If you look at the plot on

the left side of the linked diagram you will see that, among non-

smokers, deaths from CHD dropped to **ZERO** at LDL-C levels below

117.

You also might want to take a look at the following link (from a .edu

site):

http://www.pitt.edu/~super1/lecture/lec10511/020.htm

http://snipurl.com/7f2w

It shows continuing declines in 'CHD events' all the way down to LDL-

C of 95, where it is very near zero. And the commentary accompanying

the diagram says: " reducing LDL-C levels decreases the number of CHD

events, ***with no significant increase in noncardiovascular death

rate (all-cause mortality rate)***. "

So what is the source of the information you believe indicates that

the optimal total cholesterol is 180 - 220?

And with regard to your remarks about vitamin C, is there a study of

people with high cholesterol levels taking vitamin C supplements, who

had a better CHD incidence rate than those in the PROCAM study with

LDL-C below 117? The only way anyone would know whether, as you

suggest, vitamin C is " the real underlying problem " would be to do a

study to demonstrate it. Can you reference one for us, please?

Rodney.

> For non-CRers, optimal is 180 mg/dl, though the healthiest range is

> 180-220 mg/dl. Half of all heart attack victims have normal total

> cholesterol levels and the lower your total cholesterol, the higher

> your risk of dying from a stroke.

>

> I vehemently disagree with having total cholesterol in non-CRers

> below 180 mg/dl, particularly in the elderly-medicare-is-paying-for-

> statins-guinea-pigs who desparately need cholesterol for hormone

> synthesis. It is the oxidation of LDL specifically that is an

> alleged cause for concern, not total cholesterol, HDL or LDL.

Other

> than the body using cholesterol to use as hormone substitutes (thus

> pushing up the total level), the real underlying problem is not

> arterial plaques (of which oxidized LDL is a small component), but

> chronic inflammation brought about by sub-clinical Vitamin C

> deficiency (required for collagen synthesis and repair of arteries).

>

> Logan

[Guest guest]

Who can say until cholesterol studies are controlled for CR and non-

CR subjects? But the current evidence is that total cholesterol

levels below 180 mg/dl can increase risk of cerebral hemorrhage and

other lethal diseases. Some statin users can get dangerously low,

particularly below 150 mg/dl.

In my opinion, CRers will probably see a lower total cholesterol

level due to lesser demand for hormone manufacturing. Hormones do

have correlations with being pro-aging (e.g. insuling, IGF-1, et

al.). However, this lower level should be completely offset by HDL

being above 50 and LDL below 100 which I tend to doubt is reflected

in statin users or S.A.D. eaters.

Logan

--- In , " jwwright " <jwwright@e...>

wrote:

> Just a question. Do you also " vehemently " agree that 156 is ok for

CRers?

>

> Regards.

>

> ----- Original Message -----

> From: beneathremains

>

> Sent: Monday, June 28, 2004 11:18 PM

> Subject: [ ] Re: Cholesterol: How Low Should You Go?

>

>

> > The optimum total cholesterol level in the blood is 100 mg/dl

(2.6

> > mM)? The WUSTL study CRers had levels of 158 versus the

controls'

> > 205 mg/dl. Mine was just above 100.

>

> I vehemently disagree with having total cholesterol in non-CRers

> below 180 mg/dl...

>

> Logan

[Guest guest]

> Well data like the following do not seem to agree with your view

> (stated below):

The data you point to doesn't reflect TC and non-CHD risks from low

TC which I was referring to. Of course, there is a big difference

between the TC, HDL and LDL semantics! LDL levels in that chart

below 117 is close enough to the optimal number of below 100.

Suppose you had a HDL of 25 and LDL of 100 for a TC of 125, would you

consider that to be more optimal instead of a TC of 180 where HDL is

100 and LDL is 80? TC is generally useless without getting more

specific, but one can still make broad assumptions based on TC for

studies.

> So what is the source of the information you believe indicates that

> the optimal total cholesterol is 180 - 220?

I apologize, but I did make a mistake in the upper number when

quoting from memory, it is 200 not 220. Anything above TC of 200

mg/dl is considered " at risk " . About 52% of the total population has

TC of 200mg/dl and 21% have TC of 240mg/dl or above. These risk

factors are from Boston and Columbia Universities (1999). I have no

online source for that.

> And with regard to your remarks about vitamin C, is there a study

> of people with high cholesterol levels taking vitamin C

> supplements, who had a better CHD incidence rate than those in the

> PROCAM study with LDL-C below 117? The only way anyone would know

> whether, as you suggest, vitamin C is " the real underlying

> problem " would be to do a study to demonstrate it. Can you

> reference one for us, please?

I don't know if there's been any study like that yet (who's going to

fund it?), but as this is Linus ing's & M. Rath's theory, go to:

http://www4.dr-rath-

foundation.org/THE_FOUNDATION/About_Dr_Matthias_Rath/scientific_public

ations.htm

Logan

[Guest guest]

> So what is the source of the information you believe indicates that

> the optimal total cholesterol is 180 - 200? [edited]

Laemmle P, et al. Know your cholesterol: population screening. J Lab

Clin Med 1988 Nov;112(5):567-74.

Stone NJ, et al. Controlling cholesterol levels through diet.

Postgrad Med 1988 Jun;83(8):229-37, 241-2.

Hulley SB. A national program for lowering high blood cholesterol. Am

J Obstet Gynecol 1988 Jun;158(6 Pt 2):1561-7.

" Report of the National Cholesterol Education Program Expert Panel on

Detection, Evaluation, and Treatment of High Blood Cholesterol in

Adults. " The Expert Panel. Arch Intern Med 1988 Jan;148(1):36-69.

Vogt HB. Hyperlipoproteinemias: Part III. When to treat. S D J Med

1991 Apr;44(4):97-100.

Leis HP. The relationship of diet to cancer, cardiovascular disease

and longevity. Int Surg 1991 Jan-Mar;76(1):1-5.

Gil VF, et al. [The validity of the separate determination of total

cholesterol in the primary prevention of coronary risk]. Med Clin

(Barc) 1995 Apr 29;104(16):612-6.

Iribarren C, et al. Low serum cholesterol and mortality. Which is the

cause and which is the effect? Circulation 1995 Nov 1;92(9):2396-403.

Iribarren C, et al. Low serum cholesterol and mortality. Which is the

cause and which is the effect? Circulation 1995 Nov 1;92(9):2396-403.

Iribarren C, et al. Serum total cholesterol and mortality.

Confounding factors and risk modification in Japanese-American men.

JAMA 1995 Jun 28;273(24):1926-32.

" LDL is not dangerous unless oxdized " :

SR, et al. Inhibition of LDL oxidation by ubiquinol-10. A

protective mechanism for coenzyme Q in atherogenesis? Mol Aspects Med

1997;18 Suppl:S85-103.

Stocker R, et al. Ubiquinol-10 protects human low density lipoprotein

more efficiently against lipid peroxidation than does alpha-

tocopherol. Proc Natl Acad Sci U S A 1991 Mar 1;88(5):1646-50.

SR, et al. Oxidation and antioxidation of human low-density

lipoprotein and plasma exposed to 3-morpholinosydnonimine and reagent

peroxynitrite. Chem Res Toxicol 1998 May;11(5):484-94.

SR, et al. A role for reduced coenzyme Q in atherosclerosis?

Biofactors 1999;9(2-4):207-24.

It appears that DHEA is integral for complete protection against LDL

oxidation as Vitamin E fails at that role unless adequate DHEA levels

are present:

Khalil A, et al. Age-related decrease of dehydroepiandrosterone

concentrations in low density lipoproteins and its role in the

susceptibility of low density lipoproteins to lipid peroxidation. J

Lipid Res 2000 Oct;41(10):1552-61.

" Heart attack victims with normal cholesterol levels " :

Bo M, et al. Cholesterol and long-term mortality after acute

myocardial infarction in elderly patients. Age Ageing 1999 May;28

(3):313-5.

Jadhav PP, et al. Evaluation of apolipoproteins A1 and B in survivors

of myocardial infarction. J Assoc Physicians India 1994 Sep;42(9):703-

5.

Bux-Gewehr I, et al. Recurring myocardial infarction in a 35 year old

woman. Heart 1999 Mar;81(3):316-7.

Fournier JA, et al. Normal angiogram after myocardial infarction in

young patients: a prospective clinical-angiographic and long-term

follow-up study. Int J Cardiol 1997 Aug 8;60(3):281-7.

Schmidt HH, et al. Elevated lipoprotein(a) is lowered by a

cholesterol synthesis inhibitor in a normocholesterolaemic patient

with premature myocardial infarction. Blood Coagul Fibrinolysis 1993

Feb;4(1):173-5.

Prati PL . [The periodic flashes of E. Brunwald: lowering cholesterol

levels in subjects with myocardial infarction and normal cholesterol

levels]. G Ital Cardiol 1997 Jan;27(1):76-8.

Lawless C, et al. Lipid lowering in post-MI patients with normal

cholesterol. J Fam Pract 1997 Jan;44(1):30.

Hartley H. [The reduction of cardiovascular events after a myocardial

infarct in patients with normal cholesterol levels]. Rev Clin Esp

1996 Dec;196(4 Monografico): 43-6.

Logan

[Guest guest]

> and that under 180 is better. But at 180, your risk is still

> around 20-25%. In the Framingham study, there has never been a

> heart attack in anyone with a total cholesterol under 155.

>

> We recommend people keep their total to below 100 plus their age,

> with a maximum of 165 and have published the results of these

> including 5 year follow ups.

>

> While I have seen lots of claims that cholesterol can go to low, I

> have never seen any real date that showed that it was harmful, as

> long as it occurred as a result of a healthy lifestyle.

Isn't that a non-sequitor? Who can have extremely low TC unless they

go to an extreme of drugs or a radical lifestyle like CR? :-)

Nonetheless, unless there's been contradictory research, the studies

below imply that TC of 180 mg/dl to 200 mg/dl is the best way to

protect against cerebral hemorrhagic stroke (risk when TC is below

150 mg/dl) and against the more widespread ischemic stroke (risk when

TC is " too high " ). So I have to respectfully disagree with your

center's position, at least for middle-aged people with TC below 180

mg/dl.

Gatchev O, et al. Subarachnoid hemorrhage, cerebral hemorrhage, and

serum cholesterol concentration in men and women. Ann Epidemiol 1993

Jul;3(4):403-9.

Okumura K, et al. Low serum cholesterol as a risk factor for

hemorrhagic stroke in men: a community-based mass screening in

Okinawa, Japan. Jpn Circ J 1999 Jan;63(1):53-8.

Iso H, et al. Serum cholesterol levels and six-year mortality from

stroke in 350,977 men screened for the multiple risk factor

intervention trial. N Engl J Med 1989 Apr 6;320(14):904-10.

s DR. The relationship between cholesterol and stroke. Health

Rep 1994;6(1):87-93.

Gil-Nunez AC, et al. Advantages of lipid-lowering therapy in cerebral

ischemia: role of hmg-coa reductase inhibitors. Cerebrovasc Dis 2001

Feb;11 Suppl 1:85-95.

Liu S, et al. Fruit and vegetable intake and risk of cardiovascular

disease: the Women's Health Study. Am J Clin Nutr 2000 Oct;72(4):922-

8.

Gramenzi A, et al. Association between certain foods and risk of

acute myocardial infarction in women. BMJ 1990 Mar 24;300(6727):771-3.

Singh RB, et al. Effects on serum lipids of adding fruits and

vegetables to prudent diet in the Indian Experiment of Infarct

Survival (IEIS). Cardiology 1992;80(3-4):283-93.

Logan

[Guest guest]

--- In , " jwwright " <jwwright@e...>

> In the case of statin users, you overlook the fact that TC is

> monitored by a doctor who cannot prescribe a statin unless it's

> req'd, for one, and cannot continue to prescribe it without blood

> tests every 6 months. The TC will never get below your " feared " 150

Have you heard about the new economic agenda pushing to reclassify

statins as OTC and become available to everybody? Do we really want

to trade off lower ischemic stroke risk for higher cerebral stroke

risk?

> level, rather the people who require a statin will likely have to

> make do with 220. Some people are almost totally unaffected by diet

I would think my grandmother's TC of 114 would disprove your

statement? She is on Zocor. In her case the risk of ischemic stroke

may be higher than cerebral hemorrhaging, but that's not an ideal

compromise to me when both ought to be negated (and could if the GP

had any clue about nutrition rather than drugs).

> weight to a nominal level. But mine has never been high. I think

> your fear that levels might go to low in healthy people is

> unfounded. Low level due to sickness a diff story.

That's possible. But drugs can also give you " sickness " just by

virture of taking them. Statins do have negative side-effects apart

from the risks specific to low TC.

> And as Jeff Novick has accurately put it, the liver is very

> capable, so capable in fact, that even statins, a modified diet,

> and exercise will not change the TC appreciably in those special

> people.

That just goes to prove suppressing TC in the non-special people when

the body keeps TC relatively higher to assure continual hormone

substitution is wrong-headed and potentially dangerous. That ought

to be " self-evident " from observing TC declining after hormones

levels are restored to optimal. Do we really want to wait 20-30

years for such research to become widely " self-evident " after the

damage has already been done? Even now, it's still not widely " self-

evident " statins deplete CoQ10.

> Cerebral hemorrhage is notable, although I sincerely doubt statins

> will increase the risk, it's not near the risk of ischemic stroke,

> heart disease. So we have to balance the risk factors. About age

> 85, the hemorrhagic stroke risk seems to surpass the IS risk.

Fair enough.

> Finally, my TC has been as low as 116, last 156, and I have no

> intention of trying to raise it 180-220, even if I knew how.

FWIW, my TC was 160 mg/dl last I checked. I'm not too worried about

it as long as it stays between 150 mg/dl and 200 mg/dl. Below 150

mg/dl would suggest to me inadequate intake of saturated fat or

excessive drug/supplement TC suppression.

Would that CRONer with a TC of 110 or so in here please state their

HDL and LDL numbers?

Logan

[Guest guest]

Hi Logan:

You seem to have a misunderstanding about how total cholesterol is

calculated. If your HDL was 25 and your LDL was 100 your total

cholesterol would NOT be 125, it would be higher because you have not

taken account of the TG. Similarly if your HDL were 100 and your LDL

80 your TC would not be 180.

I will take a look at some of your referenced studies over the

weekend.

Rodney.

> Suppose you had a HDL of 25 and LDL of 100 for a TC of 125, would

you

> consider that to be more optimal instead of a TC of 180 where HDL

is

> 100 and LDL is 80?

[Guest guest]

Hi :

Well, if you believe that I suggest you try adding up your LDL + HDL

and see if that sum comes out to be your TC.

Rodney.

> >

> >

> > > Suppose you had a HDL of 25 and LDL of 100 for a TC of 125,

would

> >you

> > > consider that to be more optimal instead of a TC of 180 where

HDL

> >is

> > > 100 and LDL is 80?

> >

> >

> >

[Guest guest]

Hi :

I have tried to find a specific source that says this, but my

understanding is that as a practical matter TC is calculated by

adding one-fifth of your TG to the sum of HDL and LDL.

The logic, I believe, is that one fifth of TG is supposed to be a

half-decent approximation for VLDL. But VLDL (presumably) is

difficult to measure directly.

If you find otherwise no doubt you will let us know.

Rodney.

> > >

> > >

> > > > Suppose you had a HDL of 25 and LDL of 100 for a TC of 125,

> would

> > >you

> > > > consider that to be more optimal instead of a TC of 180 where

> HDL

> > >is

> > > > 100 and LDL is 80?

> > >

> > >

> > >

[Guest guest]

Hi :

So if as you posted ..........

LDL = TC - (HDL + TG/5) , then .........

TC = LDL + (HDL + TG/5) , and ..........

TC = LDL + HDL + TG/5.

No?

(I was not aware of the exception if TG was above 400.)

Rodney.

> >

> >

> > > Suppose you had a HDL of 25 and LDL of 100 for a TC of 125,

would

> >you

> > > consider that to be more optimal instead of a TC of 180 where

HDL

> >is

> > > 100 and LDL is 80?

> >

> >

> >

[Guest guest]

Hi :

LOL. Crossed posts!

Rodney.

> > > >

> > > >

> > > > > Suppose you had a HDL of 25 and LDL of 100 for a TC of 125,

> >would

> > > >you

> > > > > consider that to be more optimal instead of a TC of 180

where

> >HDL

> > > >is

> > > > > 100 and LDL is 80?

> > > >

> > > >

> > > >

> >

[Guest guest]

> > Well data like the following do not seem to agree with your

view

> > (stated below):

>

> The data you point to doesn't reflect TC and non-CHD risks

from low

> TC which I was referring to. Of course, there is a big difference

> between the TC, HDL and LDL semantics! LDL levels in that

chart

> below 117 is close enough to the optimal number of below

100.

> Suppose you had a HDL of 25 and LDL of 100 for a TC of 125,

Logan,

If I add my HDL and LDL #'s together I do not get the total

cholesterol # I'ts about 20??? different.

Canary Peg

[Guest guest]

>

> The logic, I believe, is that one fifth of TG is supposed to be a

> half-decent approximation for VLDL. But VLDL (presumably) is

> difficult to measure directly.

>

> If you find otherwise no doubt you will let us know.

>

> Rodney.

>

Canary Peg here,

Yes that's the way my #'s add up HDL + LDL + 1/5th of

Tryglycerides. I wont give my #'s as they're not in line with you

CRONers

[Guest guest]

> >>Isn't that a non-sequitor? Who can have extremely low TC

unless they

> go to an extreme of drugs or a radical lifestyle like CR? :-)

>

> Actually no, cholesterol levels of under 180 are common in

many areas of the world, even under 165. Mine has (and

remains) under 150-155 without ever using drugs or

supplements aimed at lowering it.

Canary Peg here:

My last five years have been spent in the UK and the Canaries

and not once has a doctor wanted to do a cholesterol study on

me. Having spent 40 years partaking of US medicine I

automatically asked for 6 monthly checkups. The docs have

been most obliging but dont seem to have the concern about

cholesterol - if it's around 200 or even slightly higher in an older

patient. Many of my relatives - in the UK - have never had a

cholesterol check done and some of them lived well into their

90's. Diet was high fat but there was much more exercise - in

the form of walking. Another advantage that we oldsters have is

that we weren't raised on junk food - it wasn't to be had.

I think that any extreme can stress the body leading to ill health.

My eldest son was a marathon runner weighed about 145lbs

and was 6ft tall. IMO he stressed his body to exhaustion and

together with a very stressful job and lifestyle his body rebelled.

He died at the age of 44 after a 5 yr fight with lung cancer. BTW

he never smoked.

[Guest guest]

>

> Are you saying (or implying) that a lifestyle (or mine, more

specifically) that leads to a cholesterol under 160 is extreme?

No I'm not implying that, what I'm implying is what Francesca

pointed out in her last post. Carrying diet, exercise or anything

else to extreme can IMO be harmful. I dont want to get into the

#'s on cholesterol because quite honestly I dont *know* and I

doubt that anyone else does. I think it would help to check out

some 'other than US' studies - maybe this has been done on the

list but there's the BMJ etc. Of course your goal - being much

younger than me is different than mine.

> There are also many other differences in these countries and

people you mention. Some that eat more fat, actually eat less

saturated fat than we do. And as you mentioned, junk, refined

food, highly sugared and or fat " added " food is more rare. A And

in some, total caloric intake is less and they are more active.

Well no - at least not in the UK. The Mediterranean countries do

eat more healthy fats but my family and those around them

wouldn't dream of using olive oil on salad or for cooking - this is

in the north of England. The present generation, there, and here

in the Canaries eat plenty of junk food - it seems the message

hasn't gotten out here just as the smoking warning hasn't hit

these shores.

I was speaking about oldsters in the UK. The young one's and

also the young people in Asia are prone to all the health hazards

of Yanks. In Asia they're tackling the problem in the schools and

also in the UK there's a move to stop the vending machines in

cafeterias.

One last thought on all this. In my many years of doing 'this and

that' with the goal of health in mind I've found that the mental as

well as the physical needs much attention and for me that's

been a practice of meditation.

[Guest guest]

>>>

Are you saying (or implying) that a lifestyle (or mine, more

specifically) that leads to a cholesterol under 160 is extreme?

>>>

This is not a personal comment addressed to any one in particular, but

in my opinion EVERYONE in this group is doing something out of the

ordinary, and many outsiders might consider it extreme.

Who in their right mind goes hungry, measures temperature and blood

pressure every day? Not normal people. Hunger is something that

occurs in poor African countries because of wars. But to do it

voluntarily? Devout religious people historically have fasted for

enlightenment and to atone for sins. Caloric intakes similar to those

consumed by anorexic patients are NOT normal. In an interview with

Liza May, a reporter wrote that on that particular day she had only

eaten one apple. The reporter left the reader with the impression

that she was not going to eat anything else that day, and everyone

knows that nobody can survive by eating only one apple per day. The

majority of the people do not understand CR and think that it is

abnormal and extreme.

What percentage of Americans eat vegan or vegetarian diets? Not very

many. Some cultures, e.g., India, have centuries-old traditions of

vegetarianism, but not America. We like beef, pork, and poultry.

However, the percentage of vegetarians seems to be higher in the CR

community than in the general population.

Who adds guar gum and galactomannin to the food to make it more

filling while keeping calories low? Not ordinary people.

Face it. The lifestyle that we are choosing may make us healthier,

but it also makes us weirder.

Tony

[Guest guest]

Hi Al:

Thanks. Of course you are right! They are lipo-proteins.

Rodney.

> >

> >

> > > Suppose you had a HDL of 25 and LDL of 100 for a TC of 125,

would

> > you

> > > consider that to be more optimal instead of a TC of 180 where

HDL

> > is

> > > 100 and LDL is 80?

> >

> >

> >

> >

> >

> >

> >

> >

[Guest guest]

Hi :

I agree absolutely. And in addition, on the topic of what these days

is considered 'normal', it was Ornish who pointed out (and daring to

mention it may, possibly, have been a contributing factor for his

departure from Harvard) that these days:

" recommending to a patient that he make a few changes in his

lifestyle is considered radical, while recommending to the same

patient that he have quadruple bypass surgery is considered

conservative " .

Ornish made those comments after listening to the extensive criticism

levelled at his study which demonstrated that a combination of a low

fat diet, meditation, and a little exercise, REVERSED atherosclerosis.

It is difficult to remain totally uncynical when watching stuff like

that.

Rodney.

> Absolutely! We is wierd! But look at what being normal means:

being

> overweight, sedentary, livin' on trans-fats, saturated fats,

processed

> " food " , borderline diabetic, gettin' hypertension, atherosclerotic

vascular

> disease, cancer, etc....

>

> I'll take wierd and extreme any day!

[Guest guest]

Hi All,

As I understand it, cholesterol is found in all the lipoproteins,

including HDL, LDL, VLDL and IDL. It is also in chylomicron

particles, the precursors for such lipoproteins. Triglycerides are

made of glycerol and fatty acid residues only.

Cheers, Al Pater.

--- In , " Rodney " <perspect1111@y...>

wrote:

> Hi Logan:

>

> You seem to have a misunderstanding about how total cholesterol is

> calculated. If your HDL was 25 and your LDL was 100 your total

> cholesterol would NOT be 125, it would be higher because you have

not

> taken account of the TG. Similarly if your HDL were 100 and your

LDL

> 80 your TC would not be 180.

>

> I will take a look at some of your referenced studies over the

> weekend.

>

> Rodney.

>