High cholesterol problem

[rgarling]

I don't understand what you mean by "first calculate protein and fat requirements". The RDI specifies the "requirements", so only the 2nd line of your chart is close to the government approved solution. On the other hand, I believe your idea could be improved by using this approach:

1. calculate protein requirement at .5g / pound of lean body mass. e.g. for 150 pounds lbm = 75g protein or 300 calories
2. determine the target carbohydrate intake (e.g. 75 grams or 300 calories)
3. calculate the amount of fat required to meet calorie requirements: target 2560 (2560 - 600 = 1960 or ~200g fat

[rgarling]

Sorry, but it appears we were posting at the same time. I agree that .5g per pound of lean body mass is low. Personally, I think 1gram / pound of lbm is much better. Dr Scott Connelly reported that he consumed about 8g per pound of protein during his body building stage without ill effect

[HFWR]

Quote:

Originally Posted by rgarling I don't understand what you mean by "first calculate protein and fat requirements". The RDI specifies the "requirements", so only the 2nd line of your chart is close to the government approved solution. On the other hand, I believe your idea could be improved by using this approach: 1. calculate protein requirement at .5g / pound of lean body mass. e.g. for 150 pounds lbm = 75g protein or 300 calories 2. determine the target carbohydrate intake (e.g. 75 grams or 300 calories) 3. calculate the amount of fat required to meet calorie requirements: target 2560 (2560 - 600 = 1960 or ~200g fat

It is assumed that protein and fat are absolute necessities, and that there is no "requirement", as such, for carbs.

[TromboneAl]

On NBC news, Dr Snyderman said "the average American eats 22 tsp of sugar per day, which is three times what you need." No one needs sugar.

[REWahoo]

Quote:

Originally Posted by TromboneAl On NBC news, Dr Snyderman said "the average American eats 22 tsp of sugar per day, which is three times what you need." No one needs sugar.

Al, no one "needs" any fun in their life either, but I'd hate to do without it.

[HFWR]

Quote:

Originally Posted by TromboneAl On NBC news, Dr Snyderman said "the average American eats 22 tsp of sugar per day, which is three times what you need." No one needs sugar.

Without sugar, there'd be no beer!

Twenty-two teaspoons of sugar is 350kcal (or more, if a "heaping" teaspoon) of empty calories...

[Moscyn]

For my own low cholesterol and reduced carbohydrate diet, I think I'll not apply any calculations or else it would be making things more difficult for myself. I know I'm not one to live like that. I'll just do the "everything in moderation" approach and avoid certain food. I think the changes I'm making to my diet and lifestyle should help - may not be in the speed as ideally desired but I just want to improve, may take a bit longer but the idea is to improve.

[Chuckanut]

Here is a good reason why some of us in the general public are confused over cholesterol and what we must do, if anything, about it.

On the 2/17/12 show of NPR's Science Friday a Dr. Robert Lustig was interviewed about the use of sugar in our diet. Towards the end he addressed cholesterol. He claimes there are two types of LDL (the bad cholesterol). One slips through our blood and does not attach to our artery walls (the large boyount LDL), the other type (the small dense LDL) does and this is the one we need to fear. The total LDL levels most of us get from our blood tests do not distinguish between the two. Sugar and refined carbs -without the natural fiber- drive up the bad LDL levels.

So, another source of confusion for we lay people.

Oh, his advice?? - Eat Real Food.

[haha]

Quote:

Originally Posted by Chuckanut Here is a good reason why some of us in the general public are confused over cholesterol and what we must do, if anything, about it. On the 2/17/12 show of NPR's Science Friday a Dr. Robert Lustig was interviewed about the use of sugar in our diet. Towards the end he addressed cholesterol. He claimes there are two types of LDL (the bad cholesterol). One slips through our blood and does not attach to our artery walls (the large boyount LDL), the other type (the small dense LDL) does and this is the one we need to fear. The total LDL levels most of us get from our blood tests do not distinguish between the two. Sugar and refined carbs -without the natural fiber- drive up the bad LDL levels.

Does he give any references? Web address not necessary, just any references.

Thanks, Ha

[Chuckanut]

The doctor certainly has plenty of credentials in this area, so I guess he is worth listening to.

No links were given on the show, but here are a few I found:

A link to the article in NATURE magazine. (Note: you have to pay to get the article.)

http://www.nature.com/nature/journal...l/482027a.html

A web article on getting sugar out of your diet:

Dr. Lustig | Healthy Eating Tips - Upgrade Your Healthstyle | Summer Tomato


A video of Dr. Lustig giving a talk

https://www.youtube.com/watch?v=dBnniua6-oM

[haha]

Thanks. I am convinced on the sugar thing, I was just looking for evidence about the differential effect of the small dense LDL carrying lipoproteins relative to the large fluffy LDL lipoprotein particles. My Dr. is not a believer. I'll spend some time looking around. Much safer for a Doc to be a late adaptor of a formerly taboo idea then to be an early adaptor.

Sugar taxes IMO would be hard to get, and I would fear them because there are a lot more people who might sign on for a fat-tax than for a sugar tax. What does your Doc lecture you about? Sugar in your diet or "unhealthy saturated fat"?

Ha

[Chuckanut]

The video posted above is long, about an hour and a half, and very informative. The good doctor is a professor of pediatric endocrinology, so I have to assume he does know something. However, I would enjoy hearing other authoritative voices who disagree.

[haha]

Quote:

Originally Posted by Chuckanut The video posted above is long, about an hour and a half, but very informative. The good doctor is a professor of pediatric endocrinology, so I have to assume he does know something. However, I would enjoy hearing other authoritative voices who disagree.

I hope you don't think I am disagreeing; I am not. But try anything put out by the ADA or American Heart Association for other viewpoints.

Ha

[TromboneAl]

I haven't read this yet:

Beyond Routine Cholesterol Testing: The Role of LDL Particle Size Assessment

http://www.centerforpreventivemedici..._messenger.pdf

[haha]

Quote:

Originally Posted by TromboneAl I haven't read this yet: Beyond Routine Cholesterol Testing: The Role of LDL Particle Size Assessment http://www.centerforpreventivemedici..._messenger.pdf

Thanks Al. There are a few references here that may be helpful. But he is really looking for an excuse to give more pharmacologial treatment to those who already qualify for treatment under current guidlines based on their standard LDL figure. He asserts that LDL as usually measured is strongly predictive of cardiac events. I have read but cannot cite papers that deny this.

Something is not quit right with this whole cholesterol thing, but unfortunately I do not know what. As best I know, the large, well done studies like the West of Scotland study show very little correlation of death rates with LDL, but it is hard to keep these things in my head.

Even statin treatment which does lower death rates modestly while dramatically lowering LDL numbers shows very little correlation between those two things.

A detail oriented person like me struggles with this.

Ha

[braumeister]

AFAIK, the way to get at least a rough estimate of your LDL particle size using your own blood test figures is to divide your triglyceride number by your HDL number. A T/H ratio of less than 3 is good (meaning your LDL particle size is most likely bigger), and 1 would be excellent.

Trig above 120 and HDL below 40 (so a ratio of more than 3) would be associated with the small, dense LDL particles, and would be worrisome.

Last time I checked mine, I had T/H = 94/88 for a ratio of 1.1 and I follow a low carb, high fat diet.

[TromboneAl]

I've now read it, and I'd summarize the article as: "The national guidelines say that LDL is bad, but it's starting to look like the small dense LDL is the real problem. You can measure LDL particle size, but if the patient has really low TG, then you don't need to even bother, since that patient won't have small, dense LDL."

My TG is 49 an HDL 69, so I'm hoping my new doctor will agree that that is good.

[haha]

Quote:

Originally Posted by TromboneAl I've now read it, and I'd summarize the article as: "The national guidelines say that LDL is bad, but it's starting to look like the small dense LDL is the real problem. You can measure LDL particle size, but if the patient has really low TG, then you don't need to even bother, since that patient won't have small, dense LDL." My TG is 49 an HDL 69, so I'm hoping my new doctor will agree that that is good.

I think she will. though she may hassle you if your LDL is 'high". Primary care today is learning how to follow a flowchart and don't bother yourself with thinking as it will just get you into trouble with your overlords.

Ha

[TromboneAl]

Is your doctor old or young?

[JOHNNIE36]

This has been one of the most interesting threads. I am surprised at all the information provided by the members. You are most knowledgeable.
In my situation, having had cardiac bypass in 2004, I have been striving to maintain "good numbers". I mentioned in an earlier post on this thread that I was going to go from 80mg simvastatin to 40mg and see what happened to the numbers. Lab test earlier last week produced the following: Total cholestrol 199, HDL 46, triglycerides 175 and LDL 118. Although the triglycerides is a little high, I'm happy overall with the results. The ratio of CHOL/HDLC is 4.3 which is in the acceptable range.