LP(a) - A better way to measure CV risk?

[RAE]

IMHO, the AHA's reputation has suffered at their own hands. My 2¢.

You are right, Chuckanut, but the whole thing was/is driven by money. And, although AHA may have modified their policy regarding endorsements a little bit since 2010, they are still giving out plenty of horrible diet advice. They continue to demonize saturated fat, and to ignore the dangers of excess sugar, for one thing. That is why you continue to see the little "AHA Heart" endorsement on products that are loaded with added sugar. And their advice to consume industrial seed oils like soybean oil and corn oil is dead wrong, based on the latest research. Here is an article written by a cardiologist on just how bad some of the diet advice from AHA is:


https://www.thedailybeast.com/the-heart-associations-junk-science-diet

 

[Fedup]

Thanks for the link from dailybeast, I can see I’m confused about trans fat and saturated fat. I thought they are the same.

 

[RAE]

Thanks for the link from dailybeast, I can see I’m confused about trans fat and saturated fat. I thought they are the same.

No, they are quite different. Most trans fat is formed through an industrial process that adds hydrogen to vegetable oil, which causes the oil to become solid at room temperature. In a trans fat, the hydrogen atoms are bound on opposite sides of the carbon in the fatty acids, giving the acids a straight structure. This change may seem small, but it totally changes the fat's physical properties--trans fats have a higher melting point than most other fats and can stack on top of each other, which makes them solid at room temperature. This partially hydrogenated oil is less likely to spoil, so foods made with it have a longer shelf life. Trans fats are hard for your body to metabolize, so they aren't a good source of energy. Since your body can't really use them, they sit in the fat tissues around the body, hindering its ability to efficiently break down and use other proteins or fats that could help keep it running. People who consume a lot of trans fats are more likely to have type 2 diabetes, stroke, or heart attack.

Saturated fats are fats that contain a high proportion of saturated fatty acids, which contain no double bonds. They are naturally found in meat and dairy products. Saturated fats have been assumed by some to cause heart disease by raising cholesterol in the blood. However, no experimental evidence has ever directly linked saturated fat to heart disease. The link between saturated fat and heart disease has been studied intensely for decades, but the biggest and best studies show that there is no statistically significant association.

 

[Fedup]

No, they are quite different. Most trans fat is formed through an industrial process that adds hydrogen to vegetable oil, which causes the oil to become solid at room temperature. In a trans fat, the hydrogen atoms are bound on opposite sides of the carbon in the fatty acids, giving the acids a straight structure. This change may seem small, but it totally changes the fat's physical properties--trans fats have a higher melting point than most other fats and can stack on top of each other, which makes them solid at room temperature. This partially hydrogenated oil is less likely to spoil, so foods made with it have a longer shelf life. Trans fats are hard for your body to metabolize, so they aren't a good source of energy. Since your body can't really use them, they sit in the fat tissues around the body, hindering its ability to efficiently break down and use other proteins or fats that could help keep it running. People who consume a lot of trans fats are more likely to have type 2 diabetes, stroke, or heart attack.

Saturated fats are fats that contain a high proportion of saturated fatty acids, which contain no double bonds. They are naturally found in meat and dairy products. Saturated fats have been assumed by some to cause heart disease by raising cholesterol in the blood. However, no experimental evidence has ever directly linked saturated fat to heart disease. The link between saturated fat and heart disease has been studied intensely for decades, but the biggest and best studies show that there is no statistically significant association.

Go to know, we stay away from French fries which I think has more Tran fats, but we do eat meat, which is saturated fat. My husband has eggs and bacon daily, same with meat and vegetables. His meals at lunch varies a little bit like different meat types. So far his cholesterol is the same or less than his number 20 years ago.

 

[plsprius]

I have come to rely on NutritionFacts.org for advice on interpreting the medical literature.

This clip is a review of the ageless debate on saturated fat (and why some of the newer studies are misleading), albeit from a plant-based perspective: https://nutritionfacts.org/video/the-saturated-fat-studies-set-up-to-fail/

On the side of poor health we have the aligned forces of the pharma & medical industries pushing statins first and then and coronary bypass grafts (the major revenue source for most hospitals), plus much of the food industry pushing low-nutrition and potentially harmful processed foods with high fat/sugar/salt levels to make them delicious. One thing both Paleo and Plant-based Vegan diets have in common is the avoidance of processed foods.

LP(a) is a newer test and it might be a good marker for risk of coronary disease, but the primary reason it is not (yet) commonly tested is that big pharma currently has no drugs to treat high LP(a) (but watch because the new and very expensive PSK9 inhibitors can lower LP(a)).

 

[Chuckanut]

There was a time when the 'experts' put pressure on burger joints to get rid of animal fats when making fries and use Trans-fats instead. Talk about bad science.

https://www.theatlantic.com/health/archive/2013/11/when-trans-fats-were-healthy/281274/

“In the 1980s, some scientists began to associate heart disease with saturated fats, and in response, groups such as the Center for Science in the Public Interest and the National Heart Savers Association (NHSA) began to hound manufacturers for “poisoning America ... by using saturated fats,” and as a result “nearly all targeted firms responded by replacing saturated fats with trans fats,” as David Schleifer wrote in 2012 for the journal Technology and Culture. “

 

[RAE]

LP(a) is a newer test and it might be a good marker for risk of coronary disease, but the primary reason it is not (yet) commonly tested is that big pharma currently has no drugs to treat high LP(a) (but watch because the new and very expensive PSK9 inhibitors can lower LP(a)).

Yep, I think you are right. I have a doc appointment next week, and I will probably get the lecture (again) about high cholesterol, and why I should probably start taking a statin (even though most of my other blood test numbers are great, including triglycerides and HDL, etc). If that happens, I am going to tell him that I would like to have the LP(a) test done before I decide about statins. I doubt that he will order that test, but we'll see.

 

[sengsational]

LP(a) is a newer test and it might be a good marker for risk of coronary disease, but the primary reason it is not (yet) commonly tested is that big pharma currently has no drugs to treat high LP(a) (but watch because the new and very expensive PSK9 inhibitors can lower LP(a)).

Watch out! Novartis is looking ready to stumble into a drug that they want to sell you for the rest of your life; here's a paper published a few days ago:

Baseline and on-statin treatment lipoprotein(a) levels for prediction of cardiovascular events: individual patient-data meta-analysis of statin outcome trials

In this individual-patient data meta-analysis of statin-treated patients, elevated baseline and on-statin lipoprotein(a) showed an independent approximately linear relation with cardiovascular disease risk. This study provides a rationale for testing the lipoprotein(a) lowering hypothesis in cardiovascular disease outcomes trials.

[FONT=georgia, times, times new roman, serif]In other words, statins are not addressing the associated risk in patients with an elevated Lp(a), and this population represents about 25% of those with previous CVD or an indication for statins. They make a strong case that clinical trials with drugs that can lower Lp(a) specifically are needed to determine if these patients can reduce their risk.[/FONT]

That meta-analysis was funded by Novartis.

By the way, my LP(a) came back quite low: 11 nmol/L.

 

[RTbyFiveThree]

As mentioned, you may think about working with a Registered Dietitian who can give you more specific diet advice to improve cholesterol levels.
One other thing to note about statins is that they lower CoQ10 levels in the body, and this may result in additional side effects. Something to speak with your doctor about.

 

[deserat]

The problem here is that you used a calculator developed by the American Heart Association. In my opinion, any and all advice from AHA is not to be trusted. All you need to do is follow the money, to figure out why AHA is always recommending drugs like statins (even for those that do not need them) and pushing pseudo-foods such as soybean oil. Their funding largely comes from the big drug companies, and the mega-agricultural companies that produce stuff like soybean oil.

With regard to drug company funding:

"The financial ties between large pharmaceutical companies and the AHA are numerous and very remunerative for the AHA, including huge donations from Abbott, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb (BMS), Eli Lilly, Merck and Pfizer."

Guess who sells most statins worldwide? Pfizer and Merck.

You bring up a good point - the AHA is one of the general cardiology groups - another one is the American College of Cardiology ACC - they are more science and clinically based and only cardiologists can be members. The ACC and AHA sometimes don't see eye-to-eye on things.

I've seen similar captures of organizations by business in clinical and other professional groups....one needs to be careful...