Diet Matters - Metabolic Health, Cholesterol, and Statins

"...suggesting that Metabolic health is perhaps of more concern than actual Cholesterol numbers"

by sgmfish - 2024-09-27 17:31:02

Could you explain what "Metabolic health" is and how it is measured?

Great Question - What is Metabolic Health?

by DoingMyBest - 2024-09-27 19:47:26

Metabolic Health is a little tricky to define since the medical community hasn't arrived at a set definition. One definition is "lack of Metabolic Syndrome." From a Mayo Clinic website,

    Metabolic syndrome is a cluster of conditions that occur together,
    increasing your risk of heart disease, stroke and type 2 diabetes.
    These conditions include increased blood pressure, high blood
    sugar, excess body fat around the waist, and abnormal cholesterol
    or triglyceride levels.

There is also a strong relationship between Metabolic Syndrome, dementia, and inflammation (not the type you feel in joints or muscles).

A definition found on levels.com is,

    Clinically speaking, metabolic health is defined by optimal levels of
    five markers: blood sugar levels, triglycerides, high-density
    lipoprotein (HDL) cholesterol, blood pressure, and waist
    circumference—without using medication.

A decent introductory article can be found here,

    What is metabolic health?
    https://zoe.com/learn/what-is-metabolic-health

I first learned about Metabolic Health from Dr. David Perlmutter, MD in his two books, Grain Brain and Drop Acid. He attracted my attention when I was looking for solutions to excess Uric Acid that causes Gout. He is a neurologist who's had an interest in the effects of diet on brain health and dementia for decades. He's zero'd in on inflammation and metabolic syndrome caused by poor diet as a major cause for many if not most of the body ailments that afflict us. In his research he's found that illness due to inflammation spans virtually all your organs, not just the brain.

Another source (book) that echoes much of what Dr. Perlmutter says about Metabolic Health is, Outlive - The Science and Art of Longevity, by Dr. Peter Attia, MD.

They make a good case. Many of our problems began with processed food production and dietary changes early in the 20th century. Not knowing better, we've been brought up in a time where we eat way too much of the wrong things and too little of what our bodies were designed for. The consequences are self-evident.

These folks also make a good case why the advice we get from government sponsored health agencies is corrupt and fraught with influence from agricultural and food businesses having financial motivations rather than your health in mind.

Seed oils, as well

by IrishToast - 2024-09-27 21:13:57

People were much more trim and healthy back in the days before so-called vegetable oils. It is difficult to find food today without seed oils, i.e. soy bean oil, sunflower, safflower, genetically modified corn oil, and much "canola" oil (rapeseed - 1978 trademarked invented process from 'Canada and ola') which are everywhere!  Sugar and fast carbs are a metabolic disaster that sets us up for cravings and disease. Big food companies are happy to help us need more of their products. I keep at my best weight now using only butter, tallow, bacon grease, olive oil and coconut oil. Store salad dressings are mostly soybean oil. Food labels are filled with stuff I wouldn't cook with. All my tests before my PM surgery came out great for my age, My heart and arteries are good. It was a pharmaceutical for a cough that caused a heart block for me. The best thing about eating differently than we have been told lately, is that it brings pretty quick results once you get past the carb addiction!

What is the missing ingredient?

by Gemita - 2024-09-28 03:23:56

DoingMyBest, I really don’t know what the answer is.  I am living proof that doing all the right things as far as diet is concerned (and I am probably already eating a Keto type diet of low carbs, the right proteins and fats), isn’t enough to bring my cholesterol levels down.  I believe there are so many causes for higher cholesterol levels that cannot be addressed by diet alone.  I know the stress in my life isn’t helping and nor is my lack of regular exercise, both of which I am now actively working on.  I believe the loss of natural oestrogen during my early menopause has been another major contributory factor to my slowly climbing cholesterol levels and I cannot safely reverse my oestrogen loss at 75.

Fortunately my triglycerides and good cholesterol are still both okay.  Until I started losing oestrogen, my LDL cholesterol levels generally were always low too.   I have so far resisted taking a Statin although my doctors are pushing for me to do so because of other health concerns.  

My husband suffers from Metabolic syndrome.  At 86 he is not able to tolerate Statins.  He has diabetes and is receiving regular insulin injections to control his often high glucose levels.  He also had high amounts of uric acid in his blood and takes Allopurinol to prevent gout.  His blood pressure is still often too high.  Even though he continues to eat some really bad foods, his cholesterol levels overall are better than mine.  We have noticed that the number 1 cause for spikes in his insulin levels (we have continuous glucose monitoring) is lack of exercise.  A healthy diet alone is clearly not the answer. 

There would appear to be inconclusive evidence that lowering cholesterol in the elderly is of any real benefit. From the data available, it is reasonable to conclude that after the age of 65, increased blood lipids, although still a risk factor for coronary heart disease, become less pronounced as risk factors and that by 75 years of age their predictive value may have disappeared. Indeed, in the very elderly, there is evidence to suggest that high total cholesterol may even be associated with longevity.  So what should we believe?

I enjoyed my Statin thread immensely and reading all the helpful comments. I  respected all the views made, for and against Statins, since finding what works for us personally is not at all easy.  There is no clear right or wrong.  Although it is often viewed as negative, cholesterol clearly does have some important functions in the body including acting as a precursor to many essential hormones.

For me personally, taking a Statin would never be a substitute for making lifestyle changes which will always bring the highest benefits to my health.  I do not wish to take a pill that will improve my numbers while allowing me to continue to eat foods or live a lifestyle that might be bad for me, that may have triggered my high cholesterol in the first place.  

Food

by piglet22 - 2024-09-28 07:29:14

We've come a long way since the days of our hunter gatherer ancestors.

Imagine having to live for just a few days on what you could catch, plants and fruits that you could find that didn't kill you or make you very ill. Then there's liquids to drink.

Turn that into a lifetime. Little wonder that remote indigenous tribes people today spend much of their time gathering food.

Now, that prospect would fill us with horror. Most people would die at the prospect of killing and processing a chicken, and rely on someone else to do it.

As a post war child, I saw a different way of living compared to now. Rationing was in place and food choice was limited. Chicken was a Christmas luxury. Food was fresher, local and seasonal. Visits to the family doctor were rare, blood tests and numbers almost non-existent. My parents wouldn't have a clue about blood pressure results.

Now, the High Street traders have gone largely and the supermarkets rule. The way they operate means that a lot of food comes in, factory prepared and plastic wrapped. Look at the list of ingredients, stabilisers, emulsifiers, acidity regulators. Those are part of our diet now.

I was looking at IrishToast's list of oils and fats. I remember the dripping bowl my mother kept. The jelly at the bottom and the solid fat on top. Bread and dripping and a dash of tomato sauce. What a treat that was. Nothing went to waste.

Olive oil came from Boots and was for medicinal use. One tiny bottle lasted for decades. Now it's single estate extra virgin cold pressed oil.

I'm going off numbers. The last text from my GP "you are one point off being type 2 diabetic" really put me off. Coupled with Qrisk.

Yes, I do check BP, oxygen, BPM and blood glucose, mainly to counter the surgery. I'm quite happy with non-diabetic hyperglycaemic than having one number push me into medication and heaven forbid, a diabetes awareness course.

Food, a good meal is something to look forward to, it lifts the spirits and that's to be welcomed.

Good Comments From You

by DoingMyBest - 2024-09-28 13:24:43

IrishToast - I agree with everything you say. This is consistent with the best info I've seen. You even have to be careful about oils like avocado oil, if it's been processed with heat. Some of the information I see says animal fats aren't a problem and concern over saturated vs. unsaturated fats is overblown -- as long as the rest of your diet is metabolically healthy.

Gemita - The point of the study was that marginally high cholesterol numbers are not a problem when on a keto (metabolically healthy) diet. I've seen this several times now. Yes, cholesterol is a component of plaque and a generally good indicator of likely problems, but seems only to actually be a problem in the absence of a good, metabolically healthy diet. In fact, somewhat high numbers (near the high limit of "normal") is an expected result of a keto diet.

Something that drives me nuts – all the fats, oils, cholesterol that we eat is fully broken down when it is digested. Cholesterol that circulates in the body is manufactured by your own body. It makes what it thinks it needs and discards the excess materials. There is no such thing as what-you-eat goes directly to plugging up your arteries. Aye-yi-yi!

"In the very elderly, there is evidence to suggest that high total cholesterol may even be associated with longevity." Yep. I've seen that several times too. I'd like to know more about the people, their diets, and lifestyles upon which that "evidence" was found.

Before making my diet changes, I was taking 200mg of Allopurinol daily. Now I am taking 100mg daily and my uric acid number is square in the center of the "normal" range. I could probably get off it altogether, but it's difficult to get tests as often as I'd like to be able to track the effect. I think I’ll look into a self-test setup.

Piglet - Exactly right. The researchers taking this seriously look at the diets and habits of our ancestors prior to 1900 -- limited carbs and sugar, lots of vegetables, seasonality, feast and famine, fasting. After many millennia of this, you'd suppose the human body was well adapted to that kind of life and diet. It's not surprising the body reacts differently to the stuff they feed us now.

Then, of course, don’t get me started on a medical system that would rather re-actively treat symptoms than proactively look at causality and prevention.

Thanks for your comments.