Determining Coronary Heart Disease Risk with Cholesterol Levels and Ratios.

This is my second post on cholesterol. 

I’ll link my previous post about the basics of cholesterol here.

In this post I’ll cover cholesterol in more depth, including the important of ratios, total cholesterol, and more. 

The last post included the more widely recognized cholesterol numbers as they relate to risk factors for atherosclerosis, an indicator for coronary heart disease (CHD). The Editor and Chief of the American College of Cardiology said over a decade ago that he recommends an upper total cholesterol of 150 mg/dl or 60 mg/dl of LDL Cholesterol (average vegan) and that all other factors aren’t as a accurate of predictor of CHD as total cholesterol. 

What’s the importance of HDL Cholesterol as it relates to LDL Cholesterol?

Well High Density Lipoprotein (HDL) Cholesterol is thought to be the “good” cholesterol. This is because while HDL and Low-Density Lipoproteins (LDL), “bad” have a relationship, HDL acts as a cleaner by moving through blood vessels and sticking to the LDL and carrying them out of the body.

You may have heard that in the past, but even this has hidden truth. That is, while HDL is better it is not necessarily “good” because even it acts to increase the risk factor of developing atherosclerosis. You see, there are many different sizes of the HDL and LDL Cholesterol. Larger soft LDL is thought to be better because it is more easily transported by HDL, while this may be true, with a more in-depth look at the science, soft LDL increases CHD risk by %44 compared to 63% of the small dense LDL Cholesterol. As for HDL, well even it increases CHD risk by up %54.

Me? I want zero risk personally. 

The Optimal Ratio of HDL to Total Cholesterol

One predictor used to measure CHD risk is the ratio of HDL to total cholesterol. This is thought to be a better predictor of CHD risk factor than HDL/LDL cholesterol ratio. The recommended minimum ratio of HDL total cholesterol is below 5, optimal being below 3.5 according to the American Heart Association who aren’t known for their strict guidelines.

What’s the Best Predictor of CHD? 

There are a couple other suggested tools for predicting your risk factors of CHD. Along with cholesterol as a tool, triglyceride levels are commonly used, and a test to review your C-reactive protein are all useful indicators of your bodies level of overall internal health. C-reactive protein gives you an indicator of the overall inflammation in your body and the triglycerides tells you how much free flowing fat there is in your blood stream. 

The two best tools that require short test from you doctor are you total cholesterol levels and the ratio of total to HDL cholesterol. 

Optimally, a cholesterol level below 150 mg/dl and a total to HDL cholesterol ratio of below 3.5 are our best known guarantee to make you heart attack proof. The reason both should be used together as predictors of CHD risk is because even HDL cholesterol isn’t harmless and as your total cholesterol rises it’s impossible to escape declining heard disease risk, even if your ratios are optimal. 

Cholesterol is Important

Our bodies make all the cholesterol we need. It serves important roles in the body; creating hormones is the commonly known one. When we don’t eat cholesterol we still have some in our bodies and this is the same for when we are born at birth as is for our fellow primates too. Though cholesterol is important it’s good to remember that the worlds #1 killer around is coronary heart disease and the #1 predictor of heart disease is atherosclerosis a cause of cholesterol.

Thank You 

Choose foods without any cholesterol. It so happens that plants don’t contain cholesterol and the only “food” that has cholesterol is animal products.

The top food groups are:

  1. Fruits
  2. Vegetables
  3. Starches – Potatoes, whole, and sprouted grains
  4. Legumes
  5. Nuts & Seeds
  6. No oil
  7. Lots of water

I hope this information finds you well and if it doesn’t consider talking to your doctor to get checked with a simple blood test. 

Please like, share, and subscribe! 

Thank You!

Carson McQuarrie

dr-kim-cardiologist-vegan-quote

nutritionfacts.org/video/does-cholesterol-size-matter/

nutritionfacts.org/video/cholesterol-crystals-may-tear-though-our-artery-lining/

nutritionfacts.org/video/optimal-cholesterol-level/

nutritionfacts.org/video/heart-attacks-and-cholesterol-dying-under-normal-circumstances/

nutritionfacts.org/video/heart-attacks-and-cholesterol-purely-a-question-of-diet/

http://www.ajconline.org/article/S0002-9149(10)01954-5/abstract

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2747394/

http://www.webmd.com/cholesterol-management/finding-the-ideal-cholesterol-ratio?page=2

http://www.healthline.com/health-slideshow/cholesterol-ratio#2

http://www.health.harvard.edu/heart-health/making-sense-of-cholesterol-tests

archinte.jamanetwork.com/article.aspx?articleid=752318

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2747394/

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All Plants Contain Complete Proteins and Harvard & AHA are Wrong.

Let’s dispel the myths, make visible the truth, and correct the wrong.

This will be a longer post and will include many citations, but it was great fun reading researching, and writing. I hope you find this fascinating 🙂 

This is certainly a popular topic when it comes to diet. A common concern of eating healthfully often includes questions about eating enough protein and consuming complete proteins in a meal, especially when your vegan.

A Step Back In History

It has been thought by some (even “experts”) that most plants lack one or more of the essential amino acids and therefore it’s necessary to carefully combine foods to get a complete protein in a single meal and throughout the day. mary-john-mcdougall

In a 2002 publication John McDoougal quoted and referenced fact that the essential 8 amino acid requirements were set by William Rose and colleges as early as 1952 by evaluating their maximum subjects’ needs, then they doubled the value to come up with the publicized “Recommended Amino Acid Requirements”  which were also considered safe.

Another bit of history regarding protein completeness I must include comes from Caldwell Esselstyne son RIP Esselstyn. In RIPs’ book My Beef with Meat he included some history from French Canadian vegan dietitian Francess Moore Lappe who in the 1971 published her book Diet for a Small Planet. She included her recommendation to carefully combine plant foods to meet the your daily requirements of protein, when adopting a vegan diet.

Is was at this point that misinformation spread.

In Francesses’ republication of the same book 10 years later, she retracted her stance on the concern saying;

“In combating the myth that meat is the only way to get high-quality protein, I reinforced another myth. I gave the impression that in order to get enough protein without meat, considerable care was needed in choosing foods. Actually, it is much easier than I thought”.

She went on to say;

“Plant protein can meet protein requirements when a variety of plant foods is consumed and energy needs are met. Research indicates that an assortment of plant foods eaten over the course of a day can provide all essential amino acids and ensure adequate nitrogen retention and use in healthy adults; thus, complimentary proteins do not need to be comsumed at the same meal.”

Basically, it’s impossible to be protein deficient unless your eating a really restricted diet that’s not meeting your calorie requirements.

The definition for protein deficiency is Kwashiorker and it’s definition is tied to insufficient calorie intake.

The American Heart Association has it Wrong

In Circulation, the AHAs scientific journal they published their recommendations for human protein requirements saying most plants are deficient in one or more amino acid and therefore not complete.

John McDougal wrote a letter of correction requesting it be fixed.

After 2 letters Barbara Howard would not budge and responded by citing protein expert Joe Millward PhD, Professor of Human Nutrition, University of Surrey (England). But after being contacted by John and reviewing the letters of dispute Joe responded to John July 10 2003;

“I thought I had made my position quite clear in my published papers. In an article I wrote for Encyclopedia of Nutrition (Millward DJ. 1998  Protein requirements. Encyclopedia of Nutrition. Academic Press pp  1661-1668) I said ‘Contrary to general opinion, the distinction between dietary protein sources in terms of the nutritional superiority of animal over plant proteins is much more difficult to demonstrate and less relevant in human nutrition.’  This is quite distinct from the AHA position which in my view is wrong.”

Barbara Howard was forwarded a copy of emails, but remains silent.

In an different review  (page 259)of the completeness of plant protein in a vegetarian diet Millward said;

However, whatever the inadequacies of such diets, amino acid supply should not be used as the argument to promote increased intake of animal foods.

Harvard has it Wrong

Vegetarians need to be aware of this. People who don’t eat meat, fish, poultry, eggs, or dairy products need to eat a variety of protein-containing foods each day in order to get all the amino acids needed to make new protein.

This is straight from the Harvard School of Public Healths‘ current stance on protein. golubicBanner

I’ll combat this public health statement by quoting Mladen Golubic, MD, PhD who’s the Medical Director for the Center for Lifestyle Medicine. He specializes in lifestyle medicine, cardiovascular disease reversal, and integrative medicine approaches to lifestyle-related cancer management.

On April 4, 2014 Mladen was interviewed on a number of topics regarding a plant based diet. A viewer online asked;

“How much protein is really needed? My nutritionist told me that I should get 64 grams per day (.8 g/kg)—which is about 15 percent of my total calories daily. But T. Colin Campbell, PhD said that 10 percent is adequate and more than that may be undesirable… Others say that 20 percent is best for an active person. Is there any consensus on this?”

Mladen responded;

Several similar questions about the adequacy of protein intake for people eating fully plant-based diet have been posted by others. If you eat a variety of whole foods of plant origin (vegetables, legumes, 100 percent whole grains and fruits) and not refined food-like products, it is very unlikely that you could be deficient in protein intake, even if your needs are higher (after major surgery, for example). In other words, if you get enough calories from whole plant foods, you get enough protein.

The more protein—especially animal protein—one eats, the higher the risk of different chronic diseases.

Not too add to the controversy but it’s basically impossible to be protein deficient!

People who literally die of starvation don’t die of protein deficiency, they die of fat deficiency. Their body literally runs out of fat reserves and thus they have no energy to sustain life.

The WHO and PCRM have it Right

The World Health Organization, a Public Health Agency of the UN established in 1948 more recently published a technical report Protein and Amino Acid Requirements for Human Nutrition.

In the report summary (page 243) they recommended 58 grams/day of protein for 70kg adult men and woman which equates to .8grams/kg. The Physicians Committee for Responsible Medicine also advises .8grams/kg of body weight.

WHO continued to state;

“No safe upper limit has been identified, it is unlikely that intakes of twice the safe level are associated with any risk. However, caution is advised to those contemplating the very high intakes of 3–4 times the safe intake, since such intakes approach the tolerable upper limit and cannot be assumed to be risk-free.”

Conclusion

Well I’ll leave it their but I would like to not a couple things.

People often say “I feel I need protein”. Personally I know it not to be true that people can actually tell if their body needs protein but I do respect peoples’ enjoyment of how protein makes them feel.

Plant proteins are one of the densest source of fiber (one indication we’re not meant to subside heavily on it) which makes people feel fuller longer and people tend to like that.

Don’t mistake this reason with animal protein which is accompanied by lots of fat, particularly saturated fat (unhealthy) which is heavy because it contains 9 grams of fat per calorie. Carbohydrate and protein only has 4 calories per gram.

I hope you enjoyed this read and didn’t find it too dense. Don’t hesitate to read the citations if you want more fascinating information.

I enjoyed writing this.

Please subscribe, like, and share!

Carson McQuarrie

dr-kim-cardiologist-vegan-quotequote-high-protein-diets-make-you-sick-in-the-long-and-short-term-expect-kidney-disease-heart-john-a-mcdougall-134-34-08

 

Referances:

http://www.drmcdougall.com/misc/2007nl/apr/protein.htm

circ.ahajournals.org/content/105/25/e197.full

my.clevelandclinic.org/health/transcripts/1602_benefits-of-plant-based-diets

circ.ahajournals.org/content/104/15/1869.full.pdf+html?ijkey=bb50bbddf6e7f5d32226a52632df941c5de41993

http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/protein/

circ.ahajournals.org/content/106/20/e148.full.pdf+html

goodfoodproject.net/home/resources/what-the-experts-say/protein-what-the-experts-say/

journals.cambridge.org/download.php?file=%2FPNS%2FPNS58_02%2FS0029665199000348a.pdf&code=bc9fa247747836920244640216120c97

apps.who.int/iris/bitstream/10665/43411/1/WHO_TRS_935_eng.pdf?ua=1

http://www.pcrm.org/health/diets/vegdiets/how-can-i-get-enough-protein-the-protein-myth

How High is Too High Cholesterol (& Why)

Hello Again,

In previous posts I’ve covered what is a too high of blood pressure and why. In this post I’ll uncover the concern about cholesterol so you know the basics of how cholesterol effects your body.

What is Cholesterol?

Cholesterol is a waxy fat-like substance found in your body. It’s made of fat and protein molecules combined. It’s used to produce hormones, Vitamin D (which is actually a hormone), and substances that allow you to digest food.

There’s typically known to be two types of cholesterol, HDL & LDL. Though they’re more types of cholesterol but for the these purposes that’s all you need to know. HDL is known as the “good” cholesterol and LDL is known as the “bad” cholesterol. The reason they’ve got those labels is because HDL acts as a cleaner and discards the LDL “bad” cholesterol, which is good. Keep in mind, that even though they’re labeled “good” & “bad”, they should really be known as “bad” and “worse”. The reason being in because when both are high the benefits diminish and at some point it can be dangerous.

What is a Healthy Cholesterol?

Well, according to the Physicians Committee for Responsible Medicine a healthy total cholesterol is 200 or less per milligrams/deciliter. A borderline total cholesterol is 200 – 239mg/dl, and very high would be higher than 239 mg/dl. On the other side of the spectrum a too low of cholesterol, particularly HDL, can be unprotective against heart disease.

Micheal Gregor and researchers from NutritionFacts.Org suggest that an optimal healthy total cholesterol is around 150 mg/dl and a optimal HDL cholesterol is 50 – 70 mg/dl.

HDL Cholesterol

Unhealthy HDL cholesterol for Men: Less than 40 mg/dl

Unhealthy HDL cholesterol for Woman: Less than 50 mg/dl

Healthy HDL cholesterol for both is above 60 mg/dl

LDL Cholesterol

Optimal LDL cholesterol: Less than 100 mg/dl

Above optimal LDL cholesterol: 100 – 129 mg/dl

Borderline high LDL cholesterol: 130 – 159 mg/dl

High LDL cholesterol: 160 – 189 mg/dl

Very high LDL cholesterol: 190 mg/dl cholesterol_scale

The Dangers of High Cholesterol

As the cholesterol in your blood increases so the formation of plaques.These plaques are made up of mostly cholesterol, saturated fat mostly, and calcium. The formation of plaques is the start of developing atherosclerosis, also known as heart disease, which leads to a heart attack and/or angina.

Angina is a crushing chest from the lack of oxygenated blood getting to your heart.

These plaques get thicker and harder over time and impair the function of your arteries to Causes of Death 2012transport blood. This can lead to sudden cardiac death and in the US its the #1 leading cause of death for males over 40. At an alarming number of 326,200 deaths a year from sudden cardiac arrest equates to roughly the same number of deaths from breast cancer, prostate cancer, diabetes, suicide, cervical cancer, colorectal cancer, HIV, motor vehicle accidents, and more, combined!

For most people their first real symptom is there last!

Conclusion

Fortunately, we can all do our part in making sure this doesn’t happen to us. It’s known that the first symptom, if monitored, can be detected over 10 years before a heart attack occurs. Even in children is can start if the diet is bad enough (Standard American Diet) so getting your cholesterol checked earlier is better.

My final 3 tips:

  1. Eat a diet of 15% or less of your total daily calories from fat and free of animal products which are high in saturated fat.
  2. Exercise at least 150 minutes a week.
  3. Eat a diet predominately made of fruits, vegetables, whole grains, and legumes.

Thank you for taking the time to read. I hope this was to your benefit.

Please comment below as I will be sure to respond to questions.

Don’t forget to like, share, and subscribe.

http://www.nhlbi.nih.gov/health/health-topics/topics/hbc

http://www.sca-aware.org/about-sca

http://www.pcrm.org/sites/default/files/pdfs/health/Kickstart-Biometrics-Screening.pdf

nutritionfacts.org/topics/cholesterol/

nutritionfacts.org/video/optimal-cholesterol-level/