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Inflammation: Medicine's burning question

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Re: Inflammation: Medicine's burning question

#111

Post by noondip »

boothead wrote: post #40
copperx wrote: post #20

Earlier quoted context omitted.

I recently visited my GP and I had a high cholesterol reading. He suggested me to reduce sugars and white flours, get a reading in a month, and depending on that he'll decide whether to prescribe statins. It surprised me that he didn't mention reducing saturated fats or meat consumption. It made me wonder whether refined carbohydrates play a role in high cholesterol. I think I'll have to take a look at the research.

I'd give Peter Attia a look: http://eatingacademy.com/start-here His writing is incredibly in depth, and he's covered cholesterol extensively.

Also be sure to see the following very critical review of this person begging us for money - http://plantpositive.com/a-very-serious-low-carber-nusi/

Re: Inflammation: Medicine's burning question

#112

Post by sliverstorm »

carapat_virulat wrote: post #13
DiabloD3 wrote: post #4

Earlier quoted context omitted.

The problem is, there is no research stating that lowering dietary cholesterol leads to lowered blood levels and the reversal of fatty liver disease. There is research stating that fatty liver disease exists due to long term over-production of cholesterol in the liver, caused by low dietary cholesterol, and increasing dietary cholesterol can lead to the reversal of fatty liver disease; and such research isn't really…

But most anti-cholesterol diets lower animal fat intake, not dietary cholesterol intake. Is this supposed not to work? I had high cholesterol for years, I didn't take it very seriously because I'm otherwise healthy and I was eating healthy, but when I decided to take care of it I got it from around 210mg/dL to something like 140mg/dL just by changing all my meat/cheese to low fat alternatives as my doctor said. I am…

There were two suspected causes of high blood cholesterol-

1) dietary saturated fat (e.g. beef)

2) dietary cholesterol (e.g. chicken eggs)

Classical anti-(blood)cholesterol diets recommend avoiding both.

Re: Inflammation: Medicine's burning question

#113

Post by noondip »

metamet wrote: post #106
blacksmith_tb wrote: post #88

Earlier quoted context omitted.

Well, there are plenty of recent studies that suggest that high-protein diets, and ones with a lot of meat in particular, are associated with increases in the rates of several cancers. But to just to play devil's advocate, why eat meat when you don't need to? I've seen some studies suggesting eating fish has health benefits (though there's the problem of pollution in the oceans), but I can't say I have seen anything…

The only issue with red meat would be the carcinogens that come from burning or charring. Saturated fat isn't the evil the FDA once thought it was. There are also a ton of studies that suggest that one of the leading indicators for wellness and longevity is total lean mass, and protein is a fundamental building block for this. There simply isn't a way to eat a whole foods diet and put on muscle mass--you have to supp…

> And vegan/vegetarian diets are notoriously high in carbohydrates and low in fat and protein. Not necessarily a great recipe for wellness.

Please cite a reputable source for this outlandish claim. You can check my post history for some links to non-profit health organizations such as WHO, which recommend the majority of caloric intake to come from carbohydrates, and to limit fat/protein intake to 15% or less each.

Re: Inflammation: Medicine's burning question

#114

Post by noondip »

JupiterMoon wrote: post #83
twistedanimator wrote: post #58

Earlier quoted context omitted.

I love the thought that "eat more vegetables" constitutes dangerous advice.

The instructions were more along the lines of "eat nothing but vegetables and ignore your doctor".

Most doctors get exactly zero nutrition education and the few which do are very limited and usually heavily influenced by Big-Ag and Big-Pharma. Certainly "only eating vegetables" is not sound advice, but it's not unreasonable to second-guess your doctor's diet recommendations.

Re: Inflammation: Medicine's burning question

#115

Post by noondip »

dspillett wrote: post #16
atomical wrote: post #9

Earlier quoted context omitted.

It comes down to diet. My LDL is 66 and my HDL is 75. I don't eat eggs, meat, or cheese. Basically, nothing that has cholesterol. My numbers will probably be even better this year. I have looked at /r/keto and /r/paleo. Their cholesterol numbers aren't good.

Recent research suggests that cholesterol directly in food isn't a major problem because most of it passes through the digestive system untouched. The problem is actually cholesterol produced by the body using other substances. 80% or more of the cholesterol in your body is produced by your body, no more than 20% of it comes from your diet unless your diet is particularly unbalanced in that manner. The reason cholest…

> Recent research suggests that cholesterol directly in food isn't a major problem because most of it passes through the digestive system untouched.

Could you please link to some of this research so we may all review and benefit from it?

Re: Inflammation: Medicine's burning question

#116

Post by noondip »

atomical wrote: post #9
boothead wrote: post #2

It's great to read things like this... I wish my GP would do the same. I recently had a really high cholesterol reading (both total cholesterol and LDL). Everything else (blood pressure, blood glucose etc) seems fine. I'm 38, fit and healthy and nothing that suspect in my family history. I found the attitude of my doctor in all this quite surprising. It amounted basically to "You definitely have familial hypercholest…

It comes down to diet. My LDL is 66 and my HDL is 75. I don't eat eggs, meat, or cheese. Basically, nothing that has cholesterol. My numbers will probably be even better this year. I have looked at /r/keto and /r/paleo. Their cholesterol numbers aren't good.

It's quite upsetting to see you're being downvoted for no apparent reason, with no logical rebuttal. I've also cut all animal and processed foods from my diet (it's much easier than it seems at first) and my cholesterol levels are similar to yours - in the optimal LDL range of 50 to 70 (https://www.ncbi.nlm.nih.gov/pubmed/15172426).

Re: Inflammation: Medicine's burning question

#117

Post by gmarx »

boothead wrote: post #69
gmarx wrote: post #66

Earlier quoted context omitted.

I'm an M.D. and let me first say this is not medical advice :). I long ago called bunk on the mainstream view on cholesterol and cholesterol lowering drugs. I think there will be a time in the future when doctors look back on it with a "what the heck were we thinking" kind of retrospective smugness. That stated, familial hypercholesterolemia is a different thing and it's no joke. It's been a long time since med schoo…

Thank you for your perspective. I am very wary of treading the "mainstream medicine doesn't know shit and drugs are bad" path, and for that reason I very much appreciate a contrary view. My plan is to give it a few months and see if fixing some of my sub optimal lifestyle makes a difference or not. I figure if I fix my sleep, cut the sugar and other crap and if necessary change my SFA to PUFA ratio and it doesn't get…

Fair enough

Re: Inflammation: Medicine's burning question

#118

Post by carbocation »

briHass wrote: post #102
carbocation wrote: post #89

Earlier quoted context omitted.

In controlled, randomized trials and in genetically-driven studies (the two most powerful tools that we have to assess causality), almost all factors that reduce LDL-cholesterol lead to reduced ischemic heart disease and death. Your commentary about statins being primary useful for secondary prevention (in those who have already had a heart attack) was true until a couple decades ago, but there is now evidence demons…

The real question is, though, is drug therapy something that should be pushed on otherwise healthy (non-FHC/high risk) individuals in order to reduce mortality. The PCSK9 research paper you linked has the percentage dead after 15 years (starting at an average of 55 yr/o) at 10.7% for those without the mutation and 8.3% for those with it. Assuming they actually work identically to the mutation, maybe one could argue t…

To rephrase the exact same data, 15-year mortality is ~30% higher among those with the normal variant compared to those with the cholesterol-lowering variant. That is an enormous mortality effect.

Based on the mechanism by which statins are postulated to cause diabetes (and LDLR-dependent mechanism), PCSK9 inhibitors may also cause diabetes, though it's not yet known. From a mortality perspective, this is irrelevant because we know that statins (and PCSK9 mutations) reduce mortality despite (probably) causing diabetes.

The timing of statins falling off patent is essentially uncorrelated with anything - there was a multi-year gap with atorvastatin off patent before the PCSK9 inhibitors were approved, which makes no sense if you would like to invoke a patent conspiracy. With the advent of genetically-informed early phase research, you will continue to see new drugs come out at an increasing frequency (reversing the trend over the past few decades of fewer approvals).

The link from cholesterol -> CHD -> mortality is as clear as anything in biology (clear enough for the basis for this work to have won a Nobel prize decades ago).

Re: Inflammation: Medicine's burning question

#119

Post by carbocation »

gone35 wrote: post #97
boothead wrote: post #39

Earlier quoted context omitted.

I think this is a bit unkind: > dismissed in a pseudo-intellectual manner by people who know a lot (just not about the subject at hand). I'm the one who's potentially sick here, and this (perhaps wrongly) smacks of appeal to authority. What I absolutely don't want to do is disregard medical opinion, but neither am I inclined to abdicate all responsibility for my own health and well being. > The genetic data currently…

[T]his (perhaps wrongly) smacks of appeal to authority. Don't dismiss appeals to authority so easily. As it happens, not giving extra weight to experts in proportion to their track record is a provably suboptimal strategy in an adversarial setting (see e.g. [1]). So, in this sense, deferring to trained medical opinion might in fact be the most responsible thing to do. Note however the bounds in [1] also (indirectly)…

This is correct. I reference one of the Mendelian randomization studies in my comment [1].

1 = https://news.ycombinator.com/item?id=10739687

Re: Inflammation: Medicine's burning question

#120

Post by JupiterMoon »

noondip wrote: post #114
JupiterMoon wrote: post #83

Earlier quoted context omitted.

The instructions were more along the lines of "eat nothing but vegetables and ignore your doctor".

Most doctors get exactly zero nutrition education and the few which do are very limited and usually heavily influenced by Big-Ag and Big-Pharma. Certainly "only eating vegetables" is not sound advice, but it's not unreasonable to second-guess your doctor's diet recommendations.

The GP said:

> Nothing beats a high anti-inflammatory whole-foods plant-based diet.

The word "Nothing" implies that this comment goes beyond diet advice in the realms of alternative medicine. This kind of advice is really dangerous.

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