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A recent large government study found that raising levels of HDL "good" cholesterol using a drug did not reduce the risk of heart disease.
As The New York Times reported:
Patients taking the medicine along with Zocor had higher levels of H.D.L. and lower levels of triglycerides, a fat in the blood. Despite these seeming improvements, the patients fared no better and may have done slightly worse than those taking Zocor alone. That is why the entire theory behind trying to increase H.D.L. levels in patients with heart disease may need rethinking.
Why?
Many people, including most physicians, believe that HDL is "good cholesterol" and LDL is "bad cholesterol." Therefore, anything that raises HDL cholesterol is good.
It's not so simple. Not everything that raises HDL is good, and not everything that lowers it is bad.
Think of HDL like the garbage trucks of your body. Your body makes HDL to remove excessive cholesterol from your blood and tissues, a process known as "reverse cholesterol transport." HDL transports cholesterol back to your liver where it is metabolized and removed from your body.
12:30 PM on 6/04/2011
I wish you could find a way to mention raw foods more often in your posts.
01:55 PM on 6/03/2011
you won’t need fish oil if you went with raw foods.
09:55 AM on 6/03/2011
The article left out the contribution of eating fish and I wonder how he feels about that. My doc recommended the addition of fish oil or Omega 3s to reduce triglycerides and raise HDLs. I use 3-6-9, about a tablespoon of liquid form once a day and it had helped my numbers.
12:59 PM on 6/03/2011
Thirty years ago, the rule-of-thumb for normal cholesterol levels as described by the 5th edition of Goodman and Gilman’s the Pharmacological Basis of Therapeutics was "200 Age". Only after statins became widely used did "normal" start to drop. As more potent statins were released, "normal" went down even further.
11:12 AM on 6/03/2011
Did you know doctors are being graded by the corporations they are part of, and they receive bad marks for patients whose blood pressure and cholesterol are high? That means they get good marks for prescribing drugs to lower those things. The doctors are nothing more than tools of the drug companies. "Acceptable" cholesterol levels and blood pressure levels have become lower and lower as the drug companies search for new markets. And there is no scientific evidence that these drugs do any good at all, while there is plenty of evidence to indicate they do harm.
03:11 PM on 6/03/2011
This is a really helpful post, kat4show. Thanks! I have often wondered if there really hasn’t been an increase of people with "high" cholesterol or "high" blood pressure, but simply a change in the levels used to designate what is normal. There’s also a prevailing unfortunate assumption that normal is the same for all people, when I’m sure different levels are ideal for different individuals.
I say this as someone whose cholesterol levels always test high, with my total number ranging anywhere from 210 to 270, which causes my doctor always to act like I’m on the brink of death. Diet and excercise might cause my level to vary temporarily, but its natural setting is always high. I think this is my body’s natural equilibrium and I’m not worried about it. No one in my family has ever had a heart attack, and I lead a fulfilling, happy, active life. I therefore won’t go on statins. I refuse to see high cholesterol as a disease when it isn’t.
10:43 AM on 6/03/2011
>
And then there were the articles about placing children of all things, on statins. The statin thing is probably the biggest pharmaceutical ripoff to hit the American public. I’m not saying there are not circumstances where they are useful, but all heart attacks are not caused by high cholesterol. I was a CCU/ICU RN for over 35 years. Many cardiac patients had normal cholesterol levels.
You are also seeing this with BP medication. It use to be that a blood pressure of 150/90 was absolutely fine. Now anything over 120/70 is considered pre-hypertension. Ridiculous. The more they lower the parameters that are supposedly now considered normal, the more antihypertensive medication they can push on people, the more money the pharmaceutical industry makes. And people fall for it. Truly pathetic.
10:05 AM on 6/03/2011
Good points. Also, the new standards of acceptable cholesterol levels appear to be way too low, and I suspect they were lowered so Big Pharma could make even more obscene profits by selling people more statins. Some healthy, active people just have moderately higher cholesterol levels. American medicine has been so warped by profit-gouging that people should be extremely cautious in visiting their doctor and especially in undergoing treatment in an American hospital. Be careful out there.
10:09 AM on 6/03/2011
1. i wish contributors (especially doctors!) would link or cite primary papers in their columns.
2. "countries such as asia?" really? that’s a damn big country, bigger than the country of africa even.
08:23 AM on 6/04/2011
After 11 years on a HFLC diet, my HDL ranges beween 90 and 110.
That’s the best way to raise your "good cholesterol," which is a good thing, no matter what Dr. Ornish would like you to believe. He has had to become rather defensive as the evidence for high-fat, low-carb lifestyles has becoming incontrovertible.
10:18 AM on 6/03/2011
Thank you, Dean, for this clear article written in layman’s terms. I’ve had low "bad cholesterol" but also low "good cholesterol." I couldn’t figure out or find out how to to raise my good cholesterol. Now I will continue to focus on eating well and loving more, and not worry about the HDL.
May you continue to bring understanding and Light to us all.
Best wishes, Swami Asokananda
01:52 PM on 6/03/2011
you could have lost more weight than that and in less time on raw food.
05:01 PM on 6/03/2011
11 years and counting on HFLC – age 58, excellent health despite a serious family history of "diabetes" and heart disease.
01:51 PM on 6/03/2011
You’re doing it exactly right. That’s what I’ve done, for 6 weeks, with the same kind of results (16 lbs so far).
10:48 AM on 6/03/2011
I got my triglycerides, blood sugar, and LDL lower and increased my HDL, as well as losing 35 lbs and getting a lot stronger. All in 6 months on a low-carb, HIGH SATURATED FAT, high protein diet incorporating walking and weight training.
I guess I have been doing it all wrong…
10:50 AM on 6/03/2011
Great article and explanation!
06:00 PM on 6/03/2011
I believe that if a participant dies from a cause other than from something due to what’s being tested (arteriosclerosis), that participant is just dropped from the study altogether, as if they never participated at all.
There have been many studues performed on all sorts of populations. It seems that once a population was found to display the desired results, the drug companies started sponsoring huge studies on similar populations, expounding the results in rhetorically deceiving but statistically valid ways. So most believe that if you take statins you’ll reduce your chances of getting a heart attack by 1/3. Depending on who you are, it *may* be true, but for the vast majority, it’s not. It’s not true, but it is profitable !
I suspect that instead of taking statins, which have a litany of potentially dangerous side effects, and are expensive, one would be better off taking an enteric coated asprin with a glass of orange juice in the morning.
I also suspect that arteriosclerosis is more of a natural response to deal with sub-clinical cases of scurvy. As the walls of the arteries get stressed and tear, the body responds by reinforcing those areas with plaque. It probably actually saves lives by preventing strokes and "blowouts" in other crucial areas. The fact that it takes the lives of 70 year olds is irrelevant in terms of evolution, because old men of 35 would have been devoured by sabre0toothed tigers long before then.
04:52 PM on 6/03/2011
@davg, generally correct posts, with a couple of exceptions:
First, consider that a large percentage of participants in these types of clinical trials are male and veterans (because it’s relatively easy to assemble the requisite test-control clinical trial populations and obtain the requisite follow-up testing). This is a high smoking population as well.
Second, the vast majority of these post FDA-clearance clinical trial participants have a recognized cholesterol issue, i.e. higher than normal. Healthy people with no cholesterol issues are not usually included in the trial design, just as women of child-bearing years or pregnancy are not included in most trials. So when participants don’t reach the end point because they "get sick" (i.e. because they’re dead), it’s not legit for you to assume that those values go towards the "insignificant" side of the balance. Assumptions like that are a statistical no-no.
10:51 AM on 6/03/2011
I’m very suspicious of the entire "cholesterol is bad" theory. At best, the correlation between high/treatable cholesterol and heart disease/stroke is very weak, something like 0.17 (1.00 = 100% correlation or certitude). About half the people who get these diseases don’t have high cholesterol at all. And the believe that plaque is a random deposition of cholesterol in arteries is a myth. At the risk of anthropomorphizind this, plaque is "intentionally" deposited between muscle layers in the arteries and contains a lot more than just cholesterol.
The statin -v- placebo study results are misleading. The stats discount the vast number of people in the studies that do not reach an end point (get sick). If they were counted, the difference between statins and placebo are insignificant. The supporting studies were conducted on secondary prevention patients (who already had disease), not primary where those results showed no significant effect of statins. Finally (and this, I believe, tells all), there are several other non-statin classes of drugs that reduce cholesterol just as effectively as statins but showed no evidence of preventing disease in drug -v- placebo studies.
What’s going on here?
(ANother note to follow).
10:51 AM on 6/03/2011
Well, statins have other properties besides reducing cholesterol. Among them are… antioxidant, anti-inflamatory and anti-coagulant. Do any of these sound familiar when it comes to preventing heart disease? I suspect the weak correlation between statins and preventing heart disease has to do with those other properties and has nothing at all to do with cholesterol.
Cholesterol is not a poison. On the contrary, it’s essential for life and your body will go out of it’s way to make what you need to survive and be healthy. I question the wisdom of poisoning that system with drugs
01:17 PM on 6/03/2011
All three of those bio-markers are important.
It’s not the low-fat philosophy that is the problem. The problem is how it is marketed to the masses. Low-fat was never intended to be a diet packed with processed foods, frozen foods, simple starches, sodium, etc. Food manufacturers market to both the low-fat AND low-carb consumers. Every day you see more low-carb foods that are packed with all kinds of junk. Even Atkins is selling shakes in cans…pure cr*p. They don’t care what you eat, as long as they make money.
A low-fat diet should be plant based (80%) with moderate consumption of fats and proteins. Whole, nutritious foods.
11:01 AM on 6/03/2011
We have been promoting a low fat diet for 30 some years and our country gets fatter. How does that not strike a chord. That is the bigger issue. Saturated fat is not evil. If we should be worrying about a bio-marker we should pay attention to trig’s and glucose levels, not cholesterol.
08:51 AM on 6/03/2011
Did the Feds ripoff a private company for their new food rules campaign?
http://alturl.com/k7cvv
05:04 PM on 6/03/2011
And, he continued to try to lower his cholesterol with a very low-fat diet. His health continually deteriorated.
03:49 PM on 6/03/2011
One more factoid for you: 1/3 (33%) of heart attack victims in the US have levels between 150-200. So, the other 2/3rd’s are above 200 and less than .0001% have levels below 150.
I work for a company that makes a statin and we are using these lobbying HARD to get insurance co’s (and Medicare) to cover statins for everyone with levels between 150-200. It will basically make most adults in the US our customers.
03:43 PM on 6/03/2011
If there is no link why do companies make and doctors prescribe statins? If there is no link, these drugs have no purpose (they don’t affect blockages etc.). You might want to make some changes in your life; especially if you are a woman.
01:03 PM on 6/03/2011
Dwight Eisenhower had his first heart attack when his cholesterol levels were 165. There is no proven link between high cholesterol levels and heart disease.
12:20 PM on 6/03/2011
A long life is the best revenge!!
11:17 AM on 6/03/2011
If most Americans followed your example, we would be shutting down hospitals all over the country for lack of need and the drug companies would be crying the blues. Both which would be good things. However judging from the general condition of American citizens, neither the hospitals nor the drug companies have much to worry about. I suppose bottom line we can only help ourselves and encourage those around us to do the same.
09:02 AM on 6/03/2011
As someone who took Niacin for 2 years with no appreciable rise in HDL. I stopped using it this year.
Then I read the latest report and felt vindicated.
My overall cholesterol stays in the 185 area and I have a low fat diet. At 6’0 and 182 I am in the gym 3-4 per week, remaining able to cycle 5-7 miles at steady aerobic pace.
I promise to stop worrying so much after reading your article. But, my wife likes to prepare Asian food! I eat sushi 3x a week.