Cholesterol

[Issangeorge]

Okay the disadvantages of living in Nakhon Nowhere, where there are no doctors that speak English well enough to discuss a medical problem. I have high blood pressure which with the use of medicine is under control 130/80 which I think is pretty good for a 65 year old. However I have high cholesterol, February last year it was Cholesterol 229/≤200 Triglyceride 103/≤150 HDL-Chol 35/40-60 LDL-Chol 184/≤100. In May it had dropped to Cholesterol 225/≤200 Triglyceride 90/≤150 HDL-Chol 33/40-60 LDL-Chol 48/≤100 I think the LDL may have been a false measurement or misprint. In July Cholesterol 260/≤200 Triglyceride 175/≤150 HDL-Chol 33/40-60 LDL-Chol 204/≤100. This month without any discussion with me I was prescribed Gemfibrozil 300 mg, one a day. I did not take any, wanted to try to get my cholesterol lower naturally. I watched somewhat the foods I ate, but in October my cholesterol was still high. Cholesterol 239/≤200 Triglyceride 117/≤150 HDL-Chol 33/40-60 LDL-Chol 201/≤100. From the beginning of October on I have walked at least an hour and over 4 kilometres every day except for maybe three. I quite often walk over 5 kilometres. However my levels are still high, but trending the right direction. Cholesterol 235/≤200 Triglyceride 113/≤150 HDL-Chol 34/40-60 LDL-Chol 167/≤100. The Doctor wants me to take the medicine, but I would really rather not take it and from what I read it seems that it is “used along with a proper diet to help lower fats (triglycerides and raise “good” cholesterol (HDL) in the blood. It may also help to lower “bad” cholesterol (LDL). Since my Triglycerides are okay, and it is my LDL, that is bad, I’m not sure this is the medicine I should be taking if any. Since my Cholesterol has dropped with my walking, especially the LDL, which went down from 201 to 167, does anyone know if I continue with my walking if it will continue to drop. I really don’t want to go on medicine if I can avoid it, and if I do, is the prescribed medicine the right one? Thanks.

[Sheryl]

Pay no attention to total cholesterol, its only value is as a crude screening tool to identify people in which it is necessary to measure the individual components.

In your case you have 2 problems, not one:

(1) your HDL is way too low. The ratio of LDL to HDL, and of triglyceride to HDL, is important and can be improved solely through raising the HDL (though lowering the LDL and triglycerides will of course also help). The ideal triglyceride:HDL ration is 2:2 whereas yours, despite a normal triglyceride, is 3.3. The LDL to HDL ratio should be less than 3.5 to 1; yours is 4.9 and while reducing the LDL would help it alone wil not get this to the desired level. You need to raise your HDL, and this can usually be accomplished through diet alone -- eat more fish, especially oily fish; use healthy oils only; eat more soy products and nuts and consider taking a fish oil supplement.

(2) Your LDL is too high, though moving in the right direction. If you require medication the first drugs of choice would be either a statin or nicotinic acid (Niaspan); in your case Niaspan might be advantageous since in addition to lowering LDL it helps raise HDL.

You are correct that fibrates (which is what Gemfibrozil is) is not the most effective in lowering LDL, it is more used for elevated triglycerides. You had elevated triglycerides when it was first prescribed but hard to understand why your doctor is still wanting you to take it now with the improved triglyceride levels.

In addition to exercise, dietary changes can help bring down LDL cholesterol - more in some people than in others. Contrary to what many people assume (and what doctors who have not kept up to date may tell you) the most important measures are not avoiding dietary fat but rather (1) avoiding processed carbs - white bread, white rice, noodles/refined pasta and anything containing added sugar and (2) eating more fiber: whole grains, oatmeal, fresh fruits and vegetables. Which is not to say you can go to town on fat intake; should consume animal fats in moderation and absolutely avoid transfats (found mainly in packaged or frozen foods, also margarine and the non-dairy creamer that for some reason is popular in Thailand).

If I were you I would try the following before considering medication:

1. Keep up the exercise regimen.

2. Take daily fish oil supplement.

3. Make dietary changes along the lines above. In Thailand, switching from white to brown rice would be important, along with adding oatmeal or high fiber (unsweetened) bran cereal to breakfast menu, eating only whole wheat breads, and more fruit, vegetables and fish.

Try that and see how your labs do.

[Issangeorge]

Thanks Sheryl, I think one of my problems is I love sweets, like cookies, and donuts, I will try to eliminate them, or at least cut way back. Don't eat much rice, but when I do, at least at home, it is usually white rice mixed with, I believe the Thais call it rice berry, which is suppose to be good for you. I will try to eat more fish, and I will follow your recommendation on taking fish oil. I'll try to eat more fibre. I don't eat that much pork or beef, but do eat a fair bit of chicken. I also eat a lot of potatoes, not French Fries, but mashed, or baked, or stir fried in olive oil. Will the potatoes raise my fat levels? Thanks again for your insightful reply, it is nice to get advice from someone who can speak English and explain things to me. In defence of the doctor who prescribed that medicine, today I think he originally prescribed another medicine, but language became a problem and he changed it. Anyway I will keep up my walking, eat more fish, and try to stay off the pastries, and see how the profile is in three months.

Edited January 4, 2016 by Issangeorge

[Sheryl]

Yes, those sweets along with not enough foods high in healthy fats (fish, nuts etc) and fiber are likely contributing factors. I'd be more worried about that than the baked potato.

Should also check what kind of cooking oil is being used in your home. Thais usually use palm oil (and anything fried in the market will certainly be that), a very unhealthy oil. Switch to olive or canola.

And dont forget the fiber, it helps a lot.

[Issangeorge]

Thanks Sheryl, I do almost all of my own cooking and use olive or coconut oil. I didn't know about the pastries, until you mentioned it. Recently not only have I been saying my usual amount of sweets, but I have consumed a lot if meat pies, the combination my well be defeating my exercise program. I was just going to order some new meat pies, that won't be happening now. What about cheese, I love cheese. I will try to get more fibre into my diet for sure.

[Retdent]

Issangeorge, I just want to give you some encouragement by relaying my experience. I too dislike the idea of medications if you can sort it out by non-chemical means.

Several years ago my GP in Australia threatened me with Statins after poor cholesterol results over several tests in a six month period, where they had spiked above what was previously a borderline level for years. Over this six month period I modified my diet in the usual ways; limiting fatty foods, those with high cholesterol etc. I too have a sweet tooth and had seriously cut down on the confectionary, soft drinks and alcoholic beverages (wine).At that time, I too was exercising, walking probably 50-60 km. per week. The levels just would not budge.

Nothing changed for me until I tried one thing that worked. Every morning for eight weeks I ate a bowl of oats with low fat milk; yes, it was bland and I got used to it (and now I don't mind it at all). I then had a fasting cholesterol test and visited the GP for the results (with a great deal of trepidation). Once I sat down, I was ask by the GP what had I been taking?. I was a bit taken back, because I did not understand his comment/question. I replied nothing medicinal had been taken. His reply to me was that I must have been taking something because he has only seen levels drop as much as they had in my case, with the use of medications. The penny then dropped and I understood what he was getting at. I then told him that I had been eating oats. That was the only thing that I had changed from the previous test.

Based on my experience, may I encourage you to give the oats a try. (If you can manage the local food, oats will be easy,55).

[Retdent]

Forgot to add, no medications prescribed, and that was several years ago.

[kkerry]

Oats are great, but avoid the flavored ones. It seems the longer it takes to prepare oats the better they are for you.

My reading suggests the best type of oats for healthy eating listed in order are:

1. Steel cut oats
2. Thick whole grain rolled oats
3. Instant oats like Quakers in the blue or red tins

Naturally the better they are for you the more they cost, and in Thailand, harder to find although many supermarkets have Quaker instant.

Quaker instant are okay until you try the other two... much better taste and texture. Add in some slivered nuts and raisins and you have a tasty breakfast.

The other good foods to include in your diet if you want to increase your LDL are avocados and raw nuts like walnuts and almonds.

Edited January 4, 2016 by kkerry

[thrilled]

If you concentrate what you eat plus exercise about 600 minutes A week you could almost do without either cholesterol or high

Blood pressure medicine.And remember 60 is the new 40.If you want to get it under control with little or no medicine,you'll have

To work hard at it.

[Sheryl]

Thanks Sheryl, I do almost all of my own cooking and use olive or coconut oil. I didn't know about the pastries, until you mentioned it. Recently not only have I been saying my usual amount of sweets, but I have consumed a lot if meat pies, the combination my well be defeating my exercise program. I was just going to order some new meat pies, that won't be happening now. What about cheese, I love cheese. I will try to get more fibre into my diet for sure.

Cheese - like meat, in moderation is OK.

You could try taking bran cereal or oatmeal before meals of things you like, it will make you full so that you will be satisfied with less. And in and of itself. helps lower LDL. Also reduces risk of GI cancers.

Oats are indeed great. I think the Quaker Quick Cooking oatmeal is better than the Instant, instant being the most processed. Tops markets usually have McGarett brand Rolled Oats which is better still.

Besides cooked as oatmeal (or homemade oatmeal cookies, a good thing for when you are craving sweets), mixed with yogurt and berries or other fruit it makes a nice, unsweetened muesli. Can then sweeten with stevia or sucralose or very small amount of honey. Don't buy the packaged mueslis they are full of sugar.

Another great fiber source is pumpkin, I only recently discovered it can easily be cooked in the microwave. Also good for when you are craving sweets - sprinkle a little cinammon on and eat the flesh when it's hot, no need for any other sweetener.

[Issangeorge]

Thanks for all your ideas, I have some oats, I will start eating them. Maybe I will make some oatmeal cookies. Thanks again.

[FruitPudding]

Interesting article below about cooking oils. According to this they could use far worse than palm oil. I think it has been unfairly demonized from a health perspective, not an environmental perspective, of course.

 

https://authoritynutrition.com/healthy-cooking-oils/

 

A very interesting article on the cause of heart disease. Yes, it's the cakes and buns - not the saturated fat or cholesterol.

 

http://www.theatlantic.com/health/archive/2014/01/a-heart-surgeons-viral-confession/283413/

 

We should basically be striving to eat an anti inflammatory diet. Article below.

 

https://authoritynutrition.com/anti-inflammatory-diet-101/

 

My top 5 tips:

 

1. Exercise

2. Sleep well

3. Take a fish oil supplement.

4. Eat plenty of fiber

5. Avoid processed foods and drinks.

 

 

[FruitPudding]

Oh..and just a note about fruit juice.

 

https://authoritynutrition.com/fruit-juice-is-just-as-bad-as-soda/

 

If you want your arteries to remain healthy, gotta watch the sugar - and don't be fooled by fruit juice. 

Edited October 9, 2016 by FruitPudding

[ExpatOilWorker]

On 9/10/2559 at 5:23 PM, FruitPudding said:

Oh..and just a note about fruit juice.

 

https://authoritynutrition.com/fruit-juice-is-just-as-bad-as-soda/

 

If you want your arteries to remain healthy, gotta watch the sugar - and don't be fooled by fruit juice. 

 

I think this only applies for processed fruit juices and it is still recommended to drink freshly squeezed pomegran or orange juice, with no sugar added of course.

Edited December 22, 2016 by ExpatOilWorker

[kkerry]

A normal glass of apple juice for example, may contain the juice of four apples.

Easy to drink in under a minute and processed or not, it contains a lot of sugar which is making it's way in to your system rapidly, almost like an IV.

Eat four apples (if you are able to, it's a lot for most people) and it will probably take you twenty minutes.

That sugar hit will be more evenly spread plus you get a small amount of fibre.

If you like a glass of juice with breakfast then mix half and half with water.

Most juices are as bad as Coca-cola with the amount of sugar they contain.

Coconut water (not from concentrate or with added flavors) has a much lower amount of sugar and is good for re-hydration.

[muskoka]

I am ordering both magnesium body spray & tablets from iherb.com as I am quite shocked to learn how important magnesium is (for heart health & balancing cholesterol) and how deficient most of us are in western society.

 

some reading for those who like to research  https://www.google.co.th/search?q=cholesterol+magnesium&ie=utf-8&oe=utf-8&client=firefox-b&gws_rd=cr&ei=KH9iWPSyA4fkvgTa86rIAw

[muskoka]

I found Magnesium Oil Spray locally made by Arun Thai. Sprayed a lot several times over my body, into my mouth, and into a glass of water I sipped overthe past two days. Within one hour I was deep breathing easily, first time in weeks. (I felt like I was not getting enough oxygen, been on blood thinners, blood pressure & Cholesterol meds since discovering I had a heart condition 2-3 months ago). Also the severe congestion (fluid/mucus) I have been experiencing for 3 weeks is +90% gone by the 2nd day. Magnesium would seem to be amazing stuff. Some reading...

 

  http://drsircus.com/magnesium

 

 

Quote

In conclusion, these results suggest that diet rich in magnesium could exert cardioprotective effect through reduced plasma total cholesterol, triglyceride, oxidative stress and ameliorated HDL-cholesterol/total cholesterol ratio as well as increased plasma ascorbic acid and magnesium in diabetic rats.

https://www.ncbi.nlm.nih.gov/pubmed/19205579

 

 http://drsircus.com/?s=cholesterol

 

 

Quote

Later that day I reviewed the medical literature for the effects of magnesium on cholesterol and was quite surprised about the results. Magnesium can lower cholesterol.

http://www.dailyherald.com/article/20150207/entlife/150209666/

 

Quote

Doctors sometimes recommend magnesium supplements to treat people with high blood pressure, preeclampsia, eclampsia, heart attacks, premenstrual syndrome (PMS) irregular heartbeat, or an unhealthy ratio of HDL (high-density lipoprotein) cholesterol to LDL (low-density lipoprotein) cholesterol.

http://www.livescience.com/42972-magnesium-supplements-facts.html