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High Cholesterol Message Board

High Cholesterol Board Index

[QUOTE=ty123]...One obvious sign is when cholesterol levels don't respond to diet.[/QUOTE]

What kind of diet? In my opinion (and many others agree), no one type of diet is right for everyone. If one type of diet doesn't get the desired results, it might be worth exploring an alternative diet that focuses on different nutrient ratios.

[QUOTE=ty123]With roughly half the cholesterol receptors of the average person, cholesterol levels don't drop much on a low fat diet. A 15% drop is typical.[/QUOTE]

In general, low fat diets aren't very effective for improving blood lipids in anyone. By improving lipids I mean raising HDL level, lowering triglycerides, or lowering LDL levels or improving particle size.

This link >>> <<< from the American Journal of Clinical Nutrition, Vol. 80, No. 3, 550-559, September 2004 states in part "...In 1977 public health recommendations to reduce the intake of fat were made for the US population, especially adults, and some recommendations were for a reduction in total fat to <30% of calories (4). In the American Heart Association Step I and Step II diets, the percentages of calories from total fat were 28.6% and 25.3%, respectively, and the percentages of calories from saturated fat were 9% and 6.1%, respectively. Step I and Step II diets were recommended for treatment of high blood cholesterol. Initial dietary recommendations for patients consuming the Step I diet were similar to those advocated by the American Heart Association. However, 40 y after the much-cited Framingham Heart Study was carried out, persons with high triacylglycerol concentrations (>1.7 mmol/L) and low HDL-cholesterol concentrations (<1.03 mmol/L) were reported to have a significantly higher rate of coronary artery disease (CAD) than were persons with lower triacylglycerol and higher HDL-cholesterol concentrations (5). In addition, studies on the long-term health benefits of consuming a low-fat diet—particularly after variation in human responses is taken into account—are lacking, and low-fat diets have been shown to exert a potentially deleterious effect on lipoprotein profiles in some persons (6, 7). As an example, in a study in which healthy, nondiabetic volunteers consumed diets that contained either 60% of total calories from carbohydrate (25% from fat and 15% from protein) or 40% from carbohydrate (45% from fat and 15% from protein), the 60%-carbohydrate diet resulted in higher fasting plasma triacylglycerol, remnant lipoprotein, and remnant lipoprotein triacylglycerol and lower HDL cholesterol without changing LDL-cholesterol concentrations. These diets were consumed in random order for 2 wk, with a 2-wk washout period between them. The effect of the low-fat diet was not limited to higher fasting plasma triacylglycerol and lower HDL cholesterol, but also included a persistent elevation in remnant lipoproteins (8). These findings led the investigators to question whether it is wise to recommend that all Americans replace dietary saturated fat with carbohydrate."

and "...Consumption of a low-fat diet (defined as one containing 20% of energy from fat) was subsequently shown to induce atherogenic dyslipidemia (122, 123). "

and "...It is now known that a high-carbohydrate diet can lead to the lipoprotein pattern (124) that characterizes atherogenic dyslipidemia."

[QUOTE=ty123]I've managed a nearly 30% drop from baseline on a low fat diet because I've followed Ornish's diet which is much lower than even the step II AHA diet. I reduced from 351 to 216.[/QUOTE]

Have you also reduced your intake of sugars, refined carbohydrates, and processed foods in general? You are also on statin therapy as well, correct?

[QUOTE=ty123]FH people also have a pre-disposition towards metabolic syndrome and type II diabetes. My mother had the former, and in her 60's developed the latter. I have the former and am pre diabetic.[/QUOTE]

That right there tells me that a diet geared more towards lower carbohydrate intake would be beneficial to someone with FH. Metabolic Syndrome X and Type II diabetes are clearly related to excess carbohydrate intake and the resulting elevated insulin levels. The elevated insulin levels in turn generally leads to insulin resistance - insulin resistance being the foundation of metabolic syndrome and Type II diabetes.

In my opinion, todays food choices which are loaded with sugars, high-fructose corn syrup, and other highly refined carbohydrates combined with a general but unwarranted fear of consuming fat (animal fats in particular) is the driving force behind the epidemic of Type II diabetes we are experiencing.

From the link I posted above "Public health recommendations for the US population in 1977 were to reduce fat intake to as low as 30% of calories to lower the incidence of coronary artery disease. These recommendations resulted in a compositional shift in food materials throughout the agricultural industry, and the fractional content of fats was replaced principally with carbohydrates. Subsequently, high-carbohydrate diets were recognized as contributing to the lipoprotein pattern that characterizes atherogenic dyslipidemia and hypertriacylglycerolemia. The rising incidences of metabolic syndrome and obesity are becoming common themes in the literature..."

And regarding dietary fat intake and heart disease the article states in part "...Although it is commonly believed that saturated fats and dietary cholesterol are the lipids that accumulate in arteries and that this accumulation is a further rationale for decreasing all saturated fatty acids in diets, this is not necessarily true. Excessive n–6 polyunsaturated fatty acid (PUFA) intake from refined vegetable oils has also been implicated as contributing to cancer and heart disease, and arterial plaque is primarily composed of unsaturated fats, particularly polyunsaturated fats, and not saturated fat (49)."

and "...The approach of many mainstream investigators in studying the effect of consuming saturated fats has been narrowly focused to produce and evaluate evidence in support of the hypothesis that dietary saturated fat elevates LDL cholesterol and thus the risk of CAD. The evidence is not strong, and, overall, dietary intervention by lowering saturated fat intake does not lower the incidence of nonfatal CAD; nor does such dietary intervention lower coronary disease or total mortality (31, 61). Unfortunately, the overwhelming emphasis on the role of saturated fats in the diet and the risk of CAD has distracted investigators from studying any other effects that individual saturated fatty acids may have on the body. If saturated fatty acids were of no value or were harmful to humans, evolution would probably not have established within the mammary gland the means to produce saturated fatty acids—butyric, caproic, caprylic, capric, lauric, myristic, palmitic, and stearic acids—that provide a source of nourishment to ensure the growth, development, and survival of mammalian offspring."

and "...Considerable evidence indicates that dietary saturated fats support the enhancement of HDL metabolism. In a study of the effects of reduced dietary intakes of total and saturated fat on HDL subpopulations in a group of multiracial, young and elderly men and women, subjects consumed each of the following 3 diets for 8 wk: an average American diet (34.3% of energy from total fat and 15.0% of energy from saturated fat), the American Heart Association Step I diet (28.6% of energy from total fat and 9.0% of energy from saturated fat), and a diet low in saturated fat (25.3% of energy from total fat and 6.1% of energy from saturated fat) (25). HDL2-cholesterol concentrations decreased in a stepwise fashion after the reduction of total and saturated fat. A reduction in dietary total and saturated fat decreased both large (HDL2 and HDL2b) and small, dense HDL subpopulations, although the decreases in HDL2 and HDL2b were most pronounced. Serum triacylglycerol concentrations were negatively correlated with changes in HDL2 and HDL2b cholesterol."

and "...It was recently pointed out that reducing the proportion of energy from fat below 30% is not supported by experimental evidence and that advice to decrease total fat intake has failed to have any effect on the prevalence of obesity, diabetes, and cardiovascular disease (125)."

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