Book Review: Cholesterol Clarity

      37 Comments on Book Review: Cholesterol Clarity

The last time we stayed with Chareva’s parents, my mother-in-law asked me to take a look at my father-in-law’s latest lipid panel and help her make sense of it. So I did.

Let’s not worry about the total cholesterol or total LDL. Those figures are close to meaningless. The best indicators of possible heart disease we can find in a standard lipid panel are the triglycerides and HDL. Triglycerides are a type of blood fat, but fasting triglycerides are mostly a reflection of how many refined carbohydrates you eat. His are pretty good for a diabetic. The HDL looks pretty decent too, but it could be higher. Eating more natural fats will do that. Let’s look at the ratio of triglycerides divided by HDL. That’s a better predictor of heart disease than total cholesterol or LDL, because it will give us an idea if his LDL is the large, fluffy variety or the small, dense variety …

Afterwards, she said it would be helpful if I could write up some kind of guidelines to help her interpret those numbers in the future. I never got around to writing those guidelines, but now I don’t have to. I’ll just send her a copy of Jimmy Moore’s latest book, Cholesterol Clarity: What the HDL Is Wrong With My Numbers?

The Clarity part of the title is appropriate because (let’s face it) there’s a lot of confusion out there about cholesterol. Most people have a vague (and incorrect) notion that too much fat and cholesterol in the diet will cause heart disease by raising cholesterol levels in our bloodstreams. Some have heard that LDL is the “bad” cholesterol and HDL is the “good” cholesterol, but that’s where their knowledge stops. Pretty much everyone believes the lower your cholesterol, the healthier you are. I even once read an online comment from a vegan who was upset that her cholesterol was “normal” because she believed that by avoiding animal products completely, her cholesterol level ought to be close to zero.

It’s that kind of confusion about cholesterol and health that Cholesterol Clarity (which Jimmy wrote with Dr. Eric Westman) aims to dispel in language the non-medical crowd can easily understand. As the introduction explains:

If you like straight talk that cuts through the muckity muck, you’ve come to the right place. The title of this book is Cholesterol Clarity for a reason: The intention is to make the truth about cholesterol absolutely clear. This book is not for medical geeks. It’s not filled with complex terminology and jargon that makes the layperson’s eyes glaze over. There are, for sure, a few technical terms you need to know, but we’ve provided a convenient glossary of terms in the back of the book that will explain everything for you in a language you can understand. In addition to examining the current recommendations for cholesterol levels and why they may not be valid, we will provide a practical guide to all the major cholesterol numbers, their ideal ranges (which are likely much different from what you have been told), and what specific actions in your diet and lifestyle you can take to address any troubling areas in your cholesterol profile.

After the introduction, Jimmy anticipates a question readers who don’t know him may have – why should I listen to a guy who isn’t a doctor? – and answers it by introducing the panel of experts he consulted when writing the book. You’re no doubt familiar with many of the names: Dr. Malcolm Kendrick, Dr. William Davis, Dr. Duave Graveline, Dr. John Briffa, Dr. Uffe Ravnskov and Dr. Chris Masterjohn, to name just a handful of the 29 people listed – people who actually understand what cholesterol does and doesn’t do to us. They are all quoted liberally throughout the book. (And as usual, some of Dr. Kendrick’s comments will make you chuckle.)

Jimmy, of course, has a vested interesting in understanding cholesterol and heart disease. His brother Kevin died of heart disease at age 41. Jimmy’s doctors have pestered him for years about his high cholesterol, and yet he scored a zero on a calcium test, which measures the plaque in coronary arteries. Back before he knew better, he even took statins and suffered through the side effects.

The easiest way to describe what the book covers is to list the chapters, so here they are:

What Is Cholesterol and Why Do You Need It?
Forget Cholesterol—It’s the Inflammation
What Do Major Health Groups Say about Cholesterol?
Doctors Are Questioning the Anticholesterol Message
Statin Drugs: Magic Pill or Marketed Poison?
What Does Heart Healthy Really Mean?
Why Low Fat Ain’t All That
Carbs and Vegetable Oils: The Twin Villains
What’s This LDL Particle Thing?
Forgotten and Ignored: Triglycerides and HDL
The Experts Weigh In on Key Heart-Health Markers
Why Are So Many Doctors Clueless about Cholesterol?
What Do You Mean My Cholesterol Is Too Low?
Nine Reasons Why Cholesterol Levels Can Go Up
I’m Still Worried about My High Cholesterol!
But Aren’t the Cholesterol Guidelines Based on Solid Science?
The Low-Fat, Vegetarian Myth
How Your Doctor (Mis)Interprets Your Cholesterol Test Results
What Your Basic Cholesterol Test Results Mean
Eight Advanced Health Markers You Should Consider
Test Your Ability to Read Cholesterol Test Results
Now That You’ve Been Enlightened, What Happens Next?

At the end of each chapter, there’s a bullet-point summary.

The chapter titled What Is Cholesterol and Why Do You Need It? would be comforting to the vegan who was upset that her cholesterol level wasn’t near zero. Here are a couple of quotes:

Cholesterol is a waxy, fatlike substance produced primarily in the liver. It is absolutely essential to the life of humans and animals; without it, our cells could not repair themselves, we could not maintain proper hormone levels, we could not properly absorb vitamin D from the sun, we could not regulate our salt and water balance, and we could not digest fats.

Did you know that cholesterol has some amazing antioxidant properties that can actually help guard you against heart disease? Ironic, isn’t it? There are many reasons why your cholesterol levels might go up: It could be your body’s response to inflammation (a critical concept we’ll discuss in chapter 2), or it could be a sign that part of your body is malfunctioning—maybe, for example, your thyroid function is low. We’ll get into these and the other possible reasons for elevated cholesterol levels later on in the book. For now, all you need to know is that cholesterol is a major line of defense when your immune system comes under attack. So lowering cholesterol levels artificially with drugs could make you more susceptible to germs or bacteria wreaking havoc on your health.

That chapter also includes an explanation of where the Lipid Hypothesis came from and why it was never based on solid science. The next several chapters cover the standard-issue “expert” beliefs about heart disease, the likely true causes of heart disease (inflammation being chief among them), and why artificially beating down our cholesterol levels with statins is usually a bad idea.

After exonerating cholesterol and pointing the finger at inflammation, the book explains why diets that restrict saturated fat and cholesterol aren’t the key to avoiding heart disease. As we Fat Heads know, those diets can, if anything, make the situation worse. Swap fats for processed carbs, and you spike your blood-sugar levels. Swap saturated fats for processed vegetable oils, and you increase your intake of inflammation-producing omega 6 fats.

Yes, vegetable oils can lower LDL, but as clinical research quoted in the book demonstrates, that doesn’t translate to a lower risk of heart disease. In at least one major study, men who lowered their LDL levels by sucking down polyunsaturated vegetable oil ended up with a higher rate of heart attacks. Why? Because what matters most is the type of LDL your body is producing, as the book explains in chapter 9:

There are two major classifications of LDL particles that can be measured: Pattern A is the large, fluffy, and generally harmless kind that is described as “good” LDL (yes, there is such a thing); Pattern B is the small, dense, potentially dangerous kind that is described as “bad.” Pattern B LDL can easily penetrate the arterial wall, compromising your heart health. This is what you are trying to avoid at all costs, so knowing the breakdown of your LDL particles is critical to determining overall heart health.

A standard lipid panel doesn’t distinguish between Pattern A and Pattern B. In fact, on a standard lipid panel, the LDL is calculated, not measured. If your doctor isn’t interested in knowing what type of LDL you’re producing, you can find out for yourself. The book lists some web sites where you can order tests that measure LDL directly and determine the particle size, not just the count.

The next several chapters explain the markers that actually matter (triglycerides, HDL, etc.) and how to interpret them if you’re looking over the results of a cholesterol test. These are the chapters that answer the questions my mother-in-law was asking me when we were going over my father-in-law’s lipid panel: Which numbers should I be looking at? What do they mean? Is this number too high, too low, or about right?

Some cholesterol skeptics insist that lipid panels are completely useless and nobody should bother even looking at them. I don’t agree, and I’m happy to say Jimmy doesn’t either. If your triglycerides are through the roof, if your HDL is in the cellar, those are indications that something could be very, very wrong with your diet or your metabolism. As the book explains in one of the later chapters, a dramatic change in your lipids can also signal an underlying health problem that’s affecting your cholesterol, such as hypothyroidism, infection, stress or hormonal imbalances.

The point of the book isn’t that lipid numbers don’t matter – they do. But as Dr. Dwight Lundell is quoted as saying, it’s important for people to educate themselves about what those numbers mean. If your HDL is 75 and your triglycerides are 62 (excellent numbers) but your total cholesterol is 220, all you’re likely to get from the average doctor is a lecture about your cholesterol being too high and a recommendation for a low-fat diet or a statin.  If you don’t know any better, you’ll end up following advice that will make your lipid panel (and your health) worse, not better.  That’s why educating yourself matters.

Cholesterol Clarity is an excellent, easy-to-read resource for those who want to educate themselves.

And yes, I’m going to send a copy to my mother-in-law.


37 thoughts on “Book Review: Cholesterol Clarity

  1. charles grashow

    “Pattern B is the small, dense, potentially dangerous kind that is described as “bad.” Pattern B LDL can easily penetrate the arterial wall, compromising your heart health. This is what you are trying to avoid at all costs, so knowing the breakdown of your LDL particles is critical to determining overall heart health.”

    Per Jimmy’s published lab tests his small LDL-P INCREASED from 221 on 10/25/12 to 478 on 4/18/13.

    Isn’t this a cause for concern??

    He’s still in the safe zone, but yes, I’m sure he’d like to see that number go down.

    1. Justin B

      Also in the book and in recent interviews with him about the book: What causes your LDL to spike. One of the reasons is weight loss, which I believe he was in the middle of when that number increased. Don’t quote me about this, but I believe I remember him saying that it has since gone down again.

      Glad you brought that up. Dr. Davis wrote about temporary rises in lipids due to weight loss on his blog:

  2. Rae

    I’m not that concerned with my cholesterol and I’ve never had it checked. But I want to give this to a (young and healthy) loved one who is taking a statin – although, I don’t want to appear to be butting in. I suppose at worst it’s like when a Jehovah’s Witness hands you a pamphlet in the parking lot – you toss it if you aren’t interested, no harm done. I may not be a doctor, but I care about my friends’ and family members’ health more than their doctors do – of that I am sure.

    I do get asked about my cholesterol a lot after people notice my “eccentric” diet. I enjoy saying, “I don’t know… because I don’t go to the doctor… because I don’t really get sick anymore!”

    My policy with friends who are harming themselves by following the standard-issue advice is to speak up once. Then I don’t mention it again unless they ask.

  3. Sizzlechest

    I used to recommend VAP tests because they measure LDL particle size profile. After Peter Attia’s series on cholesterol, I’m not so inclined anymore. Here’s the link for reference:

    His research shows that “once adjusted for particle number, particle size has no statistically significant relationship to cardiovascular risk.” He recommends an “NMR profile” to assess risk rather than a VAP test. There does seem to be some connection to cholesterol and atherosclerosis, but certainly not in the way most people (including doctors) think.

    Dr. Davis prefers the NMR test as well.

  4. Elaine Andolino

    After reading Tom Naughton’s post, I feel it necessary to read the book further to elaborate on what I already learned from Tom’s documentary. The biggest obstacle in my way is not my comprehension of what I have and continue to learn about heart health. It’ s the attitude and advice/info coming from my doctor!! She contradicts much of this information. Any Ideas you can give in finding a doctor or should I be looking elsewhere? Otherwise, its a tug of war between doctor and patient with statin drugs, lipid panels, and beliefs.

    The best way to handle that situation is to nod politely, refuse the statins, and ignore the advice.

  5. Kathy in Texas

    ” without it, our 30 chol est erol Cl arit y cells could not repair themselves, ”

    Was the cat walking on the keyboard?

    The cat does indeed walk my keyboard, but that was a copy and paste error. Thanks for the heads up.

    1. susan

      My favorite quote about our need for cholesterol has to be from Protein Power Life Plan, wherein the Drs Eades say:

      “Were you able to extract every’ last molecule of cholesterol from your body–an event that we sometimes think some misguided nutritional authorities would find desirable-you’d disintegrate; you’d melt into a puddle like the Wicked Witch of the West did when Dorothy doused her with the bucket of water.”

      I’ll keep my cholesterol, thanks!

      Dorothy should have just given the Wicked Witch of the West a high dose of Lipitor.

  6. Janet

    TBI time! (traumatic brain injury) Due to the “new model of healthcare delivery”, my doctor left the clinic where I had established my name in their files several years ago. I was interviewing providers to establish a new relationship (after all, I am almost 72 and might get a rash or sore throat one of these days)

    I was greeted in the new clinic by a medical assistant (not a licensed nurse on any level) who was morbidly obese. The “doc” was a PA who was also obese. (no physician in sight, he is off in another clinic on this day) When I commented on his physique, this PA shared with me that his wife was also needing to lose weight and both were diabetic.

    After I shared with the PA my most recent lipid profile in order to avoid having it repeated and an angiogram with all vessels wide open, and my current medications which are a multivitamin and an aspirin, he reviewed my BMI which is in the underweight category (5’3″ at 103 lbs). The only item on the lipid profile that was out of ‘normal range’ was an HDL at 75.

    When I questioned him about insulin resistance, pre-diabetes, and diabetes, his response was that if I had symptoms of diabetes I should come in and they would check my blood sugar and treat me if I needed it. What would that treatment be? Medications, of course. He would also recommend a standard ADA diet (you know the one), with portion control being most important in his opinion (everything in moderation, you know) No answer when I asked why anyone should wait until they had symptoms.

    His only professional advice for me was to cut back on salt. Really? Yes, he said that the meat I was eating was full of salt. Really?

    I’ll be moving on to interview a different provider in case I ever really need anything. I’ll need someone who can treat a head injury now.

    Welcome to modern health care.

  7. Firebird

    A friend of mine, a nutritionist, states that another marker for heart disease, and Dr. Greg Ellis seconds this, is blood pressure.

  8. Rebecca Foxworth

    I sure hope the medical community finally gets the message about cholesterol, but I doubt it. For the second year in a row, we’ve been offered the choice between a ridiculously priced monthly medical insurance premium or a lesser premium through a “wellness program”. The difference? The wellness program requires us to jump through several hoops to get the lower rate, including participating in an online class about the health benefits of a low-fat diet that includes whole grain, vegetable oils, and less meat AND regular blood testing to “insure compliance” with prescribed drug regimens.

    Read that again, please. The cholesterol cutoff for statins is 200. The insurance company would presume to raise my rates if my blood didn’t show the presence of statins (“compliance”) if my cholesterol was 203.

    The nutritional world has gone off a cliff, and for forty years, we’ve been asked to close our eyes and jump off with them. And, now? Now…the insurance companies are actually PUSHING us over that cliff.

    Yeesh. Given the choice between a statin or a higher rate, I’ll take the higher rate.

    1. Lorna

      I’m enrolled in my workplace Wellness program and love the cut rates I get because of it. So far, it’s not too invasive or demanding; I’m pretty healthy and active anyway. However, the person in charge of our Wellness programs says that there’s been a lot of pressure to make this more of an outcomes-based program, where our health markers dictate whether we could get lower-rate insurance. Since my cholesterol runs a bit high (now 231, runs in the family) though I’m otherwise deemed healthy, I would probably not be eligible.

      The new feature for next year’s program is that we can opt to sit down with a nutrition counselor 3 times, to get 150 points (out of 300 required). I don’t like the direction this is going because I don’t trust getting consistent, good advice from the “experts”. There’s too much conflicting info out there even among the professionals.

      The average nutritionist is going to give out lousy advice.

    2. Jeff

      I agree Rebecca. It sounds like an unholy alliance. I have talked to more than one healthcare professional who said that cholesterol levels were at 300 35years ago and when statins came in, suddenly levels had to get lower.
      Dr. M Dobbins has some good books on cholesterol on his site also.

  9. BA

    The fairy tale view of the Diet-Heart hypothesis is the unquestionably the single-biggest barrier to mainstream acceptance of the validity of carbohydrate restriction for weight control, diabetes management, and health in general. I think it makes a lot of sense that a book from Jimmy Moore would directly address this issue.

    The 50+ year old outdated view of heart disease that was at best just conjecture in its time is what allows crackpots like Dr. Dean Ornish to make comments about carb restriction like “you lose weight but you mortgage your health” without being a laughing stock.

    It’s what makes it socially-acceptable to say reprehensible things about Dr. Atkins everywhere in the mainstream press, and what made his career during his lifetime a non-ending confrontation with mainstream authorities, when just a few decades prior, the standard weight loss / diabetes management diet in American hospitals looked exactly like the Atkins diet!

    It’s what makes people who restrict carbohydrates have to live in the closet, because god forbid anybody sees you eating burgers without buns and lunchmeats and cheeses, and suddenly you’re somehow obligated to defend your position against some hideously obese person lecturing you about how you’re going to get a heart attack.

    The subject matter of Jimmy Moore’s book is commendable, because the Diet-Heart hypothesis is more-or-less the Berlin Wall that’s ruining everything.

    If you’d asked me in 1980 if the Berlin Wall would be gone within a decade, I would have said no way. So there’s hope.

    1. Lori

      The wall is already cracking. Health food stores here in Denver carry paleo, pro-cholesterol and anti-sugar books, nobody here bats an eye anymore when you say you avoid carbs, cereal sales are down nationwide, and even Allure magazine gives juice fasts a thumbs-down in its latest issue. (All that sugar is bad for the skin.)

      To borrow a term from social dance, we’re highjacking the lead.

  10. erik van altena

    And another one. You know, I like to read fiction. But ever since I became a fathead, I’m buying only food and health non-fiction books. Give me a break man, I still have a Game of Thrones to finish!

    A service guy who looked at our bookshelf during a visit asked which one of us is a doctor. I get in my fiction-reading by listening to books in the car.

  11. charles grashow

    Cholesterol-Absorber Status Modifies the LDL Cholesterol–Lowering Effect of a Mediterranean-Type Diet in Adults with Moderate Cardiovascular Risk Factors

    Cholesterol synthesis/absorption status was not markedly altered by diet, but the decrease in plasma LDL-C due to the Mediterranean-type diet occurred only in low absorbers of cholesterol. This should be considered during further dietary interventions.

    The present study provided 2 main findings. First, we showed that the cholesterol absorption status or the synthesis/absorption status based on serum surrogate markers, as observed with an habitual WD, remained unchanged after 3 mo of consuming the LFCMD. Second, cholesterol absorption status in combination with dietary regimen altered the plasma concentrations of cholesterol and LDL-C in the 2 sexes.

    In conclusion, the present study of 125 men and women at moderate cardiovascular risk provides 2 important pieces of information. First, the synthesis/absorption balance for cholesterol, the key for cholesterol homeostasis, is likely an intrinsic trait of the participants that is not noticeably altered by changing the diet. This applies to both men and women; thus, there is no apparent sex specificity. Second, we showed that the cholesterol absorption status of both men and women is a clear determinant of responsiveness to a healthy dietary challenge by predicting a significant lowering of LDL-C in participants with a low-cholesterol absorption status. If this observation is confirmed by other studies, it may be possible to measure the serum surrogate markers in men and women at CVD risk to determine the cholesterol absorption status and thus to predict whether a given individual may be able to lower LDL-C with dietary modification. Finally, the observed correlations between insulinemia or insulin resistance status (HOMA-IR) and cholesterol synthesis:absorption ratios (Supplemental Table 1) were stronger in women than men.

    Your thoughts

    Just one thought: If they’re defining a “Mediterranean-Type Diet” as the politically correct low-fat, whole-grain version, I’d like to see them run another study with a grain-free, high-fat version.

  12. June

    I’ve got my copy on pre-order. May get a second one just to donate to our library system. Gotta start getting the news out to the people somehow.

    Donating a copy to library is an excellent idea.

  13. mlantenac

    “I even once read an online comment from a vegan who was upset that her cholesterol was “normal” because she believed that by avoiding animal products completely, her cholesterol level ought to be close to zero.”

    Wow. The sheer… genius that’s on the other side….

    Unfortunately, lots of people believe a cholesterol level of zero would be awesome.

  14. Vic

    Statins, bad stuff. About 3 years ago my Dr prescribed them, I compliantly took them, within 3 weeks I started having severe memory loss, began getting lost when I was driving to the store, or to work. When I would finally got where I was going I would forget why I was there or how to do my job. I actually lost my job over it. When I told the Dr I felt I must be having a reaction to one or more of my Meds, she told me “no way.” Even after the muscle weakness and pain started. I ended up having to use a cane to even get from the bedroom to the bathroom. Finally one night I had a lucid moment I realized I didn’t need no stink’n Dr I have the Internet! So I started going through my meds and checking online for side effects and discovered it had to be the Statin. I quit them that night, with in 3 days I could have a normal conversation, although I have never been able to ditch the cane, still have weakness and no Dr will believe it is statin damage. I did change Drs and I had them put I was allergic to statins on my record, they don’t like it, but haven’t pushed me too hard on the subject.

    That’s what makes prescribing statins like candy such a crime: the muscle and joint damage can be permanent.

  15. Eric from belgium

    Has anyone actually seen pure cholesterol?
    I did, years ago, in a chemistry lab. The professor handled the flask like it was one of the worst poisons… It’s actually small white crystals, and smells a bit like rancid oil. And there was nothing on the label indicating whether it was ‘good’ or ‘bad’ cholesterol.

    Anyway, I always look forward to getting in discussions with medics and dieticians, asking them naively to educate me on cholesterol. Once the usual lecture has been delivered, I go for the kill…

    “But, if I remember, cholesterol is a sterol, a kind of alcohol, not a fat…”

    “If I recall correctly, HDL stands for High Density Lipoprotein, and LDL for Low density, and there is also VLDL, chlomicrons,….”

    “If my biochemistry is correct, cholesterol is amongst others the glue that binds the organism, and the precusor to vitamin D and many hormones…”

    And so forth….

    Anyway, let’s keep in mind that HDL and LDL is *NOT* just cholesterol… It’s the wheelbarrow that transport essential fat soluble substances through the body, not just cholesterol.

    Needless to say my challenging the doctrine / dogma / approved party line is not always appreciated to its true value. Eppur si muove… Heretic and proud to be so

    All the best

    And thus the joke that ends, “No, that’s God. He just thinks he’s a doctor.”

  16. Antonio Maranhao

    “If your HDL is 75 and your triglycerides are 62 (excellent numbers) but your total cholesterol is 220, all you’re likely to get from the average doctor is a lecture about your cholesterol being too high”

    Where have I seen this before. With my HDL at 77, triglycerides at 46 and a total cholesterol of 217 the doctor went all over me:
    “no more eggs, red meat, shellfish, cheese, etc.” while I was holding myself to to laugh and thinking that if I stopped eating what he said I would end up living out of air and water and I wasn’t in the mood for a cholesterol debate, but the he continued “and you must exercise more”. I just could hold myself the and with a huge smile I said “More?!?! Only if I start exercising twice a day!”.
    The doctor just stared at me for a bit with a surprised face and asked “How do you feel?” and I replied “I feel great.”. The he said “Fine then, carry on.”

    Let’s see how it goes next time.

    By the wait, I don’t think I have yet thanked you for your awesome documentary. It was what really started me a year ago to take a deeper look it the quality of what we eat, so thanks!

    Thank you for watching.

  17. shawn

    Nov 2011. At a Dr appointment – explaining that I was going to take up a weight-lifting program.. His response: You are in fine shape- no need. This was the same month that my BMI came back as ‘obese’ and I was listed as prehypertension and possible pre-diabetes… Since I had elevated blood sugar. I was a little confused.

    Got informed – loads of internetting… Learned my own lessons – thank you for the movie, and the web site.. all the links and information.

    I’m down roughly 40 lbs since then; and my freezer is FULL of bacon!

    I swear there is a relation between Bacon and Happiness..!!

    Perhaps depressed people should be given prescriptions for bacon.

  18. Lorna

    Thanks for the article! A few months ago, I had one of those health screenings measuring my cholesterol. It was all over the board, HDL very low, LDL a bit high, and triglycerides in the very healthy range. I researched to the end of the internet to find out how I could raise my “good” cholesterol. To paraphrase what I found at credible web sources: “Here are some suggestions, but we really don’t know what these HDL and LDL numbers mean or how they interact with each other.” Their suggestions were the same standard ones that I know have been debunked, like lower fat intake, etc.

    Since all my other indicators were healthy, I have chosen to ignore cholesterol because it runs higher in my family. When I ran a marathon 10 years ago, I had a cholesterol check by the heart association. It was a little high (208) and I asked why. At that time, they told me there’s very little I could do since cholesterol levels are hereditary. My obvious next question was: “Then why should I bother to get this tested if there’s nothing I can do to change it?”

    Since then, I’ve found out more about the faux cholesterol/fat scare, thanks to articles like yours.

  19. m

    hi tom,

    as we all already know, the dense smaller LDL is oxidised and gets stuck on the inner walls of the arteries and causing plague build up. My question is, are the small dense LDL (refined carbs) the only thing that get stuck on our inflammed walls or are the other harmless lipids like cholesterol calcium fats in our blood stream also get stuck in our inflammed walls? I am asking because there are also explanations of how atherosclerosis happens and is a very close explanation to the one on the film, but only difference is they mentioned cholesterol free radicals and minerals that exists in our blood

    1. Tom Naughton Post author

      A plaque is a mix of LDL, white blood cells, calcium, and probably some other gunk. The percentages are fairly consistent, which is why a calcium scan gives a good indication of how much plaque is in your coronary arteries.

      1. m

        does that mean in spite of me trying to avoid refined carbs (i have been very diligent), if i happen to have inflammed arteries, i’m fucked as we all have white blood cells and calcium in the blood?

        1. Tom Naughton Post author

          No. It’s the inflammation that damages the artery and allows the calcium and white blood cells to form a plaque, which is something like a scab.

          1. m

            ok i keep thinking vegetable oils and some foods causes inflammation.

            And when i consume refined carbs, they become oxidised dense smaller LDL and then gets built up in the inflammed arteries.

            So in order to avoid plague, i should avoid eating refined carbs. Thats why i came up with the question of whether avoiding refined carbs is enough since calcium etc also gets built up in the inflammed walls regardless if i consume refined carbs or not

            1. Tom Naughton Post author

              Best way to avoid inflammation and other triggers of heart disease, diabetes and cancer:

              1. No sugar
              2. No refined grains
              3. No industrial seed oils, usually misnamed as “vegetable” oils. Olive oil, coconut oil, avocado oil are fine.

            2. m

              i just get a little confused still… what causes the oxidised small dense LDL, is it refined carbs n sugar too? So refined carbs and sugar causes inflammation AND oxidised LDL? Thats what i am trying to understand

            3. Tom Naughton Post author

              Correct. Refined carbs lead to high triglycerides and small LDL — although small LDL can also be a genetic disposition.

          2. m

            if we already developed plaque buildup over the years, are we able to reduce the plaque buildup? I know we can stop doing more damage but can we Reverse it and undo the damage done?


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