Hi all, my lifestyle has changed in the last 6 months through diet changes, IF, and more consistent exercise. I recently got a physical as I wanted to see where I was at with my bloodwork. Physical went well, got my bloodwork results and wanted to get some opinions.

Stats:
- In my 30s, 6'1" ,180 lbs, large frame. Lost 22% of body weight in last 6 months
- Total cholesterol: 219 mg/dl
- HDL: 63
- LDL: 141
- Cholesterol/HDL ratio: 3.5
- LDL/HDL ratio: 2.2
- Non HDL cholesterol: 156
- All other bloodwork results in normal range

I eat 3 eggs daily on average which I'm sure is contributing to this.

Should I get one of those calcium tests to see how much calcium is built up around arteries? I am going to do a Dexa scan soon to get a body comp reading but know it won't help assess my risk for vascular disease.

If youve had high LDL levels, how do you manage this?
How concerning is this? Thanks for your thoughts

How far into your 30s? Also family history of cardiovascular disease? Even in most patients with iffy cholesterol we typically don't start CT scans and CAC scores until 40.

Early 30s, thanks

Dad had a TIA in his early 40s and has a history of high cholesterol/high blood pressure, but he is otherwise healthy today

You are honestly too young for a calcium score. Your numbers may not be "perfect" but they aren't alarming either. I would continue working on diet and exercise and follow the trends over time.

I have a family history of high cholesterol on my dad's side but they never exercise and don't eat great, so I thought I could manage mine better. My last 2 years my LDL went from 110 to 126 despite doing everything I could with eating clean and exercising daily.

Doc put me on 5mg rosuvastatin and it went down to 85 with me keeping everything else the same. I haven't noticed any side effects. After reading the book Outlive, I just embraced using the tools like science has given

I did get sent to do a calcium test (came back 0) and it was cheap and easy. Not sure if it's worth it at early 30s though, I'm mid 40s.

Fasted or non-fasted reading?

Score isn't that bad. Just watch the processed sugars and saturated fats. I'm at about 5-8 g of saturated fat a day max (some days is closer to zero) and my numbers went from elevated to perfect without any other real changes. Just replaced some red meat with seafood and chicken. Basically don't eat pork anymore. Red meat is about a once a week treat for me now.

You're getting about 5 g of saturated fat just from your eggs in breakfast, which isn't bad but can be bad if you eat a lot of red meat. If you'd like to reduce the numbers, try egg whites or even removing two of the three yolks and cutting back red meat. Add in some fiber and whole grain if you want to keep reducing it.

Appreciate the responses

This was a fasted reading

I cut back on red meat consumption significantly and eat a lot more chicken now. Bringing more shrimp into the diet now too

Limiting to 8g of saturated fat… that's tough!

Everyone in my family is on statins with high total and LDL cholesterol, and my TOTAL cholesterol has ranged from 110-170 my whole monitored life (43 now).

I eat a lot of meat, but almost never eat fatty meat (ground sirloin is about the fattiest I ever eat), even when I've been a fatass. I do eat like 40-80g+ of fiber every day.

I give credit to fiber intake and my muscle mass (I've spent many years as a fatass since HS too, but cholesterol and glucose markers have always stayed in check, miraculously) for keeping my numbers down through the years.

In my 20's, I upped my sat fat intake before trying to raise my cholesterol, and adding like 15-20g/day from dark chocolate and coconut for 6 months actually lowered it...

aggiegolfer03 said:

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Everyone in my family is on statins with high total and LDL cholesterol, and my TOTAL cholesterol has ranged from 110-170 my whole monitored life (43 now).

I eat a lot of meat, but almost never eat fatty meat (ground sirloin is about the fattiest I ever eat), even when I've been a fatass. I do eat like 40-80g+ of fiber every day.

I give credit to fiber intake and my muscle mass (I've spent many years as a fatass since HS too, but cholesterol and glucose markers have always stayed in check, miraculously) for keeping my numbers down through the years.

In my 20's, I upped my sat fat intake before trying to raise my cholesterol, and adding like 15-20g/day from dark chocolate and coconut for 6 months actually lowered it...

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Just wondering, what are you eating to get upwards of 80 gms of fiber a day? That's quite a lot...

Somewhat Typical day eating:

2x (2 servings of Oikos triple 0 vanilla Greek yogurt, 3 servings of PB2, 1.5 servings Kashi go lean peanut butter crunch). That is 30g right there.

Banana and an apple (3-5g)

Salad (and I'm talking a whole 3.5 serving bag of greens) with grilled meat . 6-10g

Protein bar. 10g

6 oz of berries: 6-10g

Center cut sirloin steak (10-12 oz) and plain sweet potato. 5g

3 servings of air popped pop corn. 4-6g.


Something like that.

For most people the vast majority of your blood cholesterol is made by your liver vs what comes from your diet. Typically diet accounts for about 20% vs 80% from the liver. So diet can only do so much to affect the number for most people.

This is Dr. Shawn Baker. He is well known for carnivore, specifically red meat carnivore. He basically crushes huge steaks every meal. Not only is he jacked but he questions the Cholesterol/LDL studies out there. Yes, high LDL is associated with increased health risk, but is it the cause compared to other factors? Yes, if you are an obese sedentary smoker with high blood pressure, you need to lower cholesterol, but what if you are lean mass hyper responder and don't have the other risk factors?

In this video, he discussed people similar to you who have all healthy metrics otherwise but have high LDL. Later in the video he cites a "lean mass hyper-responder" study being conducted right now that selects and controls for this. The data collection period is over this month, and we are awaiting results.

His approach is to get imaging, likely a CAC scan - calcium.

Is cholesterol killing low carbers? pic.twitter.com/hLSn8zDbwV

— Dr Shawn Baker 🥩 (@SBakerMD) February 2, 2024

It is becoming increasingly apparent that being lean, which is almost always a good thing, is the major driving force to elevate LDL cholesterol on those on a low carbohydrate diet and not the saturated fat consumption which has a small effect!

What is NOT known is whether this…

— Dr Shawn Baker 🥩 (@SBakerMD) February 2, 2024

Here he discusses an interesting study that Oreos (yes, the cookie) lowered LDL in more than statins.

Lots of other twitter bros weighing in on the issue.

Glycosylated hemoglobin A1c predicts coronary artery disease in non-diabetic patients

17x higher risk of coronary artery disease with HbA1c of >5.6, a level seen in many (most?) people

This is about metabolic health, not cholesterol

Stay lean, fit, and insulin sensitive pic.twitter.com/MgrAiRcHIl

— P. D. Mangan Health & Freedom Maximalist 🇺🇸 (@Mangan150) February 1, 2024

Insulin resistance is a much bigger risk factor for heart disease than LDL cholesterol.

— Heart Surgeon Dr. Philip Ovadia (@ifixhearts) February 3, 2024

Anyway, a different analysis to consider. Food for thought.

Random question- if another MD (or even another medical professional like a PA) who was equally jacked was popular online and mentioned that other diets showed the same results....would you trust them just as much?

True Anomaly said:

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Random question- if another MD (or even another medical professional like a PA) who was equally jacked was popular online and mentioned that other diets showed the same results....would you trust them just as much?

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I don't trust anyone solely based on their appearance. But it's kinda hard to trust a fatass on nutrition and health. My undergrad degree was biochemistry so I read scientific studies myself. I'll listen to input from all.

I do think the demonization of red meat and eggs has been driven in part by the pharmaceutical industries. I know it's n=1 but the healthiest I've been in my life has been on low carb, high protein and high egg and red meat consumption. After age 30, that's the only time I've had normal BMI. I was prescribed statins but I only take it once or twice a week and it keeps my numbers in check.

I could be wrong but I think it's more important to be thin no matter how you get there.