Comment by ggm | Hacker News Reader

Comment by ggm | Hacker News Reader

I'm a great believer in homeostasis. If you tweak cholesterol expression in one way, the body is going to react in another. Generally, the brain takes priority. I don't know how, but presumably the autonomic/hormone regulatory functions in the brain work better if they aren't marginalized, re-balancing what the body overall has to work with.

Whatever else I know in this space (not much: not a scientist, not in the field) I have become very skeptical of dietary influence on things like blood cholesterol levels. Sodium levels, I can believe something as simple as eating too much salt can alter: thats a really simple molecule. Fats and associated products are bigger, more complex, and carry things alongside which I don't think sodium usually does: the salts are simpler forms, the fats have complex side-bound payloads in the form of vitamins and fat soluable goodies. Your cells aren't just getting this stuff by osmotic pressure, they have active organelles which "seek out" the good stuff. Its the difference between random stochiometric and catalysed outcomes. There's energy, there's cellular structures, there's consumption and expression going on.

I'd take a statin if advised. I wish I wasn't on hypertension meds, I had a 10+ year hit, then a 10+ year window without, now I'm back on 'em again. I do far more exercise than I used to, and I eat as much yummy dairy and animal fat as humanly possible.

I too, second the notion that dietary changes are often not enough. I’ve gone through periods of moderately heavy alcohol use and eating terribly as well as phases where I am not drinking and exercising 3-4x a week, eating healthily. My cholesterol remained moderately bad in both situations and did not improve until a 6 month round of statin therapy.

I will add to the anecdata.

My cholesterol has been creeping up since I hit 30. At the time it started increasing, I was doing something like 15 hours vigorous exercise a week and eating pretty healthy. Not perfect, but pretty good. Doing that much exercise meant I ate a lot.

Arriving in my 40s (a lot less exercise now.. maybe 6 hours a week), my cholesterol got to the point where the doc was talking statins. I didn't like the sound of this and cut out all dairy and avoided fatty meats. The year I ate like that my cholesterol went up by 15%.

As a last resort before starting on statins, I went completely vegetarian (but not vegan) and my previous year's gain in cholesterol reversed in 6 months.

Reading up on it, that may be the one loss I get from cutting out meats and I'm destined for statins anyway.

But, fwiw, that's my experience with cholesterol and dietary changes.

More anecdata: I'm vegan, 31 and exercise plenty. My LDL cholesterol is still high - though not at statin level yet.

My dad is also vegan and is an amateur athlete. His cholesterol is high enough that they are talking statins.

His dad is on statins.

Yet despite this, nobody in my family has ever had a heart attack, stroke or heart disease.

Have you tried eliminating/restricting oils yet? Or, processed foods generally.

Sounds more like a genetic component here. I dont think most people can overcome strong genetic factors without drugs. Some populations even live long and healthy lives even with high cholesterol (I believe Iceland is one area).

When I moved to a plant based and whole grain diet my cholesterol massively dropped. It’s now healthy.

Is your vegan diet mostly based on unprocessed plants? Do you limit oils when cooking?

Vegan diets can be unhealthy, too.

Did you also try a diet high in walnuts and and oyster mushrooms?

There can also be a huge genetic component. I believe that family history should play a bigger role in determining one's risk. Some population live a long and healthy life even with high cholesterol (I believe Iceland is one area). But I'm not a pharma salesman (nor doctor), so what do I know.

"I have become very skeptical of dietary influence on things like blood cholesterol levels."

I think that's a decent heuristic on the input side.

Human beings seem wired to look for magic spells or rain dances. Eating particular special foods, or combinations of foods, or exotic ingredients seems to appeal to us.

I agree with you that this additive approach is probably mistaken.

"I have become very skeptical of dietary influence on things like blood cholesterol levels."

But on the output side ... if you stop energy inputs and just let your body run through the backlog, your cholesterol will drop. Probably plummet - and in a surprisingly short amount of time.

Rather than some exotic ingredient or weird food combination, simply staying in a fasted state longer, more regularly, would be the very first (and simplest, and least intrusive, and cheapest) step I would take.

Which is to say, "dietary influence" can be huge - just not on the input side ...

The issue is that it is very complex. You fat stores what you eat, so a diet will often not result in the significant lowering of things like cholesterol, until you've burned the fat around your belly. ...and as you said, your body can be adaptive in certain ways.

For these reasons, health is really about establishing routine lifestyle changes so that you can find that new healthy equilibrium.

how did you get off the BP meds?

My BP stabilised enough my GP suggested I try weaning off. I went half a tab, then half a tab every other day then stopped.

I do have hypertension in my heritage, but I was written up as idiopathic. Since it's returned I might find that changes. Still, a ten-year break was good. Who knows? Maybe I'll win another.

You probally did this, but take your BP at home.

Just walking into a Dr's office raises mine, and that's before the bill.

Most doctors will have you check your bp daily for a month to see if you are actually hypertensive.

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