Today's Post: Friday, 11-4-2011
Last week, the online health news had an article based on a study that found that the amount of LDL people had when tested often either overstated or understated their risk.
The reason was the particle size of their LDL. Here’s how that works.
Large particle LDL usually tends to act like beach balls or tumbleweeds and just roll over the surface of the insides of your blood vessels.
But small particle LDL in your blood vessels acts much like pouring sand into an engine. It’s literally so small that it slips into the chinks in the molecules that make up the surface of your blood vessels. This causes irritation and your body may then add extra patching which builds up the junk narrowing your blood vessels even more.
So if you have more particles meaning your LDL is made up of more small particle LDL, your real risk can be far higher.
The article then discussed if it was worth paying extra for an expensive direct test to see if you have this higher risk – or if you have lower risk.
That’s a reasonable question, since such a test can more accurately show your real risk!
Here’s why I’m writing this post. (It can be valuable for both laypeople and doctors not familiar with the new discoveries in assessing heart risk.)
Here’s the point of this post:
You DO very much need to know this information and how to fix it if it’s bad. BUT, you do NOT need the direct test!
1. The regular lipid panel your doctor likely ordered ALREADY has the information! It’s possible to make the information a bit more exact with the direct test. But the lipid panel contains the information already. You likely already have it had it done. And getting the lipid panel is less expensive than the direct test of particle size.
2. You can tell the likely result even before you take the test if you answer a few basic questions about your lifestyle. We know what makes particle size worse and what makes it better!
That means if you are doing those things wrong, your particle size is dreadfully dangerous and your real risk of heart disease is very high.
The better news is that if you are doing those things right, your particle size is almost certain to be in the safe range.
This information is critical to know because if your lipid panel is horribly bad, it tells you what to do to fix it and protect yourself!
First, here’s how to read your particle size from your lipid panel. (The lipid panel has your total cholesterol, your HDL cholesterol, your LDL cholesterol, and your triglyceride level.) A doctor from the Stanford Center for Disease prevention gave a talk I heard and revealed it. Work that I found out later was done at Harvard found that the ratio of your HDL and triglycerides is almost an exact match for the direct test of particle size of your LDL!
If your HDL is high and your triglycerides are low enough you have a larger HDL reading than your triglyceride reading, your real heart attack risk is quite low because your level of small particle LDL is also low.
Conversely, if your HDL is low and your triglycerides are five times as high or ten or more times as high, your real risk is horribly high too! You have far to much small particle LDL to expect to avoid serious heart disease!
I’ve been working on protecting my heart long enough and in enough ways, my HDL is about two times my triglycerides! (My heart attack risk isn’t zero since there are other causes of heart disease. But this factor is a majority of the risk. And in my case it is so good, my heart disease and heart attack risk approaches zero.) My HDL runs between 89 & 96 lately while my triglycerides run about 46 to 51. So my ratio varies from a bit over 2 to a bit under 2 in the safer direction!
Unfortunately many Americans currently have MUCH less desirable ratios. You may be one of them, so you should be sure you have a lipid panel done to see.
A man who has HDL of 40 and triglycerides of 240 has an uncomfortably high amount of small particle LDL, for example. And such readings today are all too common. That’s why the heart disease rate is so high!
But it can be far worse! Women tend to have higher HDL, particularly before menopause. But they very often have MUCH worse triglyceride readings.
A woman who has an HDL of 45 and triglycerides of 450 has extremely high real risk and even more small particle LDL.
Second, here are the questions that can reveal what your readings are likely to look like.
If you are a doctor you should ask your patients these questions and know the answers precisely because it both reveals their heart attack risks AND what to tell them to do to lower their risks.
If you answer them for yourself, you have the same information and can lower your risk yourself.
1. Do you usually avoid packaged desserts and snacks and commercial baked goods and food other than plain salads at fast food places? And, do you always read labels and decline to buy or eat anything that lists partially hydrogenated oil of any kind? Do you also do the same and if there is any amount greater than zero listed for trans fats, decline to buy or eat it?
If so, your intake of trans fats will be low. Since ingesting trans fats directly drives up your levels of small particle LDL, your small particle LDL will be low.
Unfortunately, if you never look for this information on labels and eat packaged desserts and snacks and commercial baked goods and food other than plain salads at fast food places several times each day, your intake of trans fats will be high and your small particle LDL will be extremely high – along with your real risk of heart disease.
2. Have you built up very gradually to doing vigorous exercise several times each week and have been doing so for over a year?
If so, your level of small particle LDL will be low. Such exercise directly lowers small particle LDL. (Such exercise has also been found to slow aging and aging itself is a heart disease risk. So such exercise is protective to your heart in that way also.)
Unfortunately, if you are completely sedentary, the reverse is true. Your small particle LDL will tend to be quite high.
(If you are beginning vigorous exercise, it’s safe to build up to an extremely vigorous level. BUT that’s ONLY true if you start with an easy level of exercise and stop each short session initially BEFORE you begin to get too out of breath. You can rest and repeat the exercise; but beginning with short, easy sessions and quitting each part or set before you need to much is critical for you to stay safe. It’s also essential to make progress a bit more slowly at first than you feel able to do. If you push the pace of your improvements by too much from one time to another, you not only can cause serious problems with your health, you can get injuries to your muscles and tendons.
Remember, if you make 1% progress just twice a week, after three or four years, your fitness will be awesome. But if you try to do twice as much each week, very soon you will be in real trouble or have an injury that will prevent you from doing that exercise for weeks.)
Of course, it is also imperative to make fast progress in all these other areas right away. That not only lowers your heart risks directly, it gradually makes your vigorous exercise safer to do.
Unfortunately, I’m out of time today. But there are several other questions to ask and ways to cut your risks. We’ll cover those in our next post.