Saturday, May 28, 2011

Part I of a conversation with a statin advocate

The statin advocate says,
"Glucose is the energy of life. You can't live without it. If it's too low you go into a coma and die. But that doesn't mean you can't have too much. LDL is also essential but you can still have too much. Just because glucose is essential doesn't mean the body always does a good job of regulating it and just because LDL is essential doesn't mean the body always does a good job of regulating it either."

The equivalency between glucose and LDL is weak. It is well established that excessive glucose causes glycation of tissues. It is not well established what harm excessive LDL levels cause. Does it directly cause plaques to form? No experiments have ever established this. Only speculation exists. Some scientists think that the cholesterol existing in plaques are byproducts of the body fighting bacteria present in the artery and also the repair process where the endothelium is injured. Granted there may be optimum LDL levels but they vary with choice of diet, exercise, presence of infection, and stress levels. The body responds by attempting to establish those optimum levels for the environmental conditions. Sometimes the body is not successful if a poor diet or chronic stress is imposed.

The body also tries to set optimum conditions for blood sugar levels under given environmental conditions. However, a high-carb diet can force these blood-sugar levels to values that cause harm to the body. The correct approach is to change the environmental conditions to bring these levels down to the normal range. This approach would be to use a low-carb diet. One would not want to use insulin to force the blood sugar to lower levels as this would only increase insulin resistance and make the underlying problem worse. Likewise LDL levels can be forced higher than the normal range by environmental factors. Again the environmental factors should usually be changed to try to bring the LDL levels back in the normal range. Sometimes this is difficult and one can only try to optimize the VAP results where triglyceride levels, fluffiness of LDL particles, etc. are all considered.

Below is an assertion that is made by the statin advocate who obviously believes that high LDL levels are a direct cause of atherosclerosis.
"What's the best way to figure out how much LDL is normal and healthy? Look at modern hunter gatherers and free living mammals. Their LDL is 50 to 70 mg/dl and they have no heart disease. The LDL level for the average American is about twice that much. If you read peer reviewed scientific articles which try not to go beyond the evidence - instead of Dr. Ravnskov's highly biased books which completely ignore evidence that doesn't support his extreme claims - it is very clear that LDL is strongly associated with atherosclerosis, heart attacks and all-cause mortality."

The statin advocate holds up the modern hunter-gatherer's (MHG's) LDL levels as ideal. The diet of MHG's varied widely. The Masai dined mostly on meat, blood and high saturated fat milk. They had little heart disease but their kin who lived in urban areas had abundant heart disease. The traditional Inuit had little heart disease but did have appreciable incidence of hemorrhagic stroke. They ate meat and less-saturated fat. There are other MHG's who had a higher carbohydrate intake but restricted calories and they also fared well. Nevertheless, most of these MHG's are infested with parasites. Most parasites excrete substances that lower the body's inflammation response to protect them. These substances may also lower the LDL levels in the body as LDL is involved in the inflammation response. The lowered inflammation response may cause less plaque buildup when the endothelium is being repaired and thereby reduce the risk for CHD. On the other hand, the lowered immune response might be a disadvantage in fighting bacterial and viral infections.

Statins also lower the inflammation response but at what price? Muscle damage, depression, etc. can result

Even if one were on an MHG diet, one might not be able to achieve these low levels of LDL if the diet were combined with the modern way of life sans parasites or statins.

I am really interested in total mortality rates rather than CHD mortality rates. These cholesterol and statin people like to focus on CHD mortality rates. I would rather die of a heart attack than cancer.

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