All posts by smartersig

HDL Efflux

Higher HDL levels are generally associated with decreased risk for heart disease because of its role in transporting cholesterol away from macrophages within the artery wall back to the liver for recycling. However it seems that the amount of HDL is not the primary driver of improvement in this area. HDL Efflux appears to be the main driver and refers to how good HDL is at ‘sucking’ up cholesterol. You can have HDL C levels above 2.0 mmol but if your Efflux is low the hoover just ain’t picking up the bits. This may explain why very high levels of HDL dont seem to be better than just above average levels.

How can we improve HDL Efflux, well it seems the good old Med’ diet comes to fore once again along with a moderate (glass with a meal) amount of red wine. More controversially for me and other more expert in the field is the advocacy of extra virgin olive oil. Nothing seems to split the heart health community like this ingredient. Some research swear by it whilst others clearly show it creates endothelial disfunction. My feelings are that when confronted with split opinions like this I prefer to leave it out of my diet especially when its non essential. I will stick with a med’ based diet and a handful of nuts each day.

LCHF and Cholesterol Profile

You may have come across the talks by Ivor Cummings on cholesterol. Ivor is a chemical engineer by trade and after receiving some personal alarming blood readings he decided to drill down into the meaning of what his readings actually meant. Applying his engineering rigour to the problem he quickly discovered that the emperor was wearing no clothes or the doctor in this case. I came across another engineer Dave Feldman, that has also gone into even more detail to extrapolate the real relationships between what we eat and how it effects cholesterol and associated lipid readings. It is a real beauty of a presentation which if you are new to the subject might take more than one listening. You can also easily replicate the experiment yourself, in fact he is appealing for people to try it and log their results on his blog.

Sugar and Oil

The two things that have exploded in consumption along side the widespread development of heart disease are the consumption of these two food sources. We were all advised by the diet guideline experts in the 70’s to switch from saturated fat to vegetable oils and veg’ oil even today is common place in UK kitchens. Restaurants not only use it but to save money only change it when its oxidized to exhaustion. This study, until recently kept hidden, makes you wonder how we ever got on this path. It also suggests that what we eat is a bigger threat than cholesterol per se.

A Must Watch

During the Vietnam war the US realized that they could create more damage to the opposition forces by inventing a bullet that would maim opposing soldiers rather than kill them. Why was this and what does it have to do with the staggering increase in Autism we have experience in just one generation. Mercola talks this interview up in the introduction but he is not hyping, its simply a must watch, pass it on to others

Selenium Vit C and Dr Porter

I recently had an exchange with Dr Mark Porter. I took exception to his recent article in the Times which more or less trashed the idea of people using Vitamin supp’s to combat disease. I challenged this firstly on the Vit C front (but also on others) and I am glad I did because you always learn something when you talk to people with opposing views. It gets you off your backside to investigate. Dr Porter kindly replied and sent me a link to a meta analysis that essentially showed that no Vitamin was beneficial in a statistically significant way in relation to heart disease amongst other diseases, when supplemented, although selenium came pretty close. A meta analysis by the way is when a researcher takes all the research papers done on a topic and then pools together all the results to form one overall result. It also enables them to filter out badly designed studies. I decided to dig a little deeper into the meta analysis and in particular the heart disease and Vit C category. I am convinced that Vit C can impact Lp(a) and hence CVD. When I looked closely at the 7 studies forming the meta analysis on Vit C I noticed that they had weighted them. Now I forget the exact method of weighting but it sure wasn’t based on dosage because one study was weighted with 78%!! of the overall value of the analysis and this study only used 250mg of Vit C per day on people with heart disease. This study came out as pretty much neutral on Vit C and given that the overall score OR was 0.99 for Vit C (the more below 1 the better) you can see that this one study had massive or should I say 78% effect on the overall outcome of the meta analysis. As I said to Dr Porter, Linus Pauling would have laughed at 250mg even for healthy subjects. Incidently getting back to Selenium there is an interesting Swedish study that showed in subjects over 60 that a combo of Selenium and Coq10 slashed risk by 50%.

Footnote – Just discovered that Dr Porter has recently adopted a similar attitude to Carb’s as myself

Japanese Total to HDL ratio

Over the last three decades total cholesterol has risen in japan but Heart disease has dropped. The linked report suggests that the reason for this may be their higher than average HDL and healthy Total to HDL ratios. The other interesting aspect of the report was the differences logged in Dietary intake between the Japanese, American and Australian subjects monitored. The main differences were

Fats significantly lower in Japanese
Fish and sea food much higher in Japanese
Eggs much higher in Japanese
Tofu and related products much higher in Japanese
Mushrooms much higher in Japanese
Fruits higher in Japanese


were pretty much the same across the three countries.


Magnesium and CVD

With soil being continually depleted of magnesium we are getting less and less in our food supply. The research list connecting Magnesium deficiency and heart disease is long. here are just a few

Lazy solution – Eat a handful of almonds and or pumpkin seeds with your breakfast

Myeloperoxidase Test

I have mentioned before that pretty much all my ratios and markers are good eg Total to HDL ratio, ApoB/Apo A ratio, Lp(a), Homocysteine. One marker that I have found on two occasions to be too high is Lp-PLA2. This is a marker that is believed to signify unstable plaque within the arteries. So far I have not managed to lower it. I have however just got the results back for another test that looks at oxidative stress and a predictor of unstable plaque, namely Myeloperoxidase. I was kind of expecting this one might come back on the high side given that it appears to be a close cousin of Lp-PLA2 or at least testing a similar condition. I was very happy therefore to find that my reading was super low. Greater than 5 IU/ml is considered positive but I came back at less than 0.01.

The test was done with Blue Horizon and cost around £95. I will retest Lp_PLA2 later in the year and if it has not diminished perhaps try a spell on aspirin and see if that puts a dent in it or perhaps take solace from this test, surely they can’t both be right.

Good explanation here of the difference between Myeloperoxidase and Lp-PLA2

It would appear that the obvious approach to lowering Lp-PLA2 would be Niacin (Vit B3)

Iodine Deficiency

A couple of posts ago I mentioned Leptin resistance and its role in causing problems for getting LDL particles out of the blood stream when they have done their job of delivering cholesterol to cells. Iodine deficiency is one of the possible reasons for this problem with the Thyroid and Leptin resistance and it ties in nicely with a at least a couple of population studies.

The Japanese have very low rates of heart disease, even lower before they started to discover westernised food. We are usually quick to credit this to their consumption of fish but it may not only be this sole source of sea food. The Japanese consume large quantities of sea weed using it as an additive in stews and soups such as Miso soup. Sea weed is a very rich source of Iodine and perhaps their super rich Iodine content diet is a big factor in their heart protection.

Backing this up was a studies in the 1950’s in Finland which had very contrasting levels of heart disease were although both east and west were poor the east was far unhealthier when it came to cardio vascular health. This prompted an in depth study of the dietary habits of east and west and the most significant disparity was that the west consumed significantly more Iodine which may be why they have less heart disease than the East. More on this at the link below.

Needless to say I now take a 200mcg Iodine supplement daily via a Sea Kelp tablet and so far my stomach seems to tolerate these quiet well with no irritation.

Lipid Levels on Hospitalization for CAD

Given the current guidelines for getting your LDL as low as possible to reduce heart disease risk you would naturally expect that when patients are wheeled into hospitals for Coronary Heart Disease ailments such as heart attacks or angina attacks, their LDL levels would on average be rather high. If we looked at a thousand such patients what percentage would you expect to have LDL levels above 2.6 mmol ?. Maybe 60% or perhaps 70%, surely it has got to be above 50% given that we are advised to get our levels below 3 mmol. Well according to a large study done on nearly 137,000 hospitalisations in America for CAD symptoms it was only 50.4%. Taking only those who were admitted for the first time for CAD symptoms did not really change the underlying message that much.

The other interesting thing is that when you talk to cholesterol advocates about the stats showing that low cholesterol means greater all risk of dying ie from all causes, they tend to shout reverse causation. What they mean by this is that disease, including heart attacks, tend to lower cholesterol levels thus giving a false low impression of cholesterol levels on death. Would this really skew the results shown in the study to the degree shown ? and if it did move the spread you would still have less people in the higher ranges of LDL than the lower ranges maintaining the underlying message in the study that more people are coming in with ‘low’ LDL than ‘high’. The real culprits within the data seem to be low HDL and high Trig’s.