Flashback Friday: Optimal Cholesterol Level
10
September

By Adem Lewis / in , , , , , , , /


“Optimal Cholesterol Level” No matter where we live, how old we are, or what we look like, health researchers have discovered that 90% of having a first heart attack can be attributed to nine modifiable risk
factors. The nine factors that are threatening our
lives include smoking, too much bad cholesterol, high blood pressure, diabetes, abdominal obesity, stress, a lack of daily fruit and veggie consumption, as well as a lack of daily exercise. But Dr. William Clifford Roberts, Executive Director of the Baylor Heart and Vascular Institute and long-time Editor in Chief of the American Journal of Cardiology, is convinced that atherosclerosis has a single cause, namely the cholesterol, and that the other so-called atherosclerotic risk factors are only contributory at most. In other words we could be stressed, overweight, smoking, diabetic couch potatoes, but if our cholesterol is low enough there may just not be enough cholesterol in our blood stream to infiltrate our artery walls and trigger the disease. Thus the only absolute prerequisite for a fatal or nonfatal atherosclerotic event like a heart attack is an elevated cholesterol level. It was not appreciated until recently that the average blood cholesterol level in the United States, the so-called “normal” level, was actually abnormal, accelerating the blockages in our arteries and putting a large fraction of the normal population at risk. It’s our number one killer. That’s cited as one of the reasons the cholesterol controversy lasted for so long: an unwillingness to accept the notion that a very large fraction of our population actually has an unhealthily high cholesterol
level. Normal cholesterol levels may be terminal cholesterol levels. The optimal cholesterol level, the optimal “bad cholesterol” LDL level is 50 to 70. Accumulating data from multiple lines of evidence consistently demonstrate that that’s where a physiologically normal LDL level would be. That appears to be the threshold above which atherosclerosis and heart attacks develop. That’s what we start out at birth with, that’s what fellow primates have, that’s the level seen in populations free of the heart disease epidemic. But we can also look at all the big randomized, controlled cholesterol lowering trials. This is graphing the progression of atherosclerosis versus LDL cholesterol: more cholesterol, more atherosclerosis. But if you draw a line down through the points, you can estimate that the LDL level at which there is zero progression is down around a LDL cholesterol of 70. You can do the same with the studies preventing heart attacks in the first place. Zero coronary heart disease events might be reached down around 55, and those who’ve already had a heart attack and are trying to prevent a second one might need to push their LDL levels even lower. Atherosclerosis is endemic in our population in part because the average person’s LDL level cholesterol is up around 130, approximately twice the normal physiologic level. The reason the federal government doesn’t recommend everyone shoot for at least even just under 100 is that despite the lower risk accompanying more optimal cholesterol levels, the intensity of clinical intervention required to achieve such levels for everyone in the
population would financially overload the health care
system. Drug usage would rise enormously. But they’re just assuming drugs are the only way to get our LDL that low. But those eating really plant-based diets may hit the optimal cholesterol target without even trying, just naturally nailing under 70. The reason given by the federal government for not advocating what the science shows
is best was that it might frustrate the public, who would have difficulty maintaining a lower level. But maybe the public’s greatest frustration would come from not being informed of the optimal diet for health.


54 thoughts on “Flashback Friday: Optimal Cholesterol Level

  1. Since going whole foods plant-based my systolic blood pressure has gone from 140+ to 107. Does this mean that I have reversed much of the atherosclerosis?

  2. >cites the image from Facts and principles learned at the 39th Annual Williamsburg Conference on Heart Disease

    the absolute madlad

  3. What if we’re talking about an older person, who’s trying to go (mostly) plant based who has been using Lipitor for almost 20yrs? Should they continue using it?

  4. Thanks for putting the truth out there where it needs to be, again.
    I’m sure that most of the people who are smart enough to be here appreciate your efforts to save lives.

  5. I wish more people would consider looking more into this, as soon as they hear vegan/plant based often they dismiss it as insanity while depending on pills to band-aid their high blood pressure. Unaware or in denial that you can just avoid it by eating a simple far cheaper whole food diet and avoiding foods high in saturated fat or at the least limiting them.

  6. Switched to WFPB last year. I’ve hit bumps here and there like vegan cheese or non-dairy ice cream being the worst more recently, but here is where I’m at now. I go by the thought that you try to eat right and if you mess up there is always tomorrow.

    BMI: 22.2
    LDL: 50
    HDL: 41
    Triglycerides: 46
    Total Cholesterol: 104
    BP: 110/68

  7. What about instances where you eat a primarily whole food plant based diet and still have a high ldl?

  8. But what is the optimal diet? We are told different things all the time, its the sugar or its the saturated fat or its animal protein or salt. Vegans that can’t thrive on a plant based diet, somethings missing! I’ll just carry on with my unhealthy diet until somebody can say absolutely what is the best diet

  9. I was at 109 on plant based for a long time…added About 2 grams of a plant sterols supplement…down to 73 …in my late 60's

  10. Thought I was so cool with a cholesterol of 137 and LDL of 82. Dr Greger you just broke my bubble. Thanks, 81 year old vegan.

  11. I find it a fascinating human thought study that many are those who still believe dietary cholesterol does not affect heart attack and/or stroke risks. I believe the average person prefers to turn a blind eye towards solid evidence that demonstrates the dangers of their preferred lifestyle choices, thus when reports surfaced years ago saying dietary cholesterol intake was not a risk factor, people jumped on that news with glee, as it supported their bad habits. We all make our own choices, and we all experience the consequences of those choices. We cannot save the world, but your presentations Michael go a long way towards saving those who are questioning and open minded. Thanks!
    Steve

  12. The government has no economic interest in keeping everyone alive as long as possible. Social Security would go bankrupt unless they increased the retirement age to 80. Better off taking care of yourself and avoid junk food, even if it is free (like government subsidized full of saturated fat cheese they give to poor people).

  13. The WFPB is not the total answer. I have been on a strict WFPB for one and a half years and also on heart medication. The statins were causing me muscle pain so under the doctors suggestion that I stop the 20mg of statin for 10 days and check the blood work again. To my horror my LDL went from 65.7 to 116 after 10 days with me still doing a strict WFPB. It may be hereditary as the doctor said or I am thinking it may be something else. I listened to a Rich Roll pod cast where he interviews Dr. Dean Ornish, the doctor said in one university study on rabbits that the ones that had no social contact had a 60% greater plaque build up than the ones who had social interaction. Living alone may not be good for the heart and may cause plaque buildup from this study, for rabbits and people.

  14. My LDL is 84 and was flagged as "Low" on my recent lab result. Been Plant based for 16 months now. No meds.

  15. I wish he had pulled in some more recent studies. 2004 is a long time ago … (though that doesnt mean the info is bad or wrong, of course)

  16. For me, getting cholesterol and LDL down to 140/70 respectively had side effects: better health, lower blood pressure, less inflammation, better sleep, and lower HBA1C. Of course it took some attention to diet and exercise, but it really wasn't a major sacrifice. I recall my GP saying saying years ago, "Wow. I have patients on statins that can't do that well." I told him maybe he should prescribe oatmeal instead.

  17. Hi Dr I would like you to address some papers like "LDL-C does not cause cardiovascular disease: a comprehensive review of the current literature" in your next video thanks

  18. “Cholesterol May be the main factor in heart attack risk”. Not true! People on statins do NOT have a significantly lowered heart attack risk. It is clearly more than just cholesterol. Eating a plant-based diet also reduces inflammation in most people and that is a huge factor as well.

  19. You might want to see the interview from “What I’ve Learned” with Dave Feldman on why we may need LDL. It’s groundbreaking and Uber informative on the mechanistic pathways of why it’s given such a bad wrap! Those who want to delve into LDL more take a look at that interview and you will be blown away! Thanks and god bless!

  20. I kept getting getting palpitations/arrhythmia and the cardiologist was like…wow, your cholesterol is great, don't know what's wrong.

  21. The reason these people their cholesterol is high is because cholesterol is the building block for every single part of your body.
    It is a causal agent to have high cholesterol of something indicative of bodily damage, not a causal agent of an actual heart attack risk.
    Lowering cholesterol when necessary for healing is the actual danger, or having a lack thereof.
    Hydrogenated vegetable oils for example, cause plaque and cholesterol is needed to fix this damage/holes created in the arteries and gets blamed for you developping a heart attack instead of praised for relieving you from artery breaks.
    Again, it is a result from initial damage, cholesterol doesn't cause plaque in every tribe that ever existed which mainly ate animal products/fats, for example eskimos, having nearly no rates of atherosclerosis (increasing the more westernized their diet is).
    Why?
    They don't eat the very damaging foods in the first place that make cholesterol necessary to fix these arteries from within.

  22. Ever notice that there is no simple English word for "eat healthy". There are plenty of words for "pig out". A word where somebody says "I'm going to *#@!" and other people think "he must be going to eat a salad or something".

  23. Have you seen the off the rails McDougall interview?? You're headed there you bald prick. Stop spreading misinformation. There is still time to save yourself. Swallow your pride and go back to eating meat. Dumbass 🙂

  24. Who can answer this: If meat is so bad, how come cavemen did not have barely any cancer or heart disease???? The fact that they didn't have those diseased proves that SOME meat is okay.

  25. I like Dr Gregors informational snippets here on YouTube, but this is old and outdated incorrect information. You should look into Ivor Cummins reseach on behalf of Irish Heart Disease Awarenes, about the real risk factors. Which I can simplify quickly as: too high blood insulin, combined with too low HDL and too high triglyceride count. LDL is not bad by itself, so the count doesn't matter. It is how much of your LDL that is OXIDISED which really matters. Please do more research on this matter Dr Gregor. And to find out you real heart disease risk, get a CAC (Coronary Artery Calcium) score test.

  26. So…what about us poor schlumps who have been consistently been eating a WFPBD (with no added oil) and STILL cannot achieve optimal LDL levels?

  27. My LDL was 99 when I had my heart attack. I lowered it to 68 using WFPB diet and exercise. I've added Repatha and my LDL is 16.

  28. Maybe the public's greatest frustration would come from not being informed of the optimum diet for health

    Yes

    That is true

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