Heart risk tests at low cost, part 2....

Today's Post: Monday, 11-7-2011

(This is part 2 to the post on Friday, 11-4-2011)

Here, I repeat the background part and summarize part one. Next I continue this two part post.

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!

WITHOUT GETTING A TEST AT ALL,

1. If you eat the packaged snacks, packaged desserts, and commercial baked goods and other foods that contain hydrogenated oils and trans fats on most days, your particle count will be high. So will your plaque build up in your blood vessels.

If you never do and you eat mostly health OK protein foods and oils, nonstarchy vegetables and some whole fruit, your particle size will be low.

And, if you test as high by testing as having low HDL and high triglycerides, changing completely in this one area will lower your amount of dangerous small particles of LDL.

2. If you never exercise at all, your particle count will be high – or much higher than it could have been.

Getting vigorous exercise several times each week on a sustained basis, directly lowers your particle count!

So, if you have already been doing that for 3 to 7 days a week for many months or years, your particle count will be low.

That means the answers to those two questions both can tell you if you have the extra risk or likely don’t have it. They also explain how to fix it if your particle count is high.

We went into more detail on these two factors last time.

Here are some more.

3. Not eating packaged snacks, packaged desserts, and commercial baked goods and other foods OR drinking either regular soft drinks or diet soft drinks, will keep your particle sized down for another reason.

These foods almost all contain one or more of these: High fructose corn syrup, artificial sweeteners, sugar, &/or refined grains.

Tests have found that eating and drinking things that include these ingredients causes you to have blood sugar spikes which can lead to type 2 diabetes. The resulting too high blood sugar makes ALL your LDL harmful. And, the rebound hunger and excess insulin and added calories tend to make you fat.

But that’s far from all!

Your HDL goes down and your triglycerides go up a LOT! If you read part one, you know that means that your dangerous small particle LDL also has gone up a lot too.



So if you eat these things and drink soft drinks many times each week, your small particle LDL count will be high. And, you are on the way to becoming fat if you aren’t already. Plus you are giving yourself heart disease too!

That means eating packaged snacks, packaged desserts, and commercial baked goods and other foods several times a week or a day tends give you heart disease in two ways!

Both your test results and your heart attack risk will improve a lot if you completely stop doing this all the time and multiple times a week.

And, it’s easier to get that done if you stop entirely. Homemade desserts a few times a year that use whole grains and real sugar and no hydrogenated oils can be OK. But if lowering your heart risk is important to you dropping the rest of it completely, is important!

Soft drinks, both regular and diet, also increase your heart attack risk in more than one way. They too increase your amount of small particle LDL. And, they also are even more effective at fattening you and increasing your level of blood sugar.

If they push your blood sugar high enough, you get type 2 diabetes which then makes ALL your LDL harmful. (The excess sugars that stick onto your LDL make it into a carrier of bits of superglue that tear your artery walls and get stuck in your capillaries, often blocking or destroying them.)

4. Exposure to tobacco smoke also causes you to have higher amounts of small particle LDL.

Your HDL goes down. What’s left is less effective at clearing your arteries. So your effective HDL goes down even more than the test shows! And, direct tests show the amount of plaque build up in your blood vessels goes up!

This is true for EVERY exposure to tobacco smoke too. It doesn’t matter if you smoked yourself or someone next to you did.

That means every exposure to tobacco smoke harms you by increasing your heart disease risk. Each time it’s small; but over months or years or decades, the effect is HUGE.

This means that, unlike cancer, which some smokers and people exposed to second smoke, do escape, the risk from tobacco smoke for heart disease risk is completely certain.


Every time it happens you are harmed. So if you smoke or are around a smoker every day, your particle count will be high. And your real risk of heart disease will be high.

So in that case you don’t need the advanced test for LDL particle size and its cost. You already know that you are in trouble; and getting rid of your exposure to tobacco smoke is the cure.

(If you once have any build up of your heart attack risk, tobacco smoke ALSO triggers heart attacks you might otherwise have escaped we recently found out!)

5. Using oils high in omega 6 instead of extra virgin olive oil lowers your HDL.

That means it increases your amount of small particle LDL too.

Doing that combined with NOT getting enough omega 3 oils also increases your inflammation which tends to cause heart disease, looks to cause many cancers, and recent research found it also causes osteoarthritis.

That means that soy, corn, and safflower oil should be almost completely avoided. (Soy and corn oil are cheap. So they get put into a huge variety of foods. So to avoid them, always read labels.)

Unfortunately, it also means you should minimize your intake of canola oil.

Instead use extra virgin olive oil.

And for the plant based omega 3 oil, eat raw walnuts instead if you aren’t allergic. Eating raw, unsalted nuts causes your HDL to go UP. Canola oil has the plant based omega 3 oil; but too much omega 6. Walnuts have the plant based omega 3 oil; but somehow avoid driving your HDL levels down.

A. To conclude, if you get tested with a lipid panel, you don’t need the direct test of LDL particle size.

If your HDL level is high and your triglycerides are low, over 60 on your HDL and your triglycerides are under 100, your small particle LDL is low. So is your risk of heart disease.

Unfortunately, if your HDL is low, under 40 -- or worse under 30 -- and your triglycerides are high, over 150, over 200, or far worse over 300, your heart risk is very high.

B. If you eat a lot of eating packaged snacks, packaged desserts, and commercial baked goods every week; you drink several soft drinks or diet soft drinks every week; you never read labels to avoid hydrogenated oils, high fructose corn syrup, refined grains, trans fat, and excess sugar; you never exercise; and/or you are often exposed to tobacco smoke, you don’t need any test at all!

Your level of small particle LDL and heart disease risk are both extremely high.

If you avoid all of these; and you do regular exercise every week; and eat only real foods instead and drink things like water, club soda, tea, green tea, and coffee; and you avoid tobacco smoke, you could get a lipid panel just to be sure.

But the chances are excellent your level of small particle LDL and heart disease risk are both quite low.

As a bonus, you will also be far less fat. You will be less likely to get osteoarthritis. And, you will escape many cancers. Then too, the exercise also slows aging and grows new brain cells.

That means if you are a doctor and test people with lipid panels, you don’t need the extra cost direct test of the amounts of small particle LDL.

Look at the HDL to triglyceride level ratio. And ask in detail about these health habits.

That tells you both what the risk is and what to tell patients to do to lower it.

And, if you are the person who wants to know your heart disease risk and keep it low, you don’t need the extra cost direct test of the amounts of small particle LDL either!

Do your best to put all these factors into the good category. Unless you are already too late, that will protect you.

(One caveat. If you have not yet been exercising, read the system to follow to get into it GRADUALLY as far as intensity and amount per time. It’s in last Friday’s post of 11-4. That way is MUCH safer and more likely to get you into doing it from now on!)

Heart risk tests at low cost....

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!

Here’s why.

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.

Why these 5 are myths about heart disease....

Today's post: Tuesday, 12-23-2008

I got an email that in part had an ad for their information on combating heart disease.

And, I realized that my answers to these would make a good blog post for today.

“Myth #1 -- Heart disease and heart attacks are an
inevitable part of aging.

Myth #2 -- Cholesterol is the main cause of heart disease
and heart attacks.

Myth #3 -- Blood pressure drugs help you avoid heart
problems and live longer.

Myth #4 -- Aggressive, "type A" behavior increases your
risk of a heart attack.

Myth #5 -- Low-fat, low cholesterol diets are good for you
and your heart.”

Here are my answers.:

“Myth #1 -- Heart disease and heart attacks are an
inevitable part of aging.”

Aging does help cause heart disease. But I believe that this is in part because doing the things that cause it and/or doing without the things that prevent it tends to cause damage that builds up over time. So, the longer you live like that the more time the damage builds up.

But, you can make heart disease much less likely &/or take 5 times as long to show up if you:

avoid tobacco smoke and bad air pollution;
exercise regularly every week usually including strength training and interval cardio;
you avoid the foods like soft drinks, refined grain foods, and packaged snacks and desserts; you avoid excessive amounts of fatty meats and full fat dairy foods;
eat sugar or foods containing it very infrequently and then in moderation;
you eat a variety of vegetables every day – including plenty of onions;
you eat lean protein foods and some plant protein foods;
you get health OK oils from nuts, avocados, or extra virgin olive oil and no other oils with very little butter and no margarine;
you eat wild caught fish and take omega 3 supplements;
you avoid all transfats and high fructose corn syrup;
& you take the supplements such as niacin and choline that increase HDL & supplements like beta sitosterol, other kinds of sterols, & niacin that prevent high LDL levels & antioxidant supplements such as vitamin C, natural vitamin E, alpha lipoic acid, & CoQ10;
& it likely also helps to:
take a good multivitamin and mineral supplement, a B-complex supplement, & extra B12, and about 50 mg a day of B6 in addition; an additional 2,000 iu of vitamin D a day, & an extra 800 to 1600 of folic acid a day.

In addition, drinking up to a drink a day of alcohol, particularly red wine -- for women or -- up to two drinks a day for men, also seems to increase HDL and lower heart attack risk. (Unfortunately drinking more than this seems to INCREASE heart disease risk; and it tends to cause high blood pressure & sometimes causes car and other accidents with property damage or injury or worse. So this is one to be very careful of.)

Doing this set of things helps keep your LDL cholesterol at low levels; it helps keep both your HDL and LDL from oxidation; & because it lowers your triglycerides and increases your HDL, it does a great job in lowering the small particle LDL that DIRECTLY CAUSES cardiovascular and heart disease; and doing this set of things also lowers inflammation as measured by the HS CRP tests. It also tends to prevent high blood sugar levels.

If you do these things well and long enough, you will have much less risk of heart disease at first and then a risk that approaches zero.

Your heart attack and heart disease risk will still tend to go up a bit as you get older; but you’ll likely live long enough to die of something else first!

You do NOT need statin drugs to do this. And once you do this set of things long enough, your HDL, LDL, triglycerides, and CRP readings will be far better than those of the people who don’t do these things but who DO take statin drugs. You won’t get those drug side effects; and your heart attack risk will be lower.

And, you get extra benefits too. You’ll be less fat; your aging will slow down; you will be more sexually capable; and you will be dramatically less likely to get any kind of cancer.

“Myth #2 -- Cholesterol is the main cause of heart disease
and heart attacks.”

Higher levels of total cholesterol tend to go with more risk; & levels of 180 or less tend to go with less risk.

BUT low HDL plus high triglycerides and high LDL is MUCH more dangerous and correlated with heart diseases and heart attacks. So is high CRP inflammation. And, there is also some evidence that low levels of antioxidants tends to give you oxidized LDL and HDL which is also dangerous.

Someone with all those things in bad shape but total cholesterol in the 180 to 240 range is at far more risk than someone with good readings on those things with cholesterol of 240 to 260.

And, the kind of cholesterol that it IS desirable to lower if it’s high is LDL cholesterol while you want to INCREASE HDL cholesterol.

220 cholesterol with 100 HDL and 100 LDL is extremely safe while the same 220 with 30 HDL and 170 LDL is quite dangerous.

So, the total cholesterol is much less important than once believed. That said, as your total cholesterol gets to be above 240, your LDL tends to go above 130, which IS risky.

But your lifestyle, HDL and triglyceride readings, and your HS CRP readings may show it’s still moderately safe OR horribly dangerous depending on what you do and what heredity you have.

And, high levels of blood sugar as measured by fasting glucose and HBA1C also measure cardiovascular risk because bad readings on those multiply the effects of anything that’s in bad shape. In addition, such high levels of blood sugar are indicative and diagnostic of NOT following the lifestyle above, so your other heart disease risk measures are more likely to be in bad shape too.

So, since those are the measures of the things that cause heart disease they should be what you and your doctor measure and follow much MORE than total cholesterol.

Aim for HDL over at least 36 and well over 50 if you can achieve it.

Aim for LDL of at least as low as 129 and about 100 if you can achieve it.

Aim for triglycerides of 149 or well under 99 if you can achieve it.

Aim for fasting glucose of 99 or less or always 89 or less if you can achieve it.

& Aim for HBA1c of 5.9 or less or always 5.7 or less if you can achieve it.

And, do the things in # 1 above. That will help you achieve all these readings and give you added heart and health protection too.

“Myth #3 -- Blood pressure drugs help you avoid heart
problems and live longer.’

High blood pressure even in the 130 over 85 range is bad for your heart and health with higher blood pressure even worse. THAT is true.

And, blood pressure of over 160 over 100 is bad enough that drugs are likely necessary to protect your heart and health.

BUT, their track record for use at lower blood pressures is NOT as good. The side effects tend to cause more health problems than they solve at lower levels of high blood pressure. Readings like 175 over 108 DO justify taking the blood pressure drugs. Readings like 148 over 88 tend not to. They do, however, suggest that you need to do more to upgrade your lifestyle in a health protective direction right away.

And, many of these blood pressure drugs tend to cause quality of life problems too.

Beta blockers seem to lower blood pressure without much heart attack protection and can cause congestive heart failure if taken too long in larger doses I’ve read.

Diuretics tend to delete many nutrients that are heart protective, necessary for good health, and even help keep your blood pressure low otherwise!

We’re preparing to launch an eBook on how to lower high blood pressure without drugs.

But, the summary is that if you follow all of the lifestyle in # 1. above, the chances of you having blood pressure of over 160 over 100 where you need the drugs approaches zero.

“Myth #4 -- Aggressive, "type A" behavior increases your
risk of a heart attack.”

Redford Williams, MD did the studies and wrote the books on the right answer to this one.

Hurrying and trying to do a lot tend to be safe in and of themselves if done intelligently and for good cause. (They were part of the original measure of type A.) And, a lot of high achievers do such things. But if you do them with some flexibility and without anger, they are heart safe.

However, hostility, anger, and lack of compassion and emotional warmth ARE truly deadly. They often produce traffic accidents, fights, spousal abuse, divorces, dysfunctional families, getting fired from jobs, AND they produce a MASSIVELY increased risk of heart disease and death.

So that’s the part of the original type A behavior that DOES produce heart disease.

Think of legitimate reasons to like and forgive people and turn off the reverse kind of thinking. And treat other people with kindness and courtesy even if they don’t currently deserve it. (Reserve rage for people who are actually trying to kill you. Someone who cuts you off in traffic may have put you at risk; but that’s NOT the same thing usually.)

Your heart will last longer and so will you!

“Myth #5 -- Low-fat, low cholesterol diets are good for you
and your heart.”

This has NOT proved true.

Such diets tend NOT to have a good effect on heart disease risk because:

Foods such as extra virgin olive oil, omega 3 oils from wild caught fish; and from nuts and/or avocados help to boost HDL levels and provide health benefits. Plus they help keep you satisfied on LESS calories if eaten in moderation and have abundant other health benefits. So, NOT eating them to be lowfat tends to backfire.

Some animal protein foods if eaten lean and from naturally fed or wild caught animals do have cholesterol; but eating them provides high quality protein and does the best job in keeping you from being hungry. So, again they help keep you satisfied on LESS calories. So, NOT eating them to avoid cholesterol tends to
backfire. (Avoiding excessive saturated fat intake and avoiding eating farmed fish or grain fed meats and too much fat from those kinds of animals DOES make sense, however.)

But the big reason is this one: Lowfat, low animal fat diets tend to be high in sugars, refined grain foods, and often are even way too high in whole grain foods.

Those foods tend to spike your blood sugar, make you fat, and drive your triglycerides to high levels.

So they make you fat and INCREASE your risk of heart disease in several ways. And, if you combine that kind of diet with not exercising, your heart disease risk goes up expentially.