The start of my journey to get my cholesterol under control was the initial blood test I had in September 1998. My preparation for the test was atrocious. You can read about it in the “The Cholesterol Diet” section above.
Here are the results of the test.
The results came back with a total cholesterol of 261. At that time a value less than 200 was thought to be healthy. At 261 my total blood cholesterol was dangerously high. Similarly my triglycerides and LDL were far above their normal ranges.
The only bright spot was my HDL, which was 60. HDL stands for high density lipids and is the good cholesterol. LDL stands for low density lipids, or the bad cholesterol.
An important ratio is total cholesterol to HDL. The lower this is the better. In my case it was 4.4, well in the healthy range.
My doctor wanted to put me on drugs. I didn’t want to do this unless it was absolutely necessary because drugs have side effects, and I had read that there were other ways to solve the problem. So I started to do the research. I read some books and I searched all over the Internet.
The book I found the most useful was Fat Free, Flavor Full by Dr. Gabe Mirkin. His thesis was that most people could get their cholesterol under control by going on a diet that had 10% fat, 10% protein, and 80% complex carbohydrates. “Fruits, vegetables, whole grains, and beans” he said over and over. This was consistent with other material I read.
I stuck to this regimen for a year, then I went back for the retest in September, 1999. The results were handed to me in an envelope. I waited until I got to my car to read them. It was a good job that I did. When I saw the results I whooped and hollered (fortunately all the windows were shut). Here are the results:
My total cholesterol had fallen to 199, just inside the normal range. I had gone from 261 to 199, achieving a 24% reduction in my cholesterol without taking any drugs!
My LDL was in the normal range also. I had gone from 158 to 109, a 31% reduction.
That there wasn’t much change in the triglycerides was a disappointment.
The other disappointment was that my HDL had fallen. Still, that had to be expected. If I went on a diet that reduced blood fats, then I should expect that all blood fats would be reduced, even the healthy ones. However, the news on HDL was not all negative. The total cholesterol to HDL ratio was now 4.1, an improvement over the previous year’s value of 4.4
After 1999 I didn’t have a fasting blood test until March 2003. Here are the results.
The results were discouraging. My total cholesterol was 228, up from 199. My LDL was 122, up from 109. But the bad news was that my triglycerides were as high as they’d ever been—267, up from 208.
As of 2003 I had been having a party for 46 years. I started drinking beer seriously when I was 18 (the legal drinking age in England) and added wine a couple of decades later. I knew that as I got older I would have to cut down. Indeed, I had been measuring what I drank for some time. In the early 1990s I drank two light beers and 21 oz. of 11.5% wine each night. A few years later I changed to one light beer and 17 oz. of 13% wine.
One of the effects of alcohol is to raise the triglycerides. Another is to raise the liver enzymes. In previous tests only the triglycerides were a problem. But in the March 2003 blood test, the liver enzymes were no longer in the normal range.
I knew it was time to bite the bullet and cut back on the alcohol. As of March 29, 2003, I started drinking two 5 oz. glasses of wine each night and I switched to non-alcoholic beer.
The Portfolio Diet
After my 1999 test I continued researching cholesterol. Early in 2003 I read an article on research into the “portfolio” diet. PMID 16522904, also appendix 4.
Paraphrasing the researchers, they said, “OK, there have been studies showing that bran flakes lower cholesterol and soy lowers cholesterol and beans lower cholesterol and so on. Suppose we put all of these ingredients into one diet and see what happens.” The results were startling and spectacular. They achieved a 35% reduction in cholesterol.
So for a month prior to my June 2003 test I went on the Portfolio Diet. This wasn’t too far from my normal diet. I emphasized okra and eggplant a little more. I added a teaspoon of psyllium (Metamucil) in water to my lunch and my late night snack. I also added an ounce of almonds to my late night snack.
In a three month period, I reduced my alcohol intake and adopted the Portfolio Diet. The results were spectacular:
My total cholesterol dropped to 174, the lowest since I have been keeping records. My triglycerides were 129, the first time they were ever in the normal range. My LDL was a low 96. My spgt/alt liver enzyme was much improved, having gone from 61 to 43, but it was still above the normal range.
An interesting result from this test was my HDL level. I had reduced my total cholesterol to a low level, but my HDL had not gone down. It was reasonably high at 52. My total cholesterol to HDL ratio was a healthy 3.3.
The question here is this: my total cholesterol dropped to its lowest level since I have been keeping records, so why didn’t the HDL drop proportionately? My suspicion is that the mechanism of the Portfolio Diet is to sop up LDL cholesterol while not changing the rest of the fat producing mechanism very much. However, this is just the musings of a layman and needs to be proved or disproved by qualified researchers.
To quantify the magnitude of the change in my HDL levels, it’s useful to compare the ratio of my HDL to total cholesterol in each of my blood tests:
Prior to going on the Portfolio Diet the ratio was stable. In the last test it was much improved.
When I started on my quest to bring my cholesterol under control, the medical community focused on LDL, the bad cholesterol. Since then, LDL has been shown to be a poor predictor of future cardiac disease. About half the people who have cardiac events have normal LDL. Nowadays, the focus is on HDL and triglycerides.
Niacin and some other drugs raise HDL. However, studies have shown that this does not improve mortality. The other way to raise HDL modestly is by endurance exercise.
Mt. Washington is one of my favorite places. Mary Ann and I hiked up it every year. When I found out that people over 70 entered the Mt. Washington Road Race (MWRR) and walked up the mountain, I decided to enter.
More people want to participate than can be accommodated so there is a lottery. Just before the lottery results were announced in March 2009, I found I had cancer. I had won a place in the race and I was able to use it to secure a place in 2010. I spent six months training on a treadmill and it was grueling.
In April 2010, two months before the MWRR, I had a follow-up visit with my oncologist. I asked him to add a lipid profile to the blood test. Here are the results:
In 1998 doctors focused on total cholesterol and LDL. Since then it has been found that triglycerides (TG) and HDL are better predictors of cardiovascular disease. An especially important number is the TG to HDL ratio. A value under 2 is considered healthy, 4 is high risk, and 6 is very high risk. Here is a review of my TG/HDL ratio over the years.
|9/1998||261||158||215||60||3.58||Initial test, before SWLL|
|9/1999||199||109||208||48||4.33||After one year on new diet|
|3/2003||228||122||267||53||5.04||Cut alcohol after this test|
|6/2003||174||96||129||52||2.48||Added Portfolio Diet|
|4/2007||180||99||117||58||2.02||Living the Portfolio Diet|
|4/2010||199||123||80||60||1.33||Train for the MWRR|
|9/2011||200||124||117||53||2.21||No race training in 2011|
|8/2012||185||109||102||56||1.82||Two months after 2012 race|
|4/2015||186||100||114||63||1.81||Most recent lipid profile|
Here are the conclusions I draw from this table.
At the start I was in a precarious situation. Both my total cholesterol and my TG/HDL ratio were dangerously high.
After being on Dr. Gabe Mirkins high complex carbohydrate, low fat diet for a year, my total cholesterol dramatically improved. The downside was that my TG/HDL ratio, which was already dangerously high, got worse. It was during this year that I lost 11 lb. even though I wasn’t dieting.
The March 2003 test showed that my triglycerides were at an all time high. After doing the research I concluded that I needed to reduce my alcohol consumption.
For the June 2003 test I was already on the low alcohol regimen and I changed my diet to include components of the Porfolio Diet. The results were an all time low for total cholesterol and a much improved TG/HDL ratio.
In 2010 I was training for the MWRR. Once a week I would spend more than two hours on a treadmill. Two thirds of the time was at an elevation of 12%, speed 2.7 mph and the rest of the time at 15% elevation, speed 2.4 mph. I did not hold onto the treadmill. The blood test done while I was on this training regimen showed that intense exercise can lower triglycerides and raise HDL.
Finally, the table shows the contributions to the metabolic syndrome score.
My HDL level has always been above 40, so 0 metabolic syndrome points for HDL.
Since 2006 my triglycerides level has been below 150, so 0 metabolic syndrome points for triglycerides.