Eat Better Episode 8 - Doc's Opinion

In Episode 8 of the Eat Better podcast, Chloe and I talk with Dr. Axel Sigurðsson of Doc’s Opinion (www.docsopinion.com) about cholesterol, diet, statins, and heart disease. We cover: -What useful information you can get from a basic cholesterol test -Why focusing on “good” and “bad” cholesterol doesn’t really predict heart disease -What dietary and lifestyle modifications you should make if you have heart disease -The pros and cons of taking statins Notes Early on we discuss the triglyceride:HDL ratio, which you can get by diving your triglyceride level by your HDL level. Both of these can be found on the basic cholesterol test from your GP. Using UK units (mmol/L), a ratio below 0.87 is considered ideal. Click HERE (http://www.docsopinion.com/2014/07/17/triglyceride-hdl-ratio/) for an article where Axel discusses those numbers. We also discuss the pitfalls of using LDL (aka “bad”) cholesterol as a marker of heart disease, even though this is what doctors often use to decide if somebody should be on a statin. Axel has written an article about this HERE (http://www.docsopinion.com/2013/12/15/10-pitfalls-of-using-ldl-cholesterol-to-assess-risk/). Later on we discuss ways to reduce heart disease risk through diet and lifestyle. Because of the need to regulate insulin to minimise heart disease risk, Axel recommends: -A diet rich in fresh vegetables and fish -A diet low in (processed) carbohydrates -Focusing on stress modification We also discuss some of the pitfalls of statins. The evidence behind using them to prevent heart attacks (primary prevention) is pretty thin, and the downsides probably outweigh any potential benefits. HERE (http://www.ncbi.nlm.nih.gov/pubmed/25655639) is a fascinating recent paper which details why statins may (this is largely still theoretical) actually increase the risk of heart disease by interfering with mitochondrial function and vitamin K2 metabolism. There is also increasing evidence to suggest that, particularly as age increases, higher cholesterol levels reduce overall mortality, and are particularly important for things like brain function and reducing dementia risk. The Norwegian HUNT 2 study that I mention can be found HERE (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3303886/). Though this is just an observational study, they found no increase in risk of death or heart disease with increasing cholesterol levels, and in women especially, those with the highest cholesterol had the lowest risk of death. Head to www.drragnar.com for more information. Disclaimer: Podcasts do not replace medical advice from your own doctor, and any lifestyle or medication changes should be discussed with them.