On the bright side, I also got reassurance that outside the lipid panel, everything else (sugar, kidney and liver function, PSA, etc.) seems normal.
Other than laziness and procrastination, a huge part of me was dreading being told I need a prostate exam and colonoscopy, but fortunately I don’t need either for at least 3 more years.
IIUC, they no longer believe that lipid cholesterol levels are directly correlated with intake of dietary cholesterol. See, for example: https://www.hsph.harvard.edu/nutritionsource/what-should-you...
> The biggest influence on blood cholesterol level is the mix of fats and carbohydrates in your diet—not the amount of cholesterol you eat from food.
> Although it remains important to limit the amount of cholesterol you eat, especially if you have diabetes, for most people dietary cholesterol is not as problematic as once believed.
I would recommend committing to getting a full blood panel (specific to your sex, male or female) at least every 6 months, especially if you are going to be making significant changes to your diet. This was a game-changer for me. I started working with a practice that does health optimization and blood work/labs and has doctors who know how to interpret the results and give recommendations based on them. For me, I had several biomarkers significantly improve by consuming more red meat. I hadn't been trying to avoid red meat consciously, just somehow over the years I started consuming a lot more chicken and turkey and really wasn't having enough beef, etc.
https://www.iarc.who.int/wp-content/uploads/2018/07/pr240_E....
https://worldanimalfoundation.org/advocate/farm-animals/para....
> In the case of red meat, the classification is based on limited evidence from epidemiological studies showing positive associations between eating red meat and developing colorectal cancer as well as strong mechanistic evidence.
> Limited evidence means that a positive association has been observed between exposure to the agent and cancer but that other explanations for the observations (technically termed chance, bias, or confounding) could not be ruled out.
[0] https://www.iarc.who.int/wp-content/uploads/2018/11/Monograp...
I think my initial intake was $200-300 to get the full blood panel and have a follow-up with a patient care coordinator as well as an appointment with the doctor (who is incredible). At the time I ordered the blood panel, I wasn't even planning on having a long-term relationship with them, but after seeing some stuff on my blood panel that I wanted to work on and having them come up with a plan, speaking to the docs regularly, I've just gotten so much value out of it. The whole thing made me feel like "wow, this is what healthcare should feel like."
Sadly, it's all out of pocket, but it's the last thing on the list of things I would complain about having to spend money on.
For some people, full bloods every 6 months might be overkill, I guess it just depends on what you have going on (not that I had major issues, but definitely things to address and others to optimize). But without a full panel, you're just flying blind. Sometimes, I get the panel and nothing has moved at all and there's nothing to do. Other times there are things I can easily address and the more panels I have, the more of a personal health profile I have to work with.
Edit: FWIW, I’m not planning on abandoning red meat and eggs, but striving for no more than 4 eggs a week and 1, or max 2, servings of red meat. I would rather enjoy beef and lamb for the rest of my life and avoid ever having to eat only egg whites.
However risk factors are individual so take everyones commentary as educational but apply on what's relevant look at your on individual use case.
You might however get a health checkup from occupational healthcare sometimes!
Just putting this a note here for non-american readers so they don't get confused.
I'm surprised other countries with free government healthcare don't do that. I would assume it's more economical to detect signs of serious issues early.
So would I (Germany), yet it’s only one blood test every 3 years from the age of 35 on.
Do you go to the dentist for regular cleaning & exams or only go if you have a toothache?
Annual checkups seem so critical to overall health outcomes- it's far better to catch cancer at stage 1 than stage 4, or to address blood pressure before having a stroke or heart attack rather than after, I'd have thought they'd be strongly prioritized and incentivized my government-controlled healthcare systems.
Primary Care Physician for anyone else wondering (equivalent to a GP in England I think)
https://academic.oup.com/ajcn/advance-article-abstract/doi/1...
- Exercise can help lower cholesterol slightly. But try to have a reasonable balance between cardio and resistance training. Too much cardio risks having some muscles actually weaken if you maintain a large calorie deficit.
- Diet-wise, you want to go for sustainable weight management, so no extreme or gimmicky diets. Avoid Atkins and Keto (unless a professional tells you you actually need to avoid carbs), extreme fasting, etc.
- 3 moderate meals a day are better than 2 or 1 large feast(s) because they keep your metabolism going for most of the day. Your body can adapt to feast/famine and can go into ketosis, but these are survival mechanisms and harmful, even counterproductive, if you keep your body in these modes for long periods of time (you might even gain weight in feast/famine mode because when you do eat, your body converts as much sugar into fat as it possibly can, in order to prepare reserves for the next “famine”).
- Some fasting is good for spirituality and to teach self-control, but it should not be a permanent state (I plan to fast Mondays and Thursdays as much as possible, leading up to Ramadan in about 50 days). Fasting every single day for the rest of your life is not realistic and probably does more harm than good.
- Eat raw nuts (raw almonds have been observed to lower total cholesterol, lower LDL, and raise the HDL/LDL ratio) as much as you can within your calorie allowance. In general, more plant-based protein and fats, and less animal-based is very helpful (but watch out for high saturated fat from coconuts, and too much soy can mess up men’s hormones). Edit: the soy evidence is not conclusive - see comments below.
- Keep your calorie allowance reasonable and sustainable, and try to eat a good variety of fruits, vegetables, grains, beans, legume, meats, etc. with moderation in everything.
Rest of the advice seems good. Lower fat in diet (specifically dairy fats), increase exercise, higher fiber, lower sugar, more nuts/avocados/salmon.
Treat the disease and not the numbers - so look at all your risk factors for atherosclerosis.
What evidence is there for this statement? What is considered "fasting?" I can't see how a 12-hour feeding window would be problematic. I could understand some people might develop "disordered eating" if their approach is unsustainable, but "more harm than good" isn't true for those that can do it.
One reason for fasting is that it improves insulin sensitivity.
From: https://www.health.harvard.edu/blog/intermittent-fasting-sur...
"Based on this, researchers from the University of Alabama conducted a study with a small group of obese men with prediabetes. They compared a form of intermittent fasting called "early time-restricted feeding," where all meals were fit into an early eight-hour period of the day (7 am to 3 pm), or spread out over 12 hours (between 7 am and 7 pm). Both groups maintained their weight (did not gain or lose) but after five weeks, the eight-hours group had dramatically lower insulin levels and significantly improved insulin sensitivity, as well as significantly lower blood pressure. The best part? The eight-hours group also had significantly decreased appetite. They weren’t starving."
I can only speak to my case, so YMMV. Through a liver blood panel, I learned that I had high bilirubin, SHBG, and GGH - which indicate compromised gallbladder and liver function. One doctor suggested I have my gallbladder removed.
Instead, through research on pubmed and examine.com, I was pointed to TUDCA - a bile salt that helps clear cholesterol and biliary sludge. After two months of supplementation, I've seen a severe reduction in intestinal discomfort - and I suspect a follow-up blood test will show a reduction in my high liver panel and LDL.
If you have abnormally high LDL for your body type and lifestyle, I would encourage you to get a liver panel and look into TUDCA.
