Demystifying Cholesterol

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Today’s 30-Second Summary

If you don’t have time to read the whole email today, here are some key takeaways:

• There are several layers to understanding cholesterol, and it’s easy to start getting confused after the basics.

  • Today’s main feature demystifies that; you’ll understand not only HDL and LDL, but also VLDL, as well as LpA and Apo-B, the physical processes involved as well as genetic risk factors, and what to usefully do about all of the above.

• Bone broth is packed with nutrients, but the options tend to be “make it yourself” (which may involve eating much more meat than is healthy, to get the bones), or… Yeah, that’s pretty much it.

  • Today’s sponsor Brodo will ship many kinds of bone broth to your door! Their bone broths are made from scratch, with no additives, concentrates, or shortcuts.

• Today’s featured recipe is for cannellini protein gratin, for a healthier take on a classic!

Read on to learn more about these things, or click here to visit our archive

A Word To The Wise

Watch and Learn

5 Ways to Beat Menopausal Weight Gain!

As it turns out, “common” does not mean “inevitable”:

Prefer text? The above video will take you to a 10almonds page with a text-overview, as well as the video!

Wildcard Wednesday

All About Cholesterol

When it comes to cholesterol, the most common lay understanding (especially under a certain age) is “it’s bad”.

A more informed view (and more common after a certain age) is “LDL cholesterol is bad; HDL cholesterol is good”.

A more nuanced view is “LDL cholesterol is established as significantly associated with (and almost certainly a causal factor of) atherosclerotic cardiovascular disease and related mortality in men; in women it is less strongly associated and may or may not be a causal factor”

You can read more about that here:

Statins: His & Hers? ← we highly recommend reading this, especially if you are a woman and/or considering/taking statins. To be clear, we’re not saying “don’t take statins!”, because they might be the right medical choice for you and we’re not your doctors. But we are saying: here’s something to at least know about and consider.

Beyond HDL & LDL

There is also VLDL cholesterol, which as you might have guessed, stands for “very low-density lipoprotein”. It has a high, unhealthy triglyceride content, and it increases atherosclerotic plaque. In other words, it hardens your arteries more quickly.

The term “hardening the arteries” is an insufficient descriptor of what’s happening though, because while yes it is hardening the arteries, it’s also narrowing them. Because minerals and detritus passing through in the blood (the latter sounds bad, but there is supposed to be detritus passing through in the blood; it’s got to get out of the body somehow, and it’s off to get filtered and excreted) get stuck in the cholesterol (which itself is a waxy substance, by the way) and before you know it, those minerals and other things have become a solid part of the interior of your artery wall, like a little plastering team came and slapped plaster on the inside of the walls, then when it hardened, slapped more plaster on, and so on. Macrophages (normally the body’s best interior clean-up team) can’t eat things much bigger than themselves, so that means they can’t tackle the build-up of plaque.

Impact on the heart

Narrower less flexible arteries means very poor circulation, which means that organs can start having problems, which obviously includes your heart itself as it is not only having to do a harder job to keep the blood circulating through the narrower blood vessels, but also, it is not immune to also being starved of oxygen and nutrients along with the rest of the body when the circulation isn’t good enough. It’s a catch 22.

What if LDL is low and someone is getting heart disease anyway?

That’s often a case of apolipoprotein B, and unlike lipoprotein A, which is bound to LDL so usually* isn’t a problem if LDL is in “safe” ranges, Apo-B can more often cause problems even when LDL is low. Neither of these are tested for in most standard cholesterol tests by the way, so you might have to ask for them.

*Some people, around 1 in 20 people, have hereditary extra risk factors for this.

What to do about it?

Well, get those lipids tests! Including asking for the LpA and Apo-B tests, especially if you have a history of heart disease in your family, or otherwise know you have a genetic risk factor.

With or without extra genetic risks, it’s good to get lipids tests done annually from 40 onwards (earlier, if you have extra risk factors).

See also: Understanding your cholesterol numbers

Wondering whether you have an increased genetic risk or not?

Genetic Testing: Health Benefits & Methods ← we think this is worth doing; it’s a “one-off test tells many useful things”. Usually done from a saliva sample, but some companies arrange a blood draw instead. Cost is usually quite affordable; do shop around, though.

Additionally, talk to your pharmacist to check whether any of your meds have contraindications or interactions you should be aware of in this regard. Pharmacists usually know contraindications/interactions stuff better than doctors, and/but unlike doctors, they don’t have social pressure on them to know everything, which means that if they’re not sure, instead of just guessing and reassuring you in a confident voice, they’ll actually check.

Lastly, shocking nobody, all the usual lifestyle medicine advice applies here, especially get plenty of moderate exercise and eat a good diet, preferably mostly if not entirely plant-based, and go easy on the saturated fat.

Note: while a vegan diet contains zero dietary cholesterol (because plants don’t make it), vegans can still get unhealthy blood lipid levels, because we are animals and—like most animals—our body is perfectly capable of making its own cholesterol (indeed, we do need some cholesterol to function), and it can make its own in the wrong balance, if for example we go too heavy on certain kinds of (yes, even some plant-based) saturated fat.

Read more: Can Saturated Fats Be Healthy? ← see for example how palm oil and coconut oil are both plant-based, and both high in saturated fat, but palm oil’s is heart-unhealthy on balance, while coconut oil’s is heart-healthy on balance (in moderation).

Want to know more about your personal risk?

Try the American College of Cardiology’s ASCVD risk estimator (it’s free) 😎

Take care!

Our Sponsors Make This Publication Possible

The best broth, now with NEW flavors. Created by James Beard award-winning chef Marco Canora. No preservatives, concentrates, or short cuts. Shop here.

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This Or That?

Vote on Which is Healthier

Yesterday we asked you to choose between oranges and lemons—we picked the oranges (click here to read about why), as did 54% of you!

Now for today’s choice:

Click on whichever you think is better for you!

Recipes Worth Sharing

Cannellini Protein Gratin

There’s more protein than you might think, in this healthier take on a classic:

Click below for our full recipe, and learn its secrets:

One-Minute Book Review

Power Vegan Meals: High-Protein Plant-Based Recipes for a Stronger, Healthier You – by Maya Sozer

This book has inspired some of the recipes we’ve shared recently—we’ve invariably tweaked and in our opinion improved them, but the recipes are great as written too.

The recipes, of which there are 75, are all vegan, gluten-free, high protein, and high fiber. Some reviewers on Amazon have complained that the recipes are high-calorie, and they often are, but those calories are mostly from healthy fats, so we don’t think it’s a bad thing. Still, if you’re doing a strict calorie-controlled diet, this is probably not the one for you.

Another thing the recipes are is tasty without being unduly complicated, as well as being mostly free from obscure ingredients. This latter is a good thing not because obscure ingredients are inherently bad, but rather that it can be frustrating to read a recipe and find its star ingredient is a cup of perambulatory periannath that must be harvested from the west-facing slopes of Ithilien during a full moon, no substitutions.

The style and format is simple and clear with minimal overture, one recipe per double-page; picture on one side, recipe on the other; perfect for a kitchen reading-stand.

Bottom line: these recipes are for the most part very consistent with what we share here, and we recommend them, unless you’re looking for low-calorie options.

Click here to check out Power Vegan Meals, and power-up your vegan meals!

Penny For Your Thoughts?

Wishing you a wonderful Wednesday full of wellness,

The 10almonds Team