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dstick | 2 years ago

> "total cholesterol is a terrible health metric on its own"

Yeah you've got HDL, LDL and Triglycerides, LDL should be low (L) and HDL high (H) - that's my mental shortcut for it. Triglycerides should be low as well, but not too low. That's the one that has a specific bandwidth. A high HDL and low LDL could have the same TC as a low HDL and high LDL.

I have no idea why anyone worth their salt would look at the total cholesterol value without a breakdown of the _types_ of cholesterol. It's a meaningless number.

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cheald|2 years ago

My understanding is that for triglycerides, lower is basically better, outside of "extremely low as an indicator for disease". For example, https://academic.oup.com/clinchem/article/60/5/737/5621637 . Can you point me at reading on the lower bounds for them?

(I ask because my labs routinely show very low triglycerides - generally in the 65-70mg/dL range - which I've been told is a very good sign for heart health.)

sph|2 years ago

Triglycerides are a much better indicator of health. Cholesterol is not, and it comes in different sizes as well, all with their own significance.

In short, triglycerides should always be low, whatever your diet. Cholesterol depends on your diet: if lower carb, it is necessarily high, and is positively correlated with longevity. In higher carb, it means you are eating a lot of sugar w/ fat, which is terrible for your arteries and mitochondria, causing long term atherosclerosis and systemic metabolic syndrome.

It's all in the videos I've linked.

Jarmsy|2 years ago

Then even within LDL there are different types. One of which there seems to be a strong consensus is bad, and the other (the 'big fluffy' pattern A) there is some debate about whether it's good or bad. Is that right?

nlitened|2 years ago

I was also sad to know that when you do a “normal” cholesterol blood test, your LDL is not measured, but calculated according to formula:

LDL = TC – (HDL + TG/5)

It’s not even a real measured amount, it’s a very rough middle-school-level formula, but people freak out about fluctuations of this number.

FrustratedMonky|2 years ago

Exactly. Sorry, only skimmed, but this was in Korea correct?

My recollection is that Koreans have a pretty healthy diet of meat and vegetables. It might be that they have higher HDL? So total is high, but they generally have a better ratio.

dfawcus|2 years ago

"the _types_ of cholesterol."

Cholesterol is a specific molecule, there is only one type, just like there is only one type of ethanol. (Modulo any isomers)

The "differences" (LDL, HDL) are essentially different types of "bucket" used by the body to transport the molecules through the bloodstream.