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Medical Forum / General / Nutrition / September 2004

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How quickly do fasting HDL,, LDL change?

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Adam Becker Sr - 12 Sep 2004 04:41 GMT
How quickly does someone's fasting values for HDL and LDL change?   My
doctor takes a blood draw to assess my lipids.  Does the number from
that draw mostly represent the last 2 days? a week? the last three
months?

Another way of asking - if I've been eating one diet with no change,
and abruptly change to a different diet, my HDL/LDL will gradually
change til it reaches a new steady state.  How long does it take
before 2/3 of that change is complete?  What's the time constant
(roughly) of the exponential decay to the new value?

Adam Becker
Robert - 12 Sep 2004 05:28 GMT
> How quickly does someone's fasting values for HDL and LDL change?   My
> doctor takes a blood draw to assess my lipids.  Does the number from
[quoted text clipped - 8 lines]
>
> Adam Becker

I would give it roughly a few months. They are generally very stable and
vary little over months. Triglycerides are somewhat more volatile. It is
very difficult to get major changes with diet alone. Life style changes are
often difficult to sustain for long periods of time as any weight loss
program shows. If you have diseases such as diabetes or hypertension then
levels need to be reduced to much lower levels making diet by itself almost
impossible to obtain that type of reduction alone.
Usually when lipid panels are done and they are high the doctor will try
diet alone to see how well you can do with it before prescribing meds. That
is the time to really clamp down on diet.
It really is unproductive to blame it all on diet or lack of exercise.
Phase two involves getting put on meds or rationalizing your high
cholesterol and ignoring it based on the book "myths of cholesterol".
Most people with CAD will have high lipid problems but not all people with
high lipids will have heart attacks so there are people taking meds who do
not need to. The only problem is that they don't know how to separate them
out yet.
cde - 12 Sep 2004 05:53 GMT
> I would give it roughly a few months. They are generally very stable and
> vary little over months. Triglycerides are somewhat more volatile. It is
> very difficult to get major changes with diet alone.

It depends on the intervention. Minimal interventions yield
minimal or very slow responses. In the Jenkins very high
fiber diet intervention, maximum lipid reductions occured in
one week-- PMID: 11288049. This was a very primitive diet
with enormous quantities of soluble fruit and vegetable fibers.

> Life style changes are
> often difficult to sustain for long periods of time as any weight loss
> program shows.

Yes. Only the excceptionally motivated sustain results.
Robert - 12 Sep 2004 20:11 GMT
> > I would give it roughly a few months. They are generally very stable and
> > vary little over months. Triglycerides are somewhat more volatile. It is
[quoted text clipped - 5 lines]
> one week-- PMID: 11288049. This was a very primitive diet
> with enormous quantities of soluble fruit and vegetable fibers.

The study was for only two weeks which is why several months is more a
reflection of lifestyle changes rather than a week of being good.
It was a malicious question intended to undermine the intent of the test.
People want to cheat on themselves and I am a believer on surprise testing
such as drug screening.

> > Life style changes are
> > often difficult to sustain for long periods of time as any weight loss
> > program shows.
>
> Yes. Only the excceptionally motivated sustain results.
Mirek Fidler - 12 Sep 2004 10:23 GMT
> It really is unproductive to blame it all on diet or lack of exercise.
> Phase two involves getting put on meds or rationalizing your high
[quoted text clipped - 3 lines]
> not need to. The only problem is that they don't know how to separate them
> out yet.

Wow, you surprised me once again :) I have not expected as reasonable
statements from you :)

Only one "correction" - it is not true that "most" people with CAD have
high TC - correlation is just that those with very low TC (less than
160) have half of CAD than people with TC > 240. Going from TC to
TC/HDL, prediction power of lipid panel improves, but there is still a
lot of people with "good" lipid panel and CAD. Interesting is that even
for those with good TC/HDL and low LDL statins work. That is why LDL
target guidelines are still going down. I just wonder when they stop
prescribing statins based on LDL targets... (then all that stuff would
make sense to me).

Mirek
Robert - 12 Sep 2004 20:03 GMT
> > It really is unproductive to blame it all on diet or lack of exercise.
> > Phase two involves getting put on meds or rationalizing your high
[quoted text clipped - 9 lines]
> Wow, you surprised me once again :) I have not expected as reasonable
> statements from you :)

????

> Only one "correction" - it is not true that "most" people with CAD have
> high TC -

I wasn't only speaking of TC but all lipid sub fractions Lp(a), small LDL,
and everything else not reflected in the TC, the apparent normal TC people
with heart attacks.

correlation is just that those with very low TC (less than
> 160) have half of CAD than people with TC > 240. Going from TC to
> TC/HDL, prediction power of lipid panel improves, but there is still a
[quoted text clipped - 5 lines]
>
> Mirek
 
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