Friday, October 15, 2010

Am I About to Drop Dead of a Heart Attack?

This morning, I attended a health fair at work and got my blood work checked for the first time since going paleo. (Unfortunately, the visiting clinic didn't offer the full panoply of tests – just the basics.)

I fully expected some big changes in my cholesterol numbers. After all, over the past six months or so, I’ve increased my saturated fat consumption by approximately a bazillion percent. (Which, by the way, isn’t hard to achieve, given that I used to abstain from eating anything with saturated fat – including meat – before converting to a paleo diet. Heck, less than a year ago, I was ordering meals from a macrobiotic society every Monday night. And now, I'm subsisting on what most would consider a high-fat diet.)

But when today's results came in, my total cholesterol count still gave me a jolt: 261 mg/dL. That's almost 100 mg/dL higher than it was last year.

A health advisor at the fair frowned at the number, and then handed me this handy chart:

“Your total cholesterol level is alarming," she began. "You may want to talk to your doctor about statins. Right now, you're clearly at risk for heart disease.”

Uh, oh. That doesn't sound too good.

More after the jump...

But then I remembered: Total cholesterol doesn't mean anything.

The health advisor then turned to my HDL cholesterol results. (As you probably know, HDL is the “good” cholesterol – or, more precisely, the high-density lipoproteins that act as carriers for cholesterol.)

“Well, this is...interesting. Your HDL is 100 mg/dL, which is good.”

No, lady -- it’s frickin' awesome!

The almighty chart agrees: “The higher the HDL level … the lower the risk of heart attack.” And my number is in the triple digits. Booyah!

I think Dr. Oz is a bit of a quack, but even he confirms that an HDL count of 100 mg/dL is a marker of low risk of heart disease:
HDL (healthy) cholesterol: The ideal number is greater than 40 mg/dl. Like basketball players, the higher the better. In fact, if your HDL is over 100 mg/dl, the chances of having a heart attack or stroke related to lack of blood flow are smaller than the chance that a Hollywood celeb could walk through Boise unnoticed. (Except in some extremely rare cases where HDL malfunctions inside the body, there has never been a heart attack or lack of blood flow stroke reported in the entire medical literature with a functional HDL over 100.)
We then moved on to discuss the Total Cholesterol / HDL Ratio. The chart helpfully pointed out that “the lower the risk ratio, the lower the risk for developing heart disease. Conversely, the higher the risk ration, the higher the risk for developing heart disease.”

My ratio – 2.6 – looks pretty darn good, right? According to the chart, my risk of heart disease is super-low.

(Incidentally, they also measured my LDL (the “bad” cholesterol) at 97 mg/dL, which is squarely in the “optimal” category. And my HDL / LDL ratio is 1.0 – significantly higher than the "ideal" of 0.4 or above.)

But the health advisor wasn’t finished. “Your ratios are excellent,” she said, “but I’m still worried about your total cholesterol. It really shouldn’t be that high. Your doctor can help you get on medication to lower it. In the meantime, you need to watch what you eat, and cut down on saturated fat. Eating less meat will help.” She smiled and patted my hand.

So which is it? Am I at risk of keeling over any second now, or am I pretty much risk-free from developing heart disease?

The health advisor couldn't answer the question, but she was nice and well-meaning. I didn’t have the heart to inform her that:
So I told her I was seriously considering becoming a vegan.