Lawrence Tam says, "My LDL-C is consistently high.
It was 3.9 millimoles per liter three days ago, total cholesterol was 6.2 millimoles
per liter, trigs 1.4, HDL 1.7.
How do I avoid having a large amount of oxidized LDL particles in my blood?"
Lawrence, I'm not treating anyone here.
I'm not a doctor, so I'm going to answer your question more generally.
The general version of this question is, if your cholesterol is high, how do you avoid
having a large burden of oxidized LDL?
The first answer to that is get your cholesterol normal.
Now, I'm not saying that high cholesterol is the cause of heart disease.
It's not.
Oxidized LDL is.
But the number one cause of high cholesterol is not clearing it from the blood.
And the number one cause of LDL oxidizing is not clearing it from the blood.
So, I would never skip over the question of what can I do to get the cholesterol in the
normal range first.
I think the boundaries of what the normal range is are a little exaggerated.
So, if you look at traditional cultures that eat a traditional diet, live a traditional
lifestyle, they're not modernized, and they don't have heart disease, you do see cholesterol
levels that go higher than ours.
So, for a man, maybe going up to 220 in total cholesterol is pretty normal.
These are milligrams per deciliter.
I'm sorry, but my brain cannot compute millimoles per liter off the top of my head in cholesterol
right now, so I apologize for that.
But for a man, up to 220.
For a woman in her 40s and 50s, up to 250 maybe.
I'm not looking at those to change if lifestyle and diet are ancestral and if everything else
about the data make it look like that person's very healthy, especially if direct data of
carotid IMT, intima-media thickness, or coronary calcium score, which are direct measures of
the actual burden of plaque development, if those are normal and all the metabolic markers
are normal, and the lifestyle and diet is normal, I wouldn't be thinking about fixing
the cholesterol at that point.
But for someone whose cholesterol is like 300, you don't even see that in Tokelau, where
the saturated fat content and the traditional cholesterol levels are the highest ever recorded
in an ancestral population in the entire globe, you don't see that.
So, when they're that high, you have to fix it as your first line of defense.
And that means improving LDL receptor activity, usually.
I did a short Chris Masterjohn Lite and a long-form one on this.
If you Google "Masterjohn high cholesterol," you'll probably find it.
But the big things to look at are body composition, inflammation, fiber intake, so higher fiber
is better generally, and thyroid.
Those are the really big things to look at.
And then, yeah, so definitely look at those things first.
But the question is, let's say you haven't brought the cholesterol down, what do you
do to protect it?
Well, that largely comes down to a few things.
Imagine, the lipoprotein leaves the liver, some as LDL, some as VLDL, both of which wind
up being LDL at some point.
It leaves the liver packaged with antioxidants.
Those include vitamin E, they include coenzyme Q10.
Those are probably the two big ones.
But they include others.
And so many antioxidants are important there.
But then when it's circulating in the blood, it gets behind the arterial wall, and that's
the main site of oxidation.
So, the question is, how oxidizing of an environment is that?
Also, it gets stuck behind the arterial wall, so the question is, how sticky of an environment
it is?
Because if it gets stuck in the oxidizing environment of behind the arterial wall, then
that's the very powerful regulator of whether it's going to oxidize.
So, the stickiness.
Probably the dietary approach that best regulates the stickiness is manganese.
Manganese is found mostly in plant foods, and vegetarians have the highest intakes.
People with plant-rich diets that also eat animal foods are in the middle.
And people who eat a lot of animal foods and no plants are at the bottom.
So, eat a lot of plant foods is one thing.
There are some animal experiments specifically with blueberries as a source of manganese,
showing in animals that it makes the arterial wall less sticky, so there's that.
And then the oxidizing environment, a big part of that is inflammation because if you
have systemic inflammation, then you make the—inflammation causes oxidative stress.
You should have been looking at inflammation for high cholesterol in the first place.
Assume you have that covered.
And then antioxidants in general.
The antioxidant system is so—as a CMJ Masterpass holder, you have access to the premium features
on the antioxidant system, so check out that if you want to really dive down this rabbit
hole, but the antioxidant system is—or if you want the short answer, the Testing Nutritional
Status: The Ultimate Cheat Sheet has a whole section on antioxidant-related nutrients.
But it's a gigantic question.
You're looking at protein, you're looking at selenium, you're looking at zinc, copper,
iron, manganese, you're looking at vitamin C, vitamin E, you're looking at protein, glycine,
you're looking at so many things in there, so you really got to figure out what the weakest
link is in that person and focus on that weakest link.
There may be many.