"What is the Ideal White Blood Cell Count?"
A higher white blood cell count may be an important predictor
for cardiovascular disease incidence and mortality,
cancer mortality, all-cause mortality, decline in lung function.
So, an important predictor for heart attacks, strokes,
declining lung function, dying from cancer, and premature death in general.
No surprise is the number of white blood cells we have
circulating in our bloodstream is a marker of systemic inflammation.
Our body produces more white blood cells day to day
in response to inflammatory insults.
We’ve known about this link between higher white counts and heart attacks
since the 70s, when we found that higher heart attack risk
was associated with higher white blood cell counts,
just like it was with higher cholesterol levels and higher blood pressures:
something that’s been found in nearly every study done since then.
Decades of studies involving hundreds of thousands of patients
showing dramatically higher mortality rates in those with higher white counts.
But why?
Why does white blood cell count predict mortality?
Maybe because it’s a marker of inflammation and oxidation in our body.
In fact, maybe it’s even a biomarker for how fast we’re aging.
But it may be more than just an indicator of inflammation,
but an active player, contributing directly to disease
via a variety of mechanisms,
including the actual obstruction of blood flow.
The average diameter of white blood cells is like 7 1/2 micrometers,
whereas our tiniest vessels are only like 5 micrometers wide.
So, the white blood cell has to squish down
into like a sausage shape to squeeze through.
And, when there’s inflammation present,
these cells can get sticky.
Here’s more images of a white blood cell plugging up a vessel
as it exits a small artery trying to squeeze into a capillary,
slowing down or even momentarily stopping blood flow.
And, if it gets stuck there, it can end up releasing all
its internal weaponry normally reserved for microbial invaders
and damage our blood vessels.
This may be why in the days leading up to a stroke or heart attack,
you may find a spike in the white cell count.
Whether white count is just a marker of inflammation
or an active participant, it’s better to be on the low side.
How can we reduce the level of inflammation in our body?
Staying away from even second-hand smoke
can help drop your white count about half of a point.
Those that exercise also appear to have an advantage,
but you don’t know if it’s cause and effect
unless you put it to the test.
Two months of Zumba classes— just one or two hours a week—
led to about a point and a half drop in white count.
In fact, maybe that’s one of the reasons exercise is so protective.
But is that just because they lost weight?
Fitness and fatness appear to both play a role.
More than half, 51.5%, of obese persons with low fitness
have white counts above 6.6,
but those who are more fit or who have less fat
are less likely to be up that high.
Of course, that could just be because exercisers
and leaner individuals are eating healthier,
eating less inflammatory diets.
How do we know excess body fat itself increases inflammation,
increases the white count?
You’d have to find some way to get people to lose weight
without changing their diet or exercise.
How’s that possible?
Liposuction.
If you suck about a quart of fat out of people,
you can significantly drop their white count by about a point.
So, maybe this should get us to rethink the so-called
normal reference range for white blood cell count;
maybe we should revise it downward,
like we’ve done for cholesterol and triglycerides.
Up until now, we’ve just based normal values on people
that might be harboring significant background inflammatory disease.
If you just restrict it to those with normal C-reactive protein,
another indicator of inflammation,
then instead of normal being 4.5 to 10,
maybe we should instead revise it closer to 3 to 9.
OK, but where did the healthiest populations fall,
those not suffering from the ravages of chronic inflammatory diseases,
like heart disease and common cancers?
Populations eating diets centered around whole plant foods
average about 5,
whereas in the U.S., at the time, it was closer to 7 or 8.
The reason we know it’s not genetic
is if you take those living on traditional rural African diets,
who are down at around 4 or 5, and move them to Britain,
they end up closer to 6, 7, or 8.
Ironically, the researchers thought this was a good thing,
referring to the lower white counts on the uncivilized diet
as neutropenic, meaning too few white blood cells.
They noted that during an infection or pregnancy,
where you really do need more white cells,
the white count came right up to wherever necessary;
so, the bone marrow of those eating traditional plant-based diets
had the capacity to create as many white cells as needed
but “suffers from understimulation.”
They’re just not smoking enough cigarettes
and eating as many inflammatory foods.
Similar findings were reported in Western plant eaters,
with an apparent stepwise drop in white count
as diets got more and more plant based,
but maybe there are non-dietary factors,
such as lower smoking rates, in those eating healthier?
What you need are interventional trials to put it to the test.
Just 21 days of removing meat, eggs, dairy, alcohol, and junk
affected a significant drop in white count,
even in people who started out down at 5.7.
Those that started out even higher,
patients with rheumatoid arthritis starting up around 7–
no change in the control group that didn’t change their diet,
but a one and a half point drop within a month
on whole food plant based nutrition:
that’s a 20% drop.
That’s more than the drop in inflammation one might get
quitting a 28-year pack-a-day smoking habit.
The most extraordinary drop I’ve seen
was in a study of 35 asthmatics.
After 4 months of a whole food plant based diet,
their average white count dropped nearly 60%,
from up around 12 down to 5, though there was no control group,
and not enough patients to achieve statistical significance.
If white blood cell count is such a clear predictor of mortality,
so inexpensive, and reliable, and available,
why isn’t it used more often for diagnosis and prognosis?
Maybe it’s a little too inexpensive.
The industry seems more interested in fancy new risk factors
you can bill for.