[HN Gopher] Three main saturated fats raise your cholesterol
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Three main saturated fats raise your cholesterol
Author : brandonb
Score : 24 points
Date : 2026-04-03 18:54 UTC (4 hours ago)
(HTM) web link (www.empirical.health)
(TXT) w3m dump (www.empirical.health)
| profsummergig wrote:
| Is it firmly established that high LDL is bad for longevity? I've
| read conflicting information on the issue.
| nrds wrote:
| The far more important question is whether it's bad for the
| stock price of a few pharma companies.
| ctoa wrote:
| Not longevity in the general sense, but in the cardiac disease
| and mortality sense, yes, it's pretty firmly established. It's
| also an area that attracts a lot of quackery, is somewhat hard
| to study (for the normal reasons that a lot of nutrition stuff
| is hard to study).
|
| And it's an area where there is legitimate nuance: we only
| measure LDL-C partly because it's easy and available, there are
| other ways of looking at blood lipid particles we could be
| measuring that might be more effective (like ApoB), it
| interacts with other things like insulin, inflammation,
| metabolic health, blood pressure.
|
| But all that said, the case for high LDL being bad for heart
| attacks and strokes is very strong.
|
| To me the strongest short list of evidence is simply:
|
| - People who have familial hypercholesterolemia, from different
| genetic causes/pathways, all have massively increased heart
| disease at young ages.
|
| - People who naturally have a disabled PCSK9 gene have
| extremely low LDL levels, where PCSK9 is directly involved in
| the liver's ability to clear LDL from blood, and these people
| also have incredibly low incidence of heart disease.
|
| - Modifying cholesterol levels via PCSK9 or statins both have
| very strong evidence that they work on people who have heart
| disease, we have many RCT involving people who have already had
| one heart attack, and they have clear dose response curves: the
| amount of LDL reduction is directly proportional to risk
| reduction. We have less clear evidence on healthy people and
| from diet but those people are just a lot harder to study.
|
| It's true that not everyone with high LDL develops plaque and
| we don't know why, but I feel a lot of "lipid hypothesis
| skeptics" tend to swim around in the gray areas and just don't
| interact with the more smoking gun bits of evidence that have
| to be explained away if you are going to say that LDL has no
| effect.
| pedalpete wrote:
| I actually just responded with almost the exact opposite, but
| maybe I'm the "lipid hypothesis skeptic".
|
| Seeing as the threat is calcium build-up in the arteries, and
| because cholesterol is a vital component of health, I believe
| that if you are in good health, and don't have a history of
| heart-disease, or have diabetes or other auto-immune disease
| which increases risk of atherosclerosis, lowering
| cholesterols is an in direct measure.
|
| It's about understanding your personal risk and making
| decisions based on that.
| pedalpete wrote:
| There is push back on the high LDL leads to cacium build-up in
| arteries (being specific instead of just "longevity").
|
| The challenge is that some people, like myself, have
| outrageously high LDL, yet no calcium build-up in arteries via
| calcium score testing.
|
| This is why ApoB is the newer more common test. Molecules
| containing ApoB can stick to the walls of arteries, and the
| theory is that the more ApoB molecules in the blood, the more
| likelihood of a molecule sticking and then becoming calcified.
|
| If you have an auto-immune disease or diabetes, which increases
| the amount of time it takes for tears in the arteries to
| repair, you have a longer exposure time of fats sticking to the
| arterial walls which increases the likleihood of calcifying.
|
| However, that doesn't mean that everyone with high LDL and high
| ApoB are at higher risk.
|
| This is why I went for the calcium score. Don't show me the
| things that might lead to calcium build up later, just measure
| my calcium levels and let's see if I am currently at risk, and
| we can keep monitoring this.
|
| Doctors are still trying to push me on to statins, but without
| a history of heart-disease and every other biomarker being off
| the charts high, I am taking that risk myself, knowing that
| calcium score is 0, so my suspected risk is actually very low.
|
| Long answer, but hopefully that clarifies the understanding.
|
| I'm not a doctor, I work in neurotech so am around health and
| have gone through this process myself.
| bronlund wrote:
| Cholesterol is essential. It's a key building block for the cell
| membrane, it's a precursor to multiple hormones and necessary for
| producing vitamin D and bile acid. 2% of your body is
| cholesterol.
| javascriptfan69 wrote:
| Your body is 50% water and you can still die from drinking too
| much.
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