[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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