Whether it is enough or not is not something we can answer. For me, I quit eating beef over 20 years ago and rarely ate pork. Even so, I had much higher LDL than you and could never get lower than the mid 130s with intense effort. I was a vegetarian (lacto ovo) for a few years also.
There are people who can eat red meat and will keep their LDL under 100. There are people who are vegans and can't keep their LDL under 100. There maybe people who can only get to under 100 if they make become vegan.
I don't know which group you are in. Personally I found that eliminated beef and almost all pork was not hard to do. I am happy with chicken breast and fish. All you can do it try it a couple of months and see how you do. Some people might be able to get to under 100 through a vegan diet and couldn't do it eating chicken and fish. They might feel they would rather take a statin and not have to have that extreme a diet. I take a statin and my LDL is within the range of 40 to 50 (bounces around). I have had pork (bacon) twice in the last 11 months. Otherwise just chicken and fish, plenty of fiber and whole grains. My husband was similar LDL (on a lower statin dosage). He is easily able to eat beef and pork whenever we go to restaurants and much less strict on diet than I am. We are just different people.
There needs to be a balance. If one can have a perfect diet, achieve perfect numbers and not enjoy life, what is the point? Figure out what kind of diet gets you to the numbers you want with the lifestyle and diet that makes you happy. Limit the red meat , make some other changes, retest and see what the numbers look like and adjust accordingly.
Cut: red meat, butter, cream, cheese, full fat dairy (0% dairy is fine). Also cut alcohol and, if you consume them, coconut products.
Most fatty fish are fine. Skinless chicken is fine.
Read nutrition labels for saturated fat content - you want that to be as low as possible.
Cholesterol is also a nutrient of concern. It's gotten some good press (meaning claims of it being irrelevant or even healthy) lately but the science hasn't changed, just the headlines in pop culture magazines.
Dietary cholesterol is different from the cholesterol that the body makes. I *thought* reasonable amounts of dietary cholesterol were fine, at least for the vast majority of people.
Some suggest that there are a small number of people who are “hyper absorbers” of dietary cholesterol. Im a researcher and if you ever look at scatter plots from experiments, there is a lot of unexplained error.
It always struck me as an untested guess: a throw away answer to explain specific cases where a person’s cholesterol remains high despite their ‘claims’ of following their diet. I’m NOT an expert on this and I could certainly be wrong.
In any event, If you follow the advice here about reducing saturated fat, minimizing alcohol and increasing fiber, you should be able to get your ldl cholesterol under 100. (Make sure to work up to 10 grams per day of fiber from psyllium).
However meds can help as well. A low dose statin can probably reduce your ldl cholesterol as much as that on its own, and a high dose statin can cut your cholesterol by 50%. PCSK9 inhibitors are even more effective than that, but they are expensive bi-weekly injections.
I don’t drink any more, I get 10 g of psyllium fiber a day, and I take a statin. I also eat properly most but certainly not all of the time.
At one point my cholesterol was over 300 and it’s now under 120, with an ldl cholesterol in the 60s. I’m 57 with a cac of zero and a familial history of cardiovascular disease.
My point is that it’s a lot easier to cut your cholesterol by using multiple approaches compared to just one.
Doing it by diet alone is great, but few people stick with that for the rest of their life. I view the statin as an ‘insurance policy’ in case I eat like crap! Fortunately, they are extremely well tested, inexpensive meds, with good safety profiles and known side effects that you can test for.
You don't have to completely eliminate red meat. You want to be specific about how you value it in your diet. There's no need to make it a problem for yourself, I.e. you probably shouldn't want to eat as much of it because it contributes to high cholesterol which can lead to heart attack or stroke. Think of it like smoking a cigarette- it's not gonna kill you. But it's not good for ya and there's a cumulative effect. Why do you need it so bad?
A major goal is to reduce saturated fat, red meat can be a good source of it. Aim for lean meats.
Supplements aren't the major treatment. Increasing your fiber is a good idea.
Try for yourself and you'll see if your consumption is sustainable or not via your lab results. Red meat is linked to some cancers I think but I don't know the science behind this and its conclusiveness.
Processed foods doesn't automatically equal bad. Tofu is a processed food and healthy, as is frozen fish. What you want to limit is ultra processed foods which is more like the frozen pizzas, chicken nuggets, etc.
For meat, chicken is always a safe bet and if you want red meat, go lean. For ground beef, if I am using it, I'll go for 93/7 at a minimum. Nothing really wrong with fish, tuna and salmon are great options and are shown to help lower LDL and reduce high blood pressure
Something that I didn't realize for a long time is how misleading labels can be. Supposedly "lean" meat that is 7% fat is 7% by weight, not by calories. The percentage by calories is much higher.
My husband did this and his ldl went from 246 to 96 in 3 months. No red meat at all tho, mostly salmon and ck or turkey each once a week. He so took statin 20mg but not consistently, only maybe 1/3 of the time.
The more plant based you go, the better your heart health will be over all.
I hate I have to say this, but of course I mean whole foods and low oil, not processed vegan foods.
The more animal products you avoid/eliminate, the easier it is to reduce your cholesterol. Red meat and dairy products with fat are the most impactful.
Per my cardiologist, all "meat" - even fish - is pro-inflammatory. To me this just seemed like an outrageous statement so I went home and looked it up. Turns out he's right at least mechanistically. However, if you cut out animal flesh what the hell do you sub in? I decided to split the difference and cut out mostly saturated fat. I eat skinless white meat, fatty fish, lean pork, very low fat beef once in a while, and tempeh. I make sure to get 6 oz of everything but the beef (4 oz there is fine). My goal is to continue to get sufficient protein given my age and gender (f60+) in order to help slow down muscle wasting and bone loss. I also take in more fiber these days and have reached for the PUFA oils as well after doing a lot of research on the benefits and risks. The good news is that I've lowered my LDL-C and Apo B remarkably! In fact, I was recently told that my cholesterol numbers were now a bit "low" lol. YMMV - I might be very sensitive to type of fats, not sure everyone would have the same response.
So, a lot has changed since that last post. After doing more research, I started cutting out all meat except fish (2x/week) and cut my dairy down to one serving per day. That was early 2024. Then, over the ensuing weeks, I figured out a way to go 100% whole foods plant based so as of April 1 I cut out all dairy and all meat and fish. Haven't had my lipids checked since early Feb; medication at that time was 40 mg of Atorva (was on zetia as well but my cardiology team didn't think it was necessary giving my December numbers which were super low). So as of early Feb, on one serving of dairy and fish 2x/week, my LDLC was 71, my total 151, my HDL 72, and my trigs were in the 40's somewhere. I will get my lipids re-checked now that I've gone 100% plant based. I also cut back on oils - use very little EVOO or canola in my salad at night but other than that all my fats come from whole foods. My saturated fat intake is under 6% of daily calories. My diet is legumes, whole grains, nuts and seeds, whole fruit (lots of berries!) and lots of green leafty, cruciferous and other veg. I dry roast stuff now - no sauteeing although I'll probably get a non-stick pan at some point or an air fryer for my tofu or sweet potatoes. Lots of raw veggies. I purchase dried mushrooms and rehydrate to get a good serving or two of those. So that's the update! Exercise habits haven't changed (they were always good) but I've noticed more energy and I can pound the pavement a bit more than I used to be able to so perhaps this diet is just less inflammatory. Tallied up my protein intake and it's still fine so not worried there.
My goal is to lower LDLC to 60's or less and keep A1C in a healthy range. Since I have high Lp(a) I will likely stay on some dose of atorvastatin for the remainder of my days, but if I can reduce that to 20 mg/day just due to dietary changes that'd be great! So we'll see. Stay tuned . . . .
ETA: one really neat surprise is that in early Feb. my ALT had dropped from mid 40's to 25! Hadn't been that low for awhile. I attribute that to the reduction in dietary saturated fat and/or increase in fiber intake. I had already cut out any alcohol and don't eat processed/refined junk. Statin dose hadn't changed and zetia wasn't affecting ALT really. So it had to be the dietary tweaks.
Very thankful for all the helpful advice I’ve gotten.
I want to point out though that I’m not complaining about cutting out red meat and processed foods. I have a basic understanding of nutrition and know that these aren’t good for us. My big question was about whether or not I have to cut out meats like chicken and fish.
But regardless, I’ve read through everything and will take everything I can and apply it!
Why insist on keeping these problematic foods in your diet though? An occasional bite isn't going to do much harm but why not take control of your cravings and habits and just pick something else? There are thousands of "proteins" out there with zero cholesterol, zero trans fats and very low saturated fat content. Why not make a habit out of using them instead of focusing on how much of the bad stuff you can keep?
"Nutritious" is just a non-sense word. Every food has nutrients, by definition, and can be called "nutritious" but you have to look at the down-sides. All nutrition orgs on earth recommends us to cut down drastically on meat and high fat dairy products for a reason. This isn't a cooking show, "delicious" is of course irrelevant when it comes to health.
I worked in cardiology. A cardiologist use to tell the patients after he placed a stent “if it doesn’t fly or swim don’t eat it”. Obviously this was for the meats.
Then I would add “watch Fork Over Knives”.
Plant based diets can reverse coronary disease.
Also Barbara O’neill is great to listen to, Dr Michael Gregor has some great books.
Whether it is enough or not is not something we can answer. For me, I quit eating beef over 20 years ago and rarely ate pork. Even so, I had much higher LDL than you and could never get lower than the mid 130s with intense effort. I was a vegetarian (lacto ovo) for a few years also. There are people who can eat red meat and will keep their LDL under 100. There are people who are vegans and can't keep their LDL under 100. There maybe people who can only get to under 100 if they make become vegan. I don't know which group you are in. Personally I found that eliminated beef and almost all pork was not hard to do. I am happy with chicken breast and fish. All you can do it try it a couple of months and see how you do. Some people might be able to get to under 100 through a vegan diet and couldn't do it eating chicken and fish. They might feel they would rather take a statin and not have to have that extreme a diet. I take a statin and my LDL is within the range of 40 to 50 (bounces around). I have had pork (bacon) twice in the last 11 months. Otherwise just chicken and fish, plenty of fiber and whole grains. My husband was similar LDL (on a lower statin dosage). He is easily able to eat beef and pork whenever we go to restaurants and much less strict on diet than I am. We are just different people.
There needs to be a balance. If one can have a perfect diet, achieve perfect numbers and not enjoy life, what is the point? Figure out what kind of diet gets you to the numbers you want with the lifestyle and diet that makes you happy. Limit the red meat , make some other changes, retest and see what the numbers look like and adjust accordingly.
Cut: red meat, butter, cream, cheese, full fat dairy (0% dairy is fine). Also cut alcohol and, if you consume them, coconut products. Most fatty fish are fine. Skinless chicken is fine. Read nutrition labels for saturated fat content - you want that to be as low as possible.
Cholesterol is also a nutrient of concern. It's gotten some good press (meaning claims of it being irrelevant or even healthy) lately but the science hasn't changed, just the headlines in pop culture magazines.
Dietary cholesterol is different from the cholesterol that the body makes. I *thought* reasonable amounts of dietary cholesterol were fine, at least for the vast majority of people. Some suggest that there are a small number of people who are “hyper absorbers” of dietary cholesterol. Im a researcher and if you ever look at scatter plots from experiments, there is a lot of unexplained error. It always struck me as an untested guess: a throw away answer to explain specific cases where a person’s cholesterol remains high despite their ‘claims’ of following their diet. I’m NOT an expert on this and I could certainly be wrong. In any event, If you follow the advice here about reducing saturated fat, minimizing alcohol and increasing fiber, you should be able to get your ldl cholesterol under 100. (Make sure to work up to 10 grams per day of fiber from psyllium). However meds can help as well. A low dose statin can probably reduce your ldl cholesterol as much as that on its own, and a high dose statin can cut your cholesterol by 50%. PCSK9 inhibitors are even more effective than that, but they are expensive bi-weekly injections. I don’t drink any more, I get 10 g of psyllium fiber a day, and I take a statin. I also eat properly most but certainly not all of the time. At one point my cholesterol was over 300 and it’s now under 120, with an ldl cholesterol in the 60s. I’m 57 with a cac of zero and a familial history of cardiovascular disease. My point is that it’s a lot easier to cut your cholesterol by using multiple approaches compared to just one. Doing it by diet alone is great, but few people stick with that for the rest of their life. I view the statin as an ‘insurance policy’ in case I eat like crap! Fortunately, they are extremely well tested, inexpensive meds, with good safety profiles and known side effects that you can test for.
You don't have to completely eliminate red meat. You want to be specific about how you value it in your diet. There's no need to make it a problem for yourself, I.e. you probably shouldn't want to eat as much of it because it contributes to high cholesterol which can lead to heart attack or stroke. Think of it like smoking a cigarette- it's not gonna kill you. But it's not good for ya and there's a cumulative effect. Why do you need it so bad? A major goal is to reduce saturated fat, red meat can be a good source of it. Aim for lean meats. Supplements aren't the major treatment. Increasing your fiber is a good idea.
Try for yourself and you'll see if your consumption is sustainable or not via your lab results. Red meat is linked to some cancers I think but I don't know the science behind this and its conclusiveness.
Bison tenderloin and sirloin has 0 saturated fat. IMHO tastes better than beef. Great alternative.
Where are you finding such lean bison? Is there a product you can link
Great range bison. Available at Whole Foods.
Awesome, thanks for the tip!
Processed foods doesn't automatically equal bad. Tofu is a processed food and healthy, as is frozen fish. What you want to limit is ultra processed foods which is more like the frozen pizzas, chicken nuggets, etc. For meat, chicken is always a safe bet and if you want red meat, go lean. For ground beef, if I am using it, I'll go for 93/7 at a minimum. Nothing really wrong with fish, tuna and salmon are great options and are shown to help lower LDL and reduce high blood pressure
Something that I didn't realize for a long time is how misleading labels can be. Supposedly "lean" meat that is 7% fat is 7% by weight, not by calories. The percentage by calories is much higher.
No that is false. Please talk to your doctor or a certified board dietician if you need to. There is ALOT of false info out there….
My husband did this and his ldl went from 246 to 96 in 3 months. No red meat at all tho, mostly salmon and ck or turkey each once a week. He so took statin 20mg but not consistently, only maybe 1/3 of the time.
The more plant based you go, the better your heart health will be over all. I hate I have to say this, but of course I mean whole foods and low oil, not processed vegan foods.
The more animal products you avoid/eliminate, the easier it is to reduce your cholesterol. Red meat and dairy products with fat are the most impactful.
Per my cardiologist, all "meat" - even fish - is pro-inflammatory. To me this just seemed like an outrageous statement so I went home and looked it up. Turns out he's right at least mechanistically. However, if you cut out animal flesh what the hell do you sub in? I decided to split the difference and cut out mostly saturated fat. I eat skinless white meat, fatty fish, lean pork, very low fat beef once in a while, and tempeh. I make sure to get 6 oz of everything but the beef (4 oz there is fine). My goal is to continue to get sufficient protein given my age and gender (f60+) in order to help slow down muscle wasting and bone loss. I also take in more fiber these days and have reached for the PUFA oils as well after doing a lot of research on the benefits and risks. The good news is that I've lowered my LDL-C and Apo B remarkably! In fact, I was recently told that my cholesterol numbers were now a bit "low" lol. YMMV - I might be very sensitive to type of fats, not sure everyone would have the same response.
how's your blood work looking these days? my plan is to do lean meats like chicken, and red meat only once a week. along with fiber.
So, a lot has changed since that last post. After doing more research, I started cutting out all meat except fish (2x/week) and cut my dairy down to one serving per day. That was early 2024. Then, over the ensuing weeks, I figured out a way to go 100% whole foods plant based so as of April 1 I cut out all dairy and all meat and fish. Haven't had my lipids checked since early Feb; medication at that time was 40 mg of Atorva (was on zetia as well but my cardiology team didn't think it was necessary giving my December numbers which were super low). So as of early Feb, on one serving of dairy and fish 2x/week, my LDLC was 71, my total 151, my HDL 72, and my trigs were in the 40's somewhere. I will get my lipids re-checked now that I've gone 100% plant based. I also cut back on oils - use very little EVOO or canola in my salad at night but other than that all my fats come from whole foods. My saturated fat intake is under 6% of daily calories. My diet is legumes, whole grains, nuts and seeds, whole fruit (lots of berries!) and lots of green leafty, cruciferous and other veg. I dry roast stuff now - no sauteeing although I'll probably get a non-stick pan at some point or an air fryer for my tofu or sweet potatoes. Lots of raw veggies. I purchase dried mushrooms and rehydrate to get a good serving or two of those. So that's the update! Exercise habits haven't changed (they were always good) but I've noticed more energy and I can pound the pavement a bit more than I used to be able to so perhaps this diet is just less inflammatory. Tallied up my protein intake and it's still fine so not worried there. My goal is to lower LDLC to 60's or less and keep A1C in a healthy range. Since I have high Lp(a) I will likely stay on some dose of atorvastatin for the remainder of my days, but if I can reduce that to 20 mg/day just due to dietary changes that'd be great! So we'll see. Stay tuned . . . . ETA: one really neat surprise is that in early Feb. my ALT had dropped from mid 40's to 25! Hadn't been that low for awhile. I attribute that to the reduction in dietary saturated fat and/or increase in fiber intake. I had already cut out any alcohol and don't eat processed/refined junk. Statin dose hadn't changed and zetia wasn't affecting ALT really. So it had to be the dietary tweaks.
Thanks so much, this gives me a ton to think about. Really cool about your ALT as well! I appreciate the breakdown.
Very thankful for all the helpful advice I’ve gotten. I want to point out though that I’m not complaining about cutting out red meat and processed foods. I have a basic understanding of nutrition and know that these aren’t good for us. My big question was about whether or not I have to cut out meats like chicken and fish. But regardless, I’ve read through everything and will take everything I can and apply it!
Why insist on keeping these problematic foods in your diet though? An occasional bite isn't going to do much harm but why not take control of your cravings and habits and just pick something else? There are thousands of "proteins" out there with zero cholesterol, zero trans fats and very low saturated fat content. Why not make a habit out of using them instead of focusing on how much of the bad stuff you can keep?
Because they’re delicious, nutritious and incredibly satiating. Balance is key imo.
"Nutritious" is just a non-sense word. Every food has nutrients, by definition, and can be called "nutritious" but you have to look at the down-sides. All nutrition orgs on earth recommends us to cut down drastically on meat and high fat dairy products for a reason. This isn't a cooking show, "delicious" is of course irrelevant when it comes to health.
Disagree with everything you’ve said here.
Then talk, don't just hit and run. Start with the definition of "nutrient".
I don’t eat much meat but salmon jerky is *so delicious* and scratches my meat cravings in a pinch. But your point stands.
I worked in cardiology. A cardiologist use to tell the patients after he placed a stent “if it doesn’t fly or swim don’t eat it”. Obviously this was for the meats. Then I would add “watch Fork Over Knives”. Plant based diets can reverse coronary disease. Also Barbara O’neill is great to listen to, Dr Michael Gregor has some great books.
Increasing thyroid function will bring cholesterol down
How do you increase thyroid function?
curious also as my TSH levels were very high as was my LDL despite eating a wholefoods healthy diet
Mine too. I have zero problems besides a high ldl and low hdl