Demystifying Cholesterol

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All About Cholesterol

When it comes to cholesterol, the most common lay understanding (especially under a certain age) is “it’s bad”.

A more informed view (and more common after a certain age) is “LDL cholesterol is bad; HDL cholesterol is good”.

A more nuanced view is “LDL cholesterol is established as significantly associated with (and almost certainly a causal factor of) atherosclerotic cardiovascular disease and related mortality in men; in women it is less strongly associated and may or may not be a causal factor”

You can read more about that here:

Statins: His & Hers? ← we highly recommend reading this, especially if you are a woman and/or considering/taking statins. To be clear, we’re not saying “don’t take statins!”, because they might be the right medical choice for you and we’re not your doctors. But we are saying: here’s something to at least know about and consider.

Beyond HDL & LDL

There is also VLDL cholesterol, which as you might have guessed, stands for “very low-density lipoprotein”. It has a high, unhealthy triglyceride content, and it increases atherosclerotic plaque. In other words, it hardens your arteries more quickly.

The term “hardening the arteries” is an insufficient descriptor of what’s happening though, because while yes it is hardening the arteries, it’s also narrowing them. Because minerals and detritus passing through in the blood (the latter sounds bad, but there is supposed to be detritus passing through in the blood; it’s got to get out of the body somehow, and it’s off to get filtered and excreted) get stuck in the cholesterol (which itself is a waxy substance, by the way) and before you know it, those minerals and other things have become a solid part of the interior of your artery wall, like a little plastering team came and slapped plaster on the inside of the walls, then when it hardened, slapped more plaster on, and so on. Macrophages (normally the body’s best interior clean-up team) can’t eat things much bigger than themselves, so that means they can’t tackle the build-up of plaque.

Impact on the heart

Narrower less flexible arteries means very poor circulation, which means that organs can start having problems, which obviously includes your heart itself as it is not only having to do a harder job to keep the blood circulating through the narrower blood vessels, but also, it is not immune to also being starved of oxygen and nutrients along with the rest of the body when the circulation isn’t good enough. It’s a catch 22.

What if LDL is low and someone is getting heart disease anyway?

That’s often a case of apolipoprotein B, and unlike lipoprotein A, which is bound to LDL so usually* isn’t a problem if LDL is in “safe” ranges, Apo-B can more often cause problems even when LDL is low. Neither of these are tested for in most standard cholesterol tests by the way, so you might have to ask for them.

*Some people, around 1 in 20 people, have hereditary extra risk factors for this.

What to do about it?

Well, get those lipids tests! Including asking for the LpA and Apo-B tests, especially if you have a history of heart disease in your family, or otherwise know you have a genetic risk factor.

With or without extra genetic risks, it’s good to get lipids tests done annually from 40 onwards (earlier, if you have extra risk factors).

See also: Understanding your cholesterol numbers

Wondering whether you have an increased genetic risk or not?

Genetic Testing: Health Benefits & Methods ← we think this is worth doing; it’s a “one-off test tells many useful things”. Usually done from a saliva sample, but some companies arrange a blood draw instead. Cost is usually quite affordable; do shop around, though.

Additionally, talk to your pharmacist to check whether any of your meds have contraindications or interactions you should be aware of in this regard. Pharmacists usually know contraindications/interactions stuff better than doctors, and/but unlike doctors, they don’t have social pressure on them to know everything, which means that if they’re not sure, instead of just guessing and reassuring you in a confident voice, they’ll actually check.

Lastly, shocking nobody, all the usual lifestyle medicine advice applies here, especially get plenty of moderate exercise and eat a good diet, preferably mostly if not entirely plant-based, and go easy on the saturated fat.

Note: while a vegan diet contains zero dietary cholesterol (because plants don’t make it), vegans can still get unhealthy blood lipid levels, because we are animals and—like most animals—our body is perfectly capable of making its own cholesterol (indeed, we do need some cholesterol to function), and it can make its own in the wrong balance, if for example we go too heavy on certain kinds of (yes, even some plant-based) saturated fat.

Read more: Can Saturated Fats Be Healthy? ← see for example how palm oil and coconut oil are both plant-based, and both high in saturated fat, but palm oil’s is heart-unhealthy on balance, while coconut oil’s is heart-healthy on balance (in moderation).

Want to know more about your personal risk?

Try the American College of Cardiology’s ASCVD risk estimator (it’s free)

Take care!

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  • Shoulders Range – by Elia Bartolini

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    Shoulder flexibility and mobility can be a big deal, especially when it starts to decline—more so than other kinds of flexibility. Most seniors can get through the day without doing the splits against a wall, for example, but shoulder tightness can be more of a problem if you can’t easily get into or out of your clothes.

    If you think it couldn’t happen to you: the great Jane Fonda has a now-famous photoset of her looking glamorous in a dress at a red carpet event, and then looking frazzled making breakfast in the same dress in her kitchen the next morning, because, as she wrote, “I couldn’t get my dress unzipped so I slept in it”.

    Now, “to avoid ending up like Jane Fonda” is not a series of words that usually precedes advice, but in this case: this book delves into the science of one of the most quirky joints of the human body, and how to leverage this to maximize shoulder mobility, while maintaining adequate strength (because flexibility without strength is just asking for a dislocation) without doing anything that would actually bulk up our shoulders, because it’s just about progressing through passive, active, and tensed stretching, static, dynamic, and loaded stretching, as well as PNF stretching and antagonist stretching.

    If that seems like a lot of stretching, don’t worry; the author presents a series of workouts that will take us through these stretches in a very small amount of time each day.

    The style is instructional like a textbook, with clear diagrams where appropriate, and lots of callout boxes, bullet points, emboldening for key points, etc. It all makes for every easy learning.

    Bottom line: if you’d like to improve and maintain your shoulder mobility, this is an excellent book for that.

    Click here to check out Shoulders Range, and perfect your shoulders and upper body flexibility!

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  • Dates vs Figs – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing dates to figs, we picked the dates.

    Why?

    Dates are higher in sugar, but also have a lower glycemic index than figs, which makes the sugar content much healthier. On the flipside, figs do have around 3x more fiber.

    So far, so balanced.

    When it comes to micronutrients though, dates take the prize much more clearly.

    Dates have slightly more of most vitamins, and a lot more of most minerals.

    In particular, dates are several times higher in copper, iron, magnesium, manganese, phosphorus, selenium, and zinc.

    As for other phytochemical benefits going on:

    • both are good against diabetes for reasons beyond the macros
    • both have anti-inflammatory properties
    • dates have anticancer properties
    • dates have kidney-protecting properties

    So in this last case, another win for dates.

    Both are still great though, so do enjoy both!

    Want to learn more?

    You might like to read:

    Which Sugars Are Healthier, And Which Are Just The Same?

    Take care!

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  • Tips For Avoiding/Managing Rheumatoid Arthritis

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    Avoiding/Managing Rheumatoid Arthritis

    Arthritis is the umbrella term for a cluster of joint diseases involving inflammation of the joints, hence “arthr-” (joint) “-itis” (suffix used to denote inflammation). These are mostly, but not all, autoimmune diseases, in which the body’s immune system mistakenly attacks our own joints.

    Inflammatory vs Non-Inflammatory Arthritis

    Arthritis is broadly divided into inflammatory arthritis and non-inflammatory arthritis.

    You may be wondering: how does one get non-inflammatory inflammation of the joints?

    The answer is, in “non-inflammatory” arthritis, such as osteoarthritis, the damage comes first (by general wear-and-tear) and inflammation generally follows as part of the symptoms, rather than the cause. So the name can be a little confusing. In the case of osteo- and other “non-inflammatory” forms of arthritis, you definitely still want to keep your inflammation at bay as best you can, but it’s not as absolutely critical a deal as it is for “inflammatory” forms of arthritis.

    We’ll tackle the beast that is osteoarthritis another day, however.

    Today we’re going to focus on…

    Rheumatoid Arthritis

    This is the most common of the autoimmune forms of arthritis. Some quick facts:

    • It affects a little under 1% of the global population, but the older we get, the more likely it becomes
    • Early onset of rheumatoid arthritis is most likely to show up around the age of 50 (but it can show up at any age)
    • However, incidence (not onset) of rheumatoid arthritis peaks in the 70s age bracket
    • It is 2–4 times more common in women than in men
    • Approximately one third of people stop work within two years of its onset, and this increases thereafter.

    Well, that sounds gloomy.

    Indeed it’s not fun. There’s a lot of stiffness and aching of joints (often with swelling too), loss of joint function can be common, and then there are knock-on effects like fatigue, weakness, and loss of appetite.

    Beyond that it’s an autoimmune disorder, its cause is not known, and there is no known cure.

    Is there any good news?

    If you don’t have rheumatoid arthritis at the present time, you can reduce your risk factors in several ways:

    • Having an anti-inflammatory diet. Get plenty of fiber, greens, and berries. Fatty fish is great too, as are oily nuts. On the other side of things, high consumption of salt, sugar, alcohol, and red meat are associated with a greater risk of developing rheumatoid arthritis.
    • Not smoking. Smoking is bad for pretty much everything, including your chances of developing rheumatoid arthritis.
    • Not being obese. This one may be more a matter of correlation than causation, because of the dietary factors (if one eats an anti-inflammatory diet, obesity is less likely), but the association is there.

    There are other risk factors that are harder to control, such as genetics, age, sex, and having a mother who smoked.

    See: Genetic and environmental risk factors for rheumatoid arthritis

    What if I already have rheumatoid arthritis?

    If you already have rheumatoid arthritis, it becomes a matter of symptom management.

    First, reduce inflammation any (reasonable) way you can. We did a main feature on this before, so we’ll just drop that again here:

    Keep Inflammation At Bay

    Next, consider the available medications. Your doctor may or may not have discussed all of the options with you, so be aware that there are more things available than just pain relief. To talk about them all would require a whole main feature, so instead, here’s a really well-compiled list, along with explanations about each of them, up to date as of this year:

    Rheumatoid Arthritis Medication List (And What They Do, And How)

    Finally, consider other lifestyle adjustments to manage your symptoms. These include:

    • Exercise—gently, though! You do not want to provoke a flare-up, but you do want to maintain your mobility as best you can. There’s a use-it-or-lose-it factor here. Swimming and yoga are great options, as is tai chi. You may want to avoid exercises that involve repetitive impacts to your joints, like running.
    • Rest—while keeping mobility going. Get good sleep at night (this is important), but don’t make your bed your new home, or your mobility will quickly deteriorate.
    • Hot & cold—both can help, and alternating them can reduce inflammation and stiffness by improving your body’s ability to respond appropriately to these stimuli rather than getting stuck in an inappropriate-response state of inflammation.
    • Mobility aids—if it helps, it helps. Maybe you only need something during a flare-up, but when that’s the case, you want to be as gentle on your body as possible while keeping moving, so if crutches, handrails etc help, then by all means get them and use them.
    • Go easy on the use of braces, splints, etc—these can offer short-term relief, but at a long term cost of loss of mobility. Only you can decide where to draw the line when it comes to that trade-off.

    You can also check out our previous article:

    Managing Chronic Pain (Realistically!)

    Take good care of yourself!

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  • Nasal Hair; How Far To Go?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    t’s Q&A Day at 10almonds!

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    ❝As a man in his sixties I find I need to trim my nasal hair quite frequently, otherwise it sticks out in an unsightly manner. But I’m never sure how severely I should cut the hairs back, or even how best to do it. Please advise.❞

    As you might know, those hairs are really important for our health, so let’s start by mentioning that yes, trimming is the way, not plucking!

    In an ideal world, we’d not trim them further back than the entrance to our nostrils, but given the constant nature of hair-growing, that could become a Sisyphean task.

    A good compromise, if you’re not up for trimming when you get up and having visible hairs by evening, is to put the scissors away (if you haven’t already) and use a nasal hair trimmer; these are good at a) trimming nasal hairs b) abstaining from trimming them too far back.

    By all means shop around, but here’s an example product on Amazon, for your convenience!

    Enjoy!

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  • Ricezempic: is there any evidence this TikTok trend will help you lose weight?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    If you spend any time looking at diet and lifestyle content on social media, you may well have encountered a variety of weight loss “hacks”.

    One of the more recent trends is a home-made drink called ricezempic, made by soaking uncooked rice and then straining it to drink the leftover starchy water. Sounds delicious, right?

    Its proponents claim it leads to weight loss by making you feel fuller for longer and suppressing your appetite, working in a similar way to the sought-after drug Ozempic – hence the name.

    So does this drink actually mimic the weight loss effects of Ozempic? Spoiler alert – probably not. But let’s look at what the evidence tells us.

    New Africa/Shutterstock

    How do you make ricezempic?

    While the recipe can vary slightly depending on who you ask, the most common steps to make ricezempic are:

    1. soak half a cup of white rice (unrinsed) in one cup of warm or hot water up to overnight
    2. drain the rice mixture into a fresh glass using a strainer
    3. discard the rice (but keep the starchy water)
    4. add the juice of half a lime or lemon to the starchy water and drink.

    TikTokers advise that best results will happen if you drink this concoction once a day, first thing in the morning, before eating.

    The idea is that the longer you consume ricezempic for, the more weight you’ll lose. Some claim introducing the drink into your diet can lead to a weight loss of up to 27 kilograms in two months.

    Resistant starch

    Those touting ricezempic argue it leads to weight loss because of the resistant starch rice contains. Resistant starch is a type of dietary fibre (also classified as a prebiotic). There’s no strong evidence it makes you feel fuller for longer, but it does have proven health benefits.

    Studies have shown consuming resistant starch may help regulate blood sugar, aid weight loss and improve gut health.

    Research has also shown eating resistant starch reduces the risk of obesity, diabetes, heart disease and other chronic diseases.

    A birds-eye view of a glass of cloudy water on a table.
    Ricezempic is made by soaking rice in water. Kristi Blokhin/Shutterstock

    Resistant starch is found in many foods. These include beans, lentils, wholegrains (oats, barley, and rice – particularly brown rice), bananas (especially when they’re under-ripe or green), potatoes, and nuts and seeds (particularly chia seeds, flaxseeds and almonds).

    Half a cup of uncooked white rice (as per the ricezempic recipe) contains around 0.6 grams of resistant starch. For optimal health benefits, a daily intake of 15–20 grams of resistant starch is recommended. Although there is no concrete evidence on the amount of resistant starch that leaches from rice into water, it’s likely to be significantly less than 0.6 grams as the whole rice grain is not being consumed.

    Ricezempic vs Ozempic

    Ozempic was originally developed to help people with diabetes manage their blood sugar levels but is now commonly used for weight loss.

    Ozempic, along with similar medications such as Wegovy and Trulicity, is a glucagon-like peptide-1 (GLP-1) receptor agonist. These drugs mimic the GLP-1 hormone the body naturally produces. By doing so, they slow down the digestive process, which helps people feel fuller for longer, and curbs their appetite.

    While the resistant starch in rice could induce some similar benefits to Ozempic (such as feeling full and therefore reducing energy intake), no scientific studies have trialled ricezempic using the recipes promoted on social media.

    Ozempic has a long half-life, remaining active in the body for about seven days. In contrast, consuming one cup of rice provides a feeling of fullness for only a few hours. And simply soaking rice in water and drinking the starchy water will not provide the same level of satiety as eating the rice itself.

    Other ways to get resistant starch in your diet

    There are several ways to consume more resistant starch while also gaining additional nutrients and vitamins compared to what you get from ricezempic.

    1. Cooked and cooled rice

    Letting cooked rice cool over time increases its resistant starch content. Reheating the rice does not significantly reduce the amount of resistant starch that forms during cooling. Brown rice is preferable to white rice due to its higher fibre content and additional micronutrients such as phosphorus and magnesium.

    2. More legumes

    These are high in resistant starch and have been shown to promote weight management when eaten regularly. Why not try a recipe that has pinto beans, chickpeas, black beans or peas for dinner tonight?

    3. Cooked and cooled potatoes

    Cooking potatoes and allowing them to cool for at least a few hours increases their resistant starch content. Fully cooled potatoes are a rich source of resistant starch and also provide essential nutrients like potassium and vitamin C. Making a potato salad as a side dish is a great way to get these benefits.

    In a nutshell

    Although many people on social media have reported benefits, there’s no scientific evidence drinking rice water or “ricezempic” is effective for weight loss. You probably won’t see any significant changes in your weight by drinking ricezempic and making no other adjustments to your diet or lifestyle.

    While the drink may provide a small amount of resistant starch residue from the rice, and some hydration from the water, consuming foods that contain resistant starch in their full form would offer significantly more nutritional benefits.

    More broadly, be wary of the weight loss hacks you see on social media. Achieving lasting weight loss boils down to gradually adopting healthy eating habits and regular exercise, ensuring these changes become lifelong habits.

    Emily Burch, Accredited Practising Dietitian and Lecturer, Southern Cross University and Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Hazelnuts vs Cashews – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing hazelnuts to cashews, we picked the hazelnuts.

    Why?

    It’s close! This one’s interesting…

    In terms of macros, hazelnuts have more fiber and fats, while cashews have more protein and carbs. All in all, all good stuff all around; maybe a win for one or the other depending on your priorities. We’d pick hazelnuts here, but your preference may vary.

    When it comes to vitamins, hazelnuts have more of vitamins A, B1, B2, B3, B5, B6, B9, C, and E, while cashews have more vitamin K. An easy win for hazelnuts here, and the margins weren’t close.

    In the category of minerals, hazelnuts have more calcium, manganese, and potassium, while cashews have more copper, iron, magnesium, phosphorus, selenium, and zinc. This is a win for cashews, but it’s worth noting that cup for cup, both of these nuts provide more than the daily requirement of most of those minerals. This means that in practical terms, it doesn’t matter too much that (for example), while cashews provide 732% of the daily requirement for copper, hazelnuts “only” provide 575%. So while this category remains a victory for cashews, it’s something of a “on paper” thing for the most part.

    Adding up the sections (ambivalent + clear win for hazelnuts + nominal win for cashews) means that in total today we’re calling it in favour of hazelnuts… But as ever, enjoy both, because both are good and so is diversity!

    Want to learn more?

    You might like to read:

    Why You Should Diversify Your Nuts

    Take care!

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