Heart disease catches a lot of people by surprise, but it doesn’t have to:

Menopause can bring increased cholesterol levels and other heart risks. Here’s why and what to do about it

First, let’s have a quick refresher of cholesterol and triglycerides. In few words:

Cholesterol is packaged with triglycerides (the most common type of fat in the body) and specific “apo” proteins into “lipo-proteins” as a package called “very-low-density” lipoproteins (VLDLs).

• These are transported via the blood to body tissue in a form called low-density lipoprotein (LDL) cholesterol.
• Excess cholesterol can be transported back to the liver by high-density lipoprotein (HDL) cholesterol, for removal from circulation.

Another less talked about blood fat is Lipoprotein-a, or Lp(a). Having a high Lp(a) level is an independent cardiovascular disease risk factor.

For more details and numbers, see:

What is a blood cholesterol ratio? And what should yours be?

Many people, of course, have numbers far from what they should be. Especially common is to see LDL levels that are far too high for good health.

See also: Demystifying Cholesterol

So, what to do about it?

First, understand the causes, because it’s often not actually about foods that are high in cholesterol themselves.

For example:

• Egg yolks are high in cholesterol but have a minimal impact on blood cholesterol
  • Learn more: Eggs: Nutritional Powerhouse or Heart-Health Timebomb?
• Saturated and trans fats (as found in fatty meats or dairy, and some processed foods) have a greater influence on LDL levels than dietary cholesterol.
  • Learn 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).

And on the other hand:

• Fiber-rich foods help lower LDL by affecting fat absorption in the digestive tract
  • Learn more: What Matters Most For Your Heart? Eat More (Of This) For Lower Blood Pressure ← spoiler: it’s fiber
• Unsaturated fats (e.g. from fish, nuts, seeds) have anti-inflammatory benefits
  • Learn more: What Omega-3 Fatty Acids Really Do For Us

Next, understand that not all medications will be the right choice for all people.

Statins are a good example of this, as they have potential risks and benefits in general, but as a general rule of thumb, the risks are higher for women and the benefits are higher for men.

For more detail about that, see: Statins: His & Hers?

…which was largely informed by the wealth of data in this book:

The Truth About Statins – by Dr. Barbara H. Roberts

What’s this about gene-editing, then?

The gene-editing technology CRISPR can be used to tweak things so that your body is now genetically predisposed to healthy triglycerides.

At least, that’s what the preliminary trials suggest; larger studies are definitely needed to be sure.

A team of scientists used CRISPR to target the ANGPTL3 gene to permanently reduce LDL cholesterol and triglycerides in patients with lipid disorders that had otherwise remained out of control despite standard therapy.

The study was small: 15 patients (mostly men, with an average age of 53) received a single intravenous infusion of one of five doses (0.1–0.8 mg/kg) of CTX310 and were followed for at least 60 days.

You may be wondering: what is “CTX310”?

And the answer is:

❝a lipid-nanoparticle–encapsulated clustered regularly interspaced short palindromic repeats–Cas9 endonuclease (CRISPR-Cas9) messenger RNA (mRNA)❞

Source: Phase 1 Trial of CRISPR-Cas9 Gene Editing Targeting ANGPTL3

So to oversimplify that somewhat: it’s a helpful nanotechnology that rewrites part of your DNA.

As for how safe it is: no dose-limiting toxic effects were recorded. However, two serious adverse events (spinal-disc herniation and death from pre-existing cardiovascular disease) occurred, but were deemed unrelated.

As for how well it worked: at the highest doses, ANGPTL3 levels dropped sharply (up to 79%). But that’s the genes, not the consequences.

More useful to know is that LDL cholesterol fell by up to 49% at the 0.5–0.8 mg/kg doses, and triglycerides decreased up to 62%.

You can read a pop-science article about it here: Gene-editing therapy for elevated lipid levels shows promise

Don’t want to do that?

For a gentler approach, check out:

Lower Cholesterol Naturally

Take care!

Busting The Myth of “Eight Glasses Of Water A Day”

Everyone knows we must drink 8 glasses of water a day, or else we’re going to get a failing grade at being a healthy human—like not flossing, or not using adequate sunscreen.

But… Do we? And does tea count? How about (we dare but whisper it) coffee? And soda drinks are mostly water, right? But aren’t some drinks dehydrating? Are special electrolyte drinks really better? There are so many things to consider, so many differing advices, and it’s easy to give up, or just choose what to believe in as a leap of faith.

A quick brain-teaser for you first, though:

If coffee and soda don’t count because they’re dehydrating, then what if you were to take:

– A concentrated tiny cup of espresso, and then a glass of water, would the glass of water count?

– Or (we don’t relish the thought) what if you took a spoonful of soda syrup, and then a glass of water, would the glass of water count?

If your answer was “yes, it’s a glass of water”, then why would it not count if it were taken all at once (e.g. as an Americano coffee, or a regular soda)?

If your answer was “yes, but that water might only offset the dehydration caused by the coffee/syrup, so I might only be breaking even”, then you were thinking about this the right way:

How much water you need depends on many factors that can be affected by what else you are consuming and what else you are doing. Science loves averages, so eight glasses a day may be great if you are of average health, and average body size, in a temperate climate, doing moderate exercise, and so on and so on.

If you’re not the most average person of all time? You may need to take into account a lot of factors, ranging from what you ate for dinner to how much you perspired during your morning exercises. As you (probably) don’t live in laboratory conditions, this can become an impossible task—and if you missed (or guessed incorrectly) even one factor, the whole calculation will be thrown off. But is there any other way to know?

What of the infamous pee test? Drink enough to make your urine as clear as possible, and if it’s dark, you’re dehydrated, common wisdom says.

In reality, however, that tells you not what’s in your body, but rather, what got ejected from your body. If your urine is dark, it might mean you had too little water, but it also could just mean you had the right amount of water but too much sodium, for instance. A study of this was done on athletes, and found no correlation between urine color and actual bodily hydration when measured directly via a blood test.

So, if we can’t just have an app tell us “drink this many glasses of water”, and we can’t trust urine color, what can we do?

What we can do is trust that our body comes with (for free!) a wonderful homeostatic system and it will try to correct any imbalances. If you are thirsty, you’re dehydrated. Drink something with plenty of water in, if not plain water.

But what about special electrolyte drinks? If you need salts, you will crave them. Craving a salty snack? Go for it! Or if you prefer not to snack, do a salt lick test (just put a little salt on your finger, and taste it; if it tastes good, wait a minute or two, and then have a little more, and repeat until it doesn’t).

Bonus Tip:

1. Make sure you always have a source of hydration (that you enjoy!) to hand. Maybe it’s chilled water, maybe it’s a pot of tea, maybe it’s a sports drink, it doesn’t matter too much. Even coffee is actually fine, by the way (but don’t overdo it).
2. Make a personal rule: “I will always make time for hydration”. That means, if you’re thirsty, have something with water in it now. Not when you’ve finished what you’re doing (unless you really can’t stop, because you are a racecar driver mid-race, or a surgeon mid-operation, or something), but now. Do not postpone it until after you’ve done some other thing first; you will forget and it will keep getting postponed. Always make time for water.