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Time Restricted

A blog on fasting, health, and other issues of midlife

Is too much “good cholesterol” bad for you?

December 27, 2018 By spao Leave a Comment

Is too much “good cholesterol” bad for you?

A good friend just pointed me to an interesting article from the New York Times that came out Christmas Eve Day.

It was based on a study out of Emory University in Atlanta that showed higher all-cause mortality associated with HDL levels above 80!  Below is a screen capture from the press conference where the study results were presented showing “U curve” associated with adverse events with both low HDL (<40 mg/DL) and very high HDL (>80 mg/DL).

HDL-U-Shaped-Curve
Risks of mortality are higher with very low AND very high levels of HDL

The authors acknowledge some limitations of the study.  The study started with patients that already had severe heart disease and speculate there may be some reverse causation.  They also recognize that genetic mutations may be at play, citing LIPG, SCARB1, and CETP (which mean nothing to me right now!)

The recommendations were very nuanced.

HDL-Nuanced-Recommendations
Because the mechanism of high HDL and higher mortality is not known, the recommendation is to focus on risk factors we can control.

Because the mechanisms remain unclear as to why high HDL levels are associated with adverse events, they recommend focusing on the mechanisms we do know about!  Still, this is the first data point I’ve seen speculating that HDL might not be protective at very high levels.  This will be very interesting data to watch going forward!

The video of the press conference is accessible here.

Filed Under: Diabetes

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Stephen Pao is the author of the Time-Restricted blog. Following a Type II diabetes diagnosis in 2003, Steve began experimenting with alternative approaches to managing the disease, including prolonged fasting as a complement to a low-carb lifestyle. By day, Steve is a consultant and board advisor to early stage technology companies. Steve and his wife are empty nesters, with two college-aged daughters across the country.

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