Your LDL Levels
Do cholesterol levels matter? As you may know, that is a highly
controversial and "religious" topic with most health-conscious men nowadays.
But, regardless of your stance on total cholesterol, let me tell what does
matter: LDL. And let me tell you why it matters.
Most guys showing up on my site or on the
Peak Testosterone Forum have significant
cardiovascular issues, especially anyone over the age of 40. If you're
over 40 and have lived a Western lifestlyle, your arteries have significantly
hardened due to the eroding of the collagen content and the buildup of
arteriosclerosis, i.e. arterial plaque.
Very few Westerners escape the rapid acceleratio of plaque buildup. One huge
issue this causes is damage to the endothelium. What eventually happens is
that the lining of your arteries, the endothelium, becomes so covered with
plaque that it cannot pump out any signficant amount of nitric oxide. This
leads to a host of issues including erectile dysfunction, high blood pressure
and at times angina.
So one of the huge tasks facing most men is the get their arteries back.
How can they do that? Simple: lowering LDL. Many
studies and clinicians have recognized the importance of lowering LDL to
reverse plaque. Yes, your arterial plaque can be actually reduced and
blood flow increased.
NOTE: It's not just the Low Fat folks who insist on and outline how to
decrease arterilsclerosis: it's also
leading cardiologists such as William Davis and the Asteroid Study researchers
mentioned below. (You can read more about the subject in my link on
Clearing Your Arteries.)
Need to boost your Nitric Oxide naturally through food, drink and supplements? Check out Lee Myer's book here:
The Peak Erectile Strength Diet
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"But wait!", you ask, "Isn't LDL cholesterol and I thought cholesterol doesn't matter?" Okay, admittedly, it doesn't matter to a healthy, younger male with little arterial plaque.
However, the rest of us need some help and some arterial repair and need to face
the facts. Consider the current evidence on the subject:
1. Your level of arteriosclerosis is related to cardiovascular events.
And, yes, cardiovascular 'events' are not a good thing.
2. Decreasing arterial plaque (arteriosclerosis) improves cardiovascular
3. Decreasing LDL to a certain threshold will reverse arteriosclersosis.
And that's the subject of this page. Just what LDL threshold does one need
to go to actually begin to reverse his arteriosclerosis? Below I'll show
you the levels given by various experts and researchers.
Want your arteries back? Want increased blood flow? Then focus on
your LDL and quit listening to the "Cholesterol Myth" people. Remember
that heart disease is the #1 killer of men in modern societies. Lowering LDL
levels could almost completely eliminate this plague.
1. Dr. Caldwell Esselstyn. This physician was one of the early
pioneers who showed that arterial plaque could indeed be reversed. In
another link I reviewed his book, Prevent and Reverse Heart Disease, and in this
book on page 67 he writes his target LDL levels with his patients:
"Here, once again, is the basic message of my research: no one who
achieves and maintains total blood cholesterol of 150 mg/dl and LDL levels below
80 mg/dl - using strict plant-based nutrition and, where necessary, low doses of
cholesterol-reducing drug - experiences progression of heart disease."quot;
Now, granted, in this quote he does not actually promise reversal of
arteriosclerosis, but, in fact, his books has a number of photos and stories of
people who have done just that.
2. Dr. Neal Bernard. I have also reviewed Dr. Bernard's low fat book
on Reversing Diabetes (with a Low Fat, low glycemic diet) - another excellent book! - and Dr. Bernard suggests
therein that some men may need to go even lower (p. 105):
"...many scientists are now pushing for stricter standards, including reductions
to below 70 mg/dl (1.8 mmol/l) for high risk patients. Some authorities
have called for lowering your LDL by 30 to 40 percent regardless of what your
starting level is." 
3. 2007 Circulation Study. The journal Circulation looked at three
different diets and found that the more the fat, the less the blood flow: "BART
testing revealed a significant inverse correlation between flow-mediated
vasodilation and intake of total fat (r2=–0.29; P=0.03), saturated fat
(r2=–0.31; P=0.02) and monounsaturated fat (r2=–0.35; P=0.01)."  I am
inserting this comment, because it's important to realize that fat slows down
blood flow. A lot of you middle-aged guys are going to get big benefits in
erectile strength from this. Can I hear an Amen, brother? And in
this study, the Low Fat participants went down to an average LDL of 84.6 ng/dl.
4. Dr. Ornish. Probably the most famous Low Fat researcher is Dean
Ornish. His landmark studies in the 80's showed that a Low Fat Diet could
reverse heart disease and arteriosclerosis. In his bestselling book The
Spectrum (p. 204) he wrote:
"If that's enough to bring it down to an LDL level less than 100 mg/dl,
preferably below 70 mg/dl if you have heart disease, that may be sufficient."
NOTE: A Low Fat Diet has also been found improve to telomere aging, turns
off 100's of prostate cancer genes, etc. and I discuss all of the list in link
on The Incredible Health Benefits of a Low Fat Diet
Now why would Dr. Ornish even mention an LDL as high as 100 mg/dl? The
reason is that this book, The Spectrum, is built on the idea that one does not
HAVE to be on a Low Fat Diet unless you have heart disease. If you do not
have major cardiovascular problems, then you can get by more than likely with a
more moderate approach.
But then notice the LDL target that Dr. Ornish gives after that: 70
mg/dl.This is low LDL indeed but underscores the importance of taking aggressive
action if you have heart disease. Ornish's Low Fat programs can have a profound
impact on men with heart disease. For example, one of his studies showed
angina decreasing by 91% - a very impressive result to say the least. (p. 9)
5. Asteroid Study. This study gave patients high doses of statins
and then tracked, based on their LDL levels, cardiovascular outcomes. LDL
of 70 mg/dl was the level at which the authors felt that all cardiovascular
goals were achieved.
However, other commentators have noted that this study showed plaque reversal at
about 60 mg/dl.
Now, because plaque reversal has been achieved at higher levels, one cannot help
but wonder if some negative aspect of statins require one to go even lower than
is necessary with Low Fat. This seems reasonable to me considering that
statins decimate CoQ10 levels and raise arachidonic acid levels, both of which
are heart unhealthy.  For more negatives, see my link on
The Hidden Risks of
6. Dr. William Davis. Some people will trust Dr. Davis a little more, because
he a) hates wheat, b) is not in love with Low Fat Diets and c) likes some fat in the form of omega-3's and monos.
He has kind of been adopted by some in the Paleo crowd because of it, but what they don't realize is
that in his book, Track Your Plaque, he advocates an LDL of 50-60 for those who want to decrease
Choosing and LDL Level
As you can see there is some variation in what level of LDL you should
shoot for. 85 mg/dl is the highest number advocated by someone who has
actually achieved plaque reversal. But there is some evidence for men with
serious issues that it needs to be lower, probably between 60 and 70.
So you (and your physician if he/she knows anything about the subject) have to
decide for yourself. There are many unanswered questions:
How much does exercise play a role? Can certain superfoods (pomegranate
juice, berries, etc.) play a role?
We will not know the answers to these kind of questions for probably years to
come, so, in the meantime, one has to make an educated guess.
Diabetes Care, 2006, 29(suppl1):S4-S42,
American Diabetes Assocation, "STandards of Medical CAre in Diabetes - 2006"
2) Circulation, 2007, 116:II_819, "Abstract 3610: Comparative Effects of 3
Popular Diets on Lipids, Endothelial Function and Biomarkers of Atherothrombosis
in the Absence of Weight Loss"
3) American Journal of Cardiology, 2009, 104(1):29-35, "Safety and Efficacy of
Achieving Very Low Low-Density Lipoprotein Cholesterol Levels With Rosuvastatin
40 mg Daily (from the ASTEROID Study0"
5) Nutr Metab Cardiovasc Dis, 2001 Apr, 11(2):88-94, "Statins enhance arachidonic
acid synthesis in hypercholesterolemic patients"
6) Track Your Plaque, Dr. William Davis, p. 106.