Cholesterol? Overall vs ratio

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Who knows about this stuff?

My cholesterol has gone up, which is disappointing, my 'bad' cholesterol has gone up and also my good cholesterol but my ratio is much improved

Is this ok or should I worry about the overall rate?

I eat a high fat diet but over the recent few months Im eating a bit too much sugar I think in cake and chocolate form, its the sugar I need to cut out I think

My blood sugars have drastically gone down over the same period which is also confusing.

My qrisk score is 3.4 on the NHS result but when I do the online calculator its 3.9 and my heart health is older than I actually am. My risk is higher than the average for my age and sex

It depends on which fats you are eating. If saturated fats from meat, cheese, cream, coconut , cut those together with cake and chocolate.
Eat more plants and look into the Portfolio diet.

I eat a lot of animal fats yes

So even though my cholesterol has gone up, my ratio has gone down, which is the better measure?

It seems to me you are looking for technicalities in order to keep eating a diet we know is a risk factor for heart attack, a leading cause of death for women . And stroke.
So take those numbers seriously and change diet listening to real doctors and not social media. The amount of crap you hear on keto podcast and pages is shocking, but shock increases traffic and ad revenues.

Cholesterol can be reversed, statins can be avoided. It is the beginning of the New Year, the perfect time to make changes.
Animal fats need to go out. Have a look at the porfolio diet I was mentioning before
https://www.heartuk.org.uk/dietary-patterns/portfolio-diet
(when prompted, say YES, that you are a health professional) .

Habits are hard to change, but red flags and warnings shouldn’t be ignored.

The ratio is the important figure to consider. My overall cholesterol is high but my ratio is good so no need for statins, says my GP.

You're probably right about the justification but I am also a detail person about things like this, if I am going to make changes, which I havent decided yet, I want to make sure its proportionate and based on the right information

My overall cholesterol is 6.6 (5 years ago it was the same but I managed to get it down to 5.3 2 years ago, now its gone back up)
Ratio is 3.7 (5 years ago this was nearly 7)
HDL is 1.8 (5 years ago this was under 1)
LDL is 4.4, this is extremely high I think and very bad
non HDL is 4.8, again too high but has gone down over the past 5 years

I dont know if the trajectory which I have been seeing over the past 5 years with better results is ok to just carry on.

So I seem to have a good protective factor in the ratio and HDL levels which have vastly improved.

The problem is the outcome is 'no action' on the st results. I didnt even have these tests for this purpose anyway so the follow up appointment with the GP probably wont focus on this and they'll fob me off and say everything is ok, even if it isnt.

I missed the bit about 'listening to real doctors and not social media' what does this mean?

I mean, listen to your doctor that you know in real life and not random opinions on the internet. A real doctor that can assess your personal risk based on cholesterol and other factors such as your overall health, blood pressure, weight, activity levels, family history, blood work, ...
You and the internet are not the same thing, and heart health matters.

Well the doctor isnt going to speak to me about it, thats the point.

Its come back as 'normal, no action'.

I will have a GP appointment but its not for this, its for another matter, you cant talk about more than one issue at the appointment.

So I thought I would just ask if anyone has information on here.

There are various foods that you can eat to reduce cholesterol- Benecol for example, although it is a UPF so I would personally avoid that.

Foods rich in inulin are almost as effective eg onion, garlic, asparagus, leek, artichoke. I'm not sure how much of these you need to eat for cholesterol reduction but i am sure you'll easily find it with some googling.

Ive got a fat tooth, thats my problem

I eat a lot of nuts, olives, olive oil and also dairy and other animal fats. Cream butter and cheese, cant get enough of it.

In the last 6 months in particular I have also now developed a sweet tooth on top of that, which I never had so now cakes and baked stuff has crept in to my diet and Ive also let my exercise slip

I eat tons of garlic and onion

Well, reducing your intake of animal products if you eat a lot of them, is a way to start. How many times per day/week do you have an animal based food (meat, eggs, cheese, fish, …) ? Once per day? three times a day? or twice a week?

Beyond heart, many cancers are linked to high meat intake.

Just seen your last about cream and butter, sweet stuff and exercise.

Having written it down, you can now start to make small changes.
Sorry your GP won’t talk to you.

I will try and raise it at the appointment but also I dont want to derail the purpose of me being there anyway as well.

It just puzzles me that they see the result as normal whereas I thought it was high. Perhaps its not high

I eat meat or animal products several times a day. My focus would be to cut down on the sweet stuff really initially, I would find that easier to do.

The best precautions are Mediterranean diet, exercise and sleep. Lifestyle modifications only help to a degree, Statins are effective but are lifelong and for some people have side effects so need some thought. I believe the current indicator for prescribing is around a Q risk of about 10. For context my mother in law is 82 with a cholesterol of 8.1 and no sign of coronary artery disease; my dad had a massive heart attack at age 59 with a cholesterol of 4.8. It’s complicated.

Olive oil and nuts are really good for you. If you look up Dr Michael Mosely’s ‘Just one thing’ series on BBC Sounds, there is one about olive oil in which he says we should all eat a lot (2tbsp I think it was) a day.

Cream and cheese are high in saturated fats so to be eaten in moderation.

Have a look at the Portfolio diet I linked. It was created by the most famous metabolic doctor in the world. He first created the glycemic index of food in the 1980s which everyone knows about and then, after glucose metabolism, moved to lipid metabolism.

Then , in the end , it is you and your choices. You don’t want to cut meat or animal products for any of the three meals a day, it is your prerogative.

Yes I eat a huge amount of olive oil and also nuts. What I meant was its a lot of fat in my diet, thats why I referred to having a high fat diet. I do have a lot of full fat diary. Cream I think I have at xmas and weekends really but full fat milk all day long, cheese once a day. Nuts a lot of the day. Lots of chicken and tuna.

Today for example I had roasted veg and cheese for breakfast, then roast chicken dinner soup for lunch, then some cake, then ham and lentil soup, then some chocolate, then some nuts, then cheese and cucumber, now some pigs in blankets (obviously the pigs in blankets are shop bought)

Not untypical. I might sometimes have rice or quinoa with the veg at times.

Cheese, chocolate, cake and pigs in blankets probably not ideal on a regular basis if you are trying to reduce risk

in your shoes, I’d focus on reducing the saturated fat. So have a think about either reducing the portion size or frequency of cheese, cream, red meat and have a think about what you could have instead. When buying red meat, consider buying leaner cuts or even trying venison instead. Or you could have more chicken and fish.

Yes I'll have a look. I dont eat red meat really, its chicken and fish. The little sausages tonight were being used up after xmas. Same with the ham, I had slices in the freezer so just threw it into the soup

Cheese, I have 30g a day but sometimes I will have it twice, depending on what Im eating. This morning was 30g but then tonight I had the same of brie.

Cream is at weekends and xmas, Ive eaten a lot over xmas with cakes and puds.

I think its chocolate and butter and cakes. Theres a lot of fat in those things.

Im just puzzled at the 'no action' note on the results but equally why my ratio is so good if the overall cholesterol is high. Thats what I was asking really, I dont want to change my diet, I eat well and I enjoy it and wondering if over the past 5 years my ratio has virtually halved.

I was told they look at Q risk rather than cholesterol levels unless they are seriously high. Mine was in the 8s but I did the portfolio diet and got it down to the 6s. I am back eating a modified diet now - but I am minimising cheese and try and avoid butter and cream and I now have vastly more beans in my diet!

I have had high (ish) cholesterol for years. However my ratio is good as are tryglicerides. I did nothing to change what I ate and carried on regardless. GP was pushing for statins but I refused due to the side effects.

Anyway I developed Afib along the way and while in hospital for that had every cardiac test you could think of, ECG, stress, echo and bloods like Dracula. I even got a cardiac calcium CT, which to everyone's surprise (given the years of high cholesterol) gave a zero score for calcium deposits which lead to blockages in the arteries. It was the best score it could be.

So here I am, on treatment for Afib but nothing else, and cardiologist approved this. I dunno, I'm sceptical of cholesterol tests now, but there may be something in the Qrisk score, which I suppose was low in my case, as I didn't ask about that!

Yes its interesting isnt it. My ratio is good, my triglycerides are good, my good cholesterol is very good.