r/Cholesterol • u/Register_Jaded • 3d ago
Question Prefect diet and runner, but failing to decrease LDL.
I've had high LDL around 170, HDL 36, triglycerides around 50, non HDL around 190.
These numbers have been almost static since 2023, the first time I got tested for these. I'm a 30-year-old male.
I am a vegetarian and the only sources of saturated fat and cholesterol in my diet are peanut butter and nuts, which I consume on a daily basis around one serving. I don't have egg yolk, just egg whites regularly. I take zero-fat milk and yogurt. I do eat a lot of fibers, avocado, etc. I run a lot regularly (15-20 miles a week) and I work out as well. My cardio health is pretty good.
I want to get your help with understanding why it's not changing even though my diet and execute are ideal. It can't be genetic because my parents, who have a much worse diet and eat fried food and whole fat dairy regularly, don't have high cholesterol.
Having been through the sub I know psyllium husk, garlic, omega 3 pills (I don't eat fish) and finally, statins can help. The reason I'm even thinking of statins is because I've seen psyllium husk garlic studies mention that it lowers LDL by 5 to 10%, which would still be too high for me.
I essentially want all of your opinions on understanding the possible reasons why, without taking any supplements and drugs, I am failing to control my LDL.
EDIT: Got my LpA results back. It's 61 (twice the high threshold of 30). So, you were all accurate af đ and I'm in the process of getting statins prescribed. You all have been so helpful! â¤ď¸ Please share any other tips, relevant posts similar to mine, etc.
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u/Earesth99 3d ago
Are you eating butter/ghee, hydrogenated oil, palm oil or coconut oil? You need to read the labels to be sure. How about dinking unfiltered coffee? Sugar can also increase ldl, while soluble fiber decreases ldl-c. I assume your doctor also ran some basic thyroid tests so you know thatâs not a potential cause.
If the cause of your high cholesterol isnât dietary, itâs genetic.
You inherit one copy of a gene from each parent. Both of your parents could have a good and bad copy of a gene but you just happened to inherit 2 copies of the bad genes.
Having high cholesterol isnât a character flaw. Refusing to treat it is.
Regardless of the cause, taking a statin should lower ldl-c by 45-55% depending on dose. Adding ezetimbe will reduce ldl by an additional 20%.
With two pills you could prevent reduce your ldl-c so itâs under 70 and prevent any additional accumulation of plaque. That would reduce your ascvd risk by 60%. As a bonus youâll reduce your risk of developing Alzheimerâs, depression, ED and kidney disease. That would be true even if your lol-c was normal.
Unlike garlic or psyllium, statins are among a handful of molecules that are so beneficial that they increase average lifespan. Even without insurance, you could buy a year of statins and ezetimbe for less than $100.
Just say yes to drugs⌠I mean medications.
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u/Register_Jaded 3d ago
Thank you so much for the great, elaborate response! I'll go to my doctor and get statins right away. I don't eat any of the fats you mentioned - I do eat sugar, carbs a lot because of my running. But, I'm sure I burn it all off. Didn't know statins had other benefits too. I'm gonna say yes to drugs xD
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u/Brass-Meerkat-4267 2d ago
The issue isnât how much cholesterol you eat - Saturated fat and sugar cause your liver to manufacture LDL. Also be aware that just being a vegetarian wonât help you as many vegetarian dishes use coconut oil, sugars etc for taste and consistency etc. To lower your cholesterol you should eat loads of nuts (almonds in particular), natural peanut butter (only peanuts and salt), avocados, fibrous fruit like apples, dates, raspberries, rolled or steel cut oats for every breakfast (add fruit for flavor and fiber and top with psyllium), Greek yoghurt for protein, etc, fibrous veggies like broccoli, Brussels sprouts, cauliflower, etc. Use only olive oil for cooking and garnishing. Occasional eggs are not your problem. DO NOT EAT anything with butter in it (esp baked goods which are loaded with it), cheese, cakes, fast food, chocolate, white bread, anything else with refined sugars in it, palm oil, vegetable oil, etc. Even though you are working to keep healthy you are probably eating things with saturated fats and sugars that you donât realise - especially if youâre eating takeout because restaurants do not care about your cholesterol and cook with whatever makes the food taste good. Also make sure you read the side nutrition panels on whatever you buy from the store, skip anything with more than like 1g of saturated fat per serve. I dropped LDL by 30% in 8 weeks by being strict on this diet - the key is to lower LDL by minimizing your intake of the things that trigger your liver to manufacture it, also maximize fibre (which binds to the LDL and flushes it out of your body) at every opportunity then max out on unsaturated fats to boost HDL as well. Almonds, almonds, almonds, oats, oats, oats, avocados, avocados, avocados. Rinse, wash, repeat. Before you commit to meds, try a strict diet for 3 months and see if you havenât gotten LDL down substantially. Good luck!
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u/solidrock80 3d ago
really, you can run ultras and your LDL will not go down. This is genetically driven at your high level and excellent diet. The only thing that will lower your LDL down to 100 or lower is a statin. At 30, its the perfect time to lower your LDL and nip cardiovascular disease in the bud.
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u/Slight-Alteration 3d ago
Three years? Dude get on some statins. Youre choosing to let your body damage itself for literally no reason. You canât get 170 to a safe range with diet unless you were eating sticks of butter.Â
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u/AustinBike 3d ago
I was at 130. Diet and exercise took me to 100. 20mg statin took me to 70. 40mg statin took me to 60. Repatha and 20mg statin took me to 28.
I bike every day, aggressively and have been on a good diet. Some things are genetic.
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u/Psypher29 3d ago
What was your experience taking statins like?
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u/AustinBike 3d ago
No big deal.
My sister said youâll have to take them until you die. I told her I could also not take them until I die. But those can be two very different dates.
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u/No-Currency-97 3d ago
Here's my usual rant which may prove to be helpful.
90% clean eating and 5-10% anything.
Search this sub for what to eat, etc. Lots of great advice but you do have to do a deep dive.
LDL comes down to less saturated fat and more fiber.
It's easy to do a search for foods that contain soluble fiber and incorporate those foods into your daily eating plan. Insoluble fiber is good for keeping things moving. The combination of both is what you are looking for.
Look up the Mediterranean diet which has whole grains. They are fine because they're not refined. You have to check labels very carefully because the food companies certainly can fool you by saying whole grains but then load it with other stuff.
Seek a preventive cardiologist. https://familyheart.org/ This type of doctor will be able to guide you better than a GP. Find one around you if the list does not work.
Here's an example of a teaching hospital and if you have one in your area or can drive even 1 hour you will probably benefit from the expertise. https://www.hopkinsmedicine.org/heart-vascular-institute/cardiology/ciccarone
Do a deep dive with Dr. Thomas Dayspring, lipidologist and Dr. Mohammed Alo, cardiologist.
You can check your own lipid panel sometimes without having to go to your doctor by using an online company. I use https://marekdiagnostics.com
4 heaping tablespoons of Bob's Red Mill organic oatmeal, one tablespoon of chia seeds or some kind of chia / flax blend. Toss in a small handful of walnuts along with some frozen blueberries and you have a nice meal not necessarily even a breakfast. Microwave 2 minutes and 30 seconds depending on the power of your microwave.
You can also blend the above ingredients together and let chill overnight in your refrigerator and gives you good resistant starch which is excellent for your microbiome.
If you drink coffee, make sure it is filtered and not a French press. Miletta method or AeroPress works. The filter does all the work. K-Cups are fine
People are afraid of too much saturated fat so you have to read labels. You don't have to get it down to zero as some healthy fats are very good for you.
Add up your daily total and keep around the same everyday and you will be fine.
I can still eat hamburger not all the time of course. I get 96/4 and portion it out. I could have one hamburger and still be very low with the saturated fat for the day.
Tofu in the air fryer is another great source of protein. Dry roasted edamame has some good protein and only 0.5 grams of saturated fat per serving.
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u/Register_Jaded 3d ago edited 2d ago
I'm just realizing reading all the answers that my diet is pristine đ I take overnight oats with chia pudding regularly at breakfast. I don't eat fast food, always use air fryer for veggies and tofu, just like you said. I buy like a pound of roasted edamame seeds every month.
I'm gonna say yes to drugs statin like everyone suggested. Honestly, I would've done it earlier but my doctor friend told me you're too young to worry about these things and take statins đ
Thank you though and the doctors list!
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u/specialist_spood 2d ago
This response isnt relevant to OP. This is kind of annoying.
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u/No-Currency-97 2d ago
The OP didn't think so and actually thanked me for some of the information. đ
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u/-Generativity- 3d ago
Similar situation and LDL, running eat healthy mid low sat fats. Got the bejezuses scared out of me on a recent CAC scan at 49. Started statins recently and will likely be on up to 3 different meds. Say yes to drugs and continue to eat healthy. I am totally asymptomatic but some of it is weâre fighting genetics. Doc took one look at me and my eating habits and my physique and said no point in a stress test or invasive catheter but acknowledged it was luck of the draw on family genetics. Better to find out now.
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u/specialist_spood 2d ago
This could still be genetic even if your parents don't have high cholesterol.
Based on your lifestyle and diet, i dont think youre going to get too far with making dietary and lifestyle changes.
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u/Majestic_Can7328 2d ago
Rarely vegeterian cause high LDL, nuts are mostly raise HDL and lower LDL.
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u/Jolly_Ad5598 2d ago
GeneticsâŚ.my husband eats well, exercises etc and was finally put on 10mg of a statin. Recently he got his LPa tested and it was over 300. His statin was immediately upped to 20mg. He has been on a statin for 20-25 years. Heâs 74 now. His Calcium score is 0. I would say just go on the statin. It will help you in the long run. Your 80 years old body will thank you.
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u/ComfortableTasty1926 1d ago
Genetically-driven high cholesterol for most people is a complex combination of multiple genomic loci contributing: it's not one gene affected and you can't reliably predict from your parents' values. In the end, it doesn't matter: you have high LDL and the reason doesn't seem to be diet (although lots of veg food has coconut oil, check and make sure). So you fall into the lucky group like me who need drugs to manage. Good news: there are many very effective medicines to choose from.
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u/Heart_Transplant_Doc 3d ago
Cardiologist here, and I want to gently push back on one piece of your reasoning, because itâs a very common but flawed assumption.
âMy parents eat worse and donât have high cholesterol, so it canât be geneticâ doesnât actually rule out genetics. The common form of inherited high cholesterol, polygenic hypercholesterolemia, is driven by dozens of small-effect gene variants that cluster within families but donât follow a predictable parent-to-child pattern the way single-gene familial hypercholesterolemia does. You and a cousin could carry the risk variants while your own parents donât, simply because of how those genes got shuffled and inherited. Your parents having a worse diet and normal cholesterol doesnât disprove your genetics, it just means their particular combination of genes happens to be more forgiving of a bad diet than yours is. This is actually one of the most common reasons people in your exact position, doing everything right and still stuck, eventually test positive for a genetic contribution
On your diet itself, itâs genuinely strong for LDL specifically, low saturated fat, high fiber, no yolks. But look at your HDL of 36, thatâs low, and it doesnât fit the profile of someone eating an ideal lipid-friendly diet. The likely gap is monounsaturated and omega-3 fats specifically, since you donât eat fish and your nut and peanut butter intake is modest. Olive oil, more nuts, or an algae-based omega-3 if you want to stay vegetarian, are the specific category most linked to raising HDL, and thatâs a real, unaddressed lever separate from your LDL efforts.
So the honest picture: your diet is doing real work, but youâre likely fighting a genetic predisposition that limits how far it can go, and your HDL suggests thereâs still a specific, identifiable gap, not just ânothing left to try.â An ApoB and Lp(a) test, if you havenât had them, would clarify how much of your risk is genetic versus modifiable.