Carbonfiberboy 

Doctors have an app on their phones called the Pooled Cohort Equations for cardiovascular risk. They plug your stats in and get a number out, the percentage of your risk of having a CVD event in the next 10 years. Then they go to a table of statin dosages based on that risk factor and your other stats. That's what they offer you. You don't have to take their offer.

My cardiologist tells me that risk is mostly genetic and not so much about exercise and cholesterol. But that's just risk. IOW, the standard method for the diagnosis of heart disease is having a heart attack. Before that happens, most of us have no idea that we are personally at risk.

Before this year, I'd always rejected taking a statin, even though the smartphone app said I should. I figured heck, I get lots of exercise, have eaten a plant based diet for over 40 years and have a normal cholesterol of 200. But I got lucky and had signs of another heart ailment which meant that my insurance would pay for the full panel of heart examinations. And guess what? Turns out I have the normal amount of coronary arterial calcification for a man my age. IOW, I could die any time now. I was shocked, having always assumed that being in the .01% of exercisers also would be protective of heart disease. Nope. It's genetic. My older brother had a quadruple bypass when he was much younger than I am.

So now I'm on a low dose generic statin, ~$2/month. My cholesterol dropped from 200 to 141. My HDL/LDL ratio is 1. My total/HDL is 2.2. The cardiologist says that with my diet and exercise and those numbers it's possible to reduce my heart calcium score. Maybe. Meanwhile, I'll just keep on keeping on, having done everything I know to do not to make my wife a widow.

Anyway, I have zero ill effects from the statin. I take 100mg of CoQ10 twice a day to make sure that's the case. My previous attitude toward statins turned out to be simple ignorance.

Hondo Gravel

The high sugar intake may be the cause as you stated. I intake an energy drink and or a cliff bar frequently which as you know is high fructose it energizes me to exercise and makes me feel good but can have adverse health effects. Who knows? I might be doomed by genetics or not. For every study that days one thing there is another that says the opposite.

Carbonfiberboy 

As long as sugar is only a part of your diet on the bike, I sure wouldn't worry about it. Say you ride 10 hours/week and average 130 cal./hr of sugar. Say your daily is 3000 calories, so that's 1300/21000 or ~6% of daily calories. Not to worry! If your daily is only 2000 calories, that's 9%, still no big deal. So the important thing is to eat a natural foods diet, avoiding sugar, and use sugar on the bike to improve your cycling. We simply don't have desert or have cookies, etc., in the house. Works for us and sure helps keep the weight down.

I would further note that exercise has a huge effect on cholesterol. There's only the one sugar/cholesterol study and it wasn't a study of endurance athletes. It's also the lowest validity study, a self-reporting study of a population. There's a https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3906547/

KraneXL

Sugar is ok as fuel during your aerobic exercise, and to load up (complex carbs) before an event. That's what carbs are good at. Otherwise, you don't need them.

wolfchild

Good post, that answers my question right there...I guess we humans are doomed by our genetics no mater how healthy we eat or how much we exercise. It seems that drugs and medical science does more to increase our life expectancy than diet and exercise.

Carbonfiberboy 

True, but I wouldn't put it quite like that. I think diet and exercise increase our enjoyment of life and of course also our life expectancy. Perhaps medical science has a greater effect on life expectancy as we can see by how long couch potatoes are living now. But it's nice to be able to do whatever one wants in old age instead of hobbling about or being confined to an inactive existence. Joy is our reward.

There's a skier up at the area where I've skied since I was 17. He is 94 and skies beautifully. He can hardly walk in his ski boots, though. Just clumps along like any little old man. But he puts on those skis and he's transformed.

wolfchild

I find it very inspirational every time I see an older person exercising, working out and taking care of themselves.

wolfchild

I agree that sugar is ok in limited amounts during or post exercise and I use it myself...but the problem is that many people get a lot of their daily calories from sugar while being sedentary. I am not talking about complex carbs here, but I am talking about refined sugar which is added to so many different foods.

DaveLeeNC

In my case it is a genetic predisposition. I think it is called familial hyperlipoproteinemia type IIA (IIRC). All my siblings have this issue (and I live on a low carb diet).

dave

pdlamb

In general, I don't know.


In my own case, it was probably inattention to diet in general. See-food, eat-food, I burn it off riding every week. Except I didn't, and I paid the price. But cut down the fat, cut out the junk food, cut down the sugar, and start on a statin, and my LDL dropped by 2/3. Since my PCP said a 25% cut is about the best you can expect from a statin, I attribute the rest to the diet change.


I suspect if most people cared enough to make a difficult lifestyle change, they could just start eating a healthy diet and most people would be fine. For those who do make the change and need it, there's drugs. Does that make cyclists who need to start statins genetically predisposed, or just human?

jsk

Well my total cholesterol is just a few point above the 'healthy' limit at 208. Thing is, my, triglycerides and LDL are well within the healthy range, and all my ratios are great. The only reason my total cholesterol is as high as it is, is because my HDL is so high (which is actually considered a good thing). I attribute the high HDL to my aerobic fitness, as it wasn't as high before I got into cycling.

Interesting thing is, my total cholesterol has been in the 200-220 range for as long as I can remember, even back when I was fat and sedentary. What's changed with improved health/fitness is the ratios of the various subcomponents. And since those numbers are a better indicator of health, I don't worry about the total number (especially since there's indicatiosn that total cholesterol levels have a pretty strong genetic component).

KraneXL

I wouldn't look at it like that since all medicines have side-effects. Besides, that would mean that I could eat whatever I wanted, and as much as I wanted, and then pop a pill and all would be well. We all know that's not true.

Carbonfiberboy 

Yeah, that's exactly what I'd been telling myself for the past couple decades, exactly. Have your doc get your score off his app. I've done a 180. "Low dose statin" is the great news for those who are already healthy by choice.

jsk

They problem with that assessment they use, is that once you age into the mid-60's it will recommend statins for EVERYBODY, no matter how fit and healthy they are, no matter how good their numbers are. IMO that's BS. There's just no science backing up such widespread use of statins in healthy people who don't haven't had a cardiac event and don't have CVD.

Carbonfiberboy 

That was exactly my rationale for refusing statins for the past 5 years or so, and is the usual internet gospel. However, the equations are based on long term observational studies of very large populations, looking at who died or had heart attacks with what numbers at what age. I've been saying that I didn't know that I had CVD until I had a coronary angiogram. Nor does anyone else. My numbers were at least as good as yours and I was equally ignorant about the possible state of my heart. As I said, the common diagnostic for CVD is a heart attack. I'd rather avoid that specific a diagnosis. As with all medical issues in our society, treatment is an individual choice.

OTOH, a echocardiogram and coronary angiogram are less expensive than many modern bicycles. It'd be an interesting choice if one had the discretionary funds. Let's see . . . life or a European vacation? Or maybe $2/month for a low dose statin might better fit the budget.

Carbonfiberboy 

Yes, we do know that, nor is anyone here or in the medical community suggesting that's a good idea. Statins aren't a fix, they're more analogous to caffeine. Caffeine won't win the race, training and talent do that. But it helps so we use it.

ctpres

Been on generic statins for over five years with no noticable complications. A few years ago I was riding 50+ mi a day 3 or 4 times a week getting ready for a century. Ran out and it was a few days before I could get more. In that short time my daily mph avg went up by a significant %. Intentionally dropped em before century and did OK. Just went thru heart stress and bubble tests. Mentioned results to heart Doc. He said it would be OK to experiment.

Orroadie

Actually, the science says that a planted based diet can counter a strong genetic disposition to heart disease. Statins can help, but diet is indisputable. The only thing about undertaking a plant based diet is that you have to adhere to it strickly to reverse arteriosclerosis. If you just want to stave off the usual build up of plaque in your arteries which can eventually lead to heart disease, a modified plant based diet and statins can accomplish this. To reverse plaque build up, you have to eliminate all oils, dairy, all animal products such as fish, chicken, meat, and eat only planted based foods such as grains, legumes, vegetables and fruits. I am currently on a modified planted based diet but still eat dairy and fish, and on 10 mg of simvastatin. Im 66 and did a 20 miler after work today. I feel pretty good but don't feel I can push it to the degree I did about 10 years ago. I am not sure whether its the statins or just getting older. If you need to get your cholesterol lower, i would work both on diet and take statins if you need them, but try to keep the dose low and take Co-Enzyme Q (100 mg Ubiquinol). Happy pedaling!

rideorfly

I think you'll get a variety of answers on what diet is best. It's helpful to experiment to see what works you. I definitely second the CoQ10 if you must take statins. I think I posted in this form when it first started. I take a water-soluble form of CoQ10 for better absorption.

Orroadie

On the issue of statins, I wrote on 5-5-`8 that I wasn't sure whether 10 mg of simvastatin is affecting my endurance on a ride. Today I went out and did my normal ride - 20 miles with hills in the mile high City of Denve, ti which am acclimated and felt strong. I didn't experience any aching or tiredness on the climbs as I usually do. In thinking about this, I think I forgot to take my dose of statins last night which may be why I felt so good!. I really don't remember whether I took it or not but don't remember popping the pill in my mouth - so that's my explanation. There have been some studies showing that taking statins on alternate days is still effective in reducing cholesterol, but by perhaps a lower percentage reduction. The feeling I had while riding today was how I used to feel maybe 10 to 15 years ago. I think its important to feel good while you ride, because it is more motivating, feels good and enables you to get a better cardiovascular work-out. Riding on statins is ok but feels like there's a governor on my speed that limits what I can do (if in fact that is what is causing aching and tiredness). I will update my post if anyone is interested to know whether alternate days on statins affects how strong I feel on a ride, which may apply to you. I am 66 so statins may have more of an effect than on a younger person.

Dudelsack 

rideorfly

Thanks for sharing! I've seen many anecdotal reports on paleo and lipid panel improvements. Triglycerides are another marker to look at. Paleo usually comes along with eating lower carb, which can potentially lower trigs. Needless to say, this is all purely informational. Also, you may want to consider adding CoQ10 to your regimen to help with potential cell damage caused by the statins. Statins can lower CoQ10 levels, which our mitochondria need to make energy.

KraneXL

Best answer. This is why there's an entire profession (dietetics) devoted to nutrition and diet. There are similarities that apply to all of us -- everyone needs to eat -- but the method and application at which those similarities are achieved can vary greatly. After all, we can't all eat and absorb the same foods.

Road Fan

After you went off it, what happenned to your cholesterol scores? Did you still need that managed?

satbuilder 

Unfortunately I have this large chain attaching me to my desk these days, so my scores are in need of management. I'm now on Crestor 20mg/day and don't suffer the side effects of the Lipitor.