“Total” cholesterol is increasingly considered less important than other elements in a comprehensive cholesterol panel, such as an NMR LipoProfile.

Cholesterol Screening: An Important Window Into Your Health

The US Navy administered my first cholesterol test. A healthy twenty-something, HDL, LDL and triglycerides were merely random numbers jotted into a government health form. I felt and looked fine. Not surprisingly, heart disease and other long term health conditions were nowhere on my list of concerns.
Fast-forward two decades. Now a father with two young children, health is a family affair. With little eyes watching, good nutrition and exercise feel like parental responsibilities. Further, the latest technology such as mobile apps and wearables allows even the most techno-phobe little excuse not to record and monitor daily activity and other health related data from year to year, employer to employer. Nowadays it seems people are more likely to wear a Fitbit than a watch.

But today’s technology does not break the skin barrier or capture much of what is going on inside each of us, blind to data that experts consider increasingly important to long term health. 
What is the big deal with cholesterol?
Cholesterol markers are found in a number of chronic conditions, including cardiovascular disease, and can serve as early warnings to other conditions such as liver disease and diabetes. Wanting to avoid any and all, cholesterol is a good place to start understanding how your body is responding to the food you feed it.
Cholesterol — An Evolving Story
However, if you haven’t been following cholesterol’s story as of late, you are probably behind. As new studies are released, not only are we learning more, we are revisiting what we thought we knew. One can expect “good” cholesterol will have a new definition and reference range as more dust settles in the scientific community. Indeed we may drop the terms “good cholesterol” and “bad cholesterol” altogether.
In the meantime cholesterol screening recommendations, as well as the depth and breadth of the tests themselves, have evolved. For instance, certain tests now measure directly rather than calculate cholesterol levels (example “p” stands for particles measured in the test, while “c” stands for calculated, often considered an inexact if not periodically erroneous representation). 
Further, science is suggesting the size of the LDL particle is important, with the goal being “big and fluffy” LDL particles, as compared to “small and dense.” Some popular best selling doctor-authors, such as Dr. Wahls and Dr. Bredesen, are now recommending minimum total cholesterol levels for optimal brain health. Dr. Davis, author of recently released “Undoctored” and bestseller “Wheat Belly”, asks that we “stay tuned” to future discussions on acceptable levels of large LDL particles. 
Until the matter is settled we should remain open minded about traditional total cholesterol guidelines.

Jimmy Moore — author of Cholesterol Clarity, and other titles — weighs in

I discovered Jimmy Moore through a Dave Asprey podcast. For those of you following Dave Asprey, the founder of the Bulletproof diet and lifestyle movement, Dave comments frequently on the importance of body indicators and interviews many thought leaders across the health spectrum for his weekly show.

After reading Jimmy Moore’s book on cholesterol I reached out to him for inclusion here, and this is what he had to say:
“Cholesterol is one of the most misunderstood health indicators. Critical to normal cell functioning, including brain health, what has been taught in medical schools and promoted by modern culture is only part of the story, and generally wrong. Understanding and tracking your HDL, triglycerides and LDL particle size will be much more helpful in maintaining your health and avoiding many of the increasingly common chronic conditions.”

Jump start your cholesterol education

Jimmy’s book, “Cholesterol Clarity: What the HDL is Wrong With My Numbers?” is a compilation of cholesterol topics and education from collaborating with over two dozen thought leaders for his book. It’s a great starting point to catch up on the latest thinking and where new health recommendations may ultimately take us.

Cholesterol and Other Related Test
Unsure of where science takes us next, but wanting navigational health aids for what I anticipate will be the path forward, my new personalized health chart from the NMR LipoProfile test includes the following:

1. Total Cholesterol — a sum of HDL, LDL and Triglycerides. Note for those interested — cholesterol, moved through the body by lipoproteins, is actually not the same as the components that make up the “total cholesterol” count.

2. HDL-P — High Density Lipoprotein, particle count. HDL carries cholesterol throughout body.

3. LDL

a. LDL-P — Low Density Lipoprotein, total number of LDL particles. LDL carries cholesterol throughout body.

b. Small LDL-P — small sized LDL particles, believed to be a better indicator of heart disease risk

c. VLDL — Very low density lipoprotein

d. LDL Size

4. Triglycerides — storage containers for unused calories. Providing the body energy, circulates in blood along with cholesterol


5. Hemoglobin A1c — average level of blood glucose over preceding 3 months

6. Apolipoprotein B — a measure of atherogenic (artery plaque causing) lipoproteins

Health Testing Centers is offering HSA Coach users 20% off any of the many, many tests they offer, not just cholesterol.

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Functional Medicine and Health Consumer engagement

At the dawn of functional medicine, I have already experienced the patient advantage of preparing for doctor visits like I would a job interview. I now to to each with a game plan of what I’d like to accomplish. Before the appointment I gather material and research topics, ask while in the office make sure to ask my questions and take notes.

I find that not only do l get more from the visit, the doctors respond to my interest and, I think, spend a few more minutes of their increasingly compressed schedule.
As part of this new approach to health care engagement, by committing to tracking my cholesterol history, while making notes in my lifestyle regime that correspond to the results, I’ll be better prepared to turn in to the medical practitioners when the time comes.
Future Posts
In future posts I’ll discuss inflammation, blood platelet, hormone and complete metabolic panels I’ll also start including in my personal health file.

About Aaron, CFP, EA

Aaron Benway is a Certified Financial Planner (CFP) and IRS Enrolled Agent (EA). He co-founded HSA Coach, a digital tool to educate consumers on HSAs, track health expenses and other documents, and provide individual financial calculators, to help consumers get the most from their HSA and other savings. To help individuals directly with their financial planning and wealth management requirements he founded AB Financial Planning.

Prior to HSA Coach Aaron was the CFO of HelloWallet, a financial wellness software startup purchased by investment research firm Morningstar. Earlier in his career Aaron was an investor at The Carlyle Group and a nuclear engineer in the US Navy. Aaron has an Electrical Engineering degree from the US Naval Academy and an MBA from Harvard Business School. Aaron lives in the Washington DC area with his wife and two children.

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