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HDL2b -- Age, Adiposity, Alcohol and Estrogen

Posted Sep 01 2008 7:12pm
The lipoprotein subfraction HDL2b is emerging as the marker for regression of plaque and longevity. Even evidence from 10-15 yrs ago revealed this remarkable relationship. Looking at to centenarians, scientists often search for answers and clues to longevity and control of chronic illnesses. These Italian researchers examined the the relationhsip between 2 subfractions of HDL -- dense HDL 3a and large fluffy HDL 2b. HDL 2b appear protective (at 32.4%) compared to younger/healthy matched controls (at 23.4%) and HDL 3a, degenerating for longevity. The interesting thing to note is that total HDLs were similar between all groups. In other words, the HDL from traditional labs tells nothing about HDL2 or HDL2b or HDL 3a. ( Here Dr. Davis rails upon the failures and weaknesses of conventionalist-type medicine in their overreliance on Friedewald's equation. )
"In order to assess the role of HDL on longevity, we studied HDL subfraction distribution in centenarian women compared with a group of weight- and gender-matched healthy normolipidemic controls. We did not find any significant difference in the mean plasma lipid, apolipoprotein, and Lp(a) levels. On the contrary, in spite of similar HDL-cholesterol concentrations (1.32 +/- 0.41 mmol/l in centenarians vs. 1.32 +/- 0.25 mmol/l in controls, p = not significant), HDL2b and HDL3a levels were, respectively, significantly increased and significantly reduced in centenarians in comparison with controls (HDL2b 32.4 +/- 9.2% in centenarians vs. 23.4 +/- 7.7% in controls, p less than 0.002) and HDL3a 26.3 +/- 9.8% in centenarians vs. 34.1 +/- 7.3% in controls, p less than 0.01). HDL2b levels were significantly raised and HDL3a levels were significantly reduced in centenarians in comparison with both 'middle-aged' and 'elderly' subjects, whereas no difference for any HDL subfraction was found between the two groups of controls of different ages."

HDL Subclasses

The subclasses of total HDL are defined via absorbency of a protein stain which serves as an index of mass concentrations at intervals of 0.01 nm. We desire a reduction in CETP activity to prevent transfer of mass from HDL to VLDL (small dense LDL).

  • HDL3c (7.2 to 7.8 nm) -- plaque-builder (bad)
  • HDL3b (7.8 to 8.2nm)
  • HDL3a 8.2 to 8.8 nm)
  • HDL2a (8.8 to 9.7 nm)
  • HDL2b (9.7 to 12 nm) -- regressive on plaque (good)
Research that came out of the Lawrence Berkeley Labs in 1993 also reinforced how reductions of HDL2b parallels how known risks for CAD go up with age, adiposity and lack of estrogen. Williams et al studied HDL subfractions in Mormon men and women here in the Bay Area. Some Mormons kindreds did drink and smoke -- *ssshhhh* don't tell the church -- and their data were excluded from relevant analyses) The alcohol factor is curious -- for women it may appear protective however for men no distinct protective benefit for HDL2b appears strong because a corollary increase in HDL3b and 3c occurs with alcohol consumption (which may potentially negate the mild 2b increase?).
  • Williams PT, Vranizan KM, Austin MA, Krauss RM.
    Associations of age, adiposity, alcohol intake, menstrual status, and estrogen therapy with high-density lipoprotein subclasses.
    Arterioscler Thromb. 1993 Nov;13(11):1654-61.
    PMID: 8218107

Here are their conclusions as they summarized:
  • HDL3b concentrations were higher after menopause than before
  • Eighty-eight percent of the increase in HDL associated with estrogen replacement (conjugated/horse hormones most likely) in postmenopausal women occurred within HDL3a (bad) and HDL2a.
  • Adult men (> or = 18 years old) had significantly higher HDL3c and HDL3b
  • Adult men had significantly lower HDL2b and HDL2a levels than younger boys (why?)
  • There were no significant differences between the HDL profiles of women and younger boys, suggesting that divergence in HDL occurs during puberty
  • Compared with the women, adult men had higher levels of HDL3c and HDL3b
  • Adult men had lower levels of HDL2b, HDL2a, and larger-diameter HDL3a particles compared with women (is this why women live longer then men??? )
  • In both men and premenopausal adult women, increasing levels of body mass index were associated with higher levels of HDL3b (bad) and lower levels of HDL2b (very very bad).

The authors noticed that "Reported alcohol intake in adult men correlated with two HDL regions: one within the HDL2b region (good) and a second within the HDL3a/2a region (bad), whereas in women the positive correlation between alcohol and HDL levels was within the HDL2b region only."

So what are the most potent things we can do to raise HDL2? We know that most of the HDL2 increases are due to HDL2b increases. HDL2 in fact is a good surrogate for the regression marker HDL2b. Studies show this -- and the TYP program reinforces this:

--Achieving normal BMI. Reducing adiposity (esp central though the above study does note that central vs. peripheral was not measured) will raise HDL2b and lower HDL3a/HDL3b/HDL3c

--Reduce your 'biological age' -- how? movement movement movement, vitamin D3, etc

--Take Niacin raises HDL2 100% (or occasionally get ketotic with intermittent fasting -- when you're not stressed/sleep deprived which is when Cortisol is excessively high)

--Take Fish Oil 'low dose' 4 g DHA/day raises HDL2 30%

--Restrict carbohydrates (yes sirree, that includes F - R - U - I - T - S , ie, Nature's candy) and again the same researchers at Lawrence Berkeley Labs confirm this here. And even for you elite athletes out there -- the low HDL corresponds to CAD risk -- and carb (yes fruit) will trigger concomitant huge magnitudes of insulin eruptions and reductions in HDL2b and increases in VLDL/small LDL. The research demonstrated that here well.

--Consume a higher fat and saturated fat lauric acid (unprocessed coconut oil) and butyric acid (raw pasture raised butter oil)

--Get on Bio-idential/tx estrogen which raises HDL2b 150% (total HDL (if you're lacking -- yes even men? perhaps... Post-menopausal women do apply Testosterone cream, why not vice versa?) In the study below Ethinyl Estradiol 0.1mg orally was taken by pre-menopausal women and resulted in total HDL increasing 38.3% and HDL apoA1, 25-27%. Oral estrogen sometimes worsens cholesterol for some -- transderm/topically applied are preferable for some. Are women the superior species?

Well... though what would we be without the men we stand behind?

  • The effects of estrogen administration on plasma lipoprotein metabolism in premenopausal females. Schaefer EJ, e t al. J Clin Endocrinol Metab. 1983 Aug;57(2):262-7.
    PMID: 6408108


If you want plaque and a reduction in heart-protective HDL2b, follow the AHA Step I low-fat diet. The researchers are GENUISES... they repeated the same results in obese, postmenopausal women (but at least their conclusions were rationale this time).
Effects of an American Heart Association step I diet and weight loss on lipoprotein lipid levels in obese men with silent myocardial ischemia and reduced high-density lipoprotein cholesterol.Katzel LI, Coon PJ, Dengel J, Goldberg AP. Metabolism. 1995 Mar;44(3):307-14.

ENJOY! And...give a copy to your conventionalist MD... you have my need to wait for April Fool's Day or another heart attack...
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