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Ok. Steak lover here also - plus eat plenty of chicken,turkey. But have a friend who just got a report of high cholesteroal and super high triglycerides. The physician who got this report went nuts about putting my friend on no red meat diet. This person now eats ground beef, beef roasts, some steak, regularly!

The spouse will NOT eat chicken or fish. Friend is on medication for the cholesterol but these levels still went up - zoomed up.

Any reasonable ideas to help this friend's health "emergency" (according to the doctor)?

Ounce for ounce, any flesh, be it bird, mammal, or fish, has about the same amount of cholesterol. Other tissues, such as brain and organs, have a great deal more. You have to have a certain amount of cholesterol for health. If you don't get sufficient cholesterol in your diet, your body will make it. Dietary cholesterol is transported through LDL (low density lipoprotein). There is a receptor on cells (especially in the liver) that these LDL particles dock with and unload their cargo. The unloaded cargo causes the endogenous production of cholesterol to be downregulated resulting in cholesterol homeostasis--keeping a more or less constant level of cholesterol appropriate for tissue repair. If you're not getting enough dietary cholesterol, the endogenous production is increased to compensate.

There are several ways of screwing up this homeostasis: 1. you can simply ingest so much cholesterol that even if your body were to shut down its own production you could end up with too much, 2. you could screw around with the components of the transport (and reverse transport) mechanism. One of the components of the reverse transport mechanism is HDL (there are several varieties), high density lipoprotein. It carts cholesterol from the body back to the liver where it is disposed of, largely as bile salts.

There is a family in Italy with an interesting mutation in their HDL. It works so extremely well that these folks are almost completely free of cholesterol-related heart disease, even though their diet could indicate otherwise.

If you're not lucky like that, you could have a genetic defect in some other component. Very often people who have very high levels of cholesterol have some sort of problem with their LDL receptors. If LDL cannot be internalized, your body thinks it's not getting enough and continues to produce its own cholesterol.

There are consequences to this. The LDL particles floating around in the blood stream can get oxidized and damaged to the point that other receptors are impaired in their jobs of getting rid of it. The damaged LDL is scavanged by foam cells that then extravasate through the intimal lining of the blood vessels and build up between the intimal lining and the smooth muscle of the blood vessel. They die and leave their cellular debris and cholesterol load there. Over time this builds up into what is known as arterial plaque.

Increased plaque decreases the diameter of the blood vessel, reducing blood flow. If the blood flow is reduced too much, the muscle served by it may not get enough oxygen, especially if overworked. If the blood vessel is a coronary artery and the muscle is the heart, you're in trouble. If the intimal lining should happen to become ruptured over a plaque deposit, the contents, being highly thrombogenic, can quickly form a clot that can either pretty suddenly block the flow of blood, leading to the malfunction and damage of coronary muscle, or can break off and go somewhere else where it will block the flow of blood. Aspirin can help to lessen the risk of clot formation.

Anyway, the problem with high cholesterol foods together with highly saturated fats is that saturated fats can impair the functioning of the LDL receptor. So, if you have a person whose endogenous cholesterol production tends to be high who also has defective LDL receptors who also eats a lot of high cholesterol food and saturated fats who is not one of the lucky ones from Italy with super-HDL and who does not engage in enough physical activity to boost his own HDL levels, you have someone who is more likely than not to develop heart disease.

The goal is to determine the causes of the high cholesterol and then treat accordingly. If someone has defective LDL receptors, then he has to take care to reduce the amount of cholesterol he eats. This is true for anyone. You have to determine what overwhelms the system and stop before that point. Almost anyone can tolerate an ounce of alcohol. Almost no one can tolerate a quart of alcohol. He could also try to boost his HDL levels. He could take drugs that help to reduce the endogenous production of cholesterol. He could take "drugs" that bind the cholesterol in bile salts and prevent it from being reabsorbed in the intestine. All of these together can help to reduce the cholesterol to the point that its not hanging around too long in the blood stream in LDL getting oxidized and scavanged and deposited as coronary plaque.