(#006) On cholesterol and renewal
DISCLAIMER: Cholesterol isn’t exactly the kind of topic that keeps you glued to your screen. Even worse, in this article, I dive into all the dates and numbers that detail my vicissitudes with this biomolecule—this lipid, this sterol (all undeniably sexy words, as you can see). But it had to be done to make a point that cuts through the fat (pun very much intended) and gets to the heart (…) of how much power we have to self-renew and live an active, present life—a life of intention—if we commit to doing the work.
If you're only interested in the dietary conclusions, feel free to skip straight to the last chapter (“D01—Dough 01”). Bon appétit.
Also, I plan to update a few sections with more data and analysis from time to time, so if this topic interests you, be sure to check in every now and then.
The Piggy Bank Inside All of Us
I knew I had high cholesterol for four years.
The first time I realized it was through my blood work on January 6, 2020. The doctor took a quick stab at calculating my probability of having a heart attack based on the results, told me it was unlikely anytime soon, and moved on to discuss the rest of my health.
He didn’t dwell on the subject.
Neither did I.
My guanciale vendor didn’t lose any business.
My total cholesterol was 263 mg/dL, and my LDL—the so-called “bad cholesterol”—was 168 mg/dL.
Those numbers should have been 190 and 115, respectively.
I was over the limit by about half.
I tested it again on January 18, 2021. This time, my total cholesterol was 239 mg/dL, and my LDL was 172 mg/dL.
Different numbers. Still very high.
Different doctor. Same casual attitude about my odds of dying prematurely from heart failure.
Carbonara stayed on the menu.
The beauty of being young (I was 40 and 41, but in my mind, I was—and still am—incurably young) is that when you feel healthy and look healthy, you don’t doubt that you are healthy. Even worse, you don’t doubt that your lifestyle is healthy.
In fact, the healthcare system is built on this very cultural backdrop: as a teenager, you don’t schedule colonoscopies or routine check-ups with your general practitioner. You don’t spend your time thinking about longevity best practices.
My generation was raised to believe that health is only a concern once you lose it—or when population-wide statistics suggest you might be at risk, at which point the healthcare system steps in to foot the bill. In other words, when it’s likely too late.
In reality, we are all born with the maximum amount of health we will ever have, and we start losing it from day one.
Growth—whether neurogenesis, muscle development, hormonal shifts, or any other biological process—is essential for survival, yet inextricable from the aging mechanisms that eventually lead to our decline.
At 15, though, we’re not worried about slowing down the processes that will make us 20. At 20, we’re not worried about the ones that will make us 25. We’re in the best shape we’ll ever be, so why bother?
That is also because our biological age typically aligns closely with our chronological age in our early years. Over time, however, it may accelerate, run parallel, or even slow down relative to our chronological age, depending on our lifestyle.
During those years, our only concern is how far we can stretch ourselves—physically, mentally, emotionally, creatively—to conquer as much ground as possible. We chase victories in every area: academics, work, sports, art, relationships, life experiences.
Which is how I ended up breaking my back at 37 (a story for another time).
A good analogy is to think of birth as inheriting a million dollars from a distant uncle—money locked away in a piggy bank we can’t see inside.
We decide to withdraw a reasonable $50 a day and go on living a good life. That is, until we wake up one day and realize we’re broke (which, at this rate, happens somewhere around 40).
Like your savings, your health needs a serious plan as early as possible. And just like investing early maximizes compound interest, starting early is the single most effective strategy for maintaining an active, adventurous, fully present life for years to come.
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Blue Pill, Red Pill… Why Not No Pill?
The next blood test I did was on January 11, 2024.
The readings came back: 249 mg/dL and 191 mg/dL. Different numbers. Still high. But this time, everything was different for two reasons.
First and foremost—I had changed.
COVID-19 had dramatically reshaped my daily and weekly routines. Since 2020, I had started rediscovering how many things outside of work truly deserved my attention. I realized that overstretching yourself at work is like making a reckless all-in gamble on financial leverage, hoping for a quick win to cover the growing debt caused by the borrowing itself.
By 2024, I had also powered through a cycle of self-renewal so significant that I had only experienced anything similar twice before: once in 2004, when I left Italy for China on a one-way ticket, and again in 2008 during the financial crisis, when I abandoned the security of a job to become an entrepreneur (also a one-way ticket, so to speak).
This time, that same drive for reinvention rekindled my will to live a sharp, active, adventurous—and intentional—life for as long as possible. And that meant I was determined to have perfect blood work.
Secondly—and just as importantly—the specialist I visited at a fancy private clinic in Milan said something no doctor had ever told me before:
"Considering both your parents have high cholesterol, and your generally healthy lifestyle, this is likely genetic and not a consequence of a poor diet. I suggest you find a good nutritionist, study your diet anyway, and if we can’t make progress that way, then I recommend you start taking the pill."
The pill.
Statins. A drug that generated $14.85 billion in revenue for its lucky manufacturers (expected to nearly double to $24.26 billion by 2032), feeding the needs of 145 million people worldwide—about 2.6% of the global population in 2023.
And once you start taking it, you have to take it every single day for the rest of your life.
Talk about the comfort of collecting rent.
My doctor was suggesting I become patient number 145,000,001.
My first reaction? Fudge you, doctor. No way.
My actual words? “Thank you, doctor. I’ll look into it.”
I’m not against medication. I don’t believe in self-diagnosing or self-prescribing. But I do believe that doctors often set the bar too low for what a patient can and cannot achieve. And that kind of complacency—at its worst—borders on ignorance.
Doctors are used to patients who want the pill because they don’t want to do the work.
How many patients would a doctor actually help if—assuming it was the most effective solution—they prescribed a major lifestyle change instead of a drug?
Easier for the doctor to prescribe the pill.
Easier for the patient to take the pill.
As for me—having a vivid, cinematic imagination—the first image in my mind was straight out of every movie we’ve ever seen: the protagonist standing in front of the bathroom mirror cabinet (curiously, often referred to as the medicine cabinet), holding a plastic, compartmentalized pill organizer labeled with the days of the week. He pops open “Monday,” tips out a mix of pills, and washes them down with a splash of sink water.
That was not going to be me.
Taking a pill—for life—felt like my first step into senility.
I knew my reaction was arbitrary, but it would have been the first time that the long-term consequences of an internal process—the slow buildup of fat in my blood vessels—had resulted in a daily habit reminding me that, from this moment forward, all I could do was fight the reality of aging.
No.
I chose to do the work instead.
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Cholesterol-Increasing Supplements
I didn’t look for a nutritionist at first.
A world-class nutritionist would have saved me time, trials, and errors—but I wasn’t confident I could find a truly world-class one. Not where I lived.
So, I decided to start my own investigation. I asked the people around me—my parents, my immediate family, my close friends, and eventually anyone at all—about their cholesterol situation. If they had the same issue, what solutions were they trying? Were they working?
I figured I should have taken action years ago. A few more weeks or months before starting some form of therapy wouldn’t make a difference. But by taking my time, I’d gain a deeper understanding of my predicament. After all, hundreds of millions of people are in the same boat—what were they doing about it? Why blindly follow the advice of a single nutritionist whose competence I couldn’t verify?
Among the many suggestions I received, my father recommended I try Danacol. It had worked for him—or at least, that’s what he said.
Danacol is a supplement, part of the $731 million cholesterol-lowering supplement industry (as of 2023, expected to cross the $1 billion mark by 2030).
Unlike statins, these are not drugs but nutritional supplements marketed for their cholesterol-reducing benefits.
I decided to approach this scientifically. (Is there any other way?)
Before starting my “yogurt shots,” I kept my diet and lifestyle completely consistent for 30 days, cooking almost exclusively at home.
Then, on March 12, I took a blood test to establish my baseline.
New numbers: 206 mg/dL (total cholesterol) and 137 mg/dL (LDL).
Still above the recommended limits of 180 and 115, but an improvement from my January results.
This was the starting line for my experiment.
Then, I began taking my yogurt shots daily for 60 days straight—without changing anything else in my diet or lifestyle—starting on March 17. (Side note: Danacol is sweet and tasty. They clearly put in the work to make sure people would actually enjoy taking it.)
On May 16, the morning after my 60th Danacol shot, I went back to the clinic for another test.
New numbers: 230 mg/dL and 151 mg/dL.
Yes, you read that right.
My cholesterol increased.
(Needless to say, my lifestyle remained consistent, and all my tests were done at the same lab under the same conditions.)
Not only was I back at square one in my quest for a solution, but since I had needed a prescription from my general practitioner for the blood test, she too now recommended the pill.
Healthcare System: 2. Luca: 0.
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The Rabbit Hole
On May 25th—less than ten days after the exam confirmed I needed a new solution—my brother gifted me a book: Lifespan by Prof. David A. Sinclair (PhD).
Despite having given me advice on health and well-being before (including plenty regarding my back), my brother calling to say he was sending me a book titled Lifespan was unexpected.
I was eager to read (or rather, listen to) the book—not just because of the title, but also to understand what had impressed my brother so much that he felt compelled to recommend it.
It wasn’t an easy read—something I’ve come to respect and seek out in the content I consume (another example being the three-to-four-hour, unforgivingly scientific interviews that Prof. Andrew Huberman (PhD) conducts on his channel).
I finished Lifespan on June 23rd, and its impact reached far beyond my search for a cholesterol solution.
What I realized is that prioritizing the quality of your lifestyle—including your diet—isn’t about simply living longer.
It’s about living at your best for as long as possible.
The book presents a powerful thought experiment (paraphrased): If someone asked if you wanted to live to 200, you’d likely say no—who wants to drag out the afflictions of old age? But if the question was whether you’d want to live to 200 while maintaining the physical and mental state of your 25- or 30-year-old self, the answer would likely be an emphatic yes.
For me, this insight compounded with a period of deep personal renewal—one as significant as those I’d experienced at 24 and 28.
My mind and spirit felt twenty-something.
My body, however, was sending signals that it was moving onto a separate track, fast-forwarding through time.
My resolve to keep my body where it needed to be—to fully live the life I still had in my heart—became absolute.
Never before had I so deeply understood the saying, “It’s not the years in your life, it’s the life in your years.”
Slowing down aging, arresting aging, or even reversing aging does not mean slowing down, arresting, or reversing time.
As eccentric as it may sound, many people have never truly reflected on this distinction, which is why the idea of slowing down aging often seems flimsy or even amusing to them.
But in reality, slowing down aging simply means being intentional about your choices and habits, therein including your diet and lifestyle, to maximize your physical energy and mental presence—whether you end up living the same lifespan you were headed for, a little longer, or much longer.
And, on a more speculative note, we are fortunate to live in a time where the amount of research and innovation focused on health and longevity is skyrocketing. Not just in pharmaceuticals and medical equipment, but in our fundamental understanding of how the human body functions and how we can optimize it.
The evolution of knowledge and protocols now allows us to continually incorporate new habits and practices to improve our well-being.
Fifty years ago—or even twenty—while the benefits of a mindful lifestyle were real, they weren’t significantly increasing over time. We could delay aging, but the tools at our disposal remained largely static.
Today, every day we gain through good protocols compounds in value because it grants us access to ever more effective approaches as they become available.
I had officially fallen down the rabbit hole.
The first thing I did? I stepped up my game in the kitchen.
I didn’t just pick any book—I started with How Not to Die: The Cookbook by Dr. Michael Greger.
June 27th marked the first day of my new diet:
I completely eliminated meat (which I used to eat almost daily).
I cut out dairy (except for occasional high-quality, homemade Greek yogurt).
I stopped drinking alcohol (I had been a casual drinker, with one or two drinks per week—now, zero).
I significantly increased my fiber intake.
I kept fish, since Omega-3 fats play a crucial role in cholesterol management.
The first unexpected surprise? I didn’t miss meat. At all. Not even a passing thought.
For 45 years, I had wondered how one could avoid meat while still enjoying a nutritious, delicious diet—whether at home, while traveling, or dining out.
Turns out, the answer had been right in front of me all along:
Meat is just one aisle in the market. One counter. Meanwhile, there’s an entire section of fruits, an entire section of vegetables, one for nuts, one for grains, one for fish, and so on.
In reality, meat is limiting.
To be clear, this isn’t an ideological or ethical stance, nor do I have anything against those who enjoy their steak, broadly speaking (although a specific argument should be made on the sustainability and humanity of the majority of the meat industry).
I simply realized that meat often becomes a lazy choice in the kitchen. There are so many more options—so much more variety—that, more often than not, eating meat actually reduces the diversity of one’s food intake.
In fact, a primarily meat-based diet calls for more effort to ensure it remains well-rounded and nutrient-dense.
A common critique on those who stop eating meat (and I avoid labels like vegetarian because they lead to broad generalizations and discourage scientific discussion) is that they risk deficiencies in vitamin B12, iron, and—of course—the holy grail of nutrition: protein.
This is a valid concern, made worse by the fact that many people who cut out meat do so without proper knowledge, leading to an image of the “trendy vegetarian” who follows dietary fads without scientific backing.
But saying that cutting out meat is dangerous because it could lead to nutrient deficiencies is like saying we shouldn’t exercise because we might get injured, or that we shouldn’t go to school because we might be misinformed.
How about we just exercise, learn, and eat properly instead?
In my case, I was well aware that I was making a dramatic change.
I knew that I did not know what would happen.
After all, my blood work was otherwise perfect. The last thing I wanted was to solve my cholesterol problem only to create new deficiencies in a game of metabolic whack-a-mole.
So I made sure to get enough vitamin B12—through both diet and supplementation—enough iron, and, of course, plenty of protein, not to mention continued to dig into the rabbit hole—doubling down on reading and learning on the subject.
Ironically, cutting out meat forced me to be more intentional about my overall diet, making my nutrition far more diverse and well-planned than it had ever been before.
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The Other End Of The Rabbit Hole
I planned for another 60 days of experimentation to see how my newly designed diet would work.
On August 29th, I went for a test. Same lab, same routine.
I actively worked to control my expectations. On one hand, a renewed sensibility to health was already a reward for the work I had done. However, on the other hand, I knew that if my cholesterol levels were still in the same range they had been for the past several years, I’d be one step closer to officially being “older.”
I tried hard to remind myself that all the good things I have in life took me years, if not decades, to build. This could have been no different. But sure, I wanted a win.
The results came out on September 3rd.
182 mg/dL and 116 mg/dL.
I did it!
My total cholesterol was still above the threshold by 2 mg/dL (vs. 180) and my LDL by 1 mg/dL (vs. 115), but compared to my average for the past 4 years.
I reduced my total cholesterol and LDL by 23% and 29%, respectively.
Since then, I’ve kept reading books on the subject, putting everything into practice, developed sources of exotic wholefood seeds and powders when necessary, and continuing to work on my diet and lifestyle.
I also ran more experiments: I introduced measured, limited quantities of parmesan cheese (not for the taste, but for the calcium, although... god bless the parmesan), measured, limited amounts of alcohol, and even carefully calculated amounts of meat intakes, all while running blood work tests to see what the effects were.
To my surprise, the improvements I made elsewhere in my diet outperformed even the potential downsides of those measured cholesterol intakes.
I am no longer eating meat, alcohol, or dairy, but it’s refreshing to know that my diet has even some degree of resilience towards exceptions or “cheat meals”.
The last blood work I did was on December 17th, 2024.
My readings: 170 mg/dL and 103 mg/dL.
In other words, a reduction in my total cholesterol and LDL by 28% and 37%, respectively, from where I was a year ago.
Now, you have to know that the doctor who saw me in 2020 and worked through that formula to assess the likelihood of me developing cardiovascular disease used the Framingham model. This model is the product of the Framingham Heart Study, started in 1948 in Framingham, Massachusetts, and now in its third generation of participants (https://www.framinghamheartstudy.org/).
The Framingham model takes as input your age, total cholesterol, LDL (“bad cholesterol”), HDL (“good cholesterol”), blood pressure (both diastolic and systolic), the presence of diabetes, and whether or not you are a smoker. It then gives you the probability of developing a heart condition over the next ten years.
If you were to apply my numbers to the study, going from an average of 237 mg/dL (total cholesterol) and 164 mg/dL (LDL) to 170 mg/dL and 103 mg/dL, respectively, would reduce the probability of developing a cardiovascular disease from 4.9% to 3.1%. 1.8% difference may not seem like much, but read it this way:
I reduced my risk of developing cardiovascular disease by over one third.
To further put into perspective, given all my biometrics as they are input to the Framingham Heart Study model, my 3.2% score lies between the “normal” range of 3% to 5.6%. 3% is considered the ideal threshold (“ideal” not as in “where you want to be”, but rather “the best you can be” given your age).
My distance to the best a 45 year old male is expected to be, 3%, a distance of 0.2%, can be achieved by lowering my total cholesterol to ca. 155 mg/dL (while keeping my HDL at the same level) OR by keeping my total cholesterol as-is and lowering my systolic pressure by barely 3 mmHg (from 107, which is my measured average over the past 12 months, to 104).
Also, the model developed by the Framingham Heart Study indicates that my "Heart/Vascular Age" went from 43 to 37 years old.
“Did someone just say aging?”
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Epilogue
On September 4th, 2024, I went to my physician for a health clearance certificate (the same physician who, in May, had recommended I take the pill).
She asked me how I was doing. I enthusiastically gave her an accurate account of the whole story (I admit, I get overly excited when someone asks about the subject).
I could see a growing sense of awkwardness on her face as I was telling the story.
From my point of view, I was simply being detailed and passionate.
Only later did it occur to me that—from her perspective—she had considered me a desperate case and prescribed a drug with clear and proven side effects, one that would tie me down for life, when other options existed that were not only natural but actually more effective at controlling cholesterol, with endless positive side effects.
When she asked me what I eat these days, I proudly began by describing my breakfast.
She interrupted me mid-way to say, “There’s no way I can ever have a patient eat the way you eat.”
I guess that said it all.
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D01 (Dough 01)
If you skipped the entire article and landed here, no worries—here’s what you missed:
I had very high cholesterol.
Doctors concurred that I should take pills for the rest of my life.
I refused to listen, got an education, and walked the talk by dramatically changing my diet.
I reduced my total cholesterol by over 28% and my "bad cholesterol" by over 37%.
That’s all.
The single most effective food I developed and perfected is my breakfast, which I call the “Dough 01” (the name is another long story).
Here’s what it contains:
Steel-cut Oats
Linen Seeds
Chia Seeds
Barberries
Blueberries
Homemade Organic Dates Syrup
100% Pure Cocoa Powder
Cinnamon
Oat Milk
Almonds
Nutritional facts, for one serving (300g of product):
Cal, 427 kcal
Protein, 13.6 g
Fat, 15.3 g
Saturated fat, 1.9 g (the bad ones)
Mono-unsaturated fat, 10 g (the good ones)
Poli-unsaturated fat, 3.24 g (the best ones)
of which Omega-3, 2.52 g (the bester ones)
Carbs, 51.8 g
Sugar, 18.1 g
Added sugar, 0 g
Salt, 0.96 g
Fibers, 13.7g eq. to 36.1% (54.8%) of the Recommended Daily Intake for adult men (women)
Plus, anywhere between 1/4 and 4/5 of the Recommended Daily Intake for most vital minerals, except only for Sodium (for which, for most people, the lesser the better):
Manganese, 4.31 mg, eq. to RDI: 187.5% (239.6%) (note: the threshold after which Manganese intake is considered to be harmful is 11 mg/day)
Copper, 0.78 mg, eq. to RDI: 86.5% (86.5%)
Iron, 5.62 mg, eq. to RDI: 70.3% (31.2%)
Phosphorous, 376.1 mg, eq. to RDI: 53.7% (53.7%)
Magnesium, 183.7 mg, eq. to RDI: 43.7% (57.4%)
Selenium, 21 mg, eq. to RDI: 38.2% (38.2%)
Zinc, 3.76 mg, eq. to RDI: 34.2% (47%)
Calcium, 316 mg, eq. to RDI: 31.6% (31.6%)
Potassium, 649.44 mg, eq. to RDI: 25% (19.1%)
Sodium, 76.89 mg, eq. to RDI: 3.3% (3.3%)
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Feeling like doing something good for yourself?
If you’re one of the 140 million people affected by higher-than-ideal cholesterol, or one of the rare cases in the remaining 7.86 billion who cares about their health today for years to come—regardless of whether or not you have a current condition—here’s a little experiment I’m excited to try out together:
You’ll take a blood work test on Day 1.
Starting from Day 1, I’ll deliver my D01 formula to you weekly for 60 days, which you will pay for at cost (materials, labor, and delivery, but no profit).
You’ll take a second blood work test on Day 61.
If your total cholesterol and LDL levels are lower, you’ll have brought a new world of health into your life, along with a delicious breakfast that will be ready in your fridge each morning. It will keep you light, energized, and set for your most productive hours.
If your cholesterol doesn’t drop, well, nothing will have changed in your life.
If this sounds interesting, drop me a line from the “About page” and let’s talk!
L.F
