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My dietary cholesterol experience

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Updated October 20, 2014 at 4:08 AM
Created April 11, 2014 at 5:31 AM

Quick summary for those who don't want to read the whole thing: Dietary changes had an enormous impact on my blood cholesterol levels. As the majority opinion on the internet seems to be that dietary cholesterol has a limited, or even beneficial impact on blood cholesterol, I'd just like to add my n=1 to the evidence to the contrary, and encourage others to test their cholesterol levels regularly when implementing significant dietary changes.

Hi, I've been reading these forums (and other paleo/primal forums) for a few years now. Over this time I've tried some pretty different dieting strategies, and being rather scientifically minded, I've kept track of my blood cholesterol levels through the different stages. I thought I'd share my experience with you guys since some of you may find it informative or interesting.

First, a little background about me. I'm male, 26, and have always been in quite good shape. I ran track in high school and college (mid distance) and started lifting seriously (first powerlifting, then olympic lifting and now bodyweight stuff) in college. I'm 6'2'', 215 (fatter than high school, but not too fat -- can still comfortably run a sub-6 mile :D ).

About 2 years ago some friends of mine introduced me to paleo. Prior to this, I had been eating a relatively healthy "typical" american diet. Fair amount of veggies and fruit, some meat, lots of grains. I weighed ~190, and my blood cholesterol was:

Total: 167

Trig: 83

HDL: 42

Total/HDL: 4.0

LDL: 108

Pretty average by common medical standards.

About 9 months ago I adopted a very lax IF/paleo-ish diet, where my diet consisted of a lot more meat, a similar amount of veggies, and carbs at dinner only (I'd probably only eat a significant amount of carbs every other day). Most days I would skip breakfast and not eat my first meal until 3-4pm, then have my last "dinner" meal at ~11pm. This January I had my cholesterol tested again just to see what changes, if any, had occurred. At the time of the test, I weighed ~210 (there was almost two years between the first test and this one, my weight increased slowly over that time as I continued lifting), and my blood cholesterol was:

Total: 167 --> 245

Trig: 83 --> 64

HDL: 42 --> 51

Total/HDL: 4.0 --> 4.8

LDL: 108 --> 181

Obviously a lot higher. While HDL went up a bit, the total/hdl ratio also went up significantly. But I thought, maybe these poor numbers were due to me not being strict enough about my paleo diet. After all, I was still eating a lot of carbs (yes, a lot of refined carbs too). So I decided to go all out and see what would happen.

I switched my diet over almost exclusively to eggs (a lot of eggs, usually around a dozen a day), lean meat and a huge amount of veggies (I was probably eating a pound of broccoli and a pound or so of spinach/bok choy/mushrooms daily). No dairy, no refined carbs. I was also going through 4-5 oz of olive oil a day. I did one carb reefed a week, but even then I stayed away from refined carbs.

After 3 weeks I felt awful, my lifts were plummeting and I had no energy throughout the day. I finally decided to throw in the towel, and went to get my cholesterol checked once more before going off the diet. At the time bodyweight was ~205 (mostly water loss due to depleted glycogen, I'd imagine), and the results were:

Total: 167 --> 245 --> 357

Trig: 83 --> 64 --> 81

HDL: 42 --> 51 --> 59

Total/HDL: 4.0 --> 4.8 --> 6.1

LDL: 108 --> 181 --> 302 (!!)

I've never even heard of someone having an LDL score that high! The modest increase in HDL did not make me feel any better about the skyrocketing LDL number, and I decided an abrupt dietary and lifestyle change was in order.

In addition to eliminating eggs completely, I cut out almost all of the red meat, and decreased the amount of butter (yes, grassfed butter) I was using. My primary energy source became kidney beans, white rice, and oatmeal. I continued eating an enormous amount of vegetables (maybe even more), and added some fruit. Olive oil consumption remained about the same, and I started eating about 1 head of garlic a day (most of it cooked, but I usually eat a raw clove with breakfast). I also started walking 2.5 miles each day in addition to my normal training routine (lift 4-5 days a week, soccer/basketball 2-3 days a week). 5 weeks later, my bodyweight is at ~215 (water, glycogen, and a small amount of muscle, I'd imagine), and my most recent cholesterol test results were:

Total: 167 --> 245 --> 357 --> 198

Trig: 83 --> 64 --> 81 --> 109

HDL: 42 --> 51 --> 59 --> 46

Total/HDL: 4.0 --> 4.8 --> 6.1 --> 4.3

LDL: 108 --> 181 --> 302 --> 104

Yes, my LDL cholesterol dropped 200 points in 5 weeks. The added exercise could not possibly account for such a dramatic change, so it is only reasonable to attribute the majority of the results to the dietary changes. My plan is to continue with this current diet for another 2-3 months, see if cholesterol levels continue to change, then slowly add eggs back into my diet while testing cholesterol to find out a what point they start influencing my cholesterol levels.

I guess my point in writing this is twofold. First, there are a lot of hypotheses about the relationship between dietary cholesterol and blood cholesterol. In studies, eggs are usually used as the source of dietary cholesterol, but the upper level is usually set somewhere around 1-2 eggs per day. There is a lot less information out there regarding taking in significantly larger amounts of dietary cholesterol, so I thought my experience might provide some useful data. Second, most of my friends who subscribe to these new theories about cholesterol implement the recommended dietary strategies without ever testing to see the actual results for themselves. I hope my experience will encourage others to actually get a series of cholesterol tests done to see how levels change over time. Imagine if I had simply taken the "dietary cholesterol doesn't affect blood cholesterol" claim at face value, and never tested myself. I could have been walking around with an LDL of 300 for 5-10 years!

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26182 · April 14, 2014 at 7:44 PM

not out of line to question the integrity of the numbers. If the numbers are off, the recommendations are off.

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26182 · April 14, 2014 at 7:43 PM

so fewer calories, less dairy, and you believe that it was the eggs?

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1005 · April 14, 2014 at 5:44 PM

Cholesterol levels are highly regulated, required in every cell of your body (lipid bilayer.) In healthy people, it will not be out of range. As 80% of the cholesterol in your body is synthesized from things like carbohydrates, you don't really need to worry about that 20%. Check out Dr. Thomas Dayspring if you don't believe what Attia is stating. The voiceover on that youtube video is horrible, haha.

On a 3000kcal diet of 75-80% fat or so, Attia's trigs were around 20. (But, his apo E gene status is E3/E3.)

http://www.youtube.com/watch?v=jKS3A_uRVdU

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897 · April 14, 2014 at 1:52 PM

BTW. Dietary cholesterol does raise cholesterol in healthy people.

http://www.youtube.com/watch?v=oWP-JDgAnvg

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897 · April 14, 2014 at 1:50 PM

Your biomarkers got worse and you also feel worse. Time to use a little common sense and try something else.

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10176 · April 12, 2014 at 1:32 PM

Out of line gastronomer. No matter how you calculate it the LDL is high, probably from eating all those eggs, since after stopping that LDL dropped. In an old obese diabetic person the high LDL would be cause for concern among many other markers. In a young healthy lifter not so much. No harm was done by the experiment, just a caution not to eat so damn many eggs.

Medium avatar
10176 · April 12, 2014 at 10:50 AM

highanddry, your N=1 experiments are the sort of thing that would affect late-life quality, and the higher HDL and lower trigs are positives. My cereal-eating experiment was entirely negative (though cheap). Despite the "heart healthy"emblem on the box, and all that fiber and vitamin load, I developed serious- life threatening - problems. When you took eggs to the limit you had high LDL and lack of energy. When I took cereal to the limit I had high blood pressure, obesity, diabetes, high TG's, low HDL and high LDL. We both saw problems with extreme approaches. But extreme SAD is far worse.

Medium avatar
10176 · April 12, 2014 at 10:11 AM

The problem with inflammation is having any sort of standard measurement. CRP is useful for traumatic burns, but dubious for day-to-day variations (except in a narrow range of people with recurring CV incidents). Basing your diet on improving something that you can't measure borders on bro-science.

http://www.patient.co.uk/health/Blood-Test-Detecting-Inflammation.htm

Lipid measurement may not be a perfect marker but it's better than having no marker at all.

Medium avatar
10176 · April 12, 2014 at 10:00 AM

Inflammation is interesting, but the professional medical community tests lipids. They have recently changed their stance on safe LDL levels.

http://www.health.harvard.edu/blog/cholesterol-and-statins-its-no-longer-just-about-the-numbers-201311136868

They still like statins, but are not encouraging physicians to target 70 LDL. Instead, 190 LDL is regarded as an upper limit for people with no CVD history or other high risk factors such as diabetes. They're using a slightly modified version of the Framingham risk calculator.

Based on that the first paleo diet is in the ok range.

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690 · April 12, 2014 at 3:18 AM

OP-

If you want to read about diet & inflammation, check out Art Ayers

http://coolinginflammation.blogspot.com/2008/09/anti-inflammatory-diet.html

Personally, I think cholesterol is a marker for problems...not the cause of the problems.

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0 · April 12, 2014 at 12:33 AM

Yeah, it was mainly that eggs are cheap and very easy to make/store (hardboiled). Also lots of articles online about how good they are for you. They probably only made up around ~20% of my daily caloric intake, though. I think people owe it to themselves to actually do a test and make sure the results for them personally are in line with what they've read about elsewhere.

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0 · April 12, 2014 at 12:28 AM

My original post was kind of wordy. To clarify: Before: eggs, lean meat, veggies, olive oil, butter (~1cup/week) After: no eggs, no red meat, same amount of veggies, same amount olive oil, less butter (~1/2cup/week), plus oatmeal, beans, and rice

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0 · April 12, 2014 at 12:26 AM

These are just the results the labs gave me. The first two and the last two tests were done at different places, I guess they calculated differently? You seem a bit unnecessarily paranoid though. I don't think I said anything anti-paleo in my original post, did I? All I did was share my personal experience since it differed from the experience I had read about from most people.

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0 · April 12, 2014 at 12:22 AM

I don't. But the extremely large deviation from "normal" results leads me to believe something abnormal is going on. It's possible such high numbers could actually have some sort of beneficial aspect, I suppose.

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0 · April 12, 2014 at 12:19 AM

Interesting article, thanks. I have not tested for my apo E gene status.

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1005 · April 11, 2014 at 8:03 PM

Man, I better get my blood lipids measured.

Medium avatar
10176 · April 11, 2014 at 11:13 AM

This is the best documented N=1 I've seen on Paleohacks.

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10176 · April 11, 2014 at 11:39 AM

Just a few comments on an interesting experiment

-The first test - call it the 80/20 - resulted in shifts similar to what I've seen posted here before. Lower trigs, higher LDL and higher HDL.

-The second test - extreme Paleo - is the most interesting. There are probably better ways to do it than with a dozen eggs a day, but there's no clear direction on which foods to use, eggs are cheap, and you did your best to follow the principle. If you had done it with fish instead of eggs maybe the LDL would not have skyrocketed. I'm surprised that your trigs started rising, maybe from the protein overload?

In retrospect I did the same kind of thing using raisin bran instead of eggs. I ended up obese, with diabetes AND high LDL. If my dr. hadn't caught the high blood sugar on a routine test I would never have known what I had done to myself. You were more prudent about getting tested, so congratulations.

Medium avatar
10176 · April 12, 2014 at 10:50 AM

highanddry, your N=1 experiments are the sort of thing that would affect late-life quality, and the higher HDL and lower trigs are positives. My cereal-eating experiment was entirely negative (though cheap). Despite the "heart healthy"emblem on the box, and all that fiber and vitamin load, I developed serious- life threatening - problems. When you took eggs to the limit you had high LDL and lack of energy. When I took cereal to the limit I had high blood pressure, obesity, diabetes, high TG's, low HDL and high LDL. We both saw problems with extreme approaches. But extreme SAD is far worse.

973663625d7a74d66282953c46ff4307
0 · April 12, 2014 at 12:33 AM

Yeah, it was mainly that eggs are cheap and very easy to make/store (hardboiled). Also lots of articles online about how good they are for you. They probably only made up around ~20% of my daily caloric intake, though. I think people owe it to themselves to actually do a test and make sure the results for them personally are in line with what they've read about elsewhere.

Medium avatar
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60 · April 15, 2014 at 10:20 AM

Dietary Cholesterol is the cholesterol obtained from food and is different from blood cholesterol. The food obtained from animal sources contains dietary cholesterol.

According to me dietary cholesterol only has slight effect on blood cholesterol level. Saturated fat has more impact on blood cholesterol level. A particular individuals total fat intake with saturated fat has more significant affect on blood cholesterol level.

There are lots of several other foods that help reduce cholesterol especially for the patient with high LDL and boost overall wellness.

Further for Reducing Dietary cholesterol limit intake of egg yolks, organ meat, meat ad milk dairy products.

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60 · April 14, 2014 at 9:07 PM

Out of curiosity H&D, what is your blood type? (A, O, B, AB)

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5 · April 11, 2014 at 8:09 PM

I don't know much about fiber, but I do know that soluble fiber can lower cholesterol numbers a little.

It looks like around the time you went strict paleo, you had very little soluble fiber, though a lot of insoluble, and your numbers went up. Then when you went off paleo and started eating refined carbs (soluble fiber) your numbers dropped.

Maybe you could start eating paleo with high amounts of paleo-approved soluble fiber and see where that leads you.

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459 · April 11, 2014 at 8:07 PM

So in the strict paleo blood test your triglycerides were 81, your HDL was 59 and your LDL was 302, but your total was only 357? WTF? Those numbers don't make sense, which leads me to believe there might be some fudging of the data going on.

Using the Friedewal formula to calculate your LDL, it should have been 282.

Using the "Iranian" formula your LDL should have been 251.

Something smells fishy....hope this isn't another anti-paleo troll.

Source: http://homepages.slingshot.co.nz/~geoff36/LDL_mg.htm

Medium avatar
10176 · April 12, 2014 at 1:32 PM

Out of line gastronomer. No matter how you calculate it the LDL is high, probably from eating all those eggs, since after stopping that LDL dropped. In an old obese diabetic person the high LDL would be cause for concern among many other markers. In a young healthy lifter not so much. No harm was done by the experiment, just a caution not to eat so damn many eggs.

973663625d7a74d66282953c46ff4307
0 · April 12, 2014 at 12:26 AM

These are just the results the labs gave me. The first two and the last two tests were done at different places, I guess they calculated differently? You seem a bit unnecessarily paranoid though. I don't think I said anything anti-paleo in my original post, did I? All I did was share my personal experience since it differed from the experience I had read about from most people.

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1005 · April 11, 2014 at 8:06 PM

Do you know what your APOE status is? I'm always curious to see those to give the lipid panel some extra context.

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1005 · April 11, 2014 at 8:06 PM

Do you know what your apo E gene status is? I'm always curious to see those to give the lipid panel some extra context.

http://www.trackyourplaque.com/report/Lipoproteins/Apoprotein_E_Diet.aspx

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0 · April 12, 2014 at 12:19 AM

Interesting article, thanks. I have not tested for my apo E gene status.

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198 · April 11, 2014 at 7:32 PM

Since you failed to actually ask a question, I will provide one.

What evidence can you provide that having a high numbers will in any way be detrimental to your health and longevity?

Current thinking seems to be that inflammation is the key.

Medium avatar
10176 · April 12, 2014 at 10:11 AM

The problem with inflammation is having any sort of standard measurement. CRP is useful for traumatic burns, but dubious for day-to-day variations (except in a narrow range of people with recurring CV incidents). Basing your diet on improving something that you can't measure borders on bro-science.

http://www.patient.co.uk/health/Blood-Test-Detecting-Inflammation.htm

Lipid measurement may not be a perfect marker but it's better than having no marker at all.

Medium avatar
10176 · April 12, 2014 at 10:00 AM

Inflammation is interesting, but the professional medical community tests lipids. They have recently changed their stance on safe LDL levels.

http://www.health.harvard.edu/blog/cholesterol-and-statins-its-no-longer-just-about-the-numbers-201311136868

They still like statins, but are not encouraging physicians to target 70 LDL. Instead, 190 LDL is regarded as an upper limit for people with no CVD history or other high risk factors such as diabetes. They're using a slightly modified version of the Framingham risk calculator.

Based on that the first paleo diet is in the ok range.

F291857fa12a0291688ea994343156dc
690 · April 12, 2014 at 3:18 AM

OP-

If you want to read about diet & inflammation, check out Art Ayers

http://coolinginflammation.blogspot.com/2008/09/anti-inflammatory-diet.html

Personally, I think cholesterol is a marker for problems...not the cause of the problems.

973663625d7a74d66282953c46ff4307
0 · April 12, 2014 at 12:22 AM

I don't. But the extremely large deviation from "normal" results leads me to believe something abnormal is going on. It's possible such high numbers could actually have some sort of beneficial aspect, I suppose.

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26182 · April 11, 2014 at 10:38 AM

You have far too many unmeasured, uncontrolled variables. For example, you said you changed your diet to exclusively eggs, some veggies, and olive oil. Then you said you changed it again to reduce the butter? Also, with such a restricted diet, your inflammation scores were probably through the roof. Thus it's hard to get any causal relationship. What we know is that dietary cholesterol plays a small part -10% in serum cholesterol. However, some fatty acids (in particular diary) have a huge effect.

http://www.sciencedirect.com/science/article/pii/0026049565900041

973663625d7a74d66282953c46ff4307
0 · April 12, 2014 at 12:28 AM

My original post was kind of wordy. To clarify: Before: eggs, lean meat, veggies, olive oil, butter (~1cup/week) After: no eggs, no red meat, same amount of veggies, same amount olive oil, less butter (~1/2cup/week), plus oatmeal, beans, and rice

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0 · April 11, 2014 at 5:36 AM

I had it formatted nice when I posted it, but now when I load the page it's just one big paragraph :( Anyone know how to fix it?

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