Paleo diet and cholesterol levels

by (3428) Updated June 02, 2014 at 9:33 AM Created December 19, 2010 at 6:35 PM

I have followed a paleo diet for the last few months, and I also try to keep my total cholesterol below 200, and in particular my ldl level low. I avoid egg yolks and look for the lean parts in cow meat. I have noticed, though, that several members of this community seem to believe that cholesterol levels or ldl numbers are irrelevant. While I agree that the anti-cholesterol frenzy in mainstream medicine is excessive (by viewing cholesterol as the only factor in cardiac problems) I still understand that there is an enormous amount of data showing the statistical relation between higher levels of total cholesterol and also higher levels of ldl on one side, and cardio-circulatory problems. So my question is: for those of you that follow a diet that includes large quantities of saturated animal fat and/or egg yolk, how do you justify scientifically this? Do you think that saturated fat/cholesterol intake is irrelevant or do you believe the huge amount of data on high correlation between cholesterol levels and cardio problems is wrong? I am really curious to know your answers.

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9983 · December 20, 2010 at 1:45 AM

Ignacio, whole eggs are an excellent source of choline.

Chris Masterjohn has written about the non alcoholic fatty liver disease epidemic:

In several recent posts, I argued that most of us aren't getting enough choline, and that the disappearance of choline-rich foods like liver and egg yolks from the modern diet is likely responsible for the silent epidemic of fatty liver disease that may be afflicting 70-100 million Americans.

Regarding low cholesterol, it is well known that folks with higher TC 225 to 275 live longer on average than do low cholesterol folks, I can't point to studies now, but I know they are out there.

Perhaps others can point you to studies.

I agree that you are a sitting duck if you still think that there is a cause and effect between eating high fat and heart diesease.

4524 · December 19, 2010 at 7:37 PM

The link between cholesterol and saturated fat with cardiovascular disease has been a myth for over 50 years.

Stephan Guyenet (Whole Health Source blog) nicely addresses the cholesterol-CVD myth, and lists the many unsupportive studies here. I also recommend the work of Drs. Malcom Kendrick and Uffe Ravnskov for more info on why elevated cholesterol is not the death sentence CW paints it to be. I believe that most (if not all) of the studies that correlated cholesterol with CVD, ignored significant confounding variables such as wheat and sugar consumption, or lumped saturated fat in with trans/hydrogenated fats.

The Monica study (which assessed 21 countries over 10 years) found no meaningful correlation at all. The tiny correlation that does exist would point towards heart disease rates going down as cholesterol levels go up. People with high cholesterol actually tend to live longer.

Dr. Malcom Kendrick talks about the MONICA study:

From "Cholesterol And The French Paradox, The Swiss Paradox, The Russian Paradox, The Lithuanian paradox...Etc..." by Dr. Malcolm Kendrick paleo-diet-and-cholesterol-levels

Even the China Study, after adjusting for confounding variables, found that cholesterol was not associated with cardiovascular disease.*

*Granted, this only came to light after persons without a vegetarian agenda dissected the actual data!

18383 · December 19, 2010 at 7:00 PM

"Do you think that saturated fat/cholesterol intake is irrelevant?"

Absolutely! Consumption of saturated fat and cholesterol does not cause heart disease. I don't even know where to begin with this.

An early article by Taubes "What if it's all been a big fat lie" might be a good starting point.

Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease is a great study, but it's recent, and we've known this with increasing certainty for over a decade at the least.

Here's a list of some more studies when this was recently asked on the forum at PaleoNu.

There are some great clips from the movie Fat Head on Youtube

And you should also look at Dr. Eades' blog

Welcome to the revelation!

9983 · December 19, 2010 at 7:51 PM

And this at The Healty Skeptic I have high cholesterol and I don't care....

His basis is that the makeup of his LDL is predominately large bouyant particles that do not harm the vascular system as opposed to the small dense particles that if are in abundance seem to irritate the linings of the circulatory system causing the body to lay down plaque to heal the irritations...thus leading to higher blood pressure and coronary heart problems. Eating paleo can change the makeup of the LDL particles over to the large bouyant type.

But Dr Kurt Harris at has a different view in his last post.

I do not believe in any of the versions of the lipid hypothesis, ranging from Ancel Keys' original idea that cholesterol or dietary fat clogs the arteries, to the currently fashionable one that “small, dense” LDL particles are like microscopic rodents that are designed to burrow under the intima of your blood vessels and kill you.

I'm on the side of the people that think small dense LDL is harmful and that TC is not a helpful measurement of cardiac risk. I eat a high sat fat, moderate protein, almost zero carbs and high 400TC, lots of LDL, most of which is large bouyant, low tryglicerides and fasting blood sugar 80s. I have familial high cholesterol which I am not worried about it. I feel absolutely great burning fat and protein instead of wheat,sugar, carbs.

If you are concerned you can get a NMR blood lipid profile on line and go to a Lab Core or Quest Blood drawing location to give the sample.

1397 · December 24, 2010 at 3:56 AM

One has to remember that correlation DOES NOT EQUAL causation.

Cholesterol is used by the body to repair damaged areas.

Think for a second of cholesterol as an internal bandaid.

Now, if you are getting lots of scrapes and cuts, you'll need a lot of bandaids, but we would possibly think that bandaids caused those scrapes would we?

Now this internal damage could be caused by many mechanisms, inflammation, high blood sugar, high radical production, high blood pressure, etc.

Indeed, C-reactive protein levels and/or HbA1C levels correlate much more highly with the severity of heart disease than does cholesterol levels, even LDL levels.

I believe that the body likely produces more cholesterol in response to vascular damage caused by other mechanisms.

1212 · December 19, 2010 at 9:17 PM

I took myself off a low dose statin,(10mm) generic for Zocor on April 1, 2010. I started paleo sometime in August. In September after eating a meal of leftover pork in coconut gravy I woke in the night very nauseous. I passed out and fell down and cracked my head open. The emergency room doc. couldn't find anything seriously wrong, but suggested that I see a cardiologist which I did. The cardio doc almost had a stroke when My Total Cholesterol measured at 391. HDL 52 and LDL 307 (not the large fluffy kind either). I had a lot of tests ekg., ultrasound CT scan etc. Everything looked fine. I felt like the Cholesterol was too high myself. The doc left it up to me (good doc). 6 weeks later I had blood tested again after taking 10 mm tablet of simvastatin daily. My total Cholesterol was 279, HDL 79 LDL 184. All while eating pastured butter, cream and fatty meats, no grains, very little sugar, little fruit. I've read about all the arguments there are against taking statins and there aren't as many as there are for taking them. I really like Kurt Harris' take on things, but he has not been heard from on his blog since he wrote the article on Familial High Cholesterol. Why not? I wonder. I do not endorse taking a statin. I just feel that levels like mine, it might not hurt to knock the numbers back a little. It is called "wearing a belt and suspenders to keep the pants up." The statins being the belt and the paleo diet being the suspenders. Good luck in making your choice.

40 · December 24, 2010 at 3:25 AM

For most people, dietary cholesterol intake has no effect on risk of coronary heart disease.

My doctor tests my blood every 3 months. Here are the before Paleo (April) after 3 weeks Paleo (July) and almost 4 months Paleo (Oct) lab results. I do exercise regularly, but it's important to note that my exercise activity did not increase during this time period. In fact my activity level may have dropped slightly between July and Oct. My main dietary change was to switch to grass fed livestock and pastured poultry and their eggs plus wild caught seafood. I had already removed most grains from my diet some years back. I allowed myself some every now and then, but recently removed even those. I also allow myself a glass of wine now and then, which isn't strictly Paleo.

To read more about the cholesterol and dietary fat myths read "Good Calories, Bad Calories" by Gary Taubes

             April    July    Oct

Cholesterol TTL 192, 164, 170

HDL 53, 52, 58

LDL 127, 98, 100

Triglycerides 62, 71, 58

VLDL 12, 14, 12

Oh, and I have type2 diabetes:

Glucose 110, 96, 84

HbA1c 5.8, 6.0, 5.5 (5.5 is considered the high side of normal for people without diabetes.)

20469 · December 20, 2010 at 4:01 AM

High cholesterol is associated with increased longevity in the elderly. If cholesterol is so bad, why is it good for old people? However, it is associated with increases cardio probs in middle aged men. But high cholesterol is also associated with DECREASED levels of cancer. Cholesterol is essential for proper bodily function and newer research indicates cholesterol is important for proper immune system function. CHolesterol levels go up and down according the what else is going on in the body, but so far there is actually no evidence that cholesterol actually causes any harm itself. Which makes sense. The body is not so stupid as to make a ton of cholesterol for no good reason.

Most cholesterol lowering drugs have been terrible failures that killed animals and people. THe statins were the first that showed any tiny improvement in overall mortality and that only in middle aged men with preexisting cardiovascular disease. Statins have many side effects and have not been shown to increase longevity in any group other than middle aged men with preexisting cardiovascular disease. And more and more people are now starting to suspect that the main reason that statins give any benefit at all is because they are antiinflamatories as well as cholesterol lowering. My advice would be to lower inflammation using natural means like diet, fish oil, exercise, stress reduction, improved sleep, being careful to get ALL nutrients needed (check it on, etc. Natural antiinflammatory methods are safer and more effective than statins and don't have all the negative side effects.

60 · December 19, 2010 at 6:55 PM

I found that the removal of refined carbohydrate and synthesized fats had a profound effect on my cholesterol levels. I eat literally dozens of whole eggs a week as well as fatty cuts of meat but avoid refined carbohydrate.

30 · March 20, 2011 at 7:25 PM

Well, I guess I may be an outsider here as i was raised vegetarian as a Seventh Day Adventist. My last grandparent (a lifelong vegetarian)just died a year ago at age 98. He had low cholesterol and blood pressure. Well, he had low bad cholesterol (LDL) and high good (HDL) just as I do. I'm an ovo lacto vegetarian so I eat eggs, butter and cheese like mad. I never worry about separating out the rich yellow yolk! I never eat diet anything I just eat well. I spend real money on real food because I value good food. Whenever possible I buy organic. I don't use any hydrogenated oils..never have as part of a health conscious community. I use extra virgin olive oil for virtually all my cooking and salad making. The only time I depart from being a vege is when a friend fishes in the nearby Pacific and brings me steel head. I love salmon and devour that right away! SDA people eat lots of nuts and beans and so do I. My good cholesterol is always around 70. My total cholesterol around 170. All of my relatives tend to reach at least their early 90's.

In a way I think that the way I eat as an ovolacto vegetarian overlaps with the paleo people here in that I avoid highly processed foods. I don't eat the modern diet. My diet is plant based but whole foods always. If you think about it, our ancestors would have liked meat but many of them wouldn't have had a lot of access to it on a regular basis. We have evolved as omnivores with very varied diets depending on where you live/lived in the world. My ancestors came from northern places where people fished (I know of one of my ancestors from the Nordland in Norway who was a crofter and fisherman according to mid nineteenth century census records) and if they got eggs from nesting birds they ate the whole egg you betcha! None of those ancestors were fat either.

Anyway it's real important to educate yourself on how people traditionally ate to sustain life and health. I know one thing, and that is, it's nothing like the disgusting super processed and lifeless diet most Americans eat.

1025 · December 26, 2010 at 7:56 PM

Study from UCLA in 2009 that showed ~73% of people admitted to hospitals for heart attack had "normal" cholesterol and ~50% had "optimal" cholesterol levels.

Why do we even think a TC that's below 200 is "normal?" 8 of the 9 doctors on the committee that advised the government on this level were receiving money from statin producing drug companies.

Mercola about cholesterol myths

LDL and HDL aren't even cholesterol, they're lipoproteins. No wonder so many people are confused.

9983 · December 20, 2010 at 2:47 AM

Ok maybe you are not a sitting duck now but wait a few years til you are 55+

Ray Peat addresses longevity:

After the age of fifty, low cholesterol is clearly associated with an increased risk of dying from a variety of causes. A study of old women indicated that a cholesterol level of 270 mg. per 100 ml. was associated with the best longevity (Forette, et al., 1989). "Mortality was lowest at serum cholesterol 7.0 mmol/l [=270.6 mg%], 5.2 times higher than the minimum at serum cholesterol 4.0 mmol/l, and only 1.8 times higher when cholesterol concentration was 8.8 mmol/l. This relation held true irrespective of age, even when blood pressure, body weight, history of myocardial infarction, creatinine clearance, and plasma proteins were taken into account."

There are at least 10 sources reported on the first two pages from a Yahoo search that higher cholesterol results in increased longevity.

Goes against the mainstream medical hacks..the AMA, the American Dietetic Association, the American Diabetes Association that still buy into Ancel Keyes' lipid hypothesis.

50 · December 19, 2010 at 11:07 PM

While others have responded about studies refuting the cholesterol myth, I will tell you how I personally addressed this issue recently.

I've been eating pretty paleo for the past couple of years with great weight loss results. I watch my cholesterol, cardiac inflammation, and A1C closely due to family history of CVD and Type II diabetes. This year I switched docs to one with an American MD and a Chinese medicine degree who is not lock-step with conventional medicine, and elected to get an NMR lipoprofile, along with C-reactive protein. Blood pressure's great, HDL's good, trigs good, total cholesterol 193. This means that my tests covered by insurance all look fine.

Doing the extra tests told a different story. Total LDL was 1441 (divide by 10 to compare to standard cholesterol test), small LDL 806 (75th percentile, high, bad). CRP was 5.18 (pretty off the chart bad, should be under 3, preferably under 1).

Doc and I made a plan. Lots of fish oil, vitamin D, turmeric, and CoQ10. I used the Robb Wolf fish oil calculator, and drank 9-12 tsp. Barlean's fish oil each day, took 5000 IUs D3, got off wheat (per William Davis which at this point was mainly just a beer or two a week, went back in 6 weeks. Small LDL dropped to 214, while overall LDL rose slightly. CRP dropped to .99. Dr. Davis mentions that eating a few almonds every day will lower large LDL, which I'm trying now.

This science experiment of one has shown me that the numbers can be pretty malleable. At age 41, I am trying to get all my numbers on the good side to hopefully avoid the long-term damage my parents experienced. With a small LDL drop of 75% and CRP drop of 80% I feel the anti-inflammatory effects of fish oil and D3 are all I need, with inflammation being the most important measure. I've dropped back to more of a maintenance level of all these supplements, and continue to see Paleo solutions as the way to address these problems.

Some friends have said that small LDL and CRP are yet unproven measures of long-term health, but I think time will prove these tests worthwhile. Hopefully my large LDL will go down a bit, but I'm less concerned about that than the previously addressed issues. We'll see!

3428 · December 20, 2010 at 1:23 AM

I really appreciate all the answer that I have received, very informed and incredibly honest. Let me state my case first: I can say that I am a low fat paleo. I mean I stay away from all cereals, all legumes, oils derived from corn, soy, any processed food, and I have lots of fish, meat and vegetables. And I choose lean meat and also avoid egg yolks. With this diet I feel extremely well, I have lost 14 pounds, my total cholesterol is at optimal levels, my tryclicerides are very low and my physical endurance has improved a lot. I understand everybody agrees that if you have lots of saturated fats, your total cholesterol and ldl will rise. There are a number of members of this community -perhaps the majority- who think that total cholesterol or ldl levels are unrelated to circulatory risk. I thank them for sending me those links, I will take a look at them but, in the meantime, I still would like to know what could I possible lose by keeping my cholesterol low though diet. I am not using statins, just a low fat diet.

253 · December 19, 2010 at 10:02 PM

Paleo / Low Carb diets offer the BEST overall heart health markers.

Go to minute 23 in this video, for the results of this one vegan researcher:

HDL goes through the roof. This is your good cholesterol. Triglycerides drop very low. LDL may increase, but the particle count drops while the particle size increases. This isn't the stuff that forms atherosclerotic plaque.

0 · June 02, 2014 at 9:33 AM

It's my understanding that cholesterol is needed because its a precursor for vitamin D and this vitamin is essential for being healthy.

0 · May 31, 2014 at 12:01 PM

Journal of American Medical Association indicated that high LDL cholesterol is not a risk factor for from coronary heart disease (CHD)There is no link found between cholesterol level in the blood and cholesterol level in food. The second statement that is believed is cholesterol-heart disease hypothesis where it is assumed that high cholesterol levels level in blood is one major causes of heart disease called as lipid hypothesis. But most of the researchers now believe oxidative stress and inflammation are the main causes of heart diseases.

0 · May 30, 2014 at 3:59 PM

Not only is dietary cholesterol not bad for your health, it’s also not the cause of heart disease as you’ve been made to believe. The truth is the intelligent body needs dietary cholesterol. The brain, for example, consists of about 2 percent of your body weight, but contains 20 percent of your body’s cholesterol. Biologically speaking, the body is not really geared to consistently shoulder the burden of cholesterol manufacturing. It is a taxing and onerous process that’s supposed to occur only in an emergency. Providing the body with sufficient cholesterol is your job through diet. If you don’t consume sufficient dietary cholesterol, then the consequences can be catastrophic to your health, especially your heart health. eating non-fat or low-fat foods with insufficient dietary cholesterol while at the same time maintaining a high-GI carb intake pretty much guarantees a consistent overproduction of cholesterol within the body. Because cholesterol is so crucial for the body’s survival, it does this to save itself from certain death. Contrarily, dietary cholesterol does not play any role whatsoever in this pernicious cycle.

Learn more about how a paleo ketogenic diet coaching site for heart health and how a paleo ketogenic diet helped cure me from chronic fatigue and immune dysfunction syndrome (CFS, CFIDS), borderline type 2 diabetes, IBS, Chron's colitis, systemic candida, hypothyroidism, anxiety and depression, which I suffered from for over twenty years.

0 · April 24, 2013 at 4:52 PM

Hello, I just started a paleo type diet about four months ago. I switched because I have chronic lyme disease, plus I am a crossfit nut and wanted to improve my results in the gym. Before I started paleo I ate a fairly low fat diet with some slips on junk food on weekends. After a few months on paleo here's my numbers and it concerns me quite a bit. Before. total 189 ldl 87 hdl 90 triglycerides 61 After total 223 ldl 124 hdl 72 triglycerides 136 I'm especially concerned about my triglycerides and Ldl. Both my brothers and my father had heart attacks before 50 and needed bypass surgery I'm now 55. I've lost twelve pounds since starting paleo and down to 9% body fat. My workouts at the gym have improved a bit since starting this diet though. Any thoughts?

-4 · September 15, 2011 at 7:48 PM

No matter what all of you say, a well balanced diet with heart healthy whole grains is the safest diet. this is a fad, just like atkins.......I am a cardiologist and no matter what you say, high ldl and low hdl cause plaque to build up on vessels, creating blockage and cause infarction. Period.

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