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. Been paleo since May. Strict paleo... Just got blood work... Vap test Total cholesterol 220, hdl 47,ldl 139, tri 137 crp 0.6. Lost about 20 pounds.
Prior lipids: tc=187, hdl 37, ldl 118, tri 138. Crp unknown. Prior diet SAD. Clean sad. Lots of p90x insanity etc through out. I feel great but was surprised at still high tri and was expecting hdl to be greater

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Oh ya pattern a/b . Again I was kinda bummed when triglycerides still somewhat high. – Dave 2.0 Sep 26 at 15:19

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Obviously what we eat affects our cholesterol. What we have found is that dietary cholesterol does not change our cholesterol levels.

Just look at http://20potatoesaday.com/ -- Cholesterol dropped 60 mg/dL. Is that all from a 20 lbs drop in weight? No, it is from the dietary make up. There are countless other studies that show this.

Magnitude of myristic acid has shown strong causal effect to increased total serum cholesterol -- http://ajcn.nutrition.org/content/17/5/281.short

The larger question is whether, and to what extent our cholesterol numbers matter. Is magnitude important? Is it the ratios? Is it just a complementary metric that has no cause/effect relationship?

I suggest you read Petter Attia's "Straight Dope" series, here's Part 1 -- http://eatingacademy.com/nutrition/the-straight-dope-on-cholesterol-part-i

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Checked out the 60 day potato diet. Ok so potatoes don't contain cholesterol. The potato dieters cholesterol dropped. Hmmm. – Dave 2.0 Sep 26 at 16:54
specious logic! potatoes don't contain any tiger blood. I bet tiger blood causes your cholesterol to go up! – CD Sep 26 at 18:33
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How much oily fish are you eating (or fish oil supplements)? how many carbs?

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Lots of Seasons brand sardines about a can a day. Salmon 1x week. Lots of grass federal beef, some nuts. Lots of greens : romaine, spinach, etc for carbs sweet potatoes fruit... I try to stay in carbon range 75-125 sometimes less than 50 a few x week. Breakfast is the usual paleo fare: 2 to 3 fresh organic eggs cooked in high grade coconut oil. Salad dressing only evoo & apple cider vinegar. Dinners typical paleo : meat veggies. I live dark chocolate go for several squares a day of 85% green and black brand, I'm obsessively paleo to a fault I suppose – Dave 2.0 Sep 26 at 21:56
Omg the Paleo hacks interface via smartphone is stone age... In a bad way – Dave 2.0 Sep 26 at 21:57
Two Nordic naturals fish oil per day. Between the fish oil supplements and actual fish I'm getting lots of omega 3. I do a fair amount of work to limit omega 6. I eat zero table sugar – Dave 2.0 Sep 26 at 22:00
I would have thought all that fish would push the tg lower than that. The fruit and carbs is the thing to look at but hard to lower if you're working out a lot. Maybe try less fruit, less carbs where you can? – PaleoRocks Sep 29 at 10:43
Hi. Thanks for comment. I really appreciate it. I'm already eating low to moderate levels of carbohydrates ;generally in the primal sweet spot of paleo approved carbs. I will not reduce the level much further, been there done that, because I begin to feel bad. Maybe I can swap fruit for tubers however. – Dave 2.0 Oct 2 at 15:57
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I believe even Ancel Keys was quoted as saying that dietary cholesterol has no bearing on blood cholesterol.

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 If that's true then why do we see lipids improving (or not in my case) when people go paleo? – Dave 2.0 Sep 26 at 15:17
Because other things in food DO affect blood cholesterol, regardless of whether dietary cholesterol does and regardless of whether Ancel Keys was right. – Anonymous Chump Sep 30 at 0:36
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Rob Wolf's most recent podcast is a very good interview with Chris Kresser and he goes into great detail about cholesterol--I highly recommend you listen to that, very informative and understandable for the lay person.

Based on what Chris said, you should ask your doctor to test you for familial hypercholesterolemia.

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Thank you I've been meaning to listen to another Robb wolf podcast... It's been far too long. My brother is actually my cardiologist; he has been on zocor baby dose for over 2 years now it was the only way to get optimal numbers (prior to statin his numbers just about identical to mine). We are both in excellent physical condition ;he runs marathons ;I ride mountain bikes plus crossfit type activity. I'm about 10% body fat as is he, but we, as our dad, seem to make excessive cholesterol. My dad had a heart attack in his early 50s;thankfully survived it but has been on statins ever since. – Dave 2.0 Sep 27 at 17:59
My dad however was a smoker and rarely exercised apart from his days as a Carpenter. So I finally came to paleo thinking I might be able to reverse the high cholesterol. It seems, despite my sincere best efforts I remain an LDL machine, lol. I was and still am obsessively paleo;I love how I feel and I believe it's the optimal human diet but I can't seem to shake the high ldl. Now, no one knows with 100% certainty what my numbers spell for me, despite high level of physical conditioning but with statins the benefits far outweigh the risks... Assuming I don't suffer from side effects. Boo. – Dave 2.0 Sep 27 at 18:07
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Bringing LDL-C down may be meaningless as LDL-c is NOT correlated to cardiovascular risk. New studies indicate LDL-P is the measurement that helps determine risk. It's important to treat the problem (if you really have elevated risk in the first place) not the symptom.

Treating LDL-C with statins is like treating pneumonia with Tylenol. Yes, it will reduce the fever (a symptom) but will not treat the underlying cause (infection) or cure the patient.

Also, the thing that keeps tris up is carbs. Have you tried dialing them down a little??? That may improve ratios and risk.

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Hi. Thanks for the comment! Perhaps you can shed some insight here: why does lowering LDL help those with coronary artery disease? In other words treating high ldl undeniably helps in cad patients. I eat in the so called primal sweet spot; on average 75 - 100 carbs a day. I am maintaining my weight which is 192...I'm 5'11 and about 10%bf. I have no desire to lose more mass so given my activity level I've finally gotten the Paleo carbs dialed in. It's actually quite easy to change mass based on carbon intake. The elevated tg are really the only thing that worries me some. – Dave 2.0 Oct 2 at 15:34
Perhaps I'm just one of these so called cholesterol hyper responders. More personal details: resting HR: generally between 52 - 56. Blood pressure :115/70...vitals all pretty much normal. My CRP was low: 0.6 Vldl:33 mg/dL; apoB :113 mg/dL – Dave 2.0 Oct 2 at 15:39
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Your liver makes the majority of cholesterol for your body. Very little comes from the food you eat. I'm afraid the only way you are going to lower your LDL and triglycerides is by taking a statin. I'm on the lowest dosage 10 MG and my LDL and Tri's are optimal. Without the statin, I'm just like you. I really don't like to take a statin but it's the lesser of two evils because no matter what diet I tried, I couldn't get my cholesterol down. So I'm a firm believer that your liver mostly controls the output of cholesterol not your diet. My cholesterol was little bit better on Paleo VS. SAD. I was taking 10 MG of statins on both diets.

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Hey paleo dude. I think your right. I've been battling these types of numbers for years. It's not to me worth the risk to just forge ahead (I plan on paleo however;there are many other benefits) trying to improve the numbers by tweaks here and there. We have a family history of heart disease and perhaps nature (genetics) wins out in this one. It's a bummer cause I dreamed of a better results! – Dave 2.0 Sep 26 at 18:16
Talk to your Doc and see what he recommends. Statins, although somewhat controversial, will bring your LDL and TRI's down. Not to scare you but your LDL of 139 is concerning especially combined with the fact that you have a family history of heart disease. Knowing your family history, most Docs would recommend trying the smallest dose of 10 mg. Lipitor or it's generic equivalent has the best track record. Your LDL should be below 100 and ideally below 70. You may want to take a CQ-10 supplement if you start taking a statin. Stanins lower your CQ10 levels. Keep us posted!! Good Luck! – Paleodude Sep 27 at 0:40
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 There are a vast magnitude of dietary factors that can increase of decrease LDL and triglycerides. It seems silly to say statins are the only option. – Mscott Sep 27 at 1:11
@ mscott Dave has been strict Paleo since May and his numbers haven't budged. What do recommend? We're all ears. I'd love to get off statins if you have the magic food options. My guess is you don't because I have tried every diet and NO combination has made a dent NONE!!! Sometimes you have to resort to medicine. I know it's a tough pill to swallow for you. – Paleodude Sep 27 at 2:20

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