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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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Do you ever notice that when an animal finds another animal's eggs in the wild - it very, very carefully picks around the yolk and makes sure to eat only the white? Me neither. – Patrik Dec 19 2010 at 19:52
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This enormous about of data you talk about - I would suspect that its all fuelled by pharma companies out to scare munger us all to take their stupid statins. You might need to read more of Dr William Davis starting with this heartscanblog.blogspot.com/2006/06/… – Vivalapaleo Dec 19 2010 at 23:30
Patrik, I do not think it is sound to compare man´s behavior to the one of animals: I do not eat grass, as a cow would do, either. – Philosopher Dec 20 2010 at 1:32
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I would be interested to see this "enormous about of data", as it doesn't exist! – Alan Dec 20 2010 at 5:24
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The biggest error humans have done is to forget that we are ANIMALS. – Aaron Curl Dec 26 2010 at 22:28
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16 Answers

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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: http://www.youtube.com/watch?v=i8SSCNaaDcE&feature=player_embedded

From "Cholesterol And The French Paradox, The Swiss Paradox, The Russian Paradox, The Lithuanian paradox...Etc..." by Dr. Malcolm Kendrick alt text

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!

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Kim thanks for your well informed answer. I will read the references! – Philosopher Dec 20 2010 at 2:12
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"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!

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thanks for your well informed answer. I will read the references, see what I find out! – Philosopher Dec 20 2010 at 2:13
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And this at The Healty Skeptic http://thehealthyskeptic.org/i-have-high-cholesterol-and-i-dont-care 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 http://www.paleonu.com/ 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.

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thanks Dexter for your answer! – Philosopher Dec 20 2010 at 2:15
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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.

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A major misconception about cholesterol is that it is the cause of problems, rather than a symptom. High cholesterol is not a disease - it's just an indication that something is going on in your body for which cholesterol is needed. Cholesterol’s job is to repair and protect. Statin drugs do not address or fix the underlying problem - they just reduce your ability to repair and protect by forcibly reducing your cholesterol to lower levels than your body thinks you need. – Kimmie Dec 19 2010 at 22:14
I believe it was Tom Naughton who brilliantly compared cholesterol to the police in a high crime area. "In high-crime areas, there are more calls to the police. Therefore, we can assume that calling the police produces an increase in crime. To get rid of crime, the answer is simple — stop calling the police." Makes sense to me! :) – Kimmie Dec 19 2010 at 22:14
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I dont think you have quite got a grasp of it all yet- you obviously still think there is a relationship with high cholesterol levels and heart disease. I am pretty confident now there is more of a relationship with Triglycerides and CHD. Nevertheless if you believe that you are at risk with high cholesterol - taking something to jolt the numbers does not fix the problem just masks it. I think your are more of a sitting duck than most of us walking around with high cholesterol and low Tri?? – Vivalapaleo Dec 19 2010 at 23:22
Hi Doris thanks for sharing your personal story! If I were in your situation I would reduce the intake of saturated fats, because I do think that cholesterol is a risk factor. It would be optimal if you would not need to use statins, in case you could achieve a lower cholesterol level through diet alone. – Philosopher Dec 20 2010 at 2:22
I empathize with wanting to believe your doctor when you have a potentially serious problem and don't know where else to turn, but I feel sorry that you have chosen statins because they are extremely likely to diminish your health, and have never shown any benefit for heart disease in women, period. – Ambimorph Dec 20 2010 at 13:48
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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.

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Drew I appreciate your taking the time to answer! Do you happen to have data on Tot. chol versus other risk factors, such as CRP, or ldl chol etc? I am curious to know about it, I am not a biochemist and I find lots of contradictory info on these issues. – Philosopher Dec 24 2010 at 17:35
health.harvard.edu/newsweek/… – Drew aka CrossFit Junkie Dec 24 2010 at 22:31
stroke.ahajournals.org/cgi/content/full/37/7/1720 – Drew aka CrossFit Junkie Dec 24 2010 at 22:31
nejm.org/doi/full/10.1056/NEJMoa042378 – Drew aka CrossFit Junkie Dec 24 2010 at 22:31
Here is some info from the Woman's health study, which found that CRP, then Total Chol.:HDL Ratio correlated with heart disease. ncbi.nlm.nih.gov/pubmed/10733371?dopt=Abstract – Drew aka CrossFit Junkie Dec 24 2010 at 22:31
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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.

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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 fitday.com), etc. Natural antiinflammatory methods are safer and more effective than statins and don't have all the negative side effects.

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Eva, Well said. Regarding cardio problems in middle age men, if I remember correctly, these problems are in SAD eaters who basically carb load their bodies with box food and do not do any real exercise to burn off the energy from all the wheat, corn, sugar, etc. which results in a preponderance of Atherosclerotic small dense LDL. – Dexter Dec 20 2010 at 4:12
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I have to wonder if a middle aged man went on a statin - would he therefore not change his life style too - I wonder if its the statin or lifestyle that made a difference in Mortality?? – Vivalapaleo Dec 20 2010 at 8:24
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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.)

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additional note: I do not take cholesterol meds. – Nancy Dec 24 2010 at 3:30
Nancy thanks for your answer and your sharing of information! – Philosopher Dec 24 2010 at 17:32
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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 http://heartscanblog.blogspot.com/) 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!

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Margaret, I hope you meant to say that you want your large LDL to increase...not decrease. As the small dense LDL goes down, the large bouyant LDL increases and we want all the large bouyant we can get as a percentage of the total LDL. You are doing great on paleo with your new numbers...but don't get too hung up on trying to meet the susposed reference ranges for good health. Your numbers will vary each time you get your blood lipid report. Listen to your body. It will tell you what you need to know. – Dexter Dec 20 2010 at 2:09
Margaret I really appreciate your answer and I am glad that you really improved! – Philosopher Dec 20 2010 at 2:31
Thanks for the notes! Right now I'm looking to improve ratios (total/HDL being one), but as I told my doctor, with the small LDL dropping like a stone with this supplement regimen, I'm not worried about the large LDL. No cutting back on red meat and butter for me (which she suggested). A friend at the gym is a drug rep, and when she heard the initial no's, she said, "You may have to go on a statin". I'm so glad there are places out there like this to learn that's not the only option, since I saw it as no option at all. – Margaret Dec 20 2010 at 2:51
Margaret, im not a doctor, but relative to one. Hes following carefully my cholesterols results since i started Paleo Nutrition. One thing to consider is to have a reasonable comparation point, is allways do the exams in the same laboratory, the results tend to vary, depending on the paramethers the labs use, no mather the Doc. Also total hight cholesterol is very good, but if is High because of the HDL, and low on LDL. LIVE LONGER, HEALTIER, DO PALEO! – PALEOBJJ Dec 20 2010 at 17:10
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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."

http://raypeat.com/articles/articles/cholesterol-longevity.shtml

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

http://search.yahoo.com/search?ei=utf-8&fr=slv8-tyc7&p=high%20cholesterol%20and%20longevity&type=

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

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Dexter did you read ANY of the links you sent me? Please, take a look: they all say that high levels of HDL cholesterol are GOOD and high levels of ldl cholesterol are BAD. You see that is EXACTLY what I am saying! – Philosopher Dec 20 2010 at 2:56
That is still the mainsteam medical answer. LDL high=bad with no mention of the size of the LDL particles....small dense or large bouyant. Yes if a person has high LDL which is made up of predominately of small dense particles...that is bad. But high LDL cholesterol with 80 to 90% being large bouyant particles is not a risk factor at all Did you happen to read the complete Ray Peat entry? – Dexter Dec 20 2010 at 3:08
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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. http://newsroom.ucla.edu/portal/ucla/majority-of-hospitalized-heart-75668.aspx

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. http://www.usatoday.com/news/health/2004-10-16-panel-conflict-of-interest_x.htm

Mercola about cholesterol myths http://www.huffingtonpost.com/dr-mercola/the-cholesterol-myth-that_b_676817.html

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

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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.

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PaloAltoBorn thanks for your answer. I do have lots of vegetables and fresh fruit too, eat eggs and dairy. I also regularly have meat and fish, which would be the largest difference with your diet. I believe as long as you avoid modern, pre-processed food, bad oils, wheat and do not smoke you will have great chances to reach the age of ninety. Humans are able to adapt very well to different types of food, actually hunter-gatherers diets went from mostly plant based (Kitavans) to almost exclusively animal based (Innuits) and all of them were free from the diseases of civilization. – Philosopher Mar 21 2011 at 1:49
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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:

http://www.youtube.com/watch?v=eREuZEdMAVo#t=1378s

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.

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I love that video! I've pasted that link many times. Gardner is a vegetarian though, not a vegan. – Fred B Feb 23 2011 at 17:38
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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.

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I do not eat lowfat paleo. I only eat/cook w/saturated fats - butter, lard, tallow, coconut oil. After less than 1yr of eating this way, my total cholesterol went up but trigs and ldl went down and HDL went up significantly. – W8liftinmom Dec 20 2010 at 1:38
Honestly, I don't think that you are risking a great deal by going with a low-fat diet, other than possibly risking protein toxicity. Lower testosterone levels are possible, but your body can make cholesterol at rate that it probably won't be that big of a deal. The kitavans show that a higher carbohydrate diet, as long as it's devoid of grains, legumes, dairy, etc, CAN be a healthful diet. I would suspect that it is not optimal, however, because of the increased blood sugar levels and therefore higher AGE formation. – Drew aka CrossFit Junkie Dec 24 2010 at 4:51
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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.

http://blog.cholesterol-and-health.com/2010/12/meeting-choline-requirement-eggs-organs.html

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.

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There are studies and these folks had sky high hdl levels, and very low ldl levels. this is directly related to the foods you eat and exercise. Genetics also play a role. eating healthy low cholesterol foods and foods which are high in omega 3 fatty acids lower ldl and raise hdl. Hdl works to "clean" the vessels. Whole grains and soluble fiber also raise hdl. The people in the studies ate all natural, lfish, flaxseed, whole grain rice, and healthy grains. The most important factor is ldl to hdl ratio. Refined sugar increase inflammation. Avoid these and processed foods for heart health – liz Sep 16 2011 at 1:13
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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?

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