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.
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.
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
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!
"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.
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!
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.
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.
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.
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.
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.
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.)
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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