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As discussed by Cordain, Wolf and here: http://www.ncbi.nlm.nih.gov/pubmed/15172426 modern HG's and our Paleo ancestors are said to have had LDL levels around 50 - 70 mg/dl.

Since I'm trying to live and eat more like my ancestors did to achieve optimal health and avoid disease, why am I not supposed to be concerned by my new LDL level of 240 mg/dl since switching to eating Paleo? Sure my CRP is 0.2, my TRG and HDL are really good, but my LDL increased from 159 to 240 in a matter of months. Is that normal?

My understanding is that such high LDL makes me susceptible to heart disease due to the oxidation of LDL. No?

I've read a lot on the subject - but it seems there are just as many studies that link high LDL to heart disease as there are studies that don't.

Thanks

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9 Answers

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As already stated by Alex. If your HDL/LDL changes are positive as in the ratio of them improving then you are good. It's not the absolute number of one or the other that's most important, it's the ratio of the two.

My LDL is barely at the "high" limit. But when I first started this 8 years ago, by trial and error having never heard of primal or paleo or even Atkins...trying to find a way to control my BGL instability and get off of insulin...my numbers were much worse and my ratio made me a "walking heart attack waiting to happen"...so even with a "barely high" LDL now, I'm much better off than I was before. Or so my doc says. This is the same doc that advised me against it because it would kill me...about a year before she asked me to help her with her own nutrition plan when she saw the positive changes in my blood work.

BTW, I'm not a paleo eater, I'm more primal and likely eat much more fat than most of you...and it's making positive changes EVERY YEAR in my blood work, LDL, HDL, and HDL/LDL ratio.

If you keep moving in the "wrong" direction, you may want to consider limiting carbohydrates a little more since paleo as described by Cordain isn't truly a "low carb" diet, although it certainly can be. Add a little more fat, reduce the carbs, keep protein moderate and see what that does for you.

My own FPC ratio is Fat 60%, Protein 35%, Carbs 5% and this is improving my lipid profile, and my health dramatically every year since beginning it.

I hope this helps.

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Here is a good page in understanding HDL/LDL ratio cholesterol.emedtv.com/hdl/hdl-ldl-ratio.html – Dexter May 17 2011 at 23:55
pre-Paleo Tot/HDL = 5.34 Currently = 5.14 pre-Paleo TRG/HDL = 1.63 Currently = 1.24 pre-Paleo LDL/HDL = 3.45 Currently = 3.93 Some slight changes, not all good, but again this type of analysis highlights my point. I tend to focus on the ratios rather than the data that show HG's and Cavemen had much, much lower LDL. I also tend to ignore studies that show damage caused by very high LDL in favor of things like particle makeup, ratios, or ignoring LDL entirely and focusing on TRG and HDL, or CRP. Am I just fooling myself? – Fred B May 18 2011 at 0:06
Doing some reverse calculations, it looks like you have Total C of 313, HDL of 61, and LDL of 240. According to the emedtv site, you need to divide HDL by LDL. 61/240 equals .25 The emedtv site says it shoud be a goal of .3 and preferabably .4 You are close. To raise it you just need 10 point raise of HDL. Along with your pattern A, continue eating HG style and you will live a long a healthy life. Along with consuming a lot of curcurmin and unsweetened chocolate. You are not fooling yourself. You are doing great. – Dexter May 18 2011 at 0:34
Dr Davis at Trackyourplaque uses Slo Niacin Brand to raise HDL quite successfully...around 2000mg per day. I know it is not HG, but it does assist the HDL. – Dexter May 18 2011 at 0:37
Reverse calculations are exactly correct (er, 314 total I think, but whatever). – Fred B May 18 2011 at 0:39
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My doctor had a problem with my Trigs, and especially with my LDL. I started to eat mostly paleo for several months. The next readings showed my trigs and LDL were both down, and well within the so-called "healthy" range.

BTW, increasingly, a number of doctors are coming to see that trigs and LDL do NOT show ANYTHING of importance. You can check out http://www.spacedoc.net/ to see many doctors take on it, and many of the reason to NOT take statins.

The ONLY people who can benefit from trig and LDL measurements, and statins, are people who have already had a heart attack.

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This is what makes me think my increased LDL is a sign that something else is wrong considering some people (like you) see their LDL decrease when eating Paleo (I'm assuming lower carb, higher fat than pre-Paleo, right?). – Fred B May 18 2011 at 15:50
It is lower carb and probably higher find - I do not count either, and never have. Could you give ONE reference that links high LDL heart disease? I have seen countless reference that that show clearly that there is no such link (some of these involved 10's of thousands of subjects). The only "studies" that "show" the link were funded by Big Pharma. Have you checked out spacedoc? It seems not. – terrence May 18 2011 at 17:07
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Just like with omega3/omega6, the LDL:HDL ratio is much more important than the individual constituents. A high HDL is more cardioprotective than a low LDL. HDL travels to the areas of plaque buildup in your arteries, picks up the cholesterol, and brings it to the liver for degradation. It also performs a number of other protective functions (stopping platelet aggregation, etc). If you have a high enough HDL performing that function, then it will overpower the LDL "laying down" that plaque.

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My doctor looked at my LDL's, but also emphasized the importance of LDL/HDL ratio. While I've never had a lot of luck controlling LDL levels without statins (high or low fat diet, significant weight loss, and high fiber), it was very easy to double my HDL by exercising and control the ratio. In a paleo sense, more hunting and gathering. – thhq Jul 8 2011 at 21:31
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In addition to Alex's, the particle size of the LDL is important. A NMR lipid panel will reveal if the LDL is comprised of mostly Large Bouyant particles that do no harm to the vascular system or it will reveal LDL made up mostly of Small Dense particles that do irritate the vascular system and can facilitate laying down of plaque in the blood vessel system.

Yes pretty normal LDL going up. Continue paleo and your trig will decline, HDL will increase, and your LDL number will drop somewhat and your sdLDL will be converted to Large Bouyant LDL. Wheat and sugar causes the Small dense to soar.

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But my LDL dropping somewhat is still a problem if I'm going for the HG health. I got a VAP, which shows most of my LDL is pattern A - BUT, this is the type of argument I'm talking about, it almost completely ignores the fact that I'm eating more like a HG but my lipid profile is moving in the opposite direction. – Fred B May 17 2011 at 23:56
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Paul Jaminet has just completed a series debunking the contention that HG's have low cholesterol.

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Thanks, I've been reading this series. I'll admit it's somewhat comforting (the basic idea being HG did NOT have "low" TC). The only problem is each cultures average TC was still around 215, and put into the "between 200 and 240" category, which is a far cry from my new TC of 315. – Fred B Jul 8 2011 at 17:21
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 Yeah, that's high. How are your other markers, like triclycerides? Triclyceride level is a good indication of LDL particle size. – Ambimorph Jul 9 2011 at 2:00
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Good thread here about LDL going up. My LDL just doubled after going off lipitor over the last three months and being totally paelo. My LDL went from 131 before to now 215. One thing I wanted to point out was that I was taking 5 gram of fish oil over that period. Should I just not take any and see if it helps. Frustrating to see it go up after being a good boy the last three months.

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How are your trigs? – CoachCanadan Sep 30 at 5:20
My trigs are at 70. Thanks – Briterian Oct 5 at 18:16
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does fish oil raise ldl?

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Chris Kresser has a new High Cholesterol Action Plan out that is just awesome. He's on Robb Wolf's latest podcast (episode 151), which is worth listening to, and they talk about how it's the amount of LDL particles that is te biggest risk factor, not the actual amount of LDL, or even the particle size. (Ie - the amount of boats carrying cargo, not the cargo itself). I won't get into more detail here, but I'd recommend listening to the podcast. They get into a lot of cholesterol stuff specifically.

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My LDL dropped on paleo.

That said, I see no real reason to beleive that high LDL is mechanically responsible for heart disease. Something happens in HD, that causes LDL to elevate hugely, and more importantly inflammation to be begin. I have no idea what the process is, but until someone actually comes up with a mechanical explaination, especially for the inflammatory process, that is well proven, its all speculative, and is probably wrong.

If lower LDL, prevented heart disease, statins would lower risk of heart attack. Which some newer studies suggest they dont.

That said, its always safest to assume a "u curve" with these things. There may be some other effects of a high LDL. Given, my LDL went down on paleo, maybe its something specific your eating?

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