Some of you have been posting that LDL skyrockets when doing Paleo. I've beend doing some research why that might be the case. One possible answer is offered by Dr. Joe Goldstrich, (most recently of the Princeton Longevity Center) who used to head the Pritikin Longevity Center in Santa Barbara -- that was back when the Pritikin diet duked out with the Atkins diet: Atkins was high fat, Pritikin was low fat.
This is from the website, Prescription2000 http://www.prescription2000.com/ which features interviews with health practitioners from the low-fat perspective (Cordain was on). Goldstrich is somewhat Paleo-friendly, though he's against saturated fat a la Cordain.
To summarize, what matters is the Apolipoprotein E (ApoE), a lipoprotein that carries cholesterol through the bloodstream. Dr. Goldstrich says you should know your ApoE status before deciding what type of diet to pursue. There are 3 kinds of ApoE: types 2, 3, and 4. And since we have 2 alleles, we can have combinations of 2-3, 3-3, 4-3, 4-4, so on.
For about 65% of the population, the ApoE status is 3-3. If you're 3-3, you can eat fat without unduly raising LDL. That is, those who seem to be thriving on the high-fat Paleo or low carb diets, judged only by their LDL, may have Apo E 3-3 alleles.
For the remaining 35% of the population, about 25% include type 4: e.g., 4-3, 3-4 or 4-4. These people's LDL may skyrocket on a fat-heavy diet, especially saturated fat. And the LDL increase may be in the form of Pattern B (the small, dense ones that are supposed to be dangerous). These people tend to thrive on a low-fat diet, as their LDL would be managed best by keeping saturated fat low. For example, eating coconut oil might increase their LDL significantly, while it would not affect the Apo E 3-3 type. Fish oil could also increase the LDL of these people, while supplement Quercetin could lower their HDL.
What does this sound like? Metabolic typing anyone? I dismissed metabolic typing when Dr. Harris pooh-poohed it. But maybe there is something to it.
Conclusion: About 65% of all dieters could benefit from a high-fat diet, but 25% may not. We're talking just in terms of their lipid numbers. Whether you believe in the lipid theory is another question altogether, however. So check your ApoE status if Paleoing seems to give you high cholesterol.
I did the Apo E tests years ago and found out that I am 4-3. The post test counseling included a prescribed diet of only 10% fat. I did 2 months on the diet, and I can tell you my mental health reached an all time low. I finally came to the conclusion that I'd rather die young happy than live a long "healthy" life of misery. My new rule is that if it isn't good for my brain, it isn't good for my body.
I'm leaning towards thinking our current understanding of Apo E is incomplete at best because my lipid panel improved after going paleo. On a vegetarian low fat diet my cholesterol was through the roof (upper 300s for LDL), and the more of my energy I get from saturated fat and meat the less panicked my docs seem to be when they get my labs. My LDL came down over 100 points in one year.
I wonder if what some people are experiencing in their labs is transient hypercholesterolemia, especially if they are adopting a ketogenic diet. I definitely know the urge go get a full physical the moment you start feeling better just to have some sort of confirmation on paper, but I think it is supposed to take at least a couple of months for your lipids to normalize.
Dr Goldstrich is going far, far beyond the evidence to untenable conclusions. All you really need to know is the ApoE e4 is the ancestral allele, two copies were the norm in the Paleolithic, and nearly everyone in the Paleolithic ate a high-fat diet, with 20% carb 15-20% protein 60-65% fat being fairly typical. It's most unlikely that pathological levels of LDL were common in the Paleolithic.
The most you can infer is that nutrient deficiencies may have greater effects on LDL levels in people with the ApoE e4 allele. The evidence certainly doesn't tell you that a low-fat diet is optimal.
Never had that test done, and, yes, my LDL has gone way up - 159 - BUT ...
So, I tend to agree with Happy Now that while there is probably something worth exploring further with ApoE, our understanding of how this affects us is still pretty incomplete. I am more inclined to think that increased inflammation from some other health issues is more relevant to the increase in my LDL numbers.
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