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(I know that total cholesterol is an inadequate measure of health and that the exact relationship between cholesterol and health is still uncertain (AND that this topic has been brought up in numerous other threads, so if this question gets closed I understand), but it is representative of something going on in the body and thus I have a desire to know if anyone else has had a similar experience.)

Last December, during the final month of my HSAD ("Healthy" Standard American Diet) my total cholesterol was 188. Over the course of my adult life, my numbers have been consistently within the 160-190 range, so this was par for the course.

After 7 weeks of Paleo (following the recommendations found in Cordain and Wolf's books, low sat. fat, moderate protein, no dairy, etc.) my total cholesterol dropped to 180.

After finishing my 90-day Paleo challenge (see the whole thing here) I decided to switch to a more Sisson-esque "Primal" diet that included cheese, cream, and fattier cuts of meats such as beef, pork, etc. and a drastically reduced carbohydrate intake.

After a month of "Primal", my total cholesterol was found to be 285 (this was a fasted reading) and the overweight phlebotomist told me that I might need statins. Admittedly, I did have a momentary freak-out, but I was reading "Good Calories Bad Calories" at the time and decided to "stay the course".

Just this past week, I gave blood and received my numbers again. Since the last reading, my diet has since gone even lower carb and higher in fat, but my total cholesterol has dropped to 248.

I'm definitely relieved to see this as the consensus seems to be that cholesterol levels, while not an issue of grave concern, shouldn't skyrocket indefinitely.

There are plenty of threads discussing what seem to be abnormally high TC readings with some individuals after switching to Paleo/Primal, but I want to know if anyone has, like me, seen their numbers "normalize" after a period of time.

*8 Month Update*

Since originally posting this question, I have steadily increased my carbohydrate intake (daily fruit plus some sort of starch from sweet potatoes, regular potatoes, plantains, beans, and white rice) swapped out some animal fat (no more heavy cream, limiting eggs to 6 per week, less butter) for more plant oils (coconut, extra virgin olive oil, nuts/seeds) and cut down on my pork intake (yup, that means bacon) though I still eat red meat like beef and venison regularly.

Exercise has mostly stayed the same although I have begun to incorporate the vilified "moderate intensity cardio" back into my routine in the form of weekly mountain bike riding and spinning.

Even so, I was still a little worried going in to our I had a health screening at work today, and the results were as follows...

Total Cholesterol 190 mg/dl (optimal, as indicted on the testing paperwork, = less than 200)

HDL 74 mg/dl (optimal = higher than 50)

TC/HDL Ratio 2.6 (optimal = less than 4.0)

LDL did not register as it was too low (optimal = less than 100mg/dl)

Triglycerides did not register as they were less than 45mg/dl (optimal = less than 150)

Fasting blood glucose 88mg/dl (optimal = less than 100)

Blood Pressure 121/70 (optimal = less than 120/80)

Body fat 13.1% ("healthy" = 8% to 19%)

6 ft tall and 192lbs = BMI 26 (optimal = 18.5 to 24.9)

The RN looked at my results and basically said that she couldn't recommend that I do anything other than "keep doing what I am doing". We eventually decided that I could technically "drink more water" just so that she could write something on her sheet.

(On a funny side note, in our discussion she assumed that I was eating "low fat dairy". I mentioned that I don't eat much, but if I do it is cultured sour cream, so I still get my "probiotics". That seemed to make her happy.)

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You need to provide more information regarding HDL, LDL, Triglycerides since TC in isolation doesn't tell us squat – Aravind Jul 29 2011 at 19:37
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Agreed. Also, have you seen this: perfecthealthdiet.com/?p=2547 – Andy Jul 29 2011 at 20:01
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thanks for the update! Updates are so critical in getting great info here! – none Mar 9 2012 at 1:36
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Studying modern hunter gatherers doesn't teach us anything that can be readily applied? So the fact that the !Kung San consume and average of 1,200 calories per day from mongongo nuts (see pg. 32 of jefferson.library.millersville.edu/reserve/…) that are 44% pufa (naturalhub.com/…) while remaining free of the "diseases of civilization" doesn't call into question the assumption that increased PUFA automatically increases CVD risk? – FED at LiveCaveman.com Mar 12 2012 at 0:12
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Furthermore, how do you explain the diversity of diets (in terms of macro-nutrient ratios as well as the proportion of plant and animal based foods) that hunter gatherer groups exhibit (naturalhub.com/…) all while remaining free of Western Disease? – FED at LiveCaveman.com Mar 12 2012 at 0:17
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3 Answers

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Your rise in LDL-C and TC are mostly the result of consumption of cream/butter, and to a lesser extent, cheese. Dairy fat tends to have a ratio of myristic/palmitic/lauric acids that will spike LDL-C like nothing else. If you continue to eat high fat, but cut out dairy, your LDL-C will plummet. Mine dropped by 20-something% in 5 weeks, though I would imagine that there is variability between individuals.

As to whether high LDL really matters, I can't say, but my gut feeling is that it is not optimal, and dairy fat consumption is as recent as wheat consumption. Personally, I feel that the dairy industry raises cholesterol and the statin industry lowers it. This oscillating paradigm is great for business, but not so much for us.

If you'd like to play it safe, skip dairy and supplement calcium via some other means.

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I tend to agree about the dairy fat after seeing my fasted TC rise from 236 to 400. HDL went from 77 to 90, Triglycerides from 28 to 54 on a much lower carb, higher (dairy) fat diet. It's too early to tell where it will or would settle. Doc recommended eating less fat... no thanks, but how about different fat? I also wondered if it's my body being in a situation where it needs high cholesterol, but 400? – Dean Jul 29 2011 at 20:21
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I suppose it's confession time. My name is Tony, and I've been in dairy denial. – FED at LiveCaveman.com Jul 29 2011 at 20:26
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It seems pretty clear that dairy fat does indeed raise LDL, and in most people, HDL right along with it. It didn't raise my HDL a bit, but tuat may be due to a nutrient or mineral deficiency for me. I am not convinced that the fact that dairy fats raise HDL and LDL is a bad thing. It may just be the body's natural response to facilite the fat consumption. If dairy has so many other positive benefits in most people, it seems odd that they would all be cancelled by some weirdo counterbalance effect that it also damages your cardiovascular health at the same time. – Jack Kronk Jul 29 2011 at 20:27
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+1 because I hope you're right Jack. I love me some dairy. Even more now since I went primal because I buy the really good stuff! :) – Andrea S. Jul 29 2011 at 21:17
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I just got back from the Dr. today, and I think my cholesterol numbers are very interesting.

In 2009 at 216 lbs and on a very unhealthy diet of frootloops, pb&j, and healthy choice boxes, here is what my numbers were.

TC 212 TriG 84 HDL 52 LDL-C 143

My BP was 126/88

Today.. I am 177 lbs, and Paleo/Lacto (for now, might ditch dariy to see what happens)

BP was 111/70

TC 260 TriG 48 HDL 64 LDL-C 186

My Dr. told me to eat less red meat, more fish and chicken.. and that because of my high HDL and low TriG he didn't recommend statins.. so I will keep him, AND keep eating my red meat. I'll be interested to see how dairy will effect my LDL in 6 months.

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Smart doctor. "This guy is probably at a low risk for atherosclerosis despite high LDL so let's not vaporize his brain". Makes me smile. – Stabby Jul 29 2011 at 20:40
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CaveDad - I think your numbers look pretty good. CMast says a good place to be is with an HDL:TC ratio of 1:3.5 or less and you are right at 1:4. Then again, your LDL is probably calculated, and with your trigs at 48, I bet your LDL calculation is overestimated based on the equation used, indicating that you TC is probably also overestimated. – Jack Kronk Jul 29 2011 at 20:43
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...but I want to know if anyone has, like me, seen their numbers "normalize" after a period of time. realized I answered without taking this into account and just generalized my thoughts on cholesterol.

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I agree that statins are dangerous and essentially useless. If cholesterol is produced in response to cellular stress, shutting it down is simply addressing the symptom of an underlying problem rather than addressing the problem itself. Whether high cholesterol is a "problem" in the first place also seems to depend more on the specific microfractions, which, I unfortunately do not have access to at this time. – FED at LiveCaveman.com Jul 29 2011 at 20:15

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