Hello. At the urging of the Paleo Hacks community to get a VAP Cholesterol test after a standard one revealed high LDL, here are the results. I am unable to attach photos so I have linked the test results via ImageShack:
My vitamin D levels were 63 ng/dL. My C-Reactive Protein was 3.00 mg/L. I have been eating Paleo for a year now with LOTS of coconut oil and grass-fed butter. I am 35 years old, 6ft 200lbs. I do Starting Strength with some HIIT. I have a family history of heart disease on both sides. For comparison, here are the results from before I went Paleo. Unfortunately at this time I had only used the standard cholesterol test:
2012 Blood Panel Results: Total cholesterol 223 mg/dL Triglycerides 92 mg/dL HDL cholesterol 70 mg/dL VLDL cholesterol 18 mg/dL LDL cholesterol 135 mg/dL
As you can see, my over cholesterol has gone up significantly since before I began Paelo. I would love insight into that as well as the VAP results I linked. Thank you all!
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Look, the first thing is not to panic over your LDL which I would not describe as a "sharp rise." Your directly measured LDL was 150 compared to a calculated LDL in 2012 of 135. Assuming the 2012 number was accurate (an assumption), the change was not so dramatic and even an LDL of 150 is "borderline high" and not nearly so extreme as others have reported (I have seen LDL as high as 435 here). Also take a look here:
If you are not a smoker and your BP is ok, then you likely have no additional risk factors so your apoB is not yet so bad by conventional standards (I suggest using either apoB or LDL-P and forgetting about LDL-C). It is also possible that your apo-b did not move much but hard to say without a baseline. I do see that the Remnant Lipo is marked high. You should know that there is new research:
suggesting that Remnant Lipo may be the best predictor of heart disease although more work needs to be done on that.
All that said, lets take a look at some of the standard paleo "wisdom" you are getting here:
1). Any assertion that "large, fluffy" LDL is somehow protective is ill-advised. At best, there is a notion that small, dense LDL is more arthrogenic however the new studies that control for confounding variables suggest that its the number of particles (LDL-P) irrespective of size that is the risk marker. No where has it ever been credibly said that large (fluffy) LDL particles are some how positive. Those with familial hypercholesterolemia have loads of "large fluffy" LDL particles but they still get heart problems.
2). Another common idea is that sky-high LDL is a sign of Thyroid disorder (hence the Brazil nuts) but assuming you have no symptoms of hypothyroidism, it would have to be subclinical (SHT). In the research I looked at, this for example:
"In the follow-up study, where we looked specifically at those with SHT, the serum TC and LDL-C levels were significantly higher in the females in the SHT group than in the controls. The serum TC and LDL-C levels were also higher in the males SHT subjects, but the difference did not reach statistical significance."
there wasn't a significant relationship between SHT and LDL for the male subjects.
3) The idea that inflammation is the "real cause" of heart disease is somewhat misleading. While there is no doubt that inflammation plays a significant role, the cause and effect has not been definitively settled. See this for an overview of the issues:
4) While it is true that for many people dietary cholesterol has no impact on serum cholesterol, there are some "hyper responders" that will see an increase:
The same goes for saturated fat and there is older research suggesting that hyper responsivity to dietary cholesterol is associated with the same for saturated fat:
However, I would say that if you have been eating this way for a year or so, you probably aren't a dramatic hyper-responder or your LDL would have skyrocketed by now.
Still, with your family history it would seem prudent to try and avoid the further increases in your LDL levels. To whit:
1) Is is really necessary to eat 6 eggs, 80 grams of butter, and 30 grams of MCT oil in one day (Bulletproof Coffee recipe)? In case you never did the calculations, thats 123 grams of fat of which about 76 grams is saturated, 382% of the RDA and 1288 mg of cholesterol which is 429% of the RDA (not to mention the 1200) calories. You also mention that you eats "lots of coconut oil and grass-fed butter" which I assume is in addition to the eggs and BP coffee. For the life of me, I don't understand how the idea came about that this level of fat and cholesterol is in any way desirable. It certainly is in no way consistent with the tenets of an evolutionary sound diet and all I can think of is that its an extreme and ill-advised reaction to older conventional wisdom about reducing fat intake. So, the first thing I would suggest is stop with the massive does of butter and coconut oil. For cooking, you can substitute some olive oil or even some lard which is higher in mono saturated fat. I am by no means suggesting a "low-fat diet", rather a lesser-fat with fats coming from more mono-saturated fats then you are getting now.
2) As far as carbohydrates, it seems that you are on a very low carb diet (VLC) but I am not sure why as you haven't said (weight loss?). While it may have some short to medium term therapeutic value, say in Metabolic Syndrome, I would really question the wisdom or necessity of this over the long term. I will take your word that you are truly what intolerant but that is no reasons that you can't eat potatoes of all kinds, starch vegetable and certainly fruit which you say you will think about "introducing", suggesting you are not eating any at all. Again, I have no idea why you aren't eating fruit other than to follow a VLC diet but it does seem strange to me that somebody is ok with the kind of fat intake discussed above but is eating zero fruit. I would definitely recommend bananas as great source of carbs. Also, if wheat gives you trouble, I see no reason not to experiment with rice, corn, and other grains in reasonable amounts.
3) In other words, try eating a more "balanced" yet still healthy diet with good natural fats in a reasonable amount along with meat/fish, dairy, fruits and vegetables, and grains if they are not really giving you a problem as opposed to conjectures about their detrimental effects. (Maybe this is all close to what some have called a "Mediterranean Paleo-Diet" although that sounds ridiculous.) This is actually more in line with how people traditionally ate and by "traditionally", I mean with a time frame that makes sense for us now as opposed to what may or may not been going on in the Paleolithic time.
For myself, I also had way high LDL (much higher than yours while following a paleo-style, lower carb diet before I started to up my carb intake. In recent months, I have also adopted all of the changes I have suggested for you regarding fat intake. In the end, my LDL started dropping some months after I added carbs back in and before I made the other changes so who knows really? There is still the possibility that time alone made the difference but altering your diet in the direction I have suggested still seems prudent given your family history and expressed concerns about cholesterol.
Let us know how it works out.
I've been researching this same issue; my cholesterol shot up to 300 since I started paleo recently. From reading various posts I've come to the following adjustments I'm trying now:
Cutting back on butter - proven to raise total cholesterol and LDL. So I limit butter to 1 tablespoon a day (add it to coffee in the morning).
I eat seafood about 4 days a week; this is my source for omega 3's. I completely stopped taking Omega 3 supplements as they provide too much EPA and DHA. Since I don't get much omega 6's in my diet I supplement with (3) 1300mg evening primrose pills per day.
Supplement with Taurine, Magnesium, Copper, and Ecklonia Cava to reduce systemic and endothelial inflammation.
Take 1 teaspoon of iodized salt along with 1 brazil nut immediately upon waking in the morning. This is to reduce the stress placed on the adrenals upon waking and to ensure I get my minimal daily iodine + selenium, deficiencies of which lower thyroid hormone levels which in turn inhibit LDL clearance from plasma.
This is still experimental. I'll have a better idea if my protocol is effective once I get my NMR lipoprofile test 3 weeks from now.
JReinhal- I have combined my two answers into one that takes into account this new information from you. See above.
Whats wrong with cholesterol ?
"Many studies have shown that low cholesterol is a bigger risk factor for heart disease and mortality than high cholesterol. Elderly people with low cholesterol died twice as often from a heart attack, when compared with elderly people with high cholesterol"
If cholesterol is REALLY high...
Based on the ____*______ at the bottom, doesn't it suggest you have the friendly, fluffy, large/buoyant type of LDL?
If so, isn't that ok?
From what I've been reading, even if the total cholesterol, or LDL is high, if it's large/buoyant type, people shouldn't worry.