11

votes

Should We Be More Reluctant to Have a Heavy Butter/Cream Intake?

Answered on August 19, 2014
Created September 05, 2011 at 8:19 PM

I touched on my experience with mostly butter, but some cream, elevating my LDL-C here:

http://paleohacks.com/questions/36855/i-think-i-may-have-figured-out-why-some-of-us-have-really-high-ldl#axzz1NZ2Ngj3p

I jolted awake last night thinking about familial hypercholesterolemia (seriously). Heterozygous FH usually results in a total cholesterol of around 300 mg/dl (and an increased rate of heart attack). Homozygous FH usually results in a TC of around 680 mg/dl (and death during childhood). FH reduces cholesterol clearance in the blood because some portion of LDL receptors are absent, so the LDL molecules aren't able to bind and unload their cholesterol cargo. This is important because the LDL-C oxidizes over time (creating oxLDL) which is taken up by macrophages which then become foam cells. They can then be trapped in blood vessel walls and contribute to the formation of plaques.

There's something about the ratio of myristic, palmitic and lauric acids in butter and cream that makes it the most potent dietary way to downregulate the hepatic LDL receptors. It happens to some extent with coconut oil, but I've seen studies that showed it to be about half as potent as butter. I don't believe that it is a systemic clearance issue like it is with FH, but rather just focused on the liver and its ability to clear excess LDL-C from the circulation. I've never seen any evidence for this, but my assumption is that the reason hepatic LDLR activity is downregulated with these fatty acids is that more LDL-C is needed in circulation during the rapid brain development of a nursing neonate. Any dairy would likely have this effect to some extent, but a highly concentrated form of cow's butter is a strongly exaggerated dose of these fatty acids, which in this case have a drug-like effect on cholesterol clearance.

As serum cholesterol levels increase, there should be a negative feedback mechanism that reduces and probably eventually nearly halts endogenous production of cholesterol. The cholesterol that builds up in the bloodstream is likely dietary cholesterol that slowly accumulates in LDL molecules.

I had only been eating a lot of butter for a few months before I hit a TC of 391. I have no reason to believe that going longer wouldn't have increased it even further. I know I don't have FH because lipid panels before that one have not had a TC that exceeded 168. This didn't occur during a time when I could create vitamin D via UVB and cholesterol, so that's a factor as well. Indeed, there are many people eating a paleo-ish diet high in butter/cream who have reported very high LDL-C levels. Take a gander at this one from PH: http://paleohacks.com/questions/3906/very-high-total-cholesterol#axzz1X1hEFAqS

I don't know exactly what she was eating but she says very high fat and that she eats dairy and 550 mg/dl is no joke. I would advise someone with a TC in the 400+ range to immediately stop eating any dietary cholesterol, go low fat, get out in the sun and try to maximize serum cholesterol clearance ASAP. Mine dropped by 20-something percent in about 5-6 weeks without sun, and is likely in the 200s right now. However, I certainly would not give the same advice to someone with a healthy level of cholesterol (low to mid 200s) like our misguided doctors do.

In the same way that having elevated levels of triglycerides in chylomicrons or VLDL floating around our blood is dangerous, I'm fairly confident that there's a safe range for LDL-C and that it being "big and fluffy" does little to make the situation safer. It is highly unsophisticated to think of LDL-C as "bad cholesterol" since it's necessary for our survival, however at these inflated levels (for which I'm sure we have no evolutionary precedent) I think it could contribute to atherosclerosis. I think that a heavy butter/cream intake simulates FH and could cause the same results.

At the very least, we might replace the butter and cream in our diets with coconut oil and have the added benefit of reduced lipogenesis due to the much greater amount of MCTs.

44348571d9bc70c02ac2975cc500f154

(5853)

on September 08, 2011
at 05:12 AM

I should have taken blood work during winter. I had so many symptoms of some sort of thyroid disorder. I am still wondering if there might be low T3 or something.

44348571d9bc70c02ac2975cc500f154

(5853)

on September 08, 2011
at 05:09 AM

Less butter and cream, i think less fat overall. More fish and less beef. High dose of vitamin c. I wonder how this high dose of vitamin D (5000 IU) affects things. I recently added coconut oil to my diet. But i still use butter for pan frying fish. It just cant be beat for that. No salmon with hollandaise for breakfast anymore thats for sure :D I think my pre paleo lipids were good, if not optimal. I have never eaten much crap food so not as much impruvement as others. For instance, i have eaten in fast food restaurant maybe under 10 times my life.

26b7615ef542394102785a67a2786867

(7967)

on September 08, 2011
at 01:20 AM

WyldKard, everything I've read about blood lipids seems to indicate that rapid and extreme increases in LDL upon changing your diet are not a sign of health. Also all the data we have on people eating traditional 'paleo' and primal-style diets shows that they tend to lower total and LDL cholesterol compared to Americans eating SAD (who average total around 200 - 300+ is a whole other ball game!)

26b7615ef542394102785a67a2786867

(7967)

on September 08, 2011
at 01:17 AM

Travis, if it could be classified as a disorder, it's a pretty weak one- we may be miserable, but we live FOREVER (unless we kill ourselves or drink ourselves to death) and have zero heart disease or diabetes, and no cancer before the 7th decade. I feel pretty lucky, both to have such good genes, and to be able to eat unlimited butter. ;)

Da8e709acde269e8b8bfbc09d1737841

(1906)

on September 07, 2011
at 07:34 PM

Why do you say it's "probably not healthy"? Based on what?

2870a69b9c0c0a19a919e54cb3a62137

(1520)

on September 07, 2011
at 05:43 PM

Dairy fat composition doesn't resemble that of other animal fats. I don't eat brains and marrow and have not found a good source of tallow or lard, so it's a matter of compromising. Just now there's another thread vilifying olive oil. If pure dairy fat might not be as unproblematic as many make it seem, this should be examined in great detail. Paleo man didn't eat it, that's for sure. It wouldn't have been HIS source of fat soluble vitamins.

Medium avatar

(39821)

on September 07, 2011
at 05:23 PM

What did you change from May to July that caused the decrease?

Medium avatar

(39821)

on September 07, 2011
at 05:22 PM

It would take years/decades for it to occur and it may require other factors that aren't relevant for paleos, *but just in case....*

Medium avatar

(39821)

on September 07, 2011
at 03:07 PM

Well, you needn't go low fat to replace dairy fat in your diet. I just think it's better to play it safe with this sort of thing. Our lab ranges in general are pretty ridiculous (149 TGs is OK?) but when you are *double* the upper limit, it's probably time to reexamine some things.

44348571d9bc70c02ac2975cc500f154

(5853)

on September 07, 2011
at 05:26 AM

My strange lipid panel: Pre-paleo: 30.08.06 TSH: 0.65 T4 16.4 26.08.10 Total: 5.5 mmol/l Trig: 0,4 HDL: 2.2 LDL: 3.1 Gluk: 4.6 HbS1c: 33 GHb-A1C: 5.2 TSH: 0.98 Paleo: 23.05.11 Gluk: 4.9 Total: 12.6 mmol/l Trig: 1.3 HDL: 2.67 LDL: 9.28 TSH: 0.84 mU/l 22.07.11 Gluk: 4.7 Total: 10.1 mmol/l Trig: 0.5 HDL: 2.89 LDL: 6.95 TSH: 0.62 T4: 14 B12 vit: 587 pmol/l

7c9f81d68c78de1a31eab9c91c17b4b8

on September 07, 2011
at 03:58 AM

travis. i don't always understand everything you say but i still like to read it.

44348571d9bc70c02ac2975cc500f154

(5853)

on September 06, 2011
at 06:57 PM

I did use little milk and some cheese, but i mostly cooked with olive oil pre paleo, and duck fat (not as long tho). I have been cooking with butter when paleo, but i dont use tons of it, just enough to get the food cook right. I dont measure or calculate anything, but i believe i eat less fat than most paleos, and quite alot of vegetables, and perhaps (too much?) protein.

Medium avatar

(39821)

on September 06, 2011
at 06:32 PM

I should also mention that dietary cholesterol absorption decreases with heavy intakes, so one would assume that serum levels of LDL-C would impact absorption. There still must be enough getting absorbed to get trapped in circulation.

Medium avatar

(39821)

on September 06, 2011
at 06:28 PM

That sounds like an as yet unclassified familial hypocholesterolemia. For someone like you, it seems like butter/cream could be necessary for health

Medium avatar

(39821)

on September 06, 2011
at 06:28 PM

That sounds like a as yet unclassified familial hypocholesterolemia. For someone like you, it seems like butter/cream could be necessary for health.

44348571d9bc70c02ac2975cc500f154

(5853)

on September 06, 2011
at 06:21 PM

Yes, i only have one lipids work done pre paleo. It was pretty good, low trigs and all. I have also always been eating tons of fish. Prepaleo i didnt actually eat much beef or eggs. I just liked fish more.

Medium avatar

(39821)

on September 06, 2011
at 06:15 PM

That's really interesting since marrow fat is largely monounsaturated. I'd be really interested to see the results. So was there a period of butter/cream consumption that preceded or coincided with the marrow intake or do you avoid dairy? Also, do you have a prior test that you can compare it to in order to rule out FH?

44348571d9bc70c02ac2975cc500f154

(5853)

on September 06, 2011
at 06:13 PM

Yes i agree, TC should be reasonable, like 250 at tops.

Medium avatar

(19479)

on September 06, 2011
at 12:10 PM

In his post, Travis didn't indicate that tallow had the same effect, but that could use some clarification. In the meantime, highly mono-unsaturated fruit/seed oils such as olive, avocado, red palm, and macadamia are almost universally lauded for their cholesterol lowering effects.

44348571d9bc70c02ac2975cc500f154

(5853)

on September 06, 2011
at 07:30 AM

What should one use, olive oils then or what? Maybe heavy use of tallow would be quite bad as well?

Medium avatar

(39821)

on September 05, 2011
at 10:25 PM

If a stick of butter a day doesn't elevate your TC above 250, I say go for it. I suspect many are "eating in the dark" as I was though.

Medium avatar

(39821)

on September 05, 2011
at 10:25 PM

If a stick of butter a day doesn't elevate your TC above 250, I say go for it. I suspect many with are "eating in the dark" as I was though.

Medium avatar

(39821)

on September 05, 2011
at 09:38 PM

I'm allergic to coconut as well, so most of the fat I eat is from egg yolks and lamb.

1a98a40ba8ffdc5aa28d1324d01c6c9f

(20378)

on September 05, 2011
at 09:11 PM

I also wonder if I am eating too much dairy. I have issues with coconut though...

E5c7f14800c5992831f5c70fa746dc5c

(12857)

on September 05, 2011
at 08:52 PM

maybe take turmeric to offset ldl dr

Medium avatar

(39821)

on September 05, 2011
at 08:34 PM

Clearly, as with all things, there is variation among individuals with regard to susceptibility to dairy fat. A stick of butter a day will do different things to me compared to you. Getting a lipid panel done occasionally is probably a good idea though.

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9 Answers

2
2870a69b9c0c0a19a919e54cb3a62137

(1520)

on September 07, 2011
at 03:48 AM

One thing that might still need more consideration is the possibility of an infectious cause of atherosclerosis and high cholesterol being a sign. What if those with very high cholesterol do not succumb to cholesterol, but to infection? Why else would moderately high cholesterol be a protective agent in late life?

Some people go paleo and get their blood analysed because of health problems. My total cholesterol rose to 400 after going paleo + dairy fat, but at the same time I was battling SIBO, leaky gut and inflammation caused by it. Curiously, I was feeling better than before, when my cholesterol had been around 230, though this might be more because of low carb than clarified butter.

I don't know my current cholesterol level, probably still high, but low fat is not an option with SIBO. I'm unconvinced dietary cholesterol factors in negatively.

2870a69b9c0c0a19a919e54cb3a62137

(1520)

on September 07, 2011
at 05:43 PM

Dairy fat composition doesn't resemble that of other animal fats. I don't eat brains and marrow and have not found a good source of tallow or lard, so it's a matter of compromising. Just now there's another thread vilifying olive oil. If pure dairy fat might not be as unproblematic as many make it seem, this should be examined in great detail. Paleo man didn't eat it, that's for sure. It wouldn't have been HIS source of fat soluble vitamins.

Medium avatar

(39821)

on September 07, 2011
at 03:07 PM

Well, you needn't go low fat to replace dairy fat in your diet. I just think it's better to play it safe with this sort of thing. Our lab ranges in general are pretty ridiculous (149 TGs is OK?) but when you are *double* the upper limit, it's probably time to reexamine some things.

2
26b7615ef542394102785a67a2786867

on September 06, 2011
at 06:20 PM

Interesting and extremely relevant info, thanks. It seems like there are rather a lot of people who get insanely elevated cholesterol scores from a paleo-style high fat diet... I agree that this is probably not healthy.

However I eat butter and cream like it's going out of style (upwards of 10,000 calories of dairy fat per week sometimes) and I've had only slight increases, which is a positive change IMO, in my lipid panels since going primal 2 years ago (my LDL and HDL are always very nearly the same number, both are a bit higher these days). People in my family rarely break into the 180s; mine was in the 150s pre-primal and is now in the 160s-170s. We have a lot of problems with depression, anxiety and mental illness.

So yes, it's also very individual.

Medium avatar

(39821)

on September 06, 2011
at 06:28 PM

That sounds like a as yet unclassified familial hypocholesterolemia. For someone like you, it seems like butter/cream could be necessary for health.

Medium avatar

(39821)

on September 06, 2011
at 06:28 PM

That sounds like an as yet unclassified familial hypocholesterolemia. For someone like you, it seems like butter/cream could be necessary for health

Da8e709acde269e8b8bfbc09d1737841

(1906)

on September 07, 2011
at 07:34 PM

Why do you say it's "probably not healthy"? Based on what?

26b7615ef542394102785a67a2786867

(7967)

on September 08, 2011
at 01:17 AM

Travis, if it could be classified as a disorder, it's a pretty weak one- we may be miserable, but we live FOREVER (unless we kill ourselves or drink ourselves to death) and have zero heart disease or diabetes, and no cancer before the 7th decade. I feel pretty lucky, both to have such good genes, and to be able to eat unlimited butter. ;)

26b7615ef542394102785a67a2786867

(7967)

on September 08, 2011
at 01:20 AM

WyldKard, everything I've read about blood lipids seems to indicate that rapid and extreme increases in LDL upon changing your diet are not a sign of health. Also all the data we have on people eating traditional 'paleo' and primal-style diets shows that they tend to lower total and LDL cholesterol compared to Americans eating SAD (who average total around 200 - 300+ is a whole other ball game!)

1
Da8e709acde269e8b8bfbc09d1737841

(1906)

on September 07, 2011
at 04:58 PM

FWIW, my TC was just over 300 after going paleo, and I was drinking a fair amount of heavy cream at the time. A CIMT scan showed no signs of atherosclerosis, however. I'll probably get another lipid panel in a couple months and see how much my TC went down after cutting back on the heavy cream.

Medium avatar

(39821)

on September 07, 2011
at 05:22 PM

It would take years/decades for it to occur and it may require other factors that aren't relevant for paleos, *but just in case....*

1
44348571d9bc70c02ac2975cc500f154

(5853)

on September 07, 2011
at 05:29 AM

My strange lipid panel

Pre-paleo:

30.08.06 (no lipids taken) TSH: 0.65 T4 16.4

26.08.10 Total: 5.5 mmol/l Trig: 0,4 HDL: 2.2 LDL: 3.1 Gluk: 4.6 HbS1c: 33 GHb-A1C: 5.2 TSH: 0.98

Paleo:

23.05.11 Gluk: 4.9 Total: 12.6 mmol/l Trig: 1.3 HDL: 2.67 LDL: 9.28 TSH: 0.84 mU/l

22.07.11 Gluk: 4.7 Total: 10.1 mmol/l Trig: 0.5 HDL: 2.89 LDL: 6.95 TSH: 0.62 T4: 14 B12 vit: 587 pmol/l

44348571d9bc70c02ac2975cc500f154

(5853)

on September 08, 2011
at 05:12 AM

I should have taken blood work during winter. I had so many symptoms of some sort of thyroid disorder. I am still wondering if there might be low T3 or something.

Medium avatar

(39821)

on September 07, 2011
at 05:23 PM

What did you change from May to July that caused the decrease?

44348571d9bc70c02ac2975cc500f154

(5853)

on September 08, 2011
at 05:09 AM

Less butter and cream, i think less fat overall. More fish and less beef. High dose of vitamin c. I wonder how this high dose of vitamin D (5000 IU) affects things. I recently added coconut oil to my diet. But i still use butter for pan frying fish. It just cant be beat for that. No salmon with hollandaise for breakfast anymore thats for sure :D I think my pre paleo lipids were good, if not optimal. I have never eaten much crap food so not as much impruvement as others. For instance, i have eaten in fast food restaurant maybe under 10 times my life.

1
44348571d9bc70c02ac2975cc500f154

(5853)

on September 06, 2011
at 06:06 PM

I had been eating alot of marrow fat during winter and got about same levels of TC as Travis did. I think marrow fat is the least saturated of beef fat (even better than tallow many ways i believe) and still it did this. I can post my lipids tomorrow once i find the paperwork.

Medium avatar

(39821)

on September 06, 2011
at 06:15 PM

That's really interesting since marrow fat is largely monounsaturated. I'd be really interested to see the results. So was there a period of butter/cream consumption that preceded or coincided with the marrow intake or do you avoid dairy? Also, do you have a prior test that you can compare it to in order to rule out FH?

44348571d9bc70c02ac2975cc500f154

(5853)

on September 06, 2011
at 06:57 PM

I did use little milk and some cheese, but i mostly cooked with olive oil pre paleo, and duck fat (not as long tho). I have been cooking with butter when paleo, but i dont use tons of it, just enough to get the food cook right. I dont measure or calculate anything, but i believe i eat less fat than most paleos, and quite alot of vegetables, and perhaps (too much?) protein.

44348571d9bc70c02ac2975cc500f154

(5853)

on September 06, 2011
at 06:21 PM

Yes, i only have one lipids work done pre paleo. It was pretty good, low trigs and all. I have also always been eating tons of fish. Prepaleo i didnt actually eat much beef or eggs. I just liked fish more.

1
Medium avatar

(19479)

on September 05, 2011
at 10:22 PM

I appreciate the post, and agree that butter/cream plus a family history of high cholesterol/elevated cholesterol is probably not a good idea.

Studies of hunter gatherer societies do not indicate that they walked around with 300+ TC values regardless of the composition of their diets (all meat, starch based, etc.)

However, if someone does not have a family history/elevated cholesterol levels, the probably have nothing to worry about dairy fats.

So I guess the answer is, "It depends."

Medium avatar

(39821)

on September 05, 2011
at 10:25 PM

If a stick of butter a day doesn't elevate your TC above 250, I say go for it. I suspect many are "eating in the dark" as I was though.

44348571d9bc70c02ac2975cc500f154

(5853)

on September 06, 2011
at 07:30 AM

What should one use, olive oils then or what? Maybe heavy use of tallow would be quite bad as well?

44348571d9bc70c02ac2975cc500f154

(5853)

on September 06, 2011
at 06:13 PM

Yes i agree, TC should be reasonable, like 250 at tops.

Medium avatar

(39821)

on September 05, 2011
at 10:25 PM

If a stick of butter a day doesn't elevate your TC above 250, I say go for it. I suspect many with are "eating in the dark" as I was though.

Medium avatar

(19479)

on September 06, 2011
at 12:10 PM

In his post, Travis didn't indicate that tallow had the same effect, but that could use some clarification. In the meantime, highly mono-unsaturated fruit/seed oils such as olive, avocado, red palm, and macadamia are almost universally lauded for their cholesterol lowering effects.

0
03a4ec34751186201a56da298ac843ce

on July 21, 2012
at 03:28 AM

Aren't there other variables such as activity level that need to be taken into consideration?

Also, in addition the the dairy and butter what else are you eating?

0
Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on July 21, 2012
at 03:13 AM

I dont eat heavy cream. I use butter and lots of aged cheese.

My LDL: It used to be very elevated when I drank booze and ate primarily carbs (like seriously 85-90% carbs).

Since going low carb, high fat, by LDL has dropped back into the "normal" range.

I was suprised, because all mainstream medical opinion is that dietary fat raises LDL. For me, cutting out carbs and increasing fat dropped it.

But in a sense, I agree with you. If eating a certain way, elevates your particular blood lipids to well out of the reference range of normal LDL to HDL , sure you might consider a change of diet.

But then again, ldl isnt nessasarily causative, and being we cant take blood tests from our paleolithic ancestors and what people eat these days is crazy, we dont really know whats a "normal"/healthy level is either. It could be that LDL and even HDL have no real connection to heart disease.

Small dense LDL is the strongest correlation. Id say, for a risk factor, thats probably the safest bet.

Oh and I thought Id add: milk fat is a short chain triglyceride (SCT). SCT's are digested as easily as MCTs. This is probably why milk fat has a slightly different effect, its a straight into the system "quick fat", like coconut oil.

0
3a966a805e09d88b0f223f2985392e4f

(836)

on July 21, 2012
at 02:48 AM

My tc is about 12mmol/l. This test was recent and the time I have ever checked it on Paleo (I've been on over 7 years). In 2004 before I started Paleo, my total cholesterol was in the 5.5 range.

It would be interesting to get a calcium scoring done now, and a year later, at these cholesterol levels. Actually, if having high cholesterol levels on Paleo is in any way similar to FH + SAD in terms of its atherogenicity, then getting a calcium score right now should show some major arterial calcification since I've been eating this way for a long time and am only 25.

I'm not sure that you should jump to the conclusion that having the same marker as someone with a genetic disorder means you will have the same outcomes.

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