2

votes

Cholesterol Confusion (Low Trigs, High HDL, High+Growing LDL)

Answered on August 19, 2014
Created June 29, 2013 at 2:06 AM

Hi all,

Just wondering whether anyone can help provide some guidance on whether I should be concerned with the change in my lipids below? According to Chris Kresser's basic lipid guidelines it appears I shouldn't be concerned (TC<290, HDL>40, TRIG<125, TC/HDL<4.0), but my conventional doctor is starting to get really worried especially as cholesterol hypersensitivity seems to run in my family. I'm even thinking of slightly increasing starchy carb intake, slightly cutting my saturated fat intake at least get my lipid numbers closer to 'normal' range because things are getting worse understanding lipid markers should 'stabilize' over the long term following my heavy increase in saturated fat intake. I'm 28 years old, 6" tall and 160lbs, relatively active with gym 2x a week and basketball 2x a week.

Lipids

  • TC 147, HDL 62, LDL 77, TRIG 35, TC/HDL 2.4, TSH 1.0, Fasting Gluc 4.1, Iron Sat/Ferritin 8%/244, hs-CRP not tested, fasting glucose 4.1
    • Pre Paleo (Aug 2010)
  • TC 236, HDL 70, LDL 155, TRIG 62, TC/HDL 3.4, TSH 3.1, Fasting Gluc 4.1, Iron Sat/Ferritin 33%/315, hs-CRP 2.1, fasting glucose 4.1
    • Post Paleo (Mar 2013)
  • TC 259, HDL 81, LDL 170, TRIG 44, TC/HDL 3.2, TSH 2.2, Fasting Gluc 4.7, Iron Sat/Ferritin 49%/357, hs-CRP 1.0, fasting glucose 4.7
    • Post Paleo (Jun 2013)
  • Note I probably went paleo at the start of 2012. The difference between Post Paleo (Mar 13) and Post Paleo (Jun 13) was that I've increased my egg intake to 3x/day from 6x/week and increased intake of both iodine and selenium to get my TSH in range (doc didn't test FT3 & FT4 after seeing my TSH drop to normal). Also note following my Post Paleo (Jun 13) iron results I'm currently getting tested for genetic hemochromatosis (results in a few days) after which I'm hoping to donate blood (if my low platelets aren't a problem) and maybe reduce vitamin C supplementation to keep numbers within a normal range. All other blood markers are within range including hsCRP which was 1.0 at Post Paleo (Jun 2013). I'm in Australia with no access to any VAP/NMR testing for LDL particle count etc.

Paleo Diet

  • Carbs (21% calories): mostly cooked non-starchy vegies apart from a sweet potato post workout
  • Protein (24% calories): mostly grass-fed beef, calf liver, salmon 3x a week, protein shake post workout
  • Fat (58% calories): mostly eggs, grass-fed beef, avocado, coconut cream & oil, red palm fruit oil and ghee
  • Other: daily bone broth, sauerkraut, fermented CLO, vitamin C & D supplementation
  • Note: saturated fat of 88g/day takes up 25% of daily calories (25g/day from organic coconut cream alone)

I've purchased Chris Kresser's High Cholesterol Action Plan, I've read through Chris Masterjohn's entire website and I've listened to countless podcasts discussing the truth about cholesterol and CVD so I am broadly comfortable with the science, history, myths, etc. But even after all this I'm still worried and confused as to whether I should make any changes as my numbers are just getting 'worse'.

Any help would be greatly appreciated!

Mike

--- UPDATE --- 1 July 2013 ---

In the absence of more advanced lipid testing (LDL-P, ApoB:ApoA1, Lp(a), Lp-PLA2, FT3/FT4, ApoE genetic testing etc) which I will talk to / convince my doctor about I'm going to make the following interim dietary changes to try bring the basic lipid markers closer to ???normal??? ranges (noting the irrelevance of the standard lipid markers, but it seems I am hyper-responsive to saturated fat and dietary cholesterol consumption so might not be such a bad idea):

  • Decreasing SFA consumption (coconut cream) by 37% or 33g/day
  • Increasing MUFA consumption (olive oil) by 44% or 33g/day
  • Decreasing cholesterol consumption (two eggs) by 37% or 421mg/day
  • Increasing PUFA O3 consumption (sardines) by 28% or 1.1g/day
  • Increasing PUFA O6 consumption by 26% or 3.4g/day
  • SFA as percentage of total energy down 10% to 15% of calories
  • MUFA as a percentage of total energy up 10% to 30% of calories
  • Virtually no change to total carbohydrate/protein/fat consumption (20%/22%/58% of calories)
  • Virtually no change to total PUFA as a percentage of total energy (7% of calories)
  • Virtually no change to O6:O3 PUFA ratio (3.3:1)
  • No change to total calorie consumption (3,200 calories)

Will keep you all updated on more recent basic/advanced lipid test results.

--- UPDATE --- 10 July 2013 ---

Got results for more advanced lipid markers today:

  • apoB 112, apoA1 200, apoB:apoA1 0.56, lp(a) 8, FT4 14.7, FT3 3.5, RT3 645, FT3:RT3 5, no detected TPO and Tg thyroid antibodies

Based on this it seems as though I shouldn't necessarily be concerned about my change in cholesterol concentration given apoB is within 'normal' range, apoA1 is slightly above 'normal' range, and the apoB:apoA1 ratio is pretty good. This is further confirmed with lp(a) in the better part of the 'normal' range. While it would be interesting to see the impact of changing my diet on both basic/advanced lipid markers described per my previous update I don't see a need at this stage to substantially decrease SFA and dietary cholesterol intake.

The only issue is my RT3, specifically my FT3:RT3 ratio. While all other thyroid markers seem OK I am above the 'normal' RT3 range. I will read into this but my basic understanding is that this may be caused by things such as calorie restriction, carbohydrate restriction, stress and inflammation.

  • I don't think I'm restricting calories given I clock in over 3,000 a day
  • I do intermittently fast almost daily (~16 hours) so perhaps I should stop this for a while
  • I do restrict carbs (20% of calories, mostly non-starchy vegetables) by probably too much, it may make sense to increase intake of starchy vegetables
  • My job doesn't cause much stress and stress very little outside work
  • I don't think I am suffering from any systemic inflammation given my low hs-CRP result of 1.0
  • I'm unsure as to whether I have a virus or infection causing unidentified stress/inflammation

I'm yet to donate blood, but have an appointment booked in.

--- UPDATE --- 31 July 2013 ---

Got my ApoE results back and found out I have the e3/3 gene ("the most common Apo E genotype ... (that) does not predispose the patient to hyperlipidaemia"), suggesting my high cholesterol figures are not releated to genetics.

Any thoughts?

Cbdc8318738324492f2d5918868ce4c9

(1211)

on July 01, 2013
at 04:18 PM

ChrisB, nope, I didn't write the bjjcaveman article.

5f651b42d4b06218a61e0eba945128d9

(40)

on July 01, 2013
at 01:17 PM

Thanks Mark, I've added an update to my original question to discuss some interim dietary changes which discuss substituting MUFA (olive oil) for SFA (coconut cream).

9c594bfaeb36a7c5336e01118b952123

(20)

on June 30, 2013
at 02:52 PM

MarkES, I believe you are the one who wrote the articles I linked? I know in my case i'm looking to gain weight. I was eating a lot of calories when doing a very low carb diet (3000+ a day). My avg intake per day to eat 3 meals and be full is between 2200-2500 calories. With higher carb intake personally I think I will be around 2500-2700 calories a day. I dont know if calories specifically could attribute to LDL increase. Other thing that is not known is that how much do carbs affect LDL. I think it is personal and would have to be played around with.

Cbdc8318738324492f2d5918868ce4c9

(1211)

on June 30, 2013
at 12:26 PM

For ApoE4, my experience has been increasing starch will normally only improve LDL to the extent that it displaces dietary cholesterol and saturated fats.

Cbdc8318738324492f2d5918868ce4c9

(1211)

on June 30, 2013
at 12:20 PM

It does help to change one variable at a time for experimenting, but a couple things to consider. One, if increasing carbs, another macro will need to decrease to maintain calories ... otherwise was it from increase in carbs or calories - so usually more than one thing will change. Two, depends on how fast the desire to reduce LDL - can change more to get the drop and experiment with fewer variables from a more comfortable level.

5f651b42d4b06218a61e0eba945128d9

(40)

on June 30, 2013
at 02:50 AM

Thanks for the advice! I'm currently eating ~35mg/day of iron. I think 21oz/600g of grass-fed beef A DAY on days where I don't eat salmon and 12.5oz/350g of grass-fed beef A DAY on days where I eat eating salmon is probably much more of an issue than 3.5oz/100g of liver A WEEK. In terms of general protein sources I'm trying to reduce chicken consumption to keep my O6:03 ratio closer to 1:1 (currently 3:1).

5f651b42d4b06218a61e0eba945128d9

(40)

on June 30, 2013
at 02:45 AM

Thanks for the advice! I'm currently eating 35mg/day of iron, and not having toooo much liver at only 3.5oz/100g a week. Perhaps the bigger issue is 12.5oz/350g a day of grass fed beef on days where I'm not eating fish and 21oz/600g a day of grass fed beef on days where I'm eating salmon.

5f651b42d4b06218a61e0eba945128d9

(40)

on June 30, 2013
at 02:42 AM

Thanks! 1) Understand issues around TSH but I was worried when it reached 4.0 at one stage in a smaller blood test between Pre Paleo (Aug 2010) and Post Paleo (Mar 13) (where I didn't have my lipid markers checked) 2) I do get out in the summer but in the winter I get very little sun, plus I work in an office 5 days a week. Taking 2000IU seems to keep my vitamin D levels between 40-50. Probably more of an issue is my vit C supplementation of just over 2g/day 3) Yeah thought adding some dulse flakes in my food and eating some brazil nuts a day for selenium was good for optimum thyroid health

5f651b42d4b06218a61e0eba945128d9

(40)

on June 30, 2013
at 02:37 AM

Interesting, I'm one of the guys that had LDL rise! I'm thinking of cutting down fat but will post an update later today/tomorrow when I've recut my diet spreadsheet :)

D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on June 29, 2013
at 04:43 PM

I'd get rid of liver nonetheless; you're at an iron overload level. You might wanna give blood sooner rather than later, and until then stay off liver and go easy on redmeat. Again, I think adding starch will solve your problem whether your problem is due to (1) ApoE4 or (2) low FT3. They'll solve problems. I've seen this in 1 out of 4 and enough people post about this that it makes me think it's exactly something like 1 in 4. I mean, cholesterol really goes out of whack when you eat low-carb Paleo.

Cbdc8318738324492f2d5918868ce4c9

(1211)

on June 29, 2013
at 03:47 PM

I've also purchased Kresser's HCAP and confirm those are the basic lipid recommendations. Evidently, it has held up with his patients. But, I've given a couple examples in my answer below where meeting this basic lipid panel did not mean LDL-P < 1000, which is also Kresser's recommendation.

Cbdc8318738324492f2d5918868ce4c9

(1211)

on June 29, 2013
at 03:38 PM

One way to look at LDL particle size as CVD predictor is that familial hypercholesterolemia folks tend to have large particle size and they are not protected. They do have high LDL-P, though. Here's the study Kresser references: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2720529/

Cbdc8318738324492f2d5918868ce4c9

(1211)

on June 29, 2013
at 03:33 PM

If it were me, I'd eat more starch, less liver/beef/SAFA. While liver has an impressive nutrient density, it isn't required for health and longevity.

5f651b42d4b06218a61e0eba945128d9

(40)

on June 29, 2013
at 03:20 PM

Oh but I've also read around the web and even here on some PaleoHacks threads that low trig and high HDL (which seems the case for me) means light fluffy LDL... Then Kresser mentioned LDL particle size is a poor predictor of CVD risk and LDL particle number is much more important which plays to your point... Oh the confusion...

Cbdc8318738324492f2d5918868ce4c9

(1211)

on June 29, 2013
at 02:14 PM

BTW, I think the LDL-P lipid examples probably show your LDL-P is high w/o getting an NMR, which wouldn't be the case pre paleo.

5f651b42d4b06218a61e0eba945128d9

(40)

on June 29, 2013
at 02:14 PM

Just to double check are you suggesting I go 50% carb or was that just a pre-paleo observation?

5f651b42d4b06218a61e0eba945128d9

(40)

on June 29, 2013
at 02:12 PM

True but then I've read liver is just so good for you as it's so nutrient dense, plus giving blood has no real downside so I'd rather reduce the risk of any micronutrient deficiency while helping others :)

Cbdc8318738324492f2d5918868ce4c9

(1211)

on June 29, 2013
at 02:09 PM

I also have low trigs 32 when eating CW healthy diet of oats, brown rice, lean meats, 50% carbs.

5f651b42d4b06218a61e0eba945128d9

(40)

on June 29, 2013
at 01:43 PM

Interesting my trigs have always been at the lower end of the conventional lipid range pre-paleo and paleo...

Cbdc8318738324492f2d5918868ce4c9

(1211)

on June 29, 2013
at 01:41 PM

Another option is to change diet to eat less iron rich foods.

5f651b42d4b06218a61e0eba945128d9

(40)

on June 29, 2013
at 01:40 PM

Unfortunately I don't think I can get VAP/NMR testing easily in Australia. But basically when moving from pre-paleo to paleo I mainly reduced chicken, olive oil, and milk (now in coffee only) and eliminated brown pasta and brown rice noting I was never much of a bread eater. Instead I included grass fed beef (previously ate much more chicken and very lean kangaroo meat), calf liver, coconut oil & cream, increased egg consumption but still have white rice occasionally. I've always eaten plenty of non starchy veggies and included fish at least 2x a week. My O6:O3 is now only 3:1, PUFA ~6% of cal

5f651b42d4b06218a61e0eba945128d9

(40)

on June 29, 2013
at 10:46 AM

Will do! I'm sure there are many people out there that hyperrespond to increased dietary cholesterol and saturated fat intake!

Ca2c940a1947e6200883908592956680

(8574)

on June 29, 2013
at 09:22 AM

Mike, I appreciate the question here, refreshing! Do keep us informed of your investigation. I would be interested to hear how you get on.

5f651b42d4b06218a61e0eba945128d9

(40)

on June 29, 2013
at 06:24 AM

Those were his numbers from the High Cholesterol Action Plan. If any one of them were out then he recommended getting further testing done.

5f651b42d4b06218a61e0eba945128d9

(40)

on June 29, 2013
at 06:05 AM

- I'm not so concerned about iron because there's an easy fix, donating blood, but lipids seem harder to manage. I'm planning on reducing to 1 egg per day for choline and fat soluble vitamins, and ditch the 25g/day of coconut cream for more bone broth. Note I'm currently taking in 3200 calories with no problems maintaining my weight and lean body mass, both are very stable

5f651b42d4b06218a61e0eba945128d9

(40)

on June 29, 2013
at 06:01 AM

- I ate a fair bit of carbs pre-paleo but nothing over the top, probably about 30-35% of calories. Any idea why trigs have always been so low? - Note at one stage my TSH was at 1.0 so not sure if I have graves or hashimotos but then again I've never tested for antibodies nor FT3/FT4

5f651b42d4b06218a61e0eba945128d9

(40)

on June 29, 2013
at 05:57 AM

Thanks very much, will read into ApoE4! Regarding your other comments I'll try to keep it brief: - Never had FT3/FT4 tested, was about to before my doc noticed TSH dropped to normal. Getting about 300ug iodine and 350ug selenium from whole food sources, so not much - I'm currently eating 140g non-starchy veggies and an extra 40g starchy veggies (sweet potato) on workout/sport days, so if you are thinking in net carbs I am probably VLC (on weekends I do eat rice occasionally) - I would like to keep eating liver given its so nutrient dense, might need to regularly donate to offset iron impact

5dd50f78f47b8848d93724d6eb38d4c1

(907)

on June 29, 2013
at 05:46 AM

"According to Chris Kresser's basic lipid guidelines it appears I shouldn't be concerned" That's not true at all. I doubt he would reccomend those numbers. Particle count test isn't needed as it will be high along with your ldl. Cut saturated fat and increase starch or monounsaturated fats. Your numbers pre-paleo were good, id be looking to reclaim those numbers if I were you.

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5 Answers

2
9c594bfaeb36a7c5336e01118b952123

on June 30, 2013
at 02:19 AM

Take a look at this: http://bjjcaveman.com/2013/03/10/the-effect-of-a-ketogenic-diet-on-cholesterol-part-1/

Might be the reason for issues with LDL. I'm testing this now myself. I would suggest either cutting fats down OR increasing carbs not both. That way you can see for sure. I find making too many changes might muck the waters.

9c594bfaeb36a7c5336e01118b952123

(20)

on June 30, 2013
at 02:52 PM

MarkES, I believe you are the one who wrote the articles I linked? I know in my case i'm looking to gain weight. I was eating a lot of calories when doing a very low carb diet (3000+ a day). My avg intake per day to eat 3 meals and be full is between 2200-2500 calories. With higher carb intake personally I think I will be around 2500-2700 calories a day. I dont know if calories specifically could attribute to LDL increase. Other thing that is not known is that how much do carbs affect LDL. I think it is personal and would have to be played around with.

Cbdc8318738324492f2d5918868ce4c9

(1211)

on July 01, 2013
at 04:18 PM

ChrisB, nope, I didn't write the bjjcaveman article.

5f651b42d4b06218a61e0eba945128d9

(40)

on June 30, 2013
at 02:37 AM

Interesting, I'm one of the guys that had LDL rise! I'm thinking of cutting down fat but will post an update later today/tomorrow when I've recut my diet spreadsheet :)

Cbdc8318738324492f2d5918868ce4c9

(1211)

on June 30, 2013
at 12:20 PM

It does help to change one variable at a time for experimenting, but a couple things to consider. One, if increasing carbs, another macro will need to decrease to maintain calories ... otherwise was it from increase in carbs or calories - so usually more than one thing will change. Two, depends on how fast the desire to reduce LDL - can change more to get the drop and experiment with fewer variables from a more comfortable level.

2
D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on June 29, 2013
at 04:33 AM

Two possibilities. The overreaction to saturated fat may be due to your genes (ApoE4). You might indeed react inordinately. In that case, I would do high starch Paleo. YOu have no weight problem and have excellent fasting blood sugar. Why not add yams, sweet potatoes, potatoes, or white rice? Cut down on coconut oil, eggs, and you'll have to cut down on liver, as that's going straight to your iron storage. 75% that increasing your starch portion will solve the problem.

There is another chance that this is related to your low FT3. This is a guess but your TSH started going up as you went Paleo. It's possible that your lower-carb Paleo induced caloric restriction and glucose deficiency, causing FT3 to go down. All the more if you have hypothyroid symptoms. If so, again, getting your carbs up could solve your problem. (Also, how much iodine are you taking? That could be problematic if you have Hashimoto's, unless you're simultaneously on Selenium. If it's a small dose, not a problem.)

Now, your pre-Paleo numbers are also low (I mean, your trigs), so this may not be the case. I mean trigs that low happen usually when VLCing but you claim to have done it without Paleoing. Were you VLCing' pre-Paleo?

5f651b42d4b06218a61e0eba945128d9

(40)

on June 30, 2013
at 02:45 AM

Thanks for the advice! I'm currently eating 35mg/day of iron, and not having toooo much liver at only 3.5oz/100g a week. Perhaps the bigger issue is 12.5oz/350g a day of grass fed beef on days where I'm not eating fish and 21oz/600g a day of grass fed beef on days where I'm eating salmon.

Cbdc8318738324492f2d5918868ce4c9

(1211)

on June 30, 2013
at 12:26 PM

For ApoE4, my experience has been increasing starch will normally only improve LDL to the extent that it displaces dietary cholesterol and saturated fats.

5f651b42d4b06218a61e0eba945128d9

(40)

on June 29, 2013
at 06:01 AM

- I ate a fair bit of carbs pre-paleo but nothing over the top, probably about 30-35% of calories. Any idea why trigs have always been so low? - Note at one stage my TSH was at 1.0 so not sure if I have graves or hashimotos but then again I've never tested for antibodies nor FT3/FT4

5f651b42d4b06218a61e0eba945128d9

(40)

on June 30, 2013
at 02:50 AM

Thanks for the advice! I'm currently eating ~35mg/day of iron. I think 21oz/600g of grass-fed beef A DAY on days where I don't eat salmon and 12.5oz/350g of grass-fed beef A DAY on days where I eat eating salmon is probably much more of an issue than 3.5oz/100g of liver A WEEK. In terms of general protein sources I'm trying to reduce chicken consumption to keep my O6:03 ratio closer to 1:1 (currently 3:1).

5f651b42d4b06218a61e0eba945128d9

(40)

on July 01, 2013
at 01:17 PM

Thanks Mark, I've added an update to my original question to discuss some interim dietary changes which discuss substituting MUFA (olive oil) for SFA (coconut cream).

5f651b42d4b06218a61e0eba945128d9

(40)

on June 29, 2013
at 06:05 AM

- I'm not so concerned about iron because there's an easy fix, donating blood, but lipids seem harder to manage. I'm planning on reducing to 1 egg per day for choline and fat soluble vitamins, and ditch the 25g/day of coconut cream for more bone broth. Note I'm currently taking in 3200 calories with no problems maintaining my weight and lean body mass, both are very stable

5f651b42d4b06218a61e0eba945128d9

(40)

on June 29, 2013
at 05:57 AM

Thanks very much, will read into ApoE4! Regarding your other comments I'll try to keep it brief: - Never had FT3/FT4 tested, was about to before my doc noticed TSH dropped to normal. Getting about 300ug iodine and 350ug selenium from whole food sources, so not much - I'm currently eating 140g non-starchy veggies and an extra 40g starchy veggies (sweet potato) on workout/sport days, so if you are thinking in net carbs I am probably VLC (on weekends I do eat rice occasionally) - I would like to keep eating liver given its so nutrient dense, might need to regularly donate to offset iron impact

D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on June 29, 2013
at 04:43 PM

I'd get rid of liver nonetheless; you're at an iron overload level. You might wanna give blood sooner rather than later, and until then stay off liver and go easy on redmeat. Again, I think adding starch will solve your problem whether your problem is due to (1) ApoE4 or (2) low FT3. They'll solve problems. I've seen this in 1 out of 4 and enough people post about this that it makes me think it's exactly something like 1 in 4. I mean, cholesterol really goes out of whack when you eat low-carb Paleo.

1
75d65450b6ff0be7b969fb321f1200ac

(2506)

on June 29, 2013
at 10:28 PM

It's quite incredible how your TC and LDL values have gone up so on the Paleo diet. Mine have gone up too but only by 10-15%, with Trig/HDL both dropping by over 30%. I eat more fish than you, and probably less carbs (my digestive tract is a bit wonky). But otherwise our diets are not substantially different. So it is hard to suggest changes. However a couple of thoughts:

1) TSH alone is not an indicator of thyroid health. You really need to look at FT3 and FT4. Yet having said this, unless you have overt hypothyroid symptoms it is unlikely that a TSH of 3.1 means trouble. No, it's not an optimal value. But it's nothing to overly worried about. Guys seem to be able to function nicely with a high-ish TSH value.

2) Being in Australia I am surprised you are supplementing with vitamin D. Are you indoors that often? I live in south Florida, I only get modest amounts of sunshine, and my vitamin D level is 55 (normal is 30 and above). Since you also have an iron issue to sort through I am wondering if extra vitamin D supplementation might be working against you somehow?

3) I don't think taking iodine in microgram dosages will do much other than prevent goiters. Such a small amount is probably safe even if you suffer from Hashimoto's, which I have no reason to believe is your problem.

_Lazza

5f651b42d4b06218a61e0eba945128d9

(40)

on June 30, 2013
at 02:42 AM

Thanks! 1) Understand issues around TSH but I was worried when it reached 4.0 at one stage in a smaller blood test between Pre Paleo (Aug 2010) and Post Paleo (Mar 13) (where I didn't have my lipid markers checked) 2) I do get out in the summer but in the winter I get very little sun, plus I work in an office 5 days a week. Taking 2000IU seems to keep my vitamin D levels between 40-50. Probably more of an issue is my vit C supplementation of just over 2g/day 3) Yeah thought adding some dulse flakes in my food and eating some brazil nuts a day for selenium was good for optimum thyroid health

1
Cbdc8318738324492f2d5918868ce4c9

(1211)

on June 29, 2013
at 01:23 PM

Seems like your labs are getting worse on paleo. I'm curious what your diet was like pre paleo.

I've seen examples where Kresser's basic lipid criteria is met, but LDL-P > 1000.

http://www.heartlifetalk.com/forums/yaf_postst134_Liposcience-Results.aspx

TC 257 HDL 72 LDL 176 TG 46 TC/HDL 3.57 LDL-P 1437
TC 228 HDL 92 LDL 130 TG 34 TC/HDL 2.48 LDL-P 1012
Interesting LDL-C as high as 130 results in LDL-P as low as 1012.

http://paleohacks.com/questions/189351/hack-my-nmr-please

TC 188 HDL 45 LDL 126 TG 87 TC/HDL 4.18 LDL-P 1641

5f651b42d4b06218a61e0eba945128d9

(40)

on June 29, 2013
at 03:20 PM

Oh but I've also read around the web and even here on some PaleoHacks threads that low trig and high HDL (which seems the case for me) means light fluffy LDL... Then Kresser mentioned LDL particle size is a poor predictor of CVD risk and LDL particle number is much more important which plays to your point... Oh the confusion...

5f651b42d4b06218a61e0eba945128d9

(40)

on June 29, 2013
at 02:14 PM

Just to double check are you suggesting I go 50% carb or was that just a pre-paleo observation?

Cbdc8318738324492f2d5918868ce4c9

(1211)

on June 29, 2013
at 02:14 PM

BTW, I think the LDL-P lipid examples probably show your LDL-P is high w/o getting an NMR, which wouldn't be the case pre paleo.

5f651b42d4b06218a61e0eba945128d9

(40)

on June 29, 2013
at 01:40 PM

Unfortunately I don't think I can get VAP/NMR testing easily in Australia. But basically when moving from pre-paleo to paleo I mainly reduced chicken, olive oil, and milk (now in coffee only) and eliminated brown pasta and brown rice noting I was never much of a bread eater. Instead I included grass fed beef (previously ate much more chicken and very lean kangaroo meat), calf liver, coconut oil & cream, increased egg consumption but still have white rice occasionally. I've always eaten plenty of non starchy veggies and included fish at least 2x a week. My O6:O3 is now only 3:1, PUFA ~6% of cal

Cbdc8318738324492f2d5918868ce4c9

(1211)

on June 29, 2013
at 03:38 PM

One way to look at LDL particle size as CVD predictor is that familial hypercholesterolemia folks tend to have large particle size and they are not protected. They do have high LDL-P, though. Here's the study Kresser references: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2720529/

Cbdc8318738324492f2d5918868ce4c9

(1211)

on June 29, 2013
at 03:33 PM

If it were me, I'd eat more starch, less liver/beef/SAFA. While liver has an impressive nutrient density, it isn't required for health and longevity.

5f651b42d4b06218a61e0eba945128d9

(40)

on June 29, 2013
at 01:43 PM

Interesting my trigs have always been at the lower end of the conventional lipid range pre-paleo and paleo...

Cbdc8318738324492f2d5918868ce4c9

(1211)

on June 29, 2013
at 02:09 PM

I also have low trigs 32 when eating CW healthy diet of oats, brown rice, lean meats, 50% carbs.

1
D396b126240f584bc358e6e4fd84e9e3

on June 29, 2013
at 03:11 AM

I would definetly start giving blood to get your ferritin levels down. I wouldn't wait for the hemochromatosis results. Your LDL is a little high but everything else looks good.

Cbdc8318738324492f2d5918868ce4c9

(1211)

on June 29, 2013
at 01:41 PM

Another option is to change diet to eat less iron rich foods.

5f651b42d4b06218a61e0eba945128d9

(40)

on June 29, 2013
at 02:12 PM

True but then I've read liver is just so good for you as it's so nutrient dense, plus giving blood has no real downside so I'd rather reduce the risk of any micronutrient deficiency while helping others :)

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