11

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Has the Paleo community leaned too heavily into its own dogma?

Answered on August 19, 2014
Created March 17, 2013 at 5:26 PM

There's a tendency in the Paleo community to treat unlimited saturated fat consumption as not only benign, but healthful. While there are some of us that can consume an avalanche of saturated fat at every meal and see no change in our cholesterol levels; for many of us treating those foods with such abandon is perilous. I just got my blood checked after eating Paleo for a year, during which time I gave little thought to my saturated fat intake. I posted about my results here yesterday; my total cholesterol went from about 180 to over 270. Since learning about the increase, I've been scouring the web and have found an endless supply of posts detailing the same circumstance: the authors followed a Paleo diet for some time, only to be faced with worrying results at their yearly physical. It's easy to muse about the futility of cholesterol readings or to dismiss them altogether, but the fact of the matter is that when you're approaching a total cholesterol of 300--and certainly when you're crossing that threshold--your diet demands modification. Sure, there is the question of particle size--do you have large, fluffy LDL or small dense LDL--but particle count is equally (possibly more) important. We can look at people with Familial Hypocholesterolemia as evidence of that; notwithstanding the size of their LDL particles, they are at very high risk for CVD simply because their particle count is so high.

No question saturated fat has been wrongly vilified over the past few decades, but blanket statements get bandied about in the Paleo community exonerating the consumption of things like bacon and beef tallow at every meal. Those statements seem misguided because they simplify an endlessly complex system of variables that results in different nutrient-processing from person to person. Not everyone can eat bacon at every meal and expect to remain healthy. What's more, if our goal is to simulate a diet that might have been consumed by our ancestors, beginning each day with 4 pastured eggs cooked in grass-fed butter and a side of pastured bacon along with greens stewed in the renderings of that bacon doesn't hit the mark. Eggs were certainly consumed by hunter gatherers, but 4 of them on a daily basis? Supermarkets with aisles filled with hundreds upon hundreds of eggs didn't exist in the Paleolithic era; our ancestors first had to find the eggs, then steal them from their nests, which would have made their consumption much more intermittent than many of our lifestyles imply. I remember Lorain Cordain making that point some time back and though I didn't alter my diet in accordance with the implications of his observation, it was a resonant comment.

When people transition to a Paleo diet, they often lean into things like grass-fed beef, ghee and coconut products; they eat them at almost every meal. The carefree incorporation of those foods into their diet is a result of this burgeoning Paleo dogma--people ranting about the wrongful vilification of saturated fats and offering anecdotal evidence of their own consumption of those foods without consequence. The web is teeming with blogs and posts on sites like this one by people advocating a diet that's tremendously high in saturated fat. To prove the healthful properties of that dietary choice, they bring up the Masaai or other hunter-gatherer societies, which is persuasive evidence. Nonetheless, it's a simplification of a very complex issue. Food-processing differs from person to person, and what may have worked for the Masaai may not work for you. I'm a huge fan of Gary Taubes. I've read just about everything he's written. His diet is very high in saturated fat, and he posted the results of a relatively recent blood test, wherein his total cholesterol came in around 200. His results helped me to quel concerns I had about saturated fat consumption, but despite my having eaten a very similar diet to his, my results were markedly higher. The discrepancy is as persuasive as any argument about the Masaai; dietary choices affect each of us differently. There is no one-size-fits-all diet.

Looking back on the way I've eaten over the past year, it's probably a good thing I got poor results on my blood test because it served to highlight a very important point that's easily lost in the Paleo community: we must apply reason and intuition when constructing our diets. There must also be an acknowledgement that we are all unique--that what works for one of us may not work for the rest of us, and that we need to monitor our blood work, so we can arrive a way of eating that best suits our own unique brand of food-processing.

Anyway, I'm not posting this to be pedantic, and I'm open to people disagreeing with me and telling me why it's ok for your total cholesterol to shoot up to 300 or above. This is just a way to spark discussion and maybe some debate. Do you think the Paleo community has leaned too heavily into--and to some degree distorted--its own dogma?

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on March 18, 2013
at 05:14 AM

plus one.....most of them are no even aware of what they do not know......paleo is a step in the ancestral direction but it is nothing more.......we need to do better than just that to reverse illness and improve our former selves.

8894ece18cd108655ed18f2056172c1c

(250)

on March 18, 2013
at 02:31 AM

I'll take a listen, though I should confess to not being a huge fan of Chris Kresser. His qualifications seem fairly limited. He's well-versed, but several of us in the Paleo community are, and he doesn't have a background in research or medicine to set him apart. He also strikes me as very money-oriented, which makes me skeptical. His "High Cholesterol Action Plan" has a price tag of $147. I haven't bought it, but I'm fairly certain it's information that's readily available here and elsewhere. I've got no problem with someone making a buck, but $147 is pretty gratuitous.

Ce41c230e8c2a4295db31aec3ef4b2ab

(32556)

on March 17, 2013
at 10:56 PM

Have you read or listened to this? http://chriskresser.com/the-healthy-skeptic-podcast-episode-11 http://chriskresser.com/episode-16-chris-masterjohn-on-cholesterol-heart-disease-part-2 http://chriskresser.com/chris-masterjohn-on-cholesterol-and-heart-disease-part-3

3327924660b1e2f8f8fc4ca27fedf2b2

(2919)

on March 17, 2013
at 10:51 PM

What symptoms does "High Cholesterol" carry by itself?

3327924660b1e2f8f8fc4ca27fedf2b2

(2919)

on March 17, 2013
at 10:51 PM

What reason do you have to believe that high cholesterol, in the absence of symptoms, is a bad thing?

8894ece18cd108655ed18f2056172c1c

(250)

on March 17, 2013
at 08:18 PM

Have read this. Very insightful, but not reason to dismiss cholesterol that hovers near 300.

Ebb10603524dd22621c1155dd7ddf106

(19150)

on March 17, 2013
at 08:10 PM

PHD (2nd ed at least) phrases it more like (to paraphrase) "SFAs and MUFAs are the only things which can be eaten without some kind of metabolic damage, and because the healthy ranges for other macronutrients are somewhat more specific, SFAs and MUFAs can be easily adjusted down if you are trying to lose weight, or up for maintenance." That's at least how I read into it, when I read the PHD. I think it's an urban-paleo-phd-myth that SFAs can be eaten with abandon - even if more people coming from low-fat-land could use more overall.

Ce41c230e8c2a4295db31aec3ef4b2ab

(32556)

on March 17, 2013
at 07:41 PM

Worth a read: http://www.marksdailyapple.com/cholesterol/#axzz2NpNZn4ey

8894ece18cd108655ed18f2056172c1c

(250)

on March 17, 2013
at 07:21 PM

Good comments, though I still maintain my argument. And yes, I meant hypercholesterolemia. Thanks for the clarification.

Medium avatar

(39831)

on March 17, 2013
at 06:58 PM

And let's not forget the people who get these bizarre numbers, freak out, and then go on statins because they think they're gonna die. I've seen two accounts of that so far. All they had to do was eat a reasonable human diet.

8894ece18cd108655ed18f2056172c1c

(250)

on March 17, 2013
at 06:50 PM

Thanks very much. I think you replied to my post yesterday, and I appreciated that too. I totally agree with everything you've said here. It is particularly dangerous when people learn that they've got wildly high levels of LDL and dismiss those numbers on account of a belief that cholesterol is meaningless. I agree with 90% of the tenants of Paleo, but this emergent notion that one need pay no attention to his/her saturated fat intake, particularly when that intake results in an elevation of his/her LDL count strikes me as corrosive.

C07939fb80c1f445cbb5b0469d665a8e

(470)

on March 17, 2013
at 06:44 PM

may lead to times when you can over do it with superdosed pure saturated fat, but in the presence of adequate vitamins commonly found in organ meats or other high vitamin whole foods I'm guessing there would nearly always be a net positive effect on the body.

C07939fb80c1f445cbb5b0469d665a8e

(470)

on March 17, 2013
at 06:42 PM

You make a good point with insulin, but i'd like to point out that insulin problems stem from refined carbohydrates, foods that in a paleolithic sense, were not consumed in the amounts or kinds available contemporarily. You could absolutely make a case for refined fats perhaps having a similar effect on some. I'm assuming you mean Familial Hypercholesterolemia(not to be disrespectful), which would indicate higher than average cholesterol. All that said, I still would not be able to say that Saturated fat is a causal factor in Heart Disease, generally. Some conditions caused by civilization-

8894ece18cd108655ed18f2056172c1c

(250)

on March 17, 2013
at 06:30 PM

Totally respect the comment and the opinion it reflects. But how do you rationalize the elevated risk of CVD in people with Familial Hypocholesterolemia if you feel cholesterol has no impact on the development of heart disease? I'd also counter that while cholesterol is naturally occurring and in many instances nourishing, that does not render an excess of it harmless. Insulin is naturally occurring, but we all recognize that in certain quantities it's perilous. Why is cholesterol different?

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3 Answers

7
Medium avatar

on March 17, 2013
at 06:10 PM

Great post; couldn't agree more. I hit a total cholesterol of 393. I've seen people go as high as 550 in response to a heavy intake of butter and cream (the specific fatty acids ratios of which differ from standard animal fat). I've corresponded recently with a fellow who got deep into the 300s just with egg yolks alone. He was very systematic about the changes he made between tests and it turned out that he hyper-responds to dietary cholesterol. When I looked into it, I found that both of these phenomena are in the scientific literature but have been totally overlooked apparently.

I don't believe it's out of the realm of possibility that someone could pick up a copy of the "Perfect Health Diet," read "saturated and monounsaturated fats are safe in any amount" and launch their cholesterol in the 500s due to an apparently not uncommon genotype. If they then dismissed doctors as being part of the CW machine and never got a lipid profile, they could have a serious CVD problem in short order. The etiology of CVD is complex and it obviously requires more than just a lot of LDL, but only an idiot would say that number can be ignored completely.

Obviously the flip-side is that there appear to also be plenty of people for whom it actually does have no perceptible effect. There isn't a way to tell which one you are without testing.

I don't know if new editions of the books that have advocated no restriction on saturated fat or dietary cholesterol have added warnings about some people being susceptible, but I've never seen it.

Medium avatar

(39831)

on March 17, 2013
at 06:58 PM

And let's not forget the people who get these bizarre numbers, freak out, and then go on statins because they think they're gonna die. I've seen two accounts of that so far. All they had to do was eat a reasonable human diet.

8894ece18cd108655ed18f2056172c1c

(250)

on March 17, 2013
at 06:50 PM

Thanks very much. I think you replied to my post yesterday, and I appreciated that too. I totally agree with everything you've said here. It is particularly dangerous when people learn that they've got wildly high levels of LDL and dismiss those numbers on account of a belief that cholesterol is meaningless. I agree with 90% of the tenants of Paleo, but this emergent notion that one need pay no attention to his/her saturated fat intake, particularly when that intake results in an elevation of his/her LDL count strikes me as corrosive.

Ebb10603524dd22621c1155dd7ddf106

(19150)

on March 17, 2013
at 08:10 PM

PHD (2nd ed at least) phrases it more like (to paraphrase) "SFAs and MUFAs are the only things which can be eaten without some kind of metabolic damage, and because the healthy ranges for other macronutrients are somewhat more specific, SFAs and MUFAs can be easily adjusted down if you are trying to lose weight, or up for maintenance." That's at least how I read into it, when I read the PHD. I think it's an urban-paleo-phd-myth that SFAs can be eaten with abandon - even if more people coming from low-fat-land could use more overall.

1
32652cb696b75182cb121009ee4edea3

(5802)

on March 17, 2013
at 11:09 PM

One thing I've always questioned about the paleo dogma is the difference between:

(1) a person who has eaten SAD for most of his life and converts to paleo, and

(2) a person who has eaten paleo from day 1 (such as modern day hunter-gatherers).

Could there be a difference between the "ideal" diet that a person COULD eat (assuming he always ate that way) and the "trying to make the best of it" diet that a person should eat with all the baggage from previous eating?

In the context of your question, might it not be possible that a person could eat unlimited saturated fat from birth and be fine, but that a person who converts should eat less?

I am sure that people will respond and say, "all the cells in your blah blah blah are made new every blah blah days." But I would hold out and say maybe we don't know. I think our knowledge is increasing, but I don't think we fully understand the damage to our bodies from decades and decades of processed foods.

On a similar note, one of the things that we lose here in America is any idea of our cultural/genetic inheritance. We see so many diet variations in modern hunter-gatherer tribes ... with the amount of inbreeding, they are certain to have evolved eating the most suitable diet for their genes. I've had people on here scoff, but I think there is something to be said for looking to our own inheritance (as best we can) and trying to imitate it to a degree. This may or may not play in to the genetic tendencies you mentioned. But I think it's an interesting tangent.

1
C07939fb80c1f445cbb5b0469d665a8e

on March 17, 2013
at 06:23 PM

While I don't believe that the same diet is right for everyone, I really don't think cholesterol is the culprit of heart disease. Cholesterol is found in every cell of your body. I don't know of many substances your body uses and produces so often, and that is so vital to your everyday life, that are also poisonous.

I also know heart disease (as well as cancer, and nearly all chronic disease), was not found in traditional cultures who survived through eating whole foods, all of them favoring cuts of meat that were rich in saturated fat (However, the total amount of fat varied extraordinarily. If you haven't already, look up Weston A Price, and Pottenger.

It is my conclusion that many chronic diseases are mostly a product of extreme malnutrition in society due to the almost zero consumption of organ meats and other rich stores of nutrients, phytic acids in foods, oxidized fats coming mainly through polyunsaturated fats(which oxidize at very low temperatures), poor gut flora, and weakened immune systems.

It seems more likely to me that high responders to saturated fat may be nothing more than excellent cholesterol producers, or perhaps even have an extra need for this substance in their body due to other processes.

Logically, I feel that the reason saturated fat intake (as well as overall fat intake) is linked to heart disease is because those who aren't afraid of it are more likely to care less about their health. Smoking, grain consumption, polyunsaturated fat consumption, sugar consumption, excess alcohol consumption, and zero exercise are far more common in people who care less about their health. Therefore, a correlation is quite likely, between saturated fat, cholesterol, and heart disease, but causation? I think not.

8894ece18cd108655ed18f2056172c1c

(250)

on March 17, 2013
at 07:21 PM

Good comments, though I still maintain my argument. And yes, I meant hypercholesterolemia. Thanks for the clarification.

8894ece18cd108655ed18f2056172c1c

(250)

on March 17, 2013
at 06:30 PM

Totally respect the comment and the opinion it reflects. But how do you rationalize the elevated risk of CVD in people with Familial Hypocholesterolemia if you feel cholesterol has no impact on the development of heart disease? I'd also counter that while cholesterol is naturally occurring and in many instances nourishing, that does not render an excess of it harmless. Insulin is naturally occurring, but we all recognize that in certain quantities it's perilous. Why is cholesterol different?

C07939fb80c1f445cbb5b0469d665a8e

(470)

on March 17, 2013
at 06:42 PM

You make a good point with insulin, but i'd like to point out that insulin problems stem from refined carbohydrates, foods that in a paleolithic sense, were not consumed in the amounts or kinds available contemporarily. You could absolutely make a case for refined fats perhaps having a similar effect on some. I'm assuming you mean Familial Hypercholesterolemia(not to be disrespectful), which would indicate higher than average cholesterol. All that said, I still would not be able to say that Saturated fat is a causal factor in Heart Disease, generally. Some conditions caused by civilization-

C07939fb80c1f445cbb5b0469d665a8e

(470)

on March 17, 2013
at 06:44 PM

may lead to times when you can over do it with superdosed pure saturated fat, but in the presence of adequate vitamins commonly found in organ meats or other high vitamin whole foods I'm guessing there would nearly always be a net positive effect on the body.

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