3

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Why does cholesterol rise in many cases when in paleo coming from low fat?

Answered on August 19, 2014
Created March 20, 2013 at 1:39 PM

I'm new to PH and I've seen that most of the things that concern me can be found currently doing some search, but I wanted to start a new question here and came up with this by reading some other posts, so here it is.

Paleo is supposed to lower LDL cholesterol and rise HDL and also lower triglycerides (the later of more concern I guess) yet many people is reporting that their levels are rising.

This seems surprising when some folks like Taubes and HFLC advocates have swear than the opposite should be the case and it has been proven in countless studies.

What do you think that may be the causes? Maybe people is not so off bad carbs as they really think they are? Could it be that a slightly amount of sugar/unhealthy carbs mixed with high fat could even be worse than just moderate carbs low fat? Or may it be that even if saturated fats are not to fear in moderation, the calories in vs calories out theory still holds some true and we may be overeating?

A1a7413b99e03bc77f02d95c4170ea43

(2393)

on April 05, 2013
at 02:43 PM

How much of a rise are we talking about? And are we talking about LDL-P, or LDL-C?

048dd52752c45129c1212bfffb37ca72

(3150)

on March 26, 2013
at 09:24 AM

I have chosen yours as the answer because I liked how you put everything altogether but could have chosen the others as everyone made good points :)

Ee6932fe54ad68039a8d5f7a8caa0468

(2668)

on March 22, 2013
at 04:20 PM

a second factor is eating a diet high in saturated fat, and particulalry low in carbohydrate. going very low carb will downregulate your LDL receptors. adding back some starch and fruit can fix this.

8894ece18cd108655ed18f2056172c1c

(250)

on March 21, 2013
at 03:34 PM

"...you'll see any amount of rationalization to ignore high LDL, which is probably not prudent." I couldn't agree with this more. It's amazing how many people in the Paleo community dismiss elevated levels of LDL because they are so staunchly convinced that eating boundless saturated fat is healthy. Whether it is or isn't is up for debate, but whether having a stratospheric LDL level is healthy is not.

048dd52752c45129c1212bfffb37ca72

(3150)

on March 20, 2013
at 08:14 PM

Really useful and very well put ideas altogether, really appreciated!

800e726cb5dff569fd8edf604c3e2793

(1655)

on March 20, 2013
at 04:15 PM

@Jim B I know the paper you're talking about, it compared results from different methods -- VAP vs. NMR vs. others -- and came to the conclusion that results from different approaches are not directly comparable and that they don't agree on pattern A / pattern B classification for the same blood sample. On the other hand that was a paper from early 2000s so hopefully things became a bit more standardized...

048dd52752c45129c1212bfffb37ca72

(3150)

on March 20, 2013
at 03:19 PM

I've heard before about genetic predisposition to cholesterol but don't remember having seen a good explanation about it, yours makes sense, thanks for the input!

048dd52752c45129c1212bfffb37ca72

(3150)

on March 20, 2013
at 03:18 PM

It sure helps, love Mark's site but hadn't seen this one, thank you a lot!

7e6644836cdbcbe2b06307ff7db92d31

(693)

on March 20, 2013
at 03:06 PM

Thanks Lumifer, I just saw one investigation where they submitted the same samples multiple times and tried different labs, but that was a ways back.

048dd52752c45129c1212bfffb37ca72

(3150)

on March 20, 2013
at 03:01 PM

These are pretty good points, thanks for this! I read many times somewhere about a high correlation between triglyceride levels and chronic inflammation so if that's the case then It may have a lot to do with CVD and why low-carb grain free seems to work so well.

800e726cb5dff569fd8edf604c3e2793

(1655)

on March 20, 2013
at 02:58 PM

"the rise in LDL is therapeutic" -- I've seen that claim, but I haven't seen justifications for it other than "your liver is clearing it all out" which isn't the most persuasive argument. Re NMR being an RNG, I've seen at least one study on the accuracy of the test and it showed the coefficient of variation to be around 4-5% which isn't bad at all.

048dd52752c45129c1212bfffb37ca72

(3150)

on March 20, 2013
at 02:39 PM

Nice answer. I agree. It even seems that cholesterol may be protecting -not causing- CVD and that makes me wonder if in case that it is rising, it may even be a good sign since it may be working to repair arteries in a situation where there is a need for it. There is also some evidence that total levels follow a U-like shape graph where over 300 will always be bad so it seems a little bit odd if one could get to this even when on Paleo and no grains-sugar-omega-6 etc. Should we look to other possible issues beyound cholesterol? I guess that's it.

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6 Answers

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3
8894ece18cd108655ed18f2056172c1c

(250)

on March 20, 2013
at 06:09 PM

Most of the answers here cover this in much the way I will; nonetheless, I'll throw my hate in the ring.

Few, if any, educated on the topic would claim eating Paleo will result in a lowered LDL count. Many adherents, myself included, experience a significant rise in total cholesterol. That rise can be swift and extreme to the point that dietary modification need be made to lower total cholesterol while still maintaining the principles of ancestral eating. There is a tremendous amount of debate about what constitutes a healthy total cholesterol number, but when you're nearing 300 I would argue that you may be setting yourself up for arterial damage. Naysayers who point to the high saturated fat consumption of certain tribal cultures to exonerate a diet built upon copious amounts of it would be well-advised to look at the total cholesterol numbers of those tribal groups--most of them are at or below 200 and certainly none (that I've seen) come near 300. I have no way of explaining the staggeringly low total cholesterol numbers of groups like the Masai in relation to their sky-high saturated fat consumption. As far as I know, no one really does. Consequently it seems only prudent to caution against using their diet as a model unless that diet yields a similar impact on your own cholesterol. If you eat as the Masai do, but experience a different reaction, I would argue that your brand of food-processing differs from theirs and your diet ought be different in kind.

All of this is to say that though ancestral eating appears to be the correct road down which to travel, there are so many iterations of it, and it's important to find the one that suits you. What constitutes nourishing or dangerous for one may not constitute either for another. To answer your question more directly, a marked increase in LDL cholesterol after consuming a diet high in saturated fat likely hints at either over consumption of it or a sensitivity to it. By over-consumption, I mean eating tablespoons of coconut oil each day along with mountains of fatty cuts of meat, piles of bacon, vegetables cooked in its renderings, grass-fed butter or ghee and bars of dark chocolate. Eating an abundance of those items may raise LDL cholesterol, even in those absent of a sensitivity to it. For those particularly sensitive though, eating that way may shoot their total cholesterol well into the 300s or higher, and though I agree total cholesterol is not the best predictor of heart disease, I also stand firmly behind the claim that a cholesterol level that high is dangerous. Studies are increasingly showing that particle count rather than total cholesterol is the best predictor of heart disease, and I am disinclined to believe arguments that a total cholesterol level over 300 has no bearing on particle count.

Anyway, long-winded reply and perhaps not filled with much content that hasn't already been said; still, hope it helps.

Ee6932fe54ad68039a8d5f7a8caa0468

(2668)

on March 22, 2013
at 04:20 PM

a second factor is eating a diet high in saturated fat, and particulalry low in carbohydrate. going very low carb will downregulate your LDL receptors. adding back some starch and fruit can fix this.

048dd52752c45129c1212bfffb37ca72

(3150)

on March 20, 2013
at 08:14 PM

Really useful and very well put ideas altogether, really appreciated!

048dd52752c45129c1212bfffb37ca72

(3150)

on March 26, 2013
at 09:24 AM

I have chosen yours as the answer because I liked how you put everything altogether but could have chosen the others as everyone made good points :)

4
7e6644836cdbcbe2b06307ff7db92d31

(693)

on March 20, 2013
at 02:48 PM

"Paleo is supposed to lower LDL cholesterol and rise HDL and also lower triglycerides (the later of more concern I guess) yet many people is reporting that their levels are rising."

I don't know that that is the necessarily the case. You'll see a few things if you look into other threads.

One is that the rise in LDL is therapeutic. Your body is healing itself after the change in diet. I'll leave that to others.

Another that I'll address is that triglycerides are so easily manipulated through diet, that I don't know what purpose they serve as a biomarker. I can go vlc and drop my TG < 50 no problem. If TG are supposed to be low, and I can lower them by restricting carbohydrates (including alcohol), then why isn't that the formal recommendation?

Another, from what I can tell, is that HDL increases with intense exercise; resistance and intervals both definitely in the unpleasant range. Not so much from the diet alone.

Another is that people are undoubtedly doing it wrong. I suspect many go overboard with all the bacon etc, which might even be ok if you were vlc, but is probably the most ill-conceived diet if your not restricting carbs and not running a caloric deficit.

Another thing is you'll see any amount of rationalization to ignore high LDL, which is probably not prudent.

Another thing is particle size, but a study a ways back found the tests (VAP and NMR) to be random number generators in a controlled analysis (I haven't kept up since that, hopefully they produce valid results).

I think if you follow the plan correctly, you should be able to have good cholesterol numbers, even within the standard context. Exercise is as important as food. Get it right, and there's no reason you won't have an enviable HDL/Total ratio, which is probably eating into LDLs street-cred as a biomarker.

048dd52752c45129c1212bfffb37ca72

(3150)

on March 20, 2013
at 03:01 PM

These are pretty good points, thanks for this! I read many times somewhere about a high correlation between triglyceride levels and chronic inflammation so if that's the case then It may have a lot to do with CVD and why low-carb grain free seems to work so well.

800e726cb5dff569fd8edf604c3e2793

(1655)

on March 20, 2013
at 02:58 PM

"the rise in LDL is therapeutic" -- I've seen that claim, but I haven't seen justifications for it other than "your liver is clearing it all out" which isn't the most persuasive argument. Re NMR being an RNG, I've seen at least one study on the accuracy of the test and it showed the coefficient of variation to be around 4-5% which isn't bad at all.

800e726cb5dff569fd8edf604c3e2793

(1655)

on March 20, 2013
at 04:15 PM

@Jim B I know the paper you're talking about, it compared results from different methods -- VAP vs. NMR vs. others -- and came to the conclusion that results from different approaches are not directly comparable and that they don't agree on pattern A / pattern B classification for the same blood sample. On the other hand that was a paper from early 2000s so hopefully things became a bit more standardized...

7e6644836cdbcbe2b06307ff7db92d31

(693)

on March 20, 2013
at 03:06 PM

Thanks Lumifer, I just saw one investigation where they submitted the same samples multiple times and tried different labs, but that was a ways back.

8894ece18cd108655ed18f2056172c1c

(250)

on March 21, 2013
at 03:34 PM

"...you'll see any amount of rationalization to ignore high LDL, which is probably not prudent." I couldn't agree with this more. It's amazing how many people in the Paleo community dismiss elevated levels of LDL because they are so staunchly convinced that eating boundless saturated fat is healthy. Whether it is or isn't is up for debate, but whether having a stratospheric LDL level is healthy is not.

4
Ebb10603524dd22621c1155dd7ddf106

(19150)

on March 20, 2013
at 02:30 PM

Paleo is supposed to lower LDL cholesterol and rise HDL and also lower triglycerides (the later of more concern I guess) yet many people is reporting that their levels are rising.

Increased consumption of saturated fat will almost certainly raise cholesterol across the board for someone coming from SAD or CW type diet. For example, my mother's total cholesterol is something like 160, and she thinks it's too high ('cause the doctor's say it's high). Her's would absolutely rise if she increased saturated fats from real food sources (she maintains a pretty normal "healthy-accepted" CW diet). Personally, my HDL shot up, and my LDL rose ever so slightly. Pretty boring, really, but paleo delivered on that, at least.

I'm getting ready for another test soon to compare again. But honestly, it's really hard to convince people that 200-240 is the optimal range to avoid CVD risks when they are told "lower is better!" by the media constantly.

048dd52752c45129c1212bfffb37ca72

(3150)

on March 20, 2013
at 02:39 PM

Nice answer. I agree. It even seems that cholesterol may be protecting -not causing- CVD and that makes me wonder if in case that it is rising, it may even be a good sign since it may be working to repair arteries in a situation where there is a need for it. There is also some evidence that total levels follow a U-like shape graph where over 300 will always be bad so it seems a little bit odd if one could get to this even when on Paleo and no grains-sugar-omega-6 etc. Should we look to other possible issues beyound cholesterol? I guess that's it.

2
B36bbab16837fe6d60eb2b5a49a561ed

(314)

on March 20, 2013
at 03:07 PM

It could be due to a lot of things. Marks has a post dedicated to this topic:

http://www.marksdailyapple.com/why-did-my-cholesterol-go-up-after-going-primal/#axzz2O5oVhbVH

Hope the information helps.

048dd52752c45129c1212bfffb37ca72

(3150)

on March 20, 2013
at 03:18 PM

It sure helps, love Mark's site but hadn't seen this one, thank you a lot!

1
800e726cb5dff569fd8edf604c3e2793

on March 20, 2013
at 02:51 PM

People are different. Even if we just look at known genetic variation, about 25% of the population does NOT have the "normal" ApoE3/3 genes and so their cholesterol response to diet is not standard. And that's not even mentioning FH, familial hypercholesterolemia.

On the stories/anecdotes basis, some people react to high-fat diet with relatively low cholesterol numbers (both total and LDL), some -- with high numbers, some -- with very high numbers. It's usual to have high HDL and low trigs, but your LDL can and does vary.

There's a lot of variation and not that much hard data.

048dd52752c45129c1212bfffb37ca72

(3150)

on March 20, 2013
at 03:19 PM

I've heard before about genetic predisposition to cholesterol but don't remember having seen a good explanation about it, yours makes sense, thanks for the input!

0
048dd52752c45129c1212bfffb37ca72

on April 05, 2013
at 08:42 AM

Yesterday I found out by chance a link to an explanation of Dr. Paul Jaminet about exactly this very topic. Thought I should come back here and share.

I've read it and it makes a lot of sense. Seems that a healthy thyroid is essential in high-fat diets because it aids in lowering the LDL that either way wouldn't get rid of the blood for long time and may cause issues. The problem is that when in low-carb, T3 seems to be highly suppressed (had read about this before) and then the problem can worsen.

That's my interpretation on the subject, for more detail have a look at the link: High LDL on Paleo Revisited: Low Carb & the Thyroid

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