on January 20, 2012
at 08:36 PM
First off, let me say that the PHD is the best book of its kind and that Jaminet did a (largely) excellent job of researching the material and putting it together.
That being said, I take issue with a few things. First, I think the 100g/wk liver target is too conservative. If I recall, part of the reasoning is that we ought to be taking a multivitamin, so we would run into too much overlap. If anything liver should be your multivitamin and should have total primacy over any supplement. Supplements should move around to accommodate liver, not the other way around. I personally eat about 25g of liver and 25g of heart per day (in sausage form). Liver truly is the only "superfood" and should be treated as such.
Secondly, I think fructose is only conditionally problematic and that the consumption of it alongside glucose at a time of low liver glycogen is highly advantageous. In fact, I would go so far as to say that (somewhat slowly) drinking a can of soda upon waking (as disgusting as that is) would not result in any real glycation, insulin resistance, elevated TGs etc. The problem with fructose as it is encountered by the average person is that they are totally sedentary and are thus never turning over their muscle glycogen. On top of that, they are constantly eating carbohydrates so their liver glycogen is almost always maxed out and they consume fructose at all times of the day. I think it's beneficial to eat something really sugary upon waking in order to dampen down the morning cortisol levels. These days I've been eating a tbsp or so of raw wildflower honey on a rice cake first thing in the morning. Delicious. [I will say that those for whom sweet foods trigger cravings/binges etc. should probably avoid it in toto.]
Most importantly, however, I think the pro-butter stance that I quoted above in the comments is potentially quite dangerous. There is nothing particularly controversial about the hypercholesterolemic effects of butter and cream. It is a phenomenon that is fairly well-documented in the scientific literature. The resistance I see to that idea makes me think that half the time I accidentally clicked to PastoralHacks (the other half of the time I think I'm on AtkinsHacks...but I digress). Anyway, the best paper that I've seen on the subject is this one:
The take home message is that coconut raises cholesterol, but butter raises it twice as much, due to it's proportions of the specific hypercholesterolemic saturated fatty acids (myristic, lauric and palmitic acids). Another interesting part was the differential response to the diets based on gender, with HDL really spiking in women in response to these fats. I can't remember if that's due to more estrogen or less testosterone. More to the point, butter increases cholesteryl ester transfer activity (which, incidentally, also occurs when trans fats are consumed: http://www.nejm.org/doi/full/10.1056/nejm199906243402501 - note that the greater the amount of trans fats, the closer the LDL is to that produced by butter). This basically shuffles cholesterol and TGs around between the lipoproteins and results in lipoprotein aberrations. Since decreased CETP activity correlates with longevity: http://jama.ama-assn.org/content/290/15/2030.full we might be hesitant to eat a particular kind of fat that greatly enhances it.
Though many of us are highly skeptical of statins, there is a subset of the population that clearly benefits from their use, i.e. those with familial hypercholesterolemia. These people (who are heterozygous, the homozygous version is deadly in childhood) will hit cholesterol levels in the 3-500 range pretty much no matter what they eat. It's well documented that they have a greatly increased risk of atherosclerosis as a result. We may be skeptical of 210 total cholesterol being unhealthy, but what about double that? Where are you going to draw the line and just how are you going to explain it away? Jaminet's convenient explanation is that it's not the butter, it's some micronutrient deficiency. I see no reason why it can't be purely the result of butter and cream consumption and the subsequent upregulation of CETP.
The primary hypercholesterolemic mechanism at play itself may be something else such as a downregulation of the liver's absorption and recycling of lipoproteins. Whatever the mechanism, the result is increased LDL. I am allergic to coconut oil, so I consumed none in order to hit a total cholesterol of 393, but if I hadn't been, it may have been even higher. I've seen 3-4 people on Paleo Hacks who hit a TC of 500-something via butter and cream and many others in that range around the paleosphere.
Butter and cream are essentially anti-statin drugs that we did not evolve to consume, and certainly not in the amounts that are frequently encountered in high fat diets. Advising people to not restrict their fat intake or their butter/cream intake within that fat intake is highly irresponsible since the effect in many people is simulated familial hypercholesterolemia, with the corresponding increase in CHD risk.
It is not out of the realm of possibility that someone could follow this advice to the letter, not bother getting a lipid panel, and have a heart attack as a result. This issue is deadly serious.
on February 06, 2012
at 10:14 AM
WHat about the idea that your LDL or Total values being enabled to reach such high numbers with butter having something to do with thyroid function and the ability of your metabolism to turn cholesterol into all of those things your body can use?
What about the idea (one of my issues with people diving into high fat diets) is that you cant utilize those levels of fat for consumption until your metabolism is much higher?
on August 14, 2012
at 09:46 PM
Thank you for this information. I am very much interested in dietary factors that raise cholesterol. Ever since I learned to restrict my carbs to <100g/day, my total cholesterol and trigs dropped to 110 and 40, despite eating a lot of coconut oil and butter fat. Those levels do not correlate with optimum health and longevity for a person over 55. Even eating 4000 mg cholesterol/day in the form of pork brains 5 days a week only raised my TC to 185. N=1 is more important than generalizations!