4

votes

Is saturated fat really healthy (or harmless)?

Answered on August 19, 2014
Created February 14, 2013 at 6:11 PM

My total cholesterol and LDL cholesterol (including LDL-P) shot up considerably after being on the paleo diet for the last 3 months (consuming lots of butter and beef with lots of veggies and no grains at all). I did some searching and I found a few studies that conclude saturated fats raise total cholesterol and LDL. Is the paleo diet promoting excessive and unhealthy consumption of saturated fats? What to make of these studies conclusions?

Effects of fats and fatty acids on blood lipids in humans: an overview (1994) Katan, Zock and Mensink http://ajcn.nutrition.org/content/60/6/1017S.long

Effect of dietary fatty acids on serum lipids and lipoproteins. A meta-analysis of 27 trials (1992) Mensink and Katan http://atvb.ahajournals.org/content/12/8/911.long

Quantitative effects of dietary fat on serum cholesterol in man (1965) Hegsted http://ajcn.nutrition.org/content/17/5/281.long

Bdb603fa3b1e2761c98047260f34b0e8

(94)

on February 17, 2013
at 11:26 PM

Unfortunately, I don't have a baseline LDL-P. I never took an NMR Lipoprofile test before. I'll post my ApoE here when I get the results. 23andme takes 4-6 weeks to process the saliva sample. BTW, the cost is now $99; it used to be $300.

748480b775b59092f4a90d3d06464dcf

on February 17, 2013
at 04:29 AM

Yeah, I have been meaning to call my insurance company to see if they cover an Apo E test. If you don't mind sharing your Apo E when it comes back, I would be really interested. What was your LDL-P before starting paleo, if you don't mind me asking?

Bdb603fa3b1e2761c98047260f34b0e8

(94)

on February 16, 2013
at 06:18 PM

Thanks for the article. Yes, my LDL-P was the only number that was really off. It was 2300; ideal LDL-P should be less than 1000. Triglycerides were ok at 80, HDL was 65. I've read that cardiologists are confounded by numbers like these from paleo dieters since usually with high LDL one sees very low HDL and high triglycerides. I joined 23andme and am awaiting my genetic analysis. I am curious as to my ApoE status, which may help explain why I have such high LDL when others on the paleo diet have lower numbers.

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on February 16, 2013
at 01:51 AM

You're Dutch, continue being awesome!

3a9d5dde5212ccd34b860bb6ed07bbef

(1782)

on February 15, 2013
at 11:19 PM

This is a bit like saying "the good thing about herpes is that it's not gonorrhea." Not a very good defense.

Medium avatar

(10611)

on February 15, 2013
at 02:09 PM

Pristine paleo diet???? The Eskimos are proof that Neolithics can successfully adapt to living in an extreme climate. Very few humans, if any, would have attempted to live in the Arctic 30,000 years ago.

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on February 15, 2013
at 12:44 PM

Don't throw out old papers. Unless they have obvious experimental flaws, the data is still relevant, though the conclusions might be a bit outdated.

A2c38be4c54c91a15071f82f14cac0b3

(12682)

on February 15, 2013
at 05:27 AM

Yeah the lack of vitamin C, or the lack of numerous important plant nutrients like manganese and potassium, or the exposure to smoke from oil lamps, or damaging cooking techniques, or more LDL oxidation from high omega-3 intake, or high blood iron from heavy red meat intake, or infections, or, who knows, saturated fat could have caused the atherosclerosis as well. Certainly a lot of potentially contributing factors. Without a control group though you really can't say saturated fat was at all to blame.

E8c2167284f0cdd16a12bea2741975b4

(476)

on February 15, 2013
at 03:30 AM

http://imaging.onlinejacc.org/article.aspx?articleid=1110017&issueno=4 "Although the diet of a particular ancient Egyptian with or without atherosclerosis is difficult to ascertain, hieroglyphic inscriptions on Egyptian temple walls indicate that beef, sheep, goats, wildfowl, bread, and cake were regularly consumed"

E8c2167284f0cdd16a12bea2741975b4

(476)

on February 15, 2013
at 03:29 AM

Although the diet of a particular ancient Egyptian with or without atherosclerosis is difficult to ascertain, hieroglyphic inscriptions on Egyptian temple walls indicate that beef, sheep, goats, wildfowl, bread, and cake were regularly consumed (11,15,19). David (11,15) suggested that the ancient Egyptian diet may have been atherogenic, particularly among the clergy who consumed the ritual feasts left by families mourning their deceased relatives. Relative to atherosclerosis, however, in this relatively small subset we found priests and priestesses to have less atherosclerosis than nonclergy.

E8c2167284f0cdd16a12bea2741975b4

(476)

on February 15, 2013
at 03:25 AM

Also I don't know what to make of the closing paragraph about the Egyptians not consuming much animal products. We know they were eating tons of bread and cooking with lots of oils, probably eating diary too. So the Eskimo's were likely eating a more pristine paleo diet

E8c2167284f0cdd16a12bea2741975b4

(476)

on February 15, 2013
at 03:19 AM

http://www.meandmydiabetes.com/wp-content/uploads/2010/03/Atherosclerosis-in-Pre-Westernized-Inuit.pdf That paper needs to be addressed. The only thing anyone has been able to argue was that the plaque could have been from a lack of vitamin C

A2c38be4c54c91a15071f82f14cac0b3

(12682)

on February 15, 2013
at 02:18 AM

I didn't downvote this, by the way. I agree your point about no perfect macro ratios.

A2c38be4c54c91a15071f82f14cac0b3

(12682)

on February 15, 2013
at 02:15 AM

I have personally not seen consistent evidence suggesting saturated fat is bad for endothelial cells (comparatively speaking) based on it's effect on nitric oxide levels, endothelial reactivity, or flow mediated dilation.

4bd4e2fe6a095663f80c69656936e487

(744)

on February 14, 2013
at 07:13 PM

I wouldn't even care about the prestige of the journal. I think they're all in the pocket big pharma. I would care about the arguments, the context, and read it carefully.

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7 Answers

4
5dd50f78f47b8848d93724d6eb38d4c1

on February 15, 2013
at 09:21 AM

Both the "saturated fat is the biggest diet villian" and the "saturated fat is good for you everyone should eat more butter and lard" sides are rather stupid. It's extremely individual. Certain gene types are putting themselves at risk by eating a high fat paleo diet while others are actually improving their profiles eating certain fats.

Even Cordains latest stance on the issue is "yes, it will most likely lead to plaque formation, it just probably won't kill you without other factors in place", which isn't the most reassuring line of reasoning.

4
Medium avatar

(10663)

on February 15, 2013
at 01:54 AM

First of all, I agree with Jim. Those papers are oooooold.

Second, I have extremely high total and LDL cholesterol after going on Paleo as well but my trigs are super low and my HDL is very high, prompting my doctor to tell me she's never seen HDL that high before. I don't worry too much about it because I do think I have a genetic predisposition towards high cholesterol. Do you know if high cholesterol runs in your family?

If you would like to do some more reading, read The Cholesterol Myth by Drs. Bowden and Sinatra. They say that there is no association between saturated fat and heart disease. Chris Kresser also has a post on how cholesterol doesn't cause heart disease.

I'd also say high triglycerides are a more important risk factor. This study found that saturated fat raises total cholesterol and LDL cholesterol but also lowers triglycerides and raises HDL cholesterol. Both this study and Dr. Bowden claim that intake of omega-3 fish oil, which is anti-inflammatory, is beneficial.

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on February 15, 2013
at 12:44 PM

Don't throw out old papers. Unless they have obvious experimental flaws, the data is still relevant, though the conclusions might be a bit outdated.

2
E8c2167284f0cdd16a12bea2741975b4

on February 15, 2013
at 01:29 AM

Saturated fat does appear to be bad for the lining of the endothelial cells. They coat them and inhibit release of nitric oxide. They do not appear to be an independent risk factor for heart attacks. Apart from that, I cannot say... It probably depends a lot on what your ancestors ate in terms of macro's. I don't think there's a perfect ratio of macro's like Paul Jaminet proposes, for instance the Ache hunter gatherers wouldn't thrive on a high fat low carb diet

A2c38be4c54c91a15071f82f14cac0b3

(12682)

on February 15, 2013
at 02:18 AM

I didn't downvote this, by the way. I agree your point about no perfect macro ratios.

A2c38be4c54c91a15071f82f14cac0b3

(12682)

on February 15, 2013
at 05:27 AM

Yeah the lack of vitamin C, or the lack of numerous important plant nutrients like manganese and potassium, or the exposure to smoke from oil lamps, or damaging cooking techniques, or more LDL oxidation from high omega-3 intake, or high blood iron from heavy red meat intake, or infections, or, who knows, saturated fat could have caused the atherosclerosis as well. Certainly a lot of potentially contributing factors. Without a control group though you really can't say saturated fat was at all to blame.

Medium avatar

(10611)

on February 15, 2013
at 02:09 PM

Pristine paleo diet???? The Eskimos are proof that Neolithics can successfully adapt to living in an extreme climate. Very few humans, if any, would have attempted to live in the Arctic 30,000 years ago.

E8c2167284f0cdd16a12bea2741975b4

(476)

on February 15, 2013
at 03:30 AM

http://imaging.onlinejacc.org/article.aspx?articleid=1110017&issueno=4 "Although the diet of a particular ancient Egyptian with or without atherosclerosis is difficult to ascertain, hieroglyphic inscriptions on Egyptian temple walls indicate that beef, sheep, goats, wildfowl, bread, and cake were regularly consumed"

E8c2167284f0cdd16a12bea2741975b4

(476)

on February 15, 2013
at 03:29 AM

Although the diet of a particular ancient Egyptian with or without atherosclerosis is difficult to ascertain, hieroglyphic inscriptions on Egyptian temple walls indicate that beef, sheep, goats, wildfowl, bread, and cake were regularly consumed (11,15,19). David (11,15) suggested that the ancient Egyptian diet may have been atherogenic, particularly among the clergy who consumed the ritual feasts left by families mourning their deceased relatives. Relative to atherosclerosis, however, in this relatively small subset we found priests and priestesses to have less atherosclerosis than nonclergy.

E8c2167284f0cdd16a12bea2741975b4

(476)

on February 15, 2013
at 03:19 AM

http://www.meandmydiabetes.com/wp-content/uploads/2010/03/Atherosclerosis-in-Pre-Westernized-Inuit.pdf That paper needs to be addressed. The only thing anyone has been able to argue was that the plaque could have been from a lack of vitamin C

A2c38be4c54c91a15071f82f14cac0b3

(12682)

on February 15, 2013
at 02:15 AM

I have personally not seen consistent evidence suggesting saturated fat is bad for endothelial cells (comparatively speaking) based on it's effect on nitric oxide levels, endothelial reactivity, or flow mediated dilation.

E8c2167284f0cdd16a12bea2741975b4

(476)

on February 15, 2013
at 03:25 AM

Also I don't know what to make of the closing paragraph about the Egyptians not consuming much animal products. We know they were eating tons of bread and cooking with lots of oils, probably eating diary too. So the Eskimo's were likely eating a more pristine paleo diet

2
7e6644836cdbcbe2b06307ff7db92d31

(693)

on February 14, 2013
at 06:57 PM

I did some searching and I found a few studies that conclude saturated fats raise total cholesterol and LDL.

I glanced at the papers. Here's some general comments that are hopefully constructive;

  1. Try to stay current. If I were researching something in an area I was unfamiliar, I'd try to get one of the most recent reviews and proceed from there. Something a year or two old at most.

  2. Try to identify the top-tier journals in the subject area and stick with them if possible.

  3. Don't just think papers, see if you have access to other resources like UpToDate.

A few specific comments;

  1. I don't think the data linking elevated saturated fat and cholesterol to heart disease is necessarily wrong, just that it's in the context of a SAD.

  2. I never liked the idea of overloading on fat. Substituting fat calories for carbohydrate calories in a diet that leaves you at or on the way to a healthy weight is probably not a problem, even if that is saturated fat. Regularly binging out on butter & bacon? I don't know, I'd have to see the body weight, and even then...

4bd4e2fe6a095663f80c69656936e487

(744)

on February 14, 2013
at 07:13 PM

I wouldn't even care about the prestige of the journal. I think they're all in the pocket big pharma. I would care about the arguments, the context, and read it carefully.

2
4bd4e2fe6a095663f80c69656936e487

(744)

on February 14, 2013
at 06:21 PM

If your thyroid function works very well, your body would convert cholesterol to other hormones. One of the good things about saturated fats is that they don't slow thyroid function like PUFA do.

3a9d5dde5212ccd34b860bb6ed07bbef

(1782)

on February 15, 2013
at 11:19 PM

This is a bit like saying "the good thing about herpes is that it's not gonorrhea." Not a very good defense.

1
748480b775b59092f4a90d3d06464dcf

on February 16, 2013
at 03:13 AM

Some of this might be a bit controversial on this forum but this is straight from paleo supporter Peter Attia, not me.... interpreted to the best of my ability of course. The source for all of this is at the bottom. First, some apo E gene types may increase your risk of atherosclerosis and these people may need to lower their saturated fat intake. However we still do no have strong support of exactly how to deal with these alleles through our diet.

We need to be honest and if the current data shows that LDL-P is a high independent risk marker for CHD and atherosclerosis we need to accept that it is more likely that you are at higher risk for these conditions and we must not immediately disregard this risk since you eat paleo.

HOWEVER, we must understand that pretty much all research is within the context of a SAD and maybe... maybe high LDL-P is not a risk factor on a completely different diet like the paleo diet, though there is no research yet to support either side of this.

Also, do not forget that there are two main factors determining your risk for atherosclerosis, one is cholesterol, the other is inflammation. It is very likely that if you have a high LDL-P level it does not matter if it is high if you have no inflammation and they cannot penetrate the endothelial wall in the first place. If you are truely eating paleo, which means you are eating very little PUFAs, this may not be a problem.

One last thing. You might just have to come to a reasonable judgment about what is going on with your numbers. Is your HDL extremely high? Are you triglycerides extremely low? Inflammation low? If 'yes', if everything seems to be consistent across the board except for one number standing out, we can probably not worry so much and believe you are doing the right thing and maybe there is just something more complex going on that we do not fully understand yet.

But at the end of the day when trying to explain Jimmy Moore's skyrocketing LDL-P he basically said, "I just don't know. The science just isn't there yet." It seems he never wrote part X of his "Straight Dope on Cholesterol" series which was supposed to answer some of this. I would watch for this article as it will have some answers to your question. I know this is not an ideal answer but this is really as much as we know about a situation like yours so far without doing more research.

http://www.askthelowcarbexperts.com/2012/10/33-dr-peter-attia-finding-the-diet-thats-right-for-you/

Bdb603fa3b1e2761c98047260f34b0e8

(94)

on February 16, 2013
at 06:18 PM

Thanks for the article. Yes, my LDL-P was the only number that was really off. It was 2300; ideal LDL-P should be less than 1000. Triglycerides were ok at 80, HDL was 65. I've read that cardiologists are confounded by numbers like these from paleo dieters since usually with high LDL one sees very low HDL and high triglycerides. I joined 23andme and am awaiting my genetic analysis. I am curious as to my ApoE status, which may help explain why I have such high LDL when others on the paleo diet have lower numbers.

748480b775b59092f4a90d3d06464dcf

on February 17, 2013
at 04:29 AM

Yeah, I have been meaning to call my insurance company to see if they cover an Apo E test. If you don't mind sharing your Apo E when it comes back, I would be really interested. What was your LDL-P before starting paleo, if you don't mind me asking?

Bdb603fa3b1e2761c98047260f34b0e8

(94)

on February 17, 2013
at 11:26 PM

Unfortunately, I don't have a baseline LDL-P. I never took an NMR Lipoprofile test before. I'll post my ApoE here when I get the results. 23andme takes 4-6 weeks to process the saliva sample. BTW, the cost is now $99; it used to be $300.

1
D2b653e1bb95489af69ece6182abec48

(375)

on February 15, 2013
at 10:50 PM

From this month's American Journal of Clinical Nutrition:

"High dietary intake of saturated fat is associated with reduced semen quality among 701 young Danish men from the general population"

http://ajcn.nutrition.org/content/97/2/411.abstract

Thank God I'm not Danish!

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on February 16, 2013
at 01:51 AM

You're Dutch, continue being awesome!

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