The Diet-Heart Myth: Cholesterol and Saturated Fat Are Not the Enemy

butter heart

To read more about heart disease and cholesterol, check out the special report page.

It’s hard to overstate the impact that cardiovascular disease (CVD) has in the U.S.. Consider the following:

  • Cardiovascular disease affects 65 million Americans.
  • Close to one million Americans have a heart attack each year.
  • In the U.S., one person dies every 39 seconds of cardiovascular disease.
  • 1 of 3 deaths that occurs in the U.S. is caused by cardiovascular disease.
  • 1 in 3 Americans have metabolic syndrome, a cluster of major cardiovascular risk factors related to overweight/obesity and insulin resistance.
  • The total cost of cardiovascular disease in 2008 was estimated at $300 billion.

To put that last statistic in perspective, the World Health Organization has estimated that ending world hunger would cost approximately $195 billion. One might argue that the $300 billion we spend on treating cardiovascular disease in the U.S. is a necessary expenditure; however, a recent study which looked at the relationship between heart disease and lifestyle suggested that 90% of CVD is caused by modifiable diet and lifestyle factors. (1)

Unfortunately, cardiovascular disease is one of the most misdiagnosed and mistreated conditions in medicine. We’ve learned a tremendous amount about what causes heart disease over the past decade, but the medical establishment is still operating on outdated science from 40-50 years ago.

In this 4-part series, I’m going to debunk 3 common myths about heart disease:

  1. Eating cholesterol and saturated fat raises cholesterol levels in the blood.
  2. High cholesterol in the blood is the cause of heart disease.
  3. Statins save lives in healthy people without heart disease.

In the fourth and final article in the series, I’ll discuss strategies for naturally protecting yourself against heart disease.

Myth #1: Eating cholesterol and saturated fat raises cholesterol levels in the blood.

Most of us grew up being told that foods like red meat, eggs and bacon raise our cholesterol levels. This idea is so deeply ingrained in our cultural psyche that few people even question it. But is it really true?

The diet-heart hypothesis—which holds that eating cholesterol and saturated fat raises cholesterol in our blood—originated with studies in both animals and humans more than half a century ago. However, more recent (and higher quality) evidence doesn’t support it.

Cholesterol and saturated fat: dietary enemies or innocent victims of bad science?Tweet This

On any given day, we have between 1,100 and 1,700 milligrams of cholesterol in our body. 25% of that comes from our diet, and 75% is produced inside of our bodies by the liver. Much of the cholesterol that’s found in food can’t be absorbed by our bodies, and most of the cholesterol in our gut was first synthesized in body cells and ended up in the gut via the liver and gall bladder. The body tightly regulates the amount of cholesterol in the blood by controlling internal production; when cholesterol intake in the diet goes down, the body makes more. When cholesterol intake in the diet goes up, the body makes less.

This explains why well-designed cholesterol feeding studies (where they feed volunteers 2-4 eggs a day and measure their cholesterol) show that dietary cholesterol has very little impact on blood cholesterol levels in about 75% of the population. The remaining 25% of the population are referred to as “hyper-responders”. In this group, dietary cholesterol does modestly increase both LDL (“bad cholesterol” and HDL (“good cholesterol”), but it does not affect the ratio of LDL to HDL or increase the risk of heart disease. (2)

In other words, eating cholesterol isn’t going to give you a heart attack. You can ditch the egg-white omelettes and start eating yolks again. That’s a good thing, since all of the 13 essential nutrients eggs contain are found in the yolk. Egg yolks are an especially good source of choline, a B-vitamin that plays important roles in everything from neurotransmitter production to detoxification to maintenance of healthy cells. (3) Studies show that up to 90% of Americans don’t get enough choline, which can lead to fatigue, insomnia, poor kidney function, memory problems and nerve-muscle imbalances. (4)

What about saturated fat? It’s true that some studies show that saturated fat intake raises blood cholesterol levels. But these studies are almost always short-term, lasting only a few weeks. (5) Longer-term studies have not shown an association between saturated fat intake and blood cholesterol levels. In fact, of all of the long-term studies examining this issue, only one of them showed a clear association between saturated fat intake and cholesterol levels, and even that association was weak. (6)

Moreover, studies on low-carbohydrate diets (which tend to be high in saturated fat) suggest that they not only don’t raise blood cholesterol, they have several beneficial impacts on cardiovascular disease risk markers. For example, a meta-analysis of 17 low-carb diet trials covering 1,140 obese patients published in the journal Obesity Reviews found that low-carb diets neither increased nor decreased LDL cholesterol. However, they did find that low-carb diets were associated with significant decreases is body weight as well as improvements in several CV risk factors, including decreases in triglycerides, fasting glucose, blood pressure, body mass index, abdominal circumference, plasma insulin and c-reactive protein, as well as an increase in HDL cholesterol. (7)

If you’re wondering whether saturated fat may contribute to heart disease in some way that isn’t related to cholesterol, a large meta-analysis of prospective studies involving close to 350,000 participants found no association between saturated fat and heart disease. (8) A Japanese prospective study that followed 58,000 men for an average of 14 years found no association between saturated fat intake and heart disease, and an inverse association between saturated fat and stroke (i.e. those who ate more saturated fat had a lower risk of stroke). (9)

That said, just as not everyone responds to dietary cholesterol in the same manner, there’s some variation in how individuals respond to dietary saturated fat. If we took ten people, fed them a diet high in saturated fat, and measured their cholesterol levels, we’d see a range of responses that averages out to no net increase or decrease. (If dietary saturated fat does increase your total or LDL cholesterol, the more important question is whether that’s a problem. I’ll address that in the next article in this series.)

Another strike against the diet-heart hypothesis is that many of its original proponents haven’t believed it for at least two decades. In a letter to the New England Journal of Medicine in 1991, Ancel Keys, the founder of the diet-heart hypothesis said (10):

Dietary cholesterol has an important effect on the cholesterol level in the blood of chickens and rabbits, but many controlled experiments have shown that dietary cholesterol has a limited effect in humans. Adding cholesterol to a cholesterol-free diet raises the blood level in humans, but when added to an unrestricted diet, it has a minimal effect.

In a 2004 editorial in the Journal of American College of Cardiology, Sylvan Lee Weinberg, former president of the American College of Cardiology and outspoken proponent of the diet-heart hypothesis, said (11):

The low-fat, high-carbohydrate diet… may well have played an unintended role in the current epidemics of obesity, lipid abnormalities, type 2 diabetes, and metabolic syndromes. This diet can no longer be defended by appeal to the authority of prestigious medical organizations.

We’ve now established that eating cholesterol and saturated fat does not increase cholesterol levels in the blood for most people. In the next article, I’ll debunk the myth that high cholesterol in the blood is the cause of heart disease.

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Comments Join the Conversation

  1. Michael Landis says

    Hi, John, I saw that you backlink to previous articles in this excellent series. Can you edit the earlier articles and forward-link to the next article? Saves time examining the overview page.

    Thank you for these excellent articles!

  2. kirk says

    since everybody is different, I decided to see how my own body reacts to lowering dietary cholesterol. I held dietary cholesterol to less than 250mg per day for a month then did a before and after comparison of blood cholesterol. the results:

    before: total=225, HDL=34, LDL=148, trig.=213
    after: total=153, HDL=25, LDL=94, trig.=174

    note HGL decreased, which is the surprise here. prior to the experiment, I had no dietary restrictions, and am borderline obese (6′, 205lb). It is an easy experiment to do, and yields individually relevant results.

    • Adarsh khanna says

      all levels of Lipid profile decreased it is good but HDL level of 25 is alarming. how about continuing with this diet and start taking NIACIN tablets. I am not expert feel taking Niacin will increase HDL level consult your physician
      khanna

  3. Don says

    Chris, what about the Esselstyn study (also ones by Ornish and others) showing striking reversal of heart disease in patients who ate *very* low fat vegan diets?

  4. Bob Werner says

    Chris, what about saturated fat and ED. I have read that a paleo type diet that uses commercial meat can increase saturated fat and very rapidly create ED symptoms in men.

    Can you comment on this please?

  5. Lu says

    I have read this entire page and now my question that I hope will be answered is this: I like carbs and feel way better when I eat them. I am actually referring to the refined carbs. Since this is my preference can I lower my intake of meats to allow for the carbs I seem to need so much more than meat(I can feel it) and will not eating as much meat but still eating carbs help my cholesterol go down some? Someone on here said that it is the combining of them that is the oxidizing bad effect so….I am just wondering if anyone knows this to help me. Thanx

  6. Prat says

    I feel bad when I see the confusion in the minds of people because two camps are being set up, 1. low fat, plant diet 2. high fat, paleo.

    But, very few people resort to common sense to resolve the issue.

    We humans are omnivorous animals. We eat plants & meat! It’s as simple as that. For a healthy lifestyle, you need to EAT both! Sorry, Ornish & low fat, plant camp, but you cannot disregard the natural human anatomy.

    It is possible to get very “fit” on a strict Ornish diet, but that is mainly coming from the “strictness” of avoiding the obvious bad processed foods and sugars. However, this camp targeting meat intake and even natural fat intake as dangerous just doesn’t make sense, as the human body was built to get nutrients from ALL THESE SOURCES to increase our chances of survival in the wild (back in the days).

    Any diet which isn’t BALANCING intake from all the key sources i.e. plant, meat & fat is a skewed diet, which will lead to other problems for the body.

    Key operating words when it comes to food is BALANCE & VARIETY. We were hunter-gatherers. We hunted our meats and gathered our plants and fruits. Continue to do that in a balanced way, along with exercise, and you would live at your optimum. This is common sense.

    • Don says

      Alas, science is not common sense. The latter is often wrong (and also at times right); the only way to find out is by careful open-minded studies. If meat is so essential to our health, then one would expect, for instance, Adventist vegans to be unhealthy, or the Okinawan elders, or the Ornish patients. Do you know of studies showing that one does poorly on a (truly, as in 10% of calories) low-fat plant-based diet?

    • John says

      For total cholesterol:
      • If your level is less than 140 mg/dL (3.6 mmol/L), then you have severely low cholesterol.
      • If your level is at least 140 mg/dL (3.6 mmol/L), but less than 160 mg/dL (4.1 mmol/L), then you have low cholesterol.
      • If your level is at least 160 mg/dL (4.1 mmol/L), but less than 200 mg/dL (5.2 mmol/L), then you have a healthy cholesterol level.
      • If your level is at least 200 mg/dL (5.2 mmol/L), but less than 240 mg/dL (6.2 mmol/L), then you have borderline high cholesterol.
      • If your level is at least 240 mg/dL (6.2 mmol/L), but less than 300 mg/dL (7.8 mmol/L), then you have high cholesterol.
      • If your level is 300 mg/dL (7.8 mmol/L) or more, then you have severely high cholesterol.

      For HDL-cholesterol:
      • If your level is less than 20 mg/dL (0.5 mmol/L), then you have severely low HDL-cholesterol.
      • If you are a male and your level is at least 20 mg/dL (0.5 mmol/L), but less than 40 mg/dL (1.0 mmol/L), then you have low HDL-cholesterol.
      • If you are a female and your level is at least 20 mg/dL (0.5 mmol/L), but less than 50 mg/dL (1.3 mmol/L), then you have low HDL-cholesterol.
      • If you are a male and your level is at least 40 mg/dL (1.0 mmol/L), but less than 60 mg/dL (1.6 mmol/L), then you have normal HDL-cholesterol.
      • If you are a female and your level is at least 50 mg/dL (1.3 mmol/L), but less than 60 mg/dL (1.6 mmol/L), then you have normal HDL-cholesterol.
      • If your level is at least 60 mg/dL (1.6 mmol/L), but less than 90 mg/dL (2.3 mmol/L), then you have high HDL-cholesterol (contrary to popular belief, this is not necessarily a good thing; although I don’t have enough sources to recommend lowering HDL-cholesterol).
      • If your level is 90 mg/dL (2.3 mmol/L) or more, then you may have severely high HDL-cholesterol (again, I have found too few sources to say for sure that this is a bad thing [aka, "too much of a good thing"] and should be reduced to the normal level).

      For triglycerides:
      • If your level is less than 35 mg/dL (0.4 mmol/L), then you have severely low triglycerides.
      • If your level is at least 35 mg/dL (0.4 mmol/L), but less than 50 mg/dL (0.6 mmol/L), then you have low triglycerides.
      • If your level is at least 50 mg/dL (0.6 mmol/L), but less than 100 mg/dL (1.1 mmol/L), then you have an optimal triglyceride level.
      • If your level is at least 50 mg/dL (0.6 mmol/L), but less than 150 mg/dL (1.7 mmol/L), then you have a healthy triglyceride level.
      • If your level is at least 150 mg/dL (1.7 mmol/L), but less than 200 mg/dL (2.3 mmol/L), then you have borderline high triglycerides.
      • If your level is at least 200 mg/dL (2.3 mmol/L), but less than 500 mg/dL (5.6 mmol/L), then you have high triglycerides.
      • If your level is 500 mg/dL (5.6 mmol/L) or more, then you have severely high triglycerides.

      As well as your specific values, you should also know your HDL/LDL ratio, HDL/total cholesterol ratio, and triglyceride/HDL ratio. Before computing these ratios, your HDL-cholesterol, LDL-cholesterol, triglycerides, and total cholesterol values should all be in mg/dL. If your blood lipid results are in mmol/L, you can convert these values to mg/dL here: http://www.onlineconversion.com/cholesterol.htm

      For HDL/LDL ratio:
      • If your ratio is no more than 0.3, then this is low.
      • If your ratio is more than 0.3, but no more than 0.4, then this is acceptable.
      • If your ratio is more than 0.4, then this is ideal.

      For HDL/total cholesterol level:
      • If your ratio is less than 0.10, then this is low.
      • If your ratio is at least 0.10, but less than 0.24, then this is acceptable.
      • If your ratio is 0.24 or more, then this is ideal.

      For triglyceride/HDL ratio:
      • If your ratio is no more than 2, then this is ideal.
      • If your ratio is more than 2, but less than 4, then this is acceptable.
      • If your ratio is at least 4, but less than 6, then this is high.
      • If your ratio is 6 or more, then this is severely high.

  7. Don Perlis says

    Chris, while I am aware of recent studies suggesting that modest reduction in dietary fat doesn’t do much, there are other studies very strongly suggesting that a major reduction in fat (as in only 10% of calories from fat) does a great deal, such as even reversing heart disease. I have in mind the published studies by Ornish and by Esselstyn, as well as the Okinawa centenarian studies, among others. What is your view on these?

  8. Matt says

    Hi,after reading all the comments above my head hurts :) Glad to have found this site and hope to learn and contribute. About a year and a half ago my Naturopathic Doctor (ND) diagnosed me with a number of “things,” including adrenal fatigue, MTHFR Gene Mutation (can’t process folate), low thyroid function, insulin resistance/pre-diabetes and high cholesterol.

    In January 2014 my weight was 202 (I’m a 51 y/o male, 5’11”) and my lipid panel was “bad.” My ND told me to lose weight, and cut back on carbs else she would have to recommend a statin, and for an ND, that is almost unthinkable. I went on aHFLC diet for 4 months and got re-tested two weeks ago. My weight dropped from 202 to 176! Yeah, that is pretty cool, and I feel better. My HDL, VLDL, Insulin, Trigly, A1C and CRP got better on the HFLC diet. However, my TC and LDL got a lot worse. My ND freaked and threatened me with statins again. She suggested getting off the HFLC diet and switching to a Paleo diet. She also suggested that my low thyroid function could be the cause of these bad numbers and wrote me a script for Naturethroid (thyroid booster). So, now I’m confused and would appreciate any help. First, regarding the lipid panel, should I be concerned with higher TC and LDL?

    Marker Jan-14 May-14
    Glucose, Serum 102 108
    Insulin 12.7 10.2
    TC 265 321
    Triglyc 340 140
    HDL 35 48
    VLDL 68 28
    LDL 162 245
    A1C 5.9 5.7
    CRP 6.91 5.6

    • Thomas Bihn says

      Matt, you can do both HFLC and Paleo together. I think that’s generally a good idea because it will encourage you to eat more vegetables and the quality of meat you are eating may improve as well. Given your thyroid issue, talk with the ND about the benefits of organ meats like liver.

      I wouldn’t worry too much just yet. If I were you, I’d get tested every couple months then only make new life changes after you get two or three consistent readings.

      You will probably discover that your trigs will go down further and HDL will go up more as you continue your healthy lifestyle.

      I think it’s also important that you get out and walk briskly at least 10 minutes daily. This also helps to reduce stress.

      I’m no professional btw. I’ve just been eating a healthier lifestyle for about 15 months now.

      • Matt says

        Thomas, thanks for your advice — makes sense. I think you are right about Trigs continuing to go down and HDL going up. So, will continue the HFLC diet and add the Paleo component to it.

        Now, the 64,000 question (that most of us have) is why is TC and LDL going up way over “conventional” guidelines and is there any good data to indicate this is something to be concerned or not concerned about? Okay, now off for that brisk walk!

        Best, Matt

  9. Romy JUGROO says

    Hi,My fasting blood cholesterol is nearly twice the normal for over 10 years.The doctor had insisted that I take the cholesterol lowering drug but I never did.

    Been running half marathons for over 30 years now.I eat everything I wish,some junk food once in a while.No alcohol,no cigarette,no unnecessary stress.But avoiding sugars now, keeping slim and fit by exercising like I always did.This works for me and is not any kind of advice.

    Great article.Thanks

  10. Ryann T. says

    This is such a scam.

    Even if it were true that saturated fat and cholesterol aren’t the culprits of high cholesterol, this article doesn’t explain what the culprits ARE. If someone reads just this article alone, it looks as if it’s written by a knowledgeable author (although not a doctor), who is claiming that it’s perfectly safe to eat all the saturated fat and cholesterol you want without having to worry about risking your safety. Meanwhile, my boyfriend’s DOCTOR has suggested the exact opposite, and whenever he cuts the amount of saturated fat and cholesterol he eats, his (bad) cholesterol levels drop.

    It’s irresponsible to go around saying things like “eating cholesterol isn’t going to give you a heart attack. You can ditch the egg-white omelettes and start eating yolks again” as a blanket statement and then withhold the information about how to protect against high cholesterol unless they read your other articles. Not to mention, there are no obvious links to the other articles, and when you look for them, you’re sent to a link to register for an e-book, which I’m sure at some point leads to a paid product or cost in some other way…

    Please stick to acupuncture and do not write things that seem to present themselves as medical advice. Not everyone will do their homework before taking it to heart… literally, in this case. :(

    • Thomas Bihn says

      Ryann T,

      I recommend you research this topic before blindly accepting nutrition advice from an MD. This seems counterintuitive, but most MDs only get one or two semesters of nutrition education and that is influenced by dogma that has since had serious flaws exposed since it was introduced 50 years ago.

      First, I’d recommend following the citation links in the article. I can also say I don’t pay for any content and was able to access his other articles. I’d also recommend looking for a two part documentary on YouTube aired a few months ago on the Australian Broadcasting Company. I don’t remember the name of the show and am on my tablet, but if you search within the comments here even, you’ll probably find a link. Also, check The Great Cholesterol Myth out of your local library. It has a lot of citations, so you may find yourself renewing it several times to give yourself enough time to track it down.

      To give you the briefest summary of the main cause of cardiovascular disease, two words: chronic inflammation. This is damage done to the endothelial walls of arteries. Several things cause it, including oxidized LDL and elevated blood glucose (look up AGEs).

      You don’t have to eat low carb high fat paleo to be healthy, but you do need to eat more vegetables than are normally consumed in a typical western diet, avoid added sugar, and seed oils. Do those, and you’ll have a great start to reducing inflammation.

      • nilsson says

        Read, “Grain Brain” written by a neurologist, look at a few science mags from the last few months, New Scientist, American Scientist, etc. then read the first chapter of Nourishing Traditions… not ALL of the scientific research that has been done on these matters has been performed with rigid scientific non-biased approaches(note how certain interests held by those funding the FLAWED and heavily skewed papers on trans-fats and cholesterol affected the outcomes and therefore the data and what we have been falsely led to believe) Before ppl have the impulse to criticise the paleo diet and comment on cholesterol, they need to read more broadly; and that includes knowing how to judge whether a piece of research has been performed at rigorous scientific standards!

  11. says

    Chris I have a talk radio show. Would love to have you on the show to talk about cholesterol. I’ve been on board for over 2 years about this myth. The major role this essential nutrient plays!

    Feel free to cal me if you’d like to discuss further.
    (702)286-5486

  12. Richard says

    You are doing the public a dis-service by stating that cholesterol is not related to heart disease. Exactly what levels increase the risk is not known but it appears that everyone with levels below 150 with LDL below 100 have not had heart disease in any study.
    There are studies that show saturated fat in meat raises cholesterol therefore if it makes it over 150 it means you just increased your risk of heart disease.

    Here are many studies that you are welcome to try to refute:
    http://en.wikipedia.org/wiki/Saturated_fat_and_cardiovascular_disease_controversy

    • John says

      “There are studies that show saturated fat in meat raises cholesterol therefore if it makes it over 150 it means you just increased your risk of heart disease.”

      … and decreased your risk of trauma, cancer, hemorrhagic stroke, respiratory and infectious diseases, suicide, depression, impulsivity, aggression, reduced brain function, dementia, etc. Bringing your cholesterol up above 150 (or even better, 160) will reduce your risk of these health problems more than it increases your risk of heart disease — thereby reducing your all-cause risk of mortality.

      Also, there was at least one study in which people had heart attacks with total cholesterol below 150 — the MRFIT study. See my last comment for details.

      As well, while saturated fat does raise LDL-cholesterol, it also raises HDL-cholesterol and lowers triglycerides. Here is one of my sources on this: http://www.more.com/health/healthy-eating/saturated-fat-good

  13. Richard says

    Difficult to find one article with more BS in it than this one.

    You totally fail to explain how people go on a whole plant-based diet and get their cholesterol levels below 150 and their LDL well below 100. You also fail to explain how during the study of 45,000 nurses in the Framingham Study there was not one person that got heart disease in 25 years with cholesterol below 150.
    Studying cholesterol levels between 180 to 255 and saying cholesterol makes no difference is more of ignorance than science.

    • John says

      Obviously, those people who go on the plant based diet bring their cholesterol down because they are eliminating processed food, factory-produced fats, and added sugar. I assume that most people who go on plant based diets choose fresh and unprocessed vegetables, rather than processed vegetables such as fries.

      However, people with total cholesterol values below 150 are not exempt from heart disease — and especially not health problems in general, as driving your total cholesterol below 160 can create serious health risks of its own. You quote the Framingham Study, in which there was supposedly no heart disease with total cholesterol below 150 in 25 years; however, how do you explain the fact that in the MRFIT study, which included 350,977 men and lasted six years, there were almost 50 deaths from CVD out of every 10,000 men with total cholesterol of 140-159, and slightly more than 50 deaths from CVD out of every 10,000 men with total cholesterol below 140? How do you explain the fact that there were more strokes in these groups than in any other group studied, even slightly more than the 280-299 group and the 300+ group? You can see the chart for yourself here: http://1.bp.blogspot.com/-BrNwqzHAwFw/UX6xKNueesI/AAAAAAAAApo/qNHDJ-3xx_c/s1600/mrfit_mortality_in_350,977_men_aged_35-57.png

      And even though people with total cholesterol in the 140-159 range have the lowest risk of heart disease, they do not have the lowest risk of mortality from all causes — people in the 180-199 range are the ones with the lowest all-cause mortality rates. Why, you may wonder? Because when you drive your cholesterol down to dangerously low levels (less than 160 mg/dL), you significantly increase your risk of dying from other causes, such as trauma, cancer, hemorrhagic stroke, respiratory and infectious diseases, and suicide, and you also increase your risk of depression, impulsivity, and aggression. Sound fun? I don’t think so. Oh, and don’t forget about poor brain function and dementia.

  14. Jake says

    What do you mean all 13 of the essential nutrients are found in the yolk? I know the yolk has more, but the white has some too.

    • John says

      My assumption is that while there are some nutrients in the white, the same nutrients are probably also found in the yolk — and then some.

  15. Elizabeth says

    Great overview and I am living proof you are right on target! Over 2 years ago I had a bad C Diff infection and at the same time was placed on a rxn low fat diet. The decent into Hades was horrible to say the least. Nobody was putting two and two together until I ended up in the ER with chest pain. They ran a cholesterol panel my levels came in at 108 with the system marking it very low…..though nobody informed. I only found out after hunting down my medical records. Needless to say every system in my body was slowly going up in flames from the GI, sex hormones, and brain function just to name a few. Luckily, I started my own research and paid for a conn. doctor to help me recover. I am still ill, but do not feel as if I am at death’s door anymore. Thank you for spreading the word about cholesterol NOT being the villain! I just wish most physicians would stop with the low fat / low cholesterol diets……way dangerous from my personal experience.

  16. says

    Oh my g.o.s.h.!!!! These days if you want to be ‘healthy’ you either need to be a M.D. or have a Ph.D in nutrition! All of these conflicting comments make me want to poke a stick in my eye, or eat dirt. But what kind of dirt? Brown, red, black, white? Is one better than the other? i”m sure there’s a dirt expert out there who can confuse me with all my options. I’m more inclined to be like money mogul Warren Buffet, and do the exact opposite of what the ‘experts’ tell me to do. So bring on the sat. fat. Hello butter, and bacon! Goodbye canola and safflower oil. Hello whole wheat bread that has been soured, soaked, or sprouted. Goodbye highly processed rice cakes, and granola bars, and all the gluten free garbage. In other words, I’m just going to eat real food, prepare it properly (grains need to be prepared before consumption – just ask Cortez) and not over think this. Just remember eggs, chocolate and sat, fat were once labeled “bad” for you. The experts of nutrition don’t know their own silly business. But they do make a lot of money anyway, don’t they?!

  17. Greg says

    Mark,

    Great article, I’m on board, zero carbs except veg, moderate prot, high fat, 9 weeks now. Everything is better, except joint pain, hands, feet, knees. It’s holding back my ability to exercise, and generally painful all day, and disturbing my sleep to the point it’s non-restorative. Any tips?

    Thanks,
    Greg

    • John says

      You don’t need to eliminate all carbs; you just need to balance. It is recommended that you consume 45% to 65% of your calories from carbs. However, I personally try to avoid an intake of 60% or more calories from carbs, with preference to 55% or less (although this is not hard for me). If you can get your intake to less than 50%, that’s even better; however, you should not cut to less than 45% of your calories from carbohydrates, because carbs have essential functions as well.

      As far as protein is concerned, the recommendation is 10% to 35% of total calories. Ideal is probably around 15% to 20% and even better may be 20% to 25% or so.

      For fat, it used to be recommended that you consume 25% to 35% of your calories from fat; although apparently that has been changed to 20% to 30% (although I don’t agree with this change). In my opinion, the closer you get to 30+% calories from fat, the better; although you should not worry if you consume 30% to 40% of your calories from fat. More than 40-45% may be excessive, as your carbs and/or protein will fall short of the essential minimum, and even if you consume 45% carbs, if 41% to 45% of your calories come from fat, you are only consuming 10% to 14% of your calories from protein, and while this is okay, it is better to aim for 15% or more of your calories from protein, as I said before.

      I don’t know if a carbohydrate deficiency causes pain as you are experiencing, but if you think it’s not the cause, or it does not improve after balancing your diet as I said before, see a doctor. I am not telling you to stop balancing your diet as mentioned above; continue to consume the balanced diet regardless of whether the pain improves or not, as this will help to improve your overall health.

    • Michele says

      Please reply to this when you get it figured out by what you added to get back to a good night’s sleep and no joint/muscle pain. I haven’t had a good night’s sleep for three months since I started low carb and am losing weight I do not want to lose. I stopped taking magnesium and that helped a great deal with my joint/muscle pain but still can’t sleep. I am adding in more carbs but that’s not helping the sleep. I really need to get this figured out.

      • John says

        See a doctor. As I said in my previous comment to this post, if you think the low carb diet is not the cause of the pain, or it does not improve after increasing the carbs to a balanced level (45% to 65% of total calories), you should see a doctor. A doctor can help to determine the cause of the pain and possible treatment options.

      • John says

        I’m surprised I didn’t think of this earlier, but if you are having trouble sleeping, you can take melatonin. This supplement is completely safe and you only need to take 3 mg tablets. If this doesn’t help, try cutting the tablet in half (melatonin is actually less effective if you take more; backwards of what you would think). In my experience, whenever I have a hard time getting to sleep and then take a melatonin, I fall asleep faster. Even when it has taken me about 4 to 6 hours to get to sleep (4 to 6 hours laying in bed with my eyes closed before getting to sleep), melatonin has helped me to get to sleep within a half hour after taking it, or shortly after going to bed, whichever is later. Keep in mind that even though it takes about half an hour for it to kick in when I take it, the time is likely to vary from person to person, so it may help you faster, slower, or just as fast as it helps me. However, it will help you to get to sleep and sleep well.

        • Michele says

          Thanks for your input. I tried melatonin. That stuff is scary. Fi rst 5 mg, then 1 mg, then 1/2 mg. I’m actually too tired to remember what was so scary about it. I got more sleep but couldn’t function during the day, something like that. My doctor is useless, I said I couldn’t sleep months ago. Checked my hormones and said they were fine. Now listening to the Thyroid Summit for the last 6 days I got some insight that my Free T4 is low and I need some progesterone. While waiting to save up to get a lab test for my thyroid and hormones on my own, I’ll try some progesterone cream.

          • John says

            Don’t tell me you took all those doses in the same day — good way to knock yourself out for about 20 hours or so. When I said to take a smaller dose if it doesn’t help, I meant the next day; not to add the smaller dose onto what you already took that same day. That’s 6½ milligrams of melatonin, more than twice what I take in a single day — no wonder you couldn’t function during the day!

            Okay, let me reiterate. Try taking one 3 mg tablet of melatonin (or half of a 5 mg tablet) about half an hour before going to bed. If it does not help as you would like, cut it in half and take half of a 3 mg tablet, or a quarter of a 5 mg tablet, THE NEXT DAY. Don’t take more than one dose in the same day; if a certain dose does not sufficiently help, reduce the dose for the next day.

            Also, if your current doctor is not helping you, you may need to find a different doctor. You don’t have to stop going to your current doctor altogether; but you may want to see another doctor who may be able to better identify the problem.

  18. Lynne says

    Sorry didn’t check script – meant to put ‘ I am sure that people with FH would show a higher than average TC no matter what normal diet they have and so if your baseline TC was lowish before altering your diet surely FH is not likely indicated.

  19. Lynne says

    Hi Richard, sounds to me as though you are really healthy and have found a doctor who does not just want to just shove Statin meds on you – which is a real bonus. You mention 2 other docs who would have you on Statins like a shot, well I would guess 9 out of 10 would but that doesn’t mean they are right as we well know.
    My TC is also 7.1 but no doctor has even suggested concern because my HDL ratio is 2. something or other.
    When on a standard diet my TC was 4 – I am sure that people with would show a higher than average TC no matter what normal diet they have and so if your TC base line was lowish and has now risen, maybe your body needed the access to more fat and 7.1 is your totally healthy range for cholesterol.
    Also as Chris has mentioned before, serum blood lipid measurement is just a snapshot in one moment in time and to gain a true picture the blood sample would have to be taken several times during the week.
    Perhaps you were fighting an infection when your blood was drawn and so LDL would be kept in the blood for defence.
    Perhaps your thyroid is not working optimally hence not enough LDL receptors on cell wall stimulated for LDL to deposit cholesterol and so LDL remains high in blood stream. You possibly could be exercising too much and exhausting body affecting production of thyroid hormone and so number of LDL receptors. But you would have symptoms – feeling cold, hairloss more than normal etc. in which case eat a few more healthy carbs.
    Just be happy with your health and dont worry about cholesterol numbers.
    I listened to an enlightening interview with an English doctor who had studied at Cambridge. She had a colleague who was actually at the event in Europe where decisions were being made re the launch of statin drugs. There was some private debate going on as to what level of TC it should be suggested a statin drug should be used. Apparantly many figures were being bandied about for consideration. She overheard 2 of the leading figures on the panel in conversation state that they couldn’t consider a figure higher than 5 TC or they wouldn’t get enough people qualify to be put on the statin drug. This is the basis upon which our medical care is founded.

  20. Richard Houlton says

    I am totally confused by this entire debate. I’m pretty certain I have familial hypercholesterolemia….as does my healthy 85 yo mother who was diagnosed with high cholestrol (but a HDL/LDL ratio of 3.4) at 40 and, after about 5 years of trying to lower her cholestrol, gave up and ignored it.

    NOTHING in this thread has helped me to understand if I should be concerned about my situation of not.

      • Richard Houlton says

        Seems to me that my only risk factor is my 7.1mmol/l (274mg/dl) high total cholesterol reading. My HDL/LDL ratio is 3.4. My Trigylcerides are only 0.1mmol/l (8mg/dl). I am 180cm (5’11″), weigh 68kgs (150lbs), have 9% bodyfat, BP of 95/45 and a resting pulse of 48bpm. I exercise very regularly (gym & running 4-5 times a week). I eat eat a very normal (but far from “vegan” diet), but changing my diet (and I’ve tried this several times) seems to have next to no impact on my total cholesterol reading.

        My doctor thinks putting me on statins would be a mistake…but other doctors I know would have had me on them. I’ve have thought of getting a scan to see if I actually have any signs of atherosclerosis though! But I don’t get breathless exercising, I feel really fit.

        • John says

          From what you say (HDL/LDL ratio of 3.4; triglycerides of 8 mg/dL; total cholesterol of 274 mg/dL), I estimate that your HDL-cholesterol is about 211 mg/dL and your LDL-cholesterol is about 62 mg/dL. That means that you have extremely high HDL-cholesterol, low LDL-cholesterol, and severely low triglycerides. A safe value would be from 40 mg/dL to 89 mg/dL for HDL-cholesterol, 70 mg/dL to 99 mg/dL for LDL-cholesterol, 50 mg/dL to 149 mg/dL for triglycerides, and 160 mg/dL to 199 mg/dL for total cholesterol.

          Also, be careful — 9% body fat indicates that you are underweight if you are under 19 or over 39 (not inclusive). You should also be aware that your blood pressure of 95/45 mmHg indicates that you may have isolated diastolic hypotension (low diastolic blood pressure). A normal blood pressure would be from 90/60 mmHg to 119/79 mmHg.

          • Richard Houlton says

            Underweight? Balonney. My BMI is 21 (which is pretty much where my BMI has been since I was 20 years old). That’s not “underweight”…it’s right in a healthy weight range according to every chart I’ve seen. The reason I’m not “fat” is that a) I’m naturally lean, b) I exercise regularly c) I eat well.

            Triglycerides be too low? How do I boost them? Eat worse? Eat MORE fat??!! LOL Now I’m really getting confused.

            Bottomline is….am I about to have a heart attack? My doc clearly doesn’t think so….but I’ve had two other docs recommending statins….and I suspect they were wrong to do this.

            • John says

              No, your BMI does not indicate that you are underweight. However, your body fat percentage does if you are under the age of 19 or over 39. You say your BMI has been 21 since you were 20 years old, so that rules out the under 19 part; however, if you are over 39, you would still be classed as underweight at 9% body fat. A healthy body fat percentage would be 8% to 19% for males ages 20 to 39, 11% to 22% for males ages 40 to 59, and 13% to 25% for males ages 60 and older. Therefore, with a body fat percentage of 9%, you would be classed as underweight if you are 40 or older, and severely underweight if you are 60 or older. However, if you are in the 20 to 39 age range, that body fat percentage is perfectly fine.

              Considering you say you are lean and exercise regularly, I am surprised that you don’t know that body fat classifications are more accurate than body mass index. BMI is just a general screening tool that makes no attempt to differentiate between muscularity and bone structure. It combines the healthy range for a set “large bone structure” and “small bone structure” and everything in between, making for a healthy range much larger than what one’s actual healthy range would be, and making no attempt to take muscle mass into consideration, therefore assuming that you are a sedentary person with barely any muscle. For example, if you have 8% body fat at a BMI of 18.5, you would have 32% body fat at a BMI of 25, and if you have 20% body fat at a BMI of 25, a BMI of 20 would represent 0% body fat. Based on the height and weight you mentioned above, I estimate that you have a BMI of 20.9, so at your current height and lean mass weight you would be healthy at a BMI of 20.7 to 23.8 if you are 20 to 39, 21.4 to 24.7 if you are 40 to 59, or 21.9 to 25.7 if you are 60 or older.

              Another example of how BMI is inaccurate is my own measurements. At 5’11½” and 218.6 pounds, my BMI is 30.1; however, nobody would dare call me obese. In fact, whenever I tell someone my weight, only the other people in the weight room can see how I weigh this much. Despite my BMI of 30.1, my body fat percentage is 17%, which is within the healthy range for a male my age (18 years → healthy body fat percentage = 10% to 19%).

              As far as your triglycerides are concerned, from what I’ve read, carbs increase your triglycerides long term, while fats only raise your triglycerides after a meal. I don’t know if it is limited to refined carbs or includes all carbs, but that is what I have read about it. However, since a diet low in fats is listed as a cause of low triglycerides, the articles are probably just trying to say that dietary fat will not give you high triglycerides, so you might be able to get up to a healthy level by consuming a diet high in healthy fats. In fact, while my total cholesterol value is dangerously low, my triglycerides value is just within the healthy range — at 51 mg/dL (compared to a healthy range of 50 mg/dL to 149 mg/dL) — and my diet is on average 34% fat. Further, the only thing that ever makes my body fat percentage exceed the 19% limit is sleep deprivation in and of itself. My body fat percentage cycles between underweight status (sometimes severe) and the maximum healthy body fat percentage, but never exceeds the maximum percentage except when I am sleep deprived.

              How to raise your LDL-cholesterol to the healthy range? Unfortunately, I cannot say. I have no idea how to raise LDL-cholesterol or total cholesterol to the healthy range.

              If you are fine with the risk of malabsorption of fat soluble vitamins, which can result in malnutrition, or even poor energy output (as triglycerides are responsible for extra energy when needed), then don’t worry about your low triglyceride level. If you are not fine with these risks, then try to increase your triglycerides to the healthy range. If you are fine with a 15.7-fold increase in cancer risk as well as an increased risk of fever, sepsis, trauma, hemorrhagic stroke, respiratory and infectious diseases, depression, anxiety, impulsivity, and aggression, then don’t worry about your low LDL-cholesterol level. If you are not fine with these risks, then find out how to increase your LDL-cholesterol to the healthy range of 70 mg/dL to 99 mg/dL. Unfortunately, I do not know how to raise the LDL-cholesterol level, so I can not help you on that.

              • Richard Houlton says

                Appreciate your long considered response. But what we have here is doctors looking at my high “total cholesterol” and leaping to the conclusion that I should be on statins, when what you are saying that my (healthy) fat intake may not be high enough!!! So they are trying to medicate me for a problem that I probably don’t have with a mediation that has known (and nasty)side-effects,,,and people wonder why we don’t take everything the medical profession say seriously.

                Oh….and I’m 55 years old and I’m well aware about how misleading BMI is as an obesity indicator. I do quite like having a 6 pack at 55 though :-)

              • John says

                It’s good that you aren’t taking the statins. Stay with your doctor and don’t go to the other doctors who are trying to recommend statins; you don’t need a doctor lecturing you that “you are going to have a heart attack if you don’t take this (harmful and unnecessary) medicine,” especially since you obviously have barely any risk of heart disease. I’ve read articles about those cholesterol lowering drugs and they are so dangerous it’s scary. Cholesterol is actually not the enemy at all; the only reason high cholesterol can be linked to heart disease is because your liver deposits cholesterol into your blood to heal the inflammation that can cause heart disease (although your liver does the same to try to heal other problems as well). So you can see why it can cause problems when your liver does not put out enough cholesterol (resulting in low cholesterol) and only indicative of potential problems if your liver puts out a lot of cholesterol (resulting in high cholesterol); although it could be as simple as an injury or something — not necessarily heart disease. However, the health experts like to blame cholesterol for the heart attacks that are unsuccessfully prevented by cholesterol (as the inflammation obviously adds up faster than the cholesterol can heal it), so they prescribe drugs to eliminate the cholesterol rather than addressing the root of the problem — talk about scary!

                Overall, I don’t think you should worry about heart disease. Aside from your total cholesterol, your only cholesterol value that is excessive is your HDL (as HDL supposedly does not protect against heart disease anymore once it reaches 90 mg/dL); however, as long as you keep exercising and limit added sugar, hydrogenated fats, and processed foods, the chances of you having heart disease are very slim. The only cholesterol values you currently need to worry about are your triglycerides and LDL-cholesterol — and those need to be higher to prevent other health problems as I have mentioned before that are risks of low triglycerides and low LDL-cholesterol.

                Concerning healthy fats, don’t fall for the myth that saturated fat is unhealthy — that myth has been busted in many articles, such as the article above and even this one: http://www.eatnakednow.com/cooknaked/2011/09/22/the-skinny-on-saturated-fat-six-important-roles-for-this-maligned-nutrient/ . It’s trans fat that you need to watch out for — specifically factory-processed, or hydrogenated, trans fat. Anything with the term “hydrogenated,” “fractionated oils,” “shortening,” or “lard” anywhere in the ingredients is a red flag. These are all different ways of saying that a product contains hydrogenated ingredients.

                Where the body fat percentage is concerned, if you’d rather stay at your current body fat percentage, just realize that it is below the healthy range and will be severely low once you turn 60. However, if you ever start experiencing health problems as a result of having a body fat percentage too low, you might want to consider getting up to 11% body fat, or 13% if you experience health problems due to a low body fat percentage after your 60th birthday.

              • John says

                Richard Houlton — I found out first-hand that fruit juice may be able to raise your triglycerides. Based on my results, it seems that you can get your triglycerides up to the optimal range if you consume 12 ounces of fruit juice per day for 13 to 28 days. Do not continue this for more than 44 days, however, or you may end up with elevated triglycerides. Keep in mind that as you raise your triglycerides, you may reduce your HDL-cholesterol; however, in your current situation that is not a problem as it would probably take 43 days to even get your HDL-cholesterol below 200 this way (assuming your body responds the same as my body did to fruit juice — in my case — 100% pure orange juice), so you will still be well above average for HDL-cholesterol.

  21. says

    Hi to all from down under – Australia.
    After decades of healthy eating (I thought) and staying as fit as possible I started my Paleo journey for amazing results and still improving. This article however is music to my ears I have had an elevated cholesterol for many years which has been managed with statins.
    I hope with a Paleo lifestyle I can change that.

  22. John says

    Can saturated fat and dietary cholesterol help to raise cholesterol levels if you already have a total cholesterol below the minimum healthy amount? If not, what would you recommend for people like me who have low cholesterol?

    • John says

      My guess is that since heart disease is a result of inflammation and not cholesterol, those people were able to reverse their angina symptoms and unblock their coronary arteries because they ate less added sugar, less hydrogenated fat (e.g. trans fat), and less processed foods.

      • Mary says

        It’s a good thought, John. A good guess. Except it doesn’t play out in reality. People’s arteries do clear a little if they lose weight – by any means, but if it’s a high fat diet, all studies show that they plateau within a year, weight begins to slowly increase while sticking to their low processed food but high fat and protein diet, and cholesterol then rises rapidly as do arterial problems. These doctors reversing heart disease find cutting sugar and reducing processed foods (ie. trans fats) simply comes no where near close enough to do the trick. It simply doesn’t work. It’s not my opinion – the research just shows that approach is not even in the ball park for reducing heart disease – even though it is a good start towards better habits. I wish that was all it took, but it isn’t.

        • John says

          Are you trying to tell me that high amounts of added sugar and trans fat are not bad for you? Also, do the studies you quote break down the fat mass and lean mass changes, or just total weight change? It is possible that there is a calorie surplus after the plateau that goes as lean mass and not fat. I know from my personal experience that while I eat a lot of fat, there have been times when I have gained a significant amount of weight while losing fat, whether I exercised or not.

          When people go on high fat diets, they need to be careful that very little of that fat is hydrogenated fat. Those people who got arterial problems on a high fat diet were probably eating a lot of hydrogenated fat. And also, people who eat plant based diets usually don’t eat a lot of processed foods. I have never heard of processed fruits or vegetables (with the exception of fries, which come from potatoes – a vegetable) — or any kind of plant based diet that was highly processed for that matter. I’m guessing that added sugars and natural sugars (such as the sugar in fruits) are not the same as far as heart disease risk is concerned. Even my health science professor has said that it is not. Hence the fact that I said that they ate less added sugars — not sugars in general — and that is why they were able to reverse their angina symptoms. For example, both apples and pepsi are high in sugar — apples have 84% of their calories from sugar, and pepsi has 100% of its calories from sugar. Although these are both well above the recommended 25% maximum, I’m sure we can all agree that the natural sugars in apples are much better for you than the added sugars in pepsi. If added sugars are not bad for you, then there is literally nothing else wrong with soda and we can all drink as much soda as we please and not have any resulting health problems.

        • Lynne says

          Hi Mary, I have no idea what my heart attack risk is, all I can say is that starting a paleo (no grains/sugar)/hi natural sat fat diet resulted in me losing 28lbs-a pound a day for a month then my weight stabilized at 7stone-the weight that I had always been in my twenties. I hadn’t really considered myself overweight and others considered me thin (just dressed to hide the lack of waist )I had just put weight on around the waist with age.
          2yrs later still on paleo/hsat fat/no grain/sugar diet I couldnt put weight on eating this way, if I wanted to.
          So just wanted to refute at least in my case that the ‘weight begins to slowly increase and then cholesterol rises rapidly.’
          From what I have studied it seems to be the industrial seed oils (the PUFA’s) that we have been conned into consuming since the 1970’s that are unstable out of but also in our bodies, causing free radical damage, having an inflammatory effect and displacing cholesterol in our cells causing lack of function. And that even 4years after deliberately not consuming PUFA’s other than what occurs naturally within food our cells will still be releasing PUFA’s causing an inflammatory process within the body.
          We know that it is oxidised LDL and inflammation that promotes plaque formation and one form of heart disease.
          Our cells need cholesterol it is vital, we make it in order to function, including LDL – if LDL hangs around in the blood stream long enough to be oxidised it is not the fault of LDL but lack of correct system function. LDL needs to deposit cholesterol into the cell by docking with receptors, too few receptors (in part thyroid misfunction) = LDL left hanging around to be oxidised.
          Infection = LDL required to neutralise pathogens so may be prioritised to remain in the blood stream. Not the fault of LDL, the fault of chronic infection.
          Seems to me we should not be worried about cholesterol numbers, a recent obsession but do our best to remain or become healthy by following a healthy lifestyle including eating natural foods from healthily raised animals and plants.
          See Chris Masterjohn’s analysis of cholesterol and heart disease.

    • Thomas Bihn says

      This is a great way to not have too many people at once eat healthy Paleo-style diet because it is pretty misinformed. For one, paleo is not generally a high protein diet. All the recommendations I’ve seen suggest to have extra vegetables and not to limit the serving sizes. Second, dairy is off limits for strict paleo. Third, unless they break down the meat eaters to those eating grass fed, pastured animals and animal products, it is very difficult to correlate the results to a paleo template. Why? Because generally people that eat a standard diet are not as concerned about their health. They don’t eat enough vegetables, consume too much sugar, and consume too many processed meats.

      People that eat paleo tend to consume low animal protein (10% or less of calories). In fact, keto dieters are probably in this group because it is higher fat. People on paleo tend to do a better job of managing stress and exercising regularly as well – something someone eating a standard diet is less likely to follow.

      Finally, this particular thread is concerning cholesterol and CVD and not cancer. Nice try at trolling.

      • Thomas Bihn says

        Typing on my phone and not reviewing…sorry about that confusion on serving size wording. The word ‘not’ shouldn’t be in the part about limiting serving size on meat.

  23. Becca says

    Myth #1: Eating cholesterol and saturated fat raises cholesterol levels in the blood.
    Isn’t it possible that some people do raise their cholesterol levels by what they eat? For example. I had lower (meaning slightly over dr. recommendations) cholesterol before starting a GAPS/Paleo diet. Ever since I changed my eating, my cholesterol total and LDL (as well has HDL) has only increased.
    Another example is my mother. She tends to have “higher” cholesterol, but when she goes on a low cholesterol diet, her lipid levels drop.
    It seems to me that in least some people (like our family) what eat really does have an affect on our levels.

  24. jonathon rempel says

    Wow. Thanks. So my big question is: Does this mean that arterial plaque and arterial sclerosis are not caused by cholesterol too? (Because I’m really missing bacon right now!) :)

  25. Justin Olson says

    Okay, I’m really tired of the run-around. How much cholesterol and saturated fat is safe or good for the body daily? I eat anywhere between 1-4 tablespoons of coconut oil; and 4-6 eggs daily? Organic, wild harvested, and natural foods are the answer to a nutrient dense diet.

  26. sue w says

    Hi all. I have familial hypercholesterolemia. Both parents and 4 siblings. All are in great shape. All are on lipitor. All have a super reaction to the lipitor of Cholesterol going from above 300 to mid 100 with only 5 or 10mg of lipitor/day.
    All of us want to free ourselves of stain usage, especially since there is quite a bit of dementia and alizimers in our family.
    I have agreed to be the ginny pig. I am 55, weigh 135, low body fat, exercise often. I am one year Paleo. My Cholesterol is 323, Tri 76, HDL 73 and LDL 234. My entire family has cholesterol above 300 when not on statins.
    I like my ratio between HDL and Trig but obviously the LDL is scary.
    My primary dr is ok with thought that I have the lg fluffy LDL. My cardiologist (very old school) is pushing hard for the statins again.
    Thoughts?

    • Onur says

      Your cholesterol numbers are just a small bit higher than my mom’s numbers after 6 months after stopping using lipitor. Her cholesterol numbers were all normal before a part of her left thyroid was taken. Thyroid hormonal activity regulates ldl-receptor activity and her free T3 and free T4 levels were just above the lower end of normal ranges, so I think we will increase her levothyroxine dose from 100 mcg to 125 mcg a day for now. Chris Masterjohn is generally the one to follow and I do not know anyone else that can give more info about it.

  27. Richard Houlton says

    Do people with Familial Hypercholesterolemia necessarily have poor LDL/HDL ratios? What role does the LDL/HDL ratio have here?

    I have a 7.1mmol/l (274mg/dl) reading, but my LDL/HDL ratio is usually around 3.2-3.4. Nothing I seem to do with diet (I’ve even tried 6 months on a virtually zero fat diet) seems to have much of an impact on my cholesterol reading…or my my ratio.

  28. Mike says

    Hi, i have a question which I hope you will be able to answer for me.
    My Cholesterol readings have increased from 175 to 250 in 6 months. I have serious back problems and take Tramadol for pain and quite a few natural remedies. Could any of this have caused this problem. My diet has not changed a great deal. My age is 59.
    Thank you
    Mike Zelley

    • Robert says

      I’ve heard of statins causing muscle pain but never have I encountered any information that would link pain medication to increases in cholesterol. Maybe your body is trying to tell you that its time to decrease the fat in your diet because it can’t metabolise it like it has in the past.

  29. Jorge Yau says

    … then, ¿what’s the cause for cardiovascular disease?, I just had a open heart bypass surgery. I don’t smoke, drink and
    140 pounds. Thanks
    JEY

  30. Adam says

    The amount of confusion here is extremely discouraging. Let me set some things straight:

    First, eggs. Eggs should not be consumed for their choline. I have no idea where Chris got his “90% of people are choline deficient” line, because it is completely untrue. (the referenced study doesn’t support this) The recommended daily choline intake is around 420 mg, while the average westerner gets around 1,100 mg, more than double what is required. Men in the highest quintile of choline intake were shown to have a 70% increased risk of lethal prostate cancer.
    http://www.ncbi.nlm.nih.gov/pubmed/22952174

    What foods are highest in choline? Eggs, fish, chicken and turkey.

    The quote by Ancel Keys says it all: “Adding cholesterol to a cholesterol-free diet raises the blood level in humans, but when added to an unrestricted diet, it has a minimal effect.”

    The reason these cholesterol and saturated fat studies find no association is that the control groups they are comparing to do not actually have ideal levels of fat/cholesterol. Try studying the health effects of cigars by giving some to one group of smokers, and then compare that to another group of smokers – you won’t find a difference, but this doesn’t mean cigars are healthy. Similarly with saturated fat, many studies consider 30% of calories from fat to be a low-fat control group, which is patently absurd. When I look at these types of studies, I can predict their conclusions just by looking at their methods sections.

    The Paleo supporters take all of these studies and throw them around as if they are gold when in fact, any researcher in the field knows about all of these issues. Just ask David Spence, the head of the Atherosclerosis and Stroke Research Centre in Canada.
    http://www.ncbi.nlm.nih.gov/pubmed/21076725

    Of course, any time a solid meta-analysis comes out vilifying saturated fat or cholesterol, Paleo people are quick to point out any flaw they possibly can about observational studies.

    Many of the people on here are posting dangerously high cholesterol levels. It is very sad that high saturated fat sources like bacon and eggs are being promoted here – this is going to harm a lot of people, whether they believe it or not.

    I love eating meat, butter, and eggs as much as the next guy, but the bulk of the evidence doesn’t lie, and no amount of quoting flawed studies will change that.

    • Rob says

      Agree completely. I predict many here posting these high numbers will, unless they change their thinking, will be candidates for CVD events over the next 15 years or so. The preponderance of evidence does not support a diet high in saturated fat.

      • Richard Houlton says

        As stated earlier, I’m a 55 year old male with an 7.1mmol/l (274mg/dl) reading. My ratio is about 3.4 so I’m equally high on HDL & LDL. My Trigylcerides are 0.1mmol/l (8mg/dl). I am 180cm (5’11″), weigh 68kgs (150lbs), have 9% bodyfat. I exercise very regularly. Eat a very normal…but low GI…diet. My BP is 95/45. My resting pulse is 48bpm. I have no family history of heart attacks, hypertension or strokes. My still very fit and active 85 year old mother was diagnosed with similar levels 40 years ago and has never taken a statin in her life. Are you suggesting I’m about to have a heart attack?

        • Rob says

          My wife’s aunt Hilda smoked well into her 70s but lived to 99. I wouldn’t recommend people smoke nor would I recommend a high fat diet to anyone. Especially someone with numbers like yours. Your situation is irrelevant to everyone but yourself. Please remember that!

          • Richard Houlton says

            I tried a virtually no-fat diet and it barely made any difference to my readings (perhaps a 5% drop) and little difference to my (already low) body fat composition. After eating tasteless food for 6 months for almost no effect, I decided there and then to completely ignore my cholesterol readings, go back to eating a normal healthy diet, going to the gym 4 days a week and running 2 mornings a week.

            My doctor says that he’d like my readings to be lower, but that he is more concerned about all of his other 50+ patients having a heart attack than me, and he feels that putting me on statins, in view of no other discernable risk factors, would be a mistake. I am happy to take his advice.

            • Rob says

              YMMV. A low fat vegetarian diet dropped my TC from 6.12mmol/L to 4.81mmol/L – a drop of 21.4%. Who knows what a low fat vegan diet would have done. I also find it easier to maintain a healthy weight with a lower fat diet.

              • Richard Houlton says

                I don’t have any problem maintaining a healthy weight….I never have. I’ve maintained a BMI of 21 all of my adult life.

                As for me becoming a vegan? LOL I’d rather have a heart attack.

              • Mary says

                Well done, Rob. A low fat vegan diet will rapidly get it below 3.8 mmol p/dl (150mg/dL). And that’s within 6 weeks. That’s in the field where no one ever has a heart event of any type.

      • Sarah says

        Okay Rob, I’ll bite; answer me this: – our physiology has NOT altered – at least not in a way that would suddenly cause previously healthy foods to become lethal – for 2.5 MILLION YEARS. Maybe you could enlighten the assembled masses to the reason you are now so sure the opposite to be true.

        Our diet has been primarily animal fat and meat all that time; IF saturated fat, eggs, red meat, etc., caused CVD then there’s one truism: – WE’D NOT BE HERE NOW! IF they did – which they don’t – then they’d have wiped out our species MILLENNIA ago.

        Disease is a result of turning our backs on our genetic dietary blueprint; we didn’t begin cultivating grains until after the last Ice Age – how on EARTH could our bodies adapt in such a short evolutionary period…?! Answer…? They didn’t. I like to think of obesity as a food intolerance; just like a coeliac eating bread, or someone who’s lactose-intolerant suffering gastric distress, obesity is the result of eating foods which disagree with our genetic makeup. The answer to obesity is no different to the answer to eliminating any other allergy or intolerance: – stop eating the foods which cause the problem and, in the case of obesity, that’s carbs.

        If people’s cholesterol is still too high, that’s got NOTHING WHATSOEVER to do with saturated fat; if they’ve not DRASTICALLY REDUCED their carb intake (this is something I CANNOT make my father understand; he’s on 80mg Lipitor and he read something about eating more fat to reduce CVD risk – so he now has BUTTER on his WHITE BAGUETTE at lunchtime, instead of Benecol or Flora Pro-Activ (these are margarines made with a blend of sunflower, vegetable and canola oils, with added plant stanols which have been “scientifically and clinically proven to DRAMATICALLY lower cholesterol”. On top of a thick layer of butter, he adds a thick layer of cheese (usually Cambozola or some kind of Brie). His cholesterol is STILL skyrocketing and it’s MY FAULT because I must have directed him to the article! I told him he can have the cheese, but he MUST lose the bread, because the carbs would ‘override’ any benefit the butter/chess would have. He doesn’t get it; I bought him Malcolm Kendrick’s ‘The Great Cholesterol Con’, but he refuses to read it (I thought that, because he’d not believe me, because I’ve no medical training, he might heed the words of a well-respected GP. Evidently, I was wrong…).

        Finally, there was a study conducted on the Inuit, a tribe who eat virtually NO vegetation at all; they also don’t suffer from CVD – or any Western diseases for that matter. A group were taken from the High Arctic and moved to Fairbanks where they were forced to adopt a LFHC Western diet. With a year ALL had developed the beginnings of CVD; they’d also lost muscle and gained fat.

        The fact is we CAN live perfectly healthily without eating ANY plant matter at all, but we CANNOT live healthily without animal foods; Campbell and McScrewball are blowing smoke rings (and, if you want proof that McScrewball’s ‘starchivorous’ (his word) approach is dangerously unhealthy, simply visit his website; he and Mark Sisson are of similar age – does McScrewball look healthy to you…?!

        He also killed Steve Jobs; Jobs had been a strict adherent to McScrewball’s ‘Starchivore Solution’ as long as it had been around. I’m of the firm belief – and I’m NOT the only one – that not only did Screwball’s diet KILL Jobs (he had him so brainwashed that Jobs refused to see real doctors; told him that his plan had been proven to cure cancer – of course it hadn’t) I believe it probably caused his cancer, too (Screwball published several ‘peer-reviewed’ studies which claimed to prove that a high intake of animal products caused ALL cancers (the ‘peers’ were Campbell and Ornish using pseudonyms).

        Campbell, Screwball and Ornish are DANGEROUS (particularly Campbell and Screwball because they claim to be real doctors).

        If people are ‘healthier’ after being brainwashed by those quacks, the reason is simple: – THEY WERE NO LONGER CONSUMING TRANS FATS; trans fats are a major contributor to CVD, saturated fat IS NOT.

        Jobs was 56 when he died, not all that old really, is it…? Are you SERIOUSLY going to sit there and tell me that adhering to a strict vegan diet made him HEALTHIER…?! That, had he been eating a LCHF diet he’d have gone at 46…?! Do me a FAVOUR! Screwball killed Steve Jobs. Long-term veganism is DANGEROUS; I know of several people who died in their 40s from the long-term complications of a vegan diet. Almost ALL our nutrition comes from animal foods, we’re no more designed to live on plants than a rabbit is to eat meat.

        If you want to be vegan because you believe you’re saving the planet, fine, just know that you’re doing so at the expense of you’re own health…

        • Minnesota fats. says

          guys its inflammation of the arteries we need to be concerned about. in any instance changing diet will affect 20% of total cholest- your body simply makes up the stuff that you deprive it of. Its more of a genetic predisposition. Would like to hear more from Chris on hypercholestoralemia with familial origin. I worry that I am downing fats like something out of a cartoon and am really risking my health … are the long term effects that safe for us that have inherited cv risk

        • PeterC says

          Sarah why do people who go on a plant based low fat diet reverse their angina and unblock their coronary arteries. just ask Bill Clinton

        • Jake says

          Sarah, you’re argument in the 2nd paragraph is completely illogical. Throughout evolution, people have been able to have multiple offspring by the time they’re in their 20’s, long before CVD would wipe them out. Today we are worried about living past 60, not 30.

          Also, you are definitely smarter than Steve Jobs for sure.

    • AT says

      where are the large studies following people on a strict low carb, high fat (moderate protein) diet? i’d like to see a large cohort study. until then, the jury is still out. and with that said, if something seems to be working for an individual they should stick to it, despite other’s interpretations.

  31. Rob says

    You guys are insane. The cholesterol numbers I see people posting here are dangerously high! And you still believe that your high fat intake isn’t responsible? Hard to believe anyone is that oblivious to what is staring you in the face. I can see many of you having a cardiac event over the next 10-15 years. Hope you can come to your senses before its too late.

    • Thomas Bihn says

      Rob, I highly recommend you check out a copy of The Great Cholesterol Myth and watch the aforementioned episode of catalyst. Also check out the Hunt2 study. Since being enlightened by that book, my life has changed remarkably. I started out by cutting out sugar, flour, and processed lunch meat from my diet and immediately discontinuing use of statins.

      3 months in, my triglycerides, a measure of fat in your blood, were already down to 118 from 245. My HDL even was up from 32 to 39. Total cholesterol was relatively unchanged and LDL was down. In November, 9 months after changing my lifestyle to what amounted to a LCHF paleo approach, my HDL was 72 and my triglycerides were down to 45. The ratio of trig to HDL is an important marker of inflammation, which is the root cause of heart disease, not the LDL that is present to help fight the inflammation. My CRP was measured at 0.27, my LDL pattern was A and I was shown to be insulin sensitive.

      One reason the numbers were so good was the fact that my weight loss had finally leveled off. If someone is reading this that is still losing fat, don’t freak out if your numbers aren’t where you’d like just yet. As your body releases those stored fat cells, with all their stored toxins, your numbers will be off.

      I digress… The group that has kept lowering what the LDL recommendation should be has always been heavily influenced by the pharmaceutical industry with generally bad correlation science. They never could actually prove that high cholesterol was the source of cvd.

      When my doctor listened to my heart and saw the numbers, he said, “usually my patients don’t get healthier as they age. What you are doing is clearly working. See you in a year.”

      Because of this change in diet, I no longer need any bp meds to keep my bp normal and my resting heart rate is around 47.

      My LDL-C level? 143, total cholesterol at 224.

      LDL is, contrary to popular sentiment, good cholesterol in the absence of oxidative stress and is essential for the production of vitamin D and hormones. If too low, you won’t live long. One final note: only half of those suffering heart attacks have high cholesterol. So anyone can really say regarding the people that report “dangerously high” cholesterol levels is that they have a 50/50 chance of experiencing a heart attack. :)

  32. Hollis says

    I’m 34 year old male. Fit, strong and still exercise and get my workouts around the hobby farm and coaching. Yet by standard BMI protocols, I’m considered obese at 5’9 and 220lbs! I’ve been very involved in strength training (and took up a career in coaching it) since I was 14. I grew up on 2% milk and for the last 6+ years have drank exclusively whole milk–and I believe I drink more than my fair share. Even with high milk/dairy consumption I am not congested, very rarely have a cold, have no known allergies. We raise egg laying hens and I eat on average 2-4 whole eggs a day. I’m not a soda drinker but do selectively eat grains and bread. I haven’t had blood work done since playing college soccer but I’d be interested to see where I’m at. I still play soccer and workout and I know I never feel I have as much energy as I do on game day as when I consume quality bacon 6-24 hours before competition! Eating bacon seems to feel like my super power :).
    Thanks for the research and the article information, as well as the comments (I read just about each one).

  33. Richard Houlton says

    This is amazing – I too have a family history of high cholesterol. My healthy 85 year old mother was diagnosed in her 40’s with it.

    I’m a 55 year old male with an 7.1mmol/l (274mg/dl) reading. My ratio is about 3.4 so I’m equally high on HDL & LDL. My Trigylcerides are almost zero they are so low 0.1mmol/l (8mg/dl). I am 180cm (5’11”), weigh 68kgs (150lbs), have 9% bodyfat. I exercise very regularly. Eat a very normal…but low GI…diet. I have a BP of 95/45. A resting pulse of 48bpm. No family history of heart attacks, hypertension or strokes. But I have been advised by two GP’s (who I’ve ignored on the advise of a 3rd GP), that I should be on statins…and have been required to provide “further evidence” on a life insurance policy application that I wasn’t about to drop dead.

    Fortunately I now have a sensible GP who has told me that my previous GP’s were barking mad and that I was, by far, the fittest 55yo patient he had. He said he was 100 times more concerned about some of his patients with half my cholesterol readings. Go figure.

  34. Calvin Burton says

    I have a family history of high cholesterol, but REALLY don’t want to take statins, which is what my doctor is recommending. I have been eating a mostly paleo diet the last year or two and my most recent results are as follows:

    VAP – Pattern A
    LDL – 250
    HDL – 62
    Trigylcerides – 46

    My doctor didn’t test for LDL-P.

    Any advice?

    • John says

      Read the following article from beginning to end and you will see why you should not take cholesterol lowering drugs:

      http://www.huffingtonpost.com/dr-mercola/the-cholesterol-myth-that_b_676817.html

      Also, note that while your LDL-cholesterol is very high (healthy range = 70 mg/dL to 99 mg/dL) and your HDL-cholesterol is within the optimal range (healthy = 40 mg/dL to 89 mg/dL; optimal = 60 mg/dL to 89 mg/dL), your triglycerides are a little low (healthy range = 50 mg/dL to 149 mg/dL), so you should try to get your triglycerides up a little to prevent malabsorption of fat soluble vitamins and poor energy output. I recommend that you consume a diet rich in healthy fats (saturated fat counts as healthy fat — believe it or not, you actually need saturated fat) and limit added sugars, hydrogenated fats, and processed foods.

  35. Mary says

    Sorry, but I don’t see how this article shows at all that saturated fat does not raise cholesterol and the Ancel Keys quote was not saying it doesn’t. What his quote says is that if a person’s diet is ALREADY high in saturated fat and already has high cholesterol, adding more to that same diet does not make much difference. However, if person eats a diet with minimal if any fat in it (and has the corresponding low cholesterol), adding saturated fat makes a heck of a difference. That is what many of the respondants to this blog have found – they are a ‘lower fat’ diet, then went Paleo, and their cholesterol shot sky high.

    How anyone these days can say that high fat diets (all fats) and high cholesterol that results from them is not related to heart disease, when for many decades, Drs Esselstyn, McDougall, Ornish and a growing host of others have been removing ALL fat from their heart-ill patient’s diets, dropping their cholesterol rapidly over a matter of weeks, and removing angina, clearing blocked arteries, giving patients put on ‘death row’ after failed by-passes and stents their lives back, beats me. It’s so clear, and is extremely well-documented. All fat is implicated in heart disease and the removal of it moves us away from the brink. This is what Keys found and it is what works in practice. It’s not a ‘familial problem’ – it’s a human problem.

    • RT says

      You cant ‘clear’ blocked arteries . Plaque build up in arteries is permanent and there are no studies to suggest regression is possible through dietary modification. What about essential fatty acids do we not need those? Think you might be referring to trans fats as opposed to saturated?

      • Mary says

        RT, I am not sure where you have been, but for over 30 years, doctors have been removing plaque from coronary arteries (and all the vascular system) using diet. It’s been shown over and over by angiograms, the disappearance of angina, and the end of erectile dysfunction (just another sign of artery blockage). Even losing weight removes plaque from arteries. And regaining it puts it on. Read the work of Dr Esselstyne for starters, then you can go from there. This is not a theory – it’s a well established fact; and a growing number of insurance companies now pay for dietary intervention for heart patients because it has been clearly proven to get these amazing results. Even those who have already had several bypasses can reverse and remove the plaque in their arteries. Esselstyne has people alive 20 years later in great health – and he’s only one of the doctors doing this so effectively. The body is an amazing self-healing organism, once it gets the right fuel into it.

      • PeterC says

        Sorry RT but you are misinformed. you can clear your arteries. In the following website i will give you Dr Esselstyn took angiograms of the same coronary artery in the same patient before and some time after implementing his program of a low fat plant based diet. the results are staggering, The angiogram clearly shows the coronary artery unblocking. Here is the web sit:
        http://www.heartattackproof.com/resolving_cade.htm

  36. zorba74 says

    I think Chris has been selective in his literature search. I am not sure why the most recent and updated Cochrane review on this topic is not mentioned here.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD002137.pub3/abstract;jsessionid=A71050B10BEB66F2912C337D107B7DDB.f02t02

    Main results

    “This updated review suggested that reducing saturated fat by reducing and/or modifying dietary fat reduced the risk of cardiovascular events by 14% (RR 0.86, 95% CI 0.77 to 0.96, 24 comparisons, 65,508 participants of whom 7% had a cardiovascular event, I2 50%). “-seems to contradict what is claimed in this article.

    • Thomas Bihn says

      Zorba,
      I was hoping that Chris or his staff would review this comments section and address this particular study, but it appears this is an after thought shortly after being published.

      I believe that this probably shows that saturated fat may increase risk, but due to the nature of the target, this can only show correlation and not causation. I would be interested to know the source and breakdown of the SFA in those that had an event for example. What other cofactors contributed, such as inflammation. While it is true that there were 14% less events in the group substituting SFA for some other form of fat, I would suspect that fat was likely sourced from a mainstream source, such as supermarket grain-fed, hormone and antibiotic filled, high omega6 food. In other words, there were most likely toxins that aren’t present in sustainable, humanely raised meats that increase the amount of inflammation in those subjects.

      What this tells me is that they need to further break down the examination of SFA and look at inflammatory ingredients in the foods used to acquire that self-reported SFA content.

      As a personal, completely anecdotal example, my inflammatory markers are almost nil while consuming copious amounts of coconut oil, mct oil, wild caught salmon, avocados, and grass fed butter. My lipid profile is even remarkable.

      • Zorba74 says

        That’s interesting. When a Cochrane study was inconclusive, it is quoted everywhere including here by Chris in support of their arguments. When it clearly shows a difference it is blamed on putative unproven factors.

        The quoted review in fact also states

        “Subgrouping suggested that this reduction in cardiovascular events was seen in studies of fat modification (not reduction – which related directly to the degree of effect on serum total and LDL cholesterol and triglycerides), of at least two years duration and in studies of men (not of women).”

        • Thomas Bihn says

          http://juvenon.com/jhj/vol4no09.htm

          There are several types of saturated fats. Additionally, since this study likely involved general population consuming typical grocery meat as the main way they modified their macros to increase saturated and reduce mono/poly, they likely introduced other toxins into their systems.

          I don’t disagree with the findings of the study or even find it sketchy. All I’m saying is that this is far from conclusive showing causation. Where I find the most logic is the fact that before the 20th century, the main type of fat used to cook with was animal fat, heavy in saturated fat. Heart disease and cancer were rare. After the introduction of sugary drinks, like Coca Cola and Pepsi, along with vegetable oils, there was an increase in CVD.

          When I look to troubleshoot an issue, I generally look to what changed. A study by the Cleveland Clinic last year found that TMAO was much more likely to be the factor in heart disease than the saturated fat. I believe that study needs to be expanded upon too for the same reasons. It does somewhat contradict this study in that saturated fat wasn’t the culprit. Perhaps this study is flawed in drawing a conclusion. After all, they didn’t just have the people eat pure fat over the course of any time and see what happened. No, they had them self-report what they ate and correlated the macros according to estimations.

          It very we’ll could be that the participants that experienced CVD episodes were consuming food containing more toxins to get those macros.

          These studies also tend to look at the effects of isolating one item, which is pretty much expected from a scientific study – make a change to one variable and see what happens. This is another case for further investigation. OK, now we know there is an increases risk for CVD in participants that had high saturated fat intake. Now let’s do a study where we keep that aspect and alter another variable. While at it, collect information on their gut microbes and particle size.

          I think these studies are great, but to say they are definitive is just foolish. I haven’t see one for or against that convinces me either way yet (which is probably why 11 months after stopping my statin use and changing my lifestyle that I’m still reading on it)

          I personally eat red meat – grass fed whenever possible – in moderation just in case. I do eat a lot of coconut oil, mct oil, and grass fed butter though. My hs-CRP came back at 0.27 and my cholesterol profile show no inflammation markers despite this. My total cholesterol isn’t especially high either. This reinforces my belief that a diet that favors a lot of vegetables and a moderate amount of meat from sustainable sources is working for me and making me healthier.

          • Thomas Bihn says

            I apologize for not proof reading what my iPad corrected…it makes the reply a little more difficult to read. :)

  37. Thomas Bihn says

    I recently found out about a study “Cutting down or changing the fat we eat may reduce our risk of heart disease” found at: http://summaries.cochrane.org/CD002137/cutting-down-or-changing-the-fat-we-eat-may-reduce-our-risk-of-heart-disease#sthash.gzBaFNlL.dpuf

    The methodology and details are restricted from the general public, but they find that there was a 14% increase in probability of having a cardiovascular event for those eating saturated fat over mono or polyunsaturated fat.

    I can think of a few potential reasons for this, but was wondering if you have reviewed this study and have any thoughts regarding it. For example, were those that died of a cardiovascular event consuming a high carbohydrate diet as well? Was it a primary event or did they have previous events – meaning they would’ve had pre-existing inflammation?

    Thanks!

  38. says

    Sept 2011
    HDL 40
    LDL 87
    TG 274.

    This is what happened when I started drinking full fat milk, eating butter, using cream on my cereal and eating lots of bacon

    9/18/2012:
    Total Cholesterol 177
    HDL 51 (very good)
    LDL 93 (very good)
    Triglyceride 163

  39. Julian Wong says

    Hey Chris, I have been following your Healthy Skeptic articles since 2011. My triglycerides have jumped (doubled to 350-450; total cholesterol stable at 250) as a result of not watching my (ie freely consuming) saturated fat intake of fats such as butter, fats on meat etc; I loved eggs and was consuming eggs containing good Omega 3 (seaweed feed). Consuming 3g of DHA from Nordic Naturals “DHA” each day and supplementing as well fresh salmon once a week helped my HDL marginally (43), with my LDL remaining stubbornly high (150). My daily breakfast of wholegrain oats and fresh ground flax seed also didn’t dent my bad cholesterol profile. During this period, I liberally consumed monosaturated fats such as extra virgin olive oil and avocados.

    About 9 months ago, I switched to Red Yeast Rice and Resveratrol; for the last 2 months, I increased the dose of Lovastin to 3g a day. I am happy to report that my triglycerides have dropped to 240, total cholesterol to 200-210, and HDL has jumped back to 43-50. My LDL also dropped to 110. I have completely stopped my intake of fish oil pills, salmon, and eggs. I still indulge in burgers, KFC, or fried food every now and then.

    My weight has been stable at 115-120 kg. I am 1.8 meters tall.

    • AT says

      It looks like that while you were consuming the higher levels of fats you were also consuming a decent amount of carbohydrates. That’s a BIG NO. If you’re going to go high fat, you really need to go low(er) carb.

  40. says

    I take in next to no sugar per se, but I still enjoy sweet treats in moderation. I use xylitol, stevia, and raw honey. I eat eggs, butter, cheese and drink whole milk – again, in moderation. Plenty of vegetables cooked and raw, a bit of fruit (when I can find decent fruit, something of a challenge these days). I take a lot of supplements including 2 grams of niacin/day, which has cholesterol-lowering properties (though that’s not the reason I take it). I eat a lot of garlic and/or take a garlic extract, which also lowers cholesterol. Other items I take regularly which I think help keep me in balance: chia seeds, tahini. unflavored gelatin, Tulsi tea, apple cider vinegar, Lugol’s iodine.

    I do yoga (the Tibetan Five Rites of Rejuvenation) and lots of outdoor walking.
    Actually, my cholesterol levels have never been a concern. Just sharing what I feel has kept me healthy, active and youthful at 60+!

    • Rhett says

      Cmoretti,
      No sweets meaning no Stevia and the like, that stuff just doesnt taste right. I am strict with myself due to the fact I dont want to go back to the way I was. And the crap thats in our food these days is so addicting thats why so many people are huge.
      I like meat and fish and veges I do like my fruits to which I do eat but in moderation like blueberrys strawberries and Rasberries.
      I cannot eat wheat rice or any grain no corn etc it makes me ill. Bloated feeling and heartburn etc not worth it.

      • Rhett says

        And grain fed No i buy my meat from a grass fed only rancher half a beef at a time every 6 months or so, and grain fed fish nope I buy it none farmed or catch fish myself.

  41. Susan says

    Over the past eight months I have made three lifestyle changes. Near elimination of sugar, near elimination of grains and eating full fat yogurt, ghee, coconut oil, bacon, cream, 4% cottage cheese and full fat cheese. My total cholesterol went from 208 in a year to 237! LDL went from 87 to 126 and HDL went from 107 down to 98. My MD concurred that my lifestyle change with consumption of too much saturated fat has altered my cholesterol in a negative way and didn’t even mention meds, which was good. I have some fitness and diet goals in mind for the next year and have already begun implementation!

    • Rhett J Dudley says

      Susan id cut down your intake of dairy to much fat isnt good either and you want more protein in your diet. Another thing is you have to cut out sugar totally and grains do it and see what happens. Again saturated fat doesnt affect cholesterol if that was the case i would be at 400 LDL and not 126

      • cmoretti says

        Dairy has sugar in it, it is called lactose and breaks down in our bodies as galactose and glucose. If you are eating any grains, flour, wheat, or rice these turn into sugar in you body. If you have increased your intake of dairy that could be the culprit. Oh and lets not forget HFCS which is automatically turned into triglycerides in the body. Just one drink a day can have devastating effects. Could this be your “near elimination” of reducing to one store bought drink a day? I really thought I was eating a very low sugar diet until I got a list of all of the names for sugar and found that everything in my fridge was full of it including supposedly healthy dairy. Condiments were the worst. Most had the first three or four ingredients was sugar! Also keep in mind that if you are eating regular store bought beef and not grass fed you are getting the sugar from the grains that they are fed! Yep, ground beef with sugar, not as nature intended.

    • AT says

      how many carbs (g) were you at per day? the yogurt and cottage cheese could kick that up? also were you actively losing weight at the time? during the phase where fat is being shed, your numbers WILL go up.

  42. Fran says

    Hi Chris:

    I just Rhett’s post and I’m flabbergasted, because it sounds like me, except that I’m 40 y/rs older.10 wks ago I had labs that were high ldl, trig & total. My doctor suggested Lipitor, but I opted to drastically cut back on fats instead. 8 wks later new labs revealed higher trigs, ldl, & lower hdl. I’ve been at my wits end trying to figure out how this could be. I’m slim and I’m active. I do love candy and ate lots of fat free candy while cutting back fats! If sugar is a culprit, why don’t we hear about this? I love my carbs too. I would love to find a diet that would work. It sounds like Rhett found the key to his problem.

    • John says

      Why don’t we hear about sugar being a culprit? Well, we do to some extent, but fat gets more attention because the experts, study directors, and drug companies like to bury the truth so they can have doctors prescribe more of their (the drug companies’) drugs, making the drug companies gain millions or billions on the millions or billions they already have (sounds like greed to me).

      It works like this: the people performing the study test their hypothesis (in this case, how diet affects cholesterol levels, and how cholesterol affects heart disease risk). While there is a correlation (notice — correlation; not causation) between cholesterol and heart disease and overall mortality, they found that in almost every case, there was either no correlation between a dietary factor and cholesterol levels, or the correlation was the opposite of what they expected. So, they continue to play around with the data to find a link, and still find no link, or the opposite of what they are looking for. In response, they seal up the evidence, and report to the general public that the results proved their hypothesis right, or they just say that the evidence is meaningless and that the specific dietary modifications (that they found to be wrong) are still valid. To see an article about the specific study I am referring to (brace yourself; this may come as a bit of a surprise), go to http://www.proteinpower.com/drmike/cardiovascular-disease/framingham-follies/ . Yes, the Framingham study, which seems to be well quoted in defense of the diet-heart hypothesis, is the study I am referring to.

      Once the lies are out to the general public, doctors, schools, and universities preach low fat diets, low cholesterol diets, and all of the other lies that came from the studies. People take their advice — and guess what — up goes obesity rates; up goes high blood pressure, high cholesterol, and diabetes rates; up goes heart disease rates. As more people develop these conditions, doctors see more patients with these conditions and prescribe more drugs to these patients. As doctors prescribe more drugs, more people buy these drugs; as more people buy these drugs, more revenue is created for the drug companies; as more revenue is created for the drug companies, the drug companies make millions or billions on top of the millions or billions they already have, feeding their greed — and the vicious cycle goes on and on. Worse yet, once a person has had a heart attack, related procedure, or even chest pain, that person is permanently considered high risk even if that person has no other risk factors; and if that person’s doctor knows about it, that person may even be a lifetime statin patient.

  43. says

    I was on a diet of about 40%fat and 45%carb. The fat breakdown was about 15%SFA, 55%MUFA, 30%PUFA. No oils except Olive oil. The PUFA was mostly from walnuts. My Cholesterol was 130Total, 65LDL, 50HDL, 90TG.
    I changed it to 25%fat and 55%Carb. The fat breakdown was about 50%SFA, 30%MUFA, 20%PUFA. No oils except Olive oil. My Cholesterol was 180Total, 125LDL, 40HDL, 95TG.
    The SFA or Carbs did seem to raise my LDL and total, but I feel that it was needed. I am trying to bump my HDL back up to 45 or 50 to improve the ratio’s. Increase MUFA’s a bit?

    • AT says

      55% carbs? no way… too much if you’re kicking up the fat. and what type of carbs are we talking here? grains? sugar? vegetables/root/tubers? all of this will make a difference.

    • John says

      You’re right that it was needed — you raised your total cholesterol from severely low (<140 mg/dL) to healthy (160-199 mg/dL) and optimal (180-199 mg/dL). Congratulations.

      Your ratios do seem to have all gone from optimal to acceptable; however, I do not really know much about raising HDL-cholesterol. However, I can give you some tips that will reduce your heart disease risk regardless of your ratios.

      What you want to do is to first of all, aim for about 50%-55% of your calories from carbohydrates and about 15%-20% of your calories from protein. The remaining 25%-35% of your calories should come from fat. Remember that fat contains 9 calories per gram and carbohydrates and protein contain 4 calories per gram. Try to consume about 14 grams of fiber for every 1000 calories you consume and at least 7%-10% of your total calories from saturated fat (more won't hurt). Consume the recommended amount of each vitamin and mineral, and consume as little of your calories as possible from sugar (with the exception of the sugar in whole fruits and vegetables), processed foods, trans fats, and anything with the terms "hydrogenated," "fractionated," "lard," or "shortening" anywhere in the ingredients. Stay away from drugs and tobacco, and do not consume diet sodas or anything else with artificial sweeteners, as these are poison.

  44. says

    I have been on a low carb way of eating for over a year my cholesterol dropped the good went up the ldl went down. I am 44 years old a test every month isnt a good way to look at it more like 6 months per test gives better results. I did find when I was eating more sugar and refined garbage my ldl shot up and my hdl went down and triglycerides were off the chart.
    Now I eat meat, cheeses, eggs, alot of geeen vegetables and low in sugar fruits. My levels have all come way down and add in some exercise and they drop even lower. We have been lied to for years to eating all the grains which is just poisoning us all.

    • Rhett J Dudley says

      Hello,
      Its me again back to explain a few things, My doctor suggested a different route and to go on the Akins way of eating. To give you an idea of my diet I will explain how i eat, and my weight.
      I started at 294 pounds was eating alot of sugars, grains fruits and meats etc. But even when i cut out the saturated things as the so called experts say nothing was changing. My test results were quite bad my ldl for example was 293 and my hdl was in the 30s range.
      So I changed my diet to eating the akins way to get rid of certain foods from my diet. And dropped carbs out of my eating totally including caffeine.
      I am now at 235 pounds though I exercise daily my current diet is the following.
      Breakfast: Frittata which contains eggs, bacon, mushrooms, olive oil, 2 cheeses goat and Parmessan and peas.

      Lunch: Steak or hamburgers no bun with mustard or a sauce that has no sugar in it, and brocolli and or celery with a dip that also has no sugar in it or any wheat fillers.

      Dinner: Steak or Chicken and i dont cut off the fat or remove the skin off the chicken. and or Salmon.
      of course i drink a lot of water close to 3 litres a day sounds like a lot but its not.
      I am full of energy, I no longer crave corn or wheat or sugar or caffeine for that matter. My findings are based off my own tests and myself being the subject of those tests. I no longer Eat wheat in any way shape or form, no corn, and no sugar. And have my blood tested every 6 months. Occasionally a glass of red wine and some ice-cream but for special events. I am finding that all the nonsense on saturated fats is exaggerated nonsense based on no evidence of any kind. If that is the case i should of had a heart attack months ago, and my arteries should be clogged but far from it they are clean compared to when i was eating the carbs. way of eating for years my arteries had blockages and has since then cleared out.
      My LDL was 293 is now 126 after 2 years of changing the diet and dropping 60 pounds.
      My HDL was 10 and is now 40.
      So you tell me what is the cause of the raise and lowering of cholesterol because i have increased my intake of saturated fats and deleted my intake of carbs. My net carb intake daily is around 20 net carbs.

  45. Dan says

    Hi. I would like to say something what people do not know. Each individual is different. When any studies are done they really do not affect me at all. I never get sick from any flue. I am always healthy but I did a test once for about two weeks only. I came to the conclusion that if I were to eat for about 6,7,8 months lots of eggs and lots fat cheese, I would die of heart attack. That is all I have to say about cholesterol. This would be like suicide for my body.
    Dan

  46. Colin says

    I’m glad people are finally starting to wake up to this fact. Saturated fat was NEVER the enemy. Refined carbs, processed foods, and sugars are.

  47. pauleis says

    Hi Chris,

    Quoting from above”
    “This explains why well-designed cholesterol feeding studies (where they feed volunteers 2-4 eggs a day and measure their cholesterol) show that dietary cholesterol has very little impact on blood cholesterol levels in about 75% of the population. The remaining 25% of the population are referred to as “hyper-responders”. In this group, dietary cholesterol does modestly increase both LDL (“bad cholesterol” and HDL (“good cholesterol”), but it does not affect the ratio of LDL to HDL or increase the risk of heart disease. (2)”

    I just finished reading the High Cholesterol Action Program & found it very informative and well balanced between mainstream and alternative lipidology. However, I think that there was one topic that was not discussed (or did I miss it?) – that is the role of dietary cholesterol for hyper-responders and especially hyper-absorbers; and what further steps can be taken by hyper-absorbers (instead of Zetia).

    Also, everyone should check out this article by Dr. Thomas Dayspring entitled
    “Lipidaholics Anonymous Case 291: Can losing weight worsen lipids?”, in which he discusses in depth the “Paleo-Lipid” condition, (dramatic increases in TC, LDL-C, LDL-P, but everything else improves).

    http://www.lecturepad.org/index.php/lipidaholicsanaonymous/1140-lipidaholics-anonymous-case-291-can-losing-weight-worsen-lipids

    A quote from that article:

    “In many (including the patient being
    discussed) but certainly not all (the true incidence remains to be determined but
    experienced colleagues who have a lot of patients on low carb diets advise it is about 1/3
    of patients) despite all of the above biomarker and waist size and BMI improvements
    there is a drastic worsening of TC, LDL-C and most worrisome of all apoB and LDL-P”

    His conclusion is that saturated fat is responsible in those patients.

    Another quote:

    “Many of the low carbers and Paleo folks not only ingest increased saturated fat but also
    cholesterol (love their eggs and shellfish) – would one expect that to also contribute to
    the increased cholesterol levels seen in some? The answer is no:”

    so some discrepancy with your statement above concerning dietary cholesterol.

    Discussion from Chris or anyone would be appreciated.

  48. Cat says

    Hi, Chris. I landed on your site very randomly a while back while looking up coconut milk (fructose malabsorption). I’ve been back many times as I try to sort out the “healthiest” approach to diet. I’ve been intrigued by all the information you’ve presented and have been leaning toward the Personal Paleo Code. However, I’ve been doing a lot of research and recently found a review article about reducing oxidative stress. It was out of Slovenia, I think. Part of the sum-up was:

    “Avoiding calorie-dense refined sugars, ***saturated fats,*** and processed foods and replacing them with nutrient-dense but calorie-poor vegetables, fruits, and legumes will result in a vastly increased intake of health-enhancing phytonutrients, including key vitamins and minerals, antioxidants, flavonoids, and other still undiscovered compounds important for our cells to work properly.”

    I’ve been leaning more toward meats (not enough grass-fed yet — hard to find even in Portland, Ore.), full-fat homemade kefir/grass-fed butter, seafood, vegetables, fruits — and very little sugar, grains, etc. (Have IBS and low FODMAPs works wonders, even if my PCP had never heard of it!)

    However, the above lit review (http://www.hindawi.com/journals/oximed/2011/194586/) has me concerned that I’m super-oxidizing myself by consuming more saturated fats (and thinking about adding more). If you have any thoughts, I would truly appreciate them, as I’ve found Western medicine is not doing us any favors on the nutrition-front. Apologies for the long comment; I’m just hoping to clear up some things to assuage my lingering hangups that were ingrained in the ’80s (carbs, carbs, carbs, low-fat, etc.) Many thanks!

  49. Oda says

    I have known this since 2004 when I read an article in the Time Magazine titled “The Fire Within”…it is chronic inflammation that is the problem, not cholesterol…

    Some things never really added up, like some family members having a naturally high cholesterol level, yet lived long and healthy lives……cholesterol is also a very normal substance in the body. It merely tries to fix the damage the chronic inflammation cause in the blood vessels by patching the defect so the blood can continue to flow. If the inflammation is not addressed,. the damage continues and chronic inflammation comes from a diet too high in sugars and simple carbs. I find it amazing (and highly unethical) how the pharmaceutical industry has apparently misrepresented research data to cause such persistent myths to continue

  50. Melanie says

    I’m so interested in this. I was raised on don’t eat eggs, no saturated fats, no bacon and so on and so on. Thanks for the article. I’ll do some research on it now that I’ve read this article. It’s amazing how much bunk we may being fed, that the public really need to know about.

  51. Joel says

    It’s hard to adjust with the fact that cholesterol and saturated fat were not actually the enemies of our heart. With this fact, my diet lifestyle will definitely change but the consumption level will still be monitored.

  52. says

    This is a very informative article, Chris! Despite the fact that these matters are considered as myth, most people including me still afraid of eating food with cholesterol and saturated fat content. I think the problem with this study is the idea that it’s not advertised or disseminated to counter such myths.

  53. nomeatforme says

    Don’t eat cholesterol one day, eat it the next. I’m so sick of studies changing day-to-day on how we should eat. How about this – eat what makes you feel good? But if you eat animal products, get them from your local, humane farmer as animals shouldn’t be treated the way they currently are because people feel the need to continue to eat animal products.

    I always say to people, “We’ll see in the end who was right.”

  54. Leela says

    Hi Chris,

    I’ve been eating a diet that follows Weston A. Price and Body Ecology principles. I’m perplexed by my cholesterol numbers. My HDL has not increased and my LDL is higher (see below). Although my ratios are not too bad, I would still like to address the high LDL. Below I’ve also pasted in some old advice from the Weston A. Price website. Are there any newer suggestions for dealing with liver imbalance or oxidative stress that could be contributing to high LDL? It’s hard to find a local practitioner who doesn’t just tell me to cut out coconut oil and butter. Thank you!

    12/2011
    Total Chol: 170
    LDL: 101
    HDL: 59
    Trig: 49

    2/2013
    Total Chol: 209 (not fasting; taken in the evening after dinner)
    LDL: 135
    HDL: 54
    Trig: 100

    3/2013
    Total Chol: 277
    LDL: 221
    HDL: 56
    Trig: 72

    From the WAP website:
    Very high LDL levels often tell me there is oxidative stress or a liver imbalance in the patient. For this condition I give 1 capsule per day of OPC synergy, a food-based antioxidant, from Standard Process and 1 teaspoon/day of an herbal bitter tonic, the best being Globe Artichoke Extract from MediHerb. This intervention will usually lower the LDL by 10-20 percent.

    • says

      The Dec ’11 numbers looked great.
      The recent seems to not be so good. What did you do different? I would begin to document carefully any changes you make from this point forward. It will help to correlate a result to an input.

    • Mary says

      I’d be worried about those changes. The facts are that high LDL people have heart attacks while those lower than 150 do not. That suggestion from the WAPF website to take antioxidants is like the blind leading the blind. If people eat a lot more vegetables, they won’t need antioxidants. As cholesterol (combined with the LDLs) can no longer enter cells to be metabolised, either for steroid hormones or to be stored as fat, because the cells are too full of cholesterol already, it continues in the bloodstream where free radicals oxidise it (make it rancid). Antioxidants are sorely needed in the body to combat free radicals. Antioxidants come in plant foods – not at all in animal foods. A person eating a diet of predominantly plants will neither have high cholesterol nor low antioxidants. It’s staring us in the face – eat more plants and less animals. How many more people have to die of heart disease before we see that eating less animal foods and more plants is the simple answer? Even Weston A Price noted the health of the tribes that ate large amounts of plant foods and a small amount of animal foods. Don’t be fooled by short term drop of LDL while on a fat rich diet – LDL does drop usually as weight is lost – but then it tends skyrocket.

  55. Lynne says

    Hi Chris, Great article, waiting for the next installment. Will you be addressing fibrinogen levels in this series? How it gets raised and how best to lower? I think you recommend 200-300 and I have just discovered mine is 5.5 which I presume is 550. I asked for a clotting test as eat/drink lots ginger, herbal teas, take curcumin and had been worried that I may have a clotting problem. Clotting 29 secs but I got a shock when I saw the fibrinogen.

  56. says

    Chris, great insights as usual. I am a big Paleo fan and have increased my egg consumption accordingly. However, a recent article in the Natural Medicine Journal (noted below) reported that dietary intake of choline was linked to a 70% increased risk of prostate cancer death. The article also mentions beef and chicken. Interested in your thoughts regarding the findings. Personally, I have always recommended patients be more concerned about the sources of the foods they eat (i.e. organic, grass fed, open range…). Thank you again for your insights. They are shared regularly with our patients!

    http://www.naturalmedicinejournal.com/article_content.asp?article=411

    • Chris Kresser says

      I’ll address this soon, or Chris Masterjohn will. He’s more of an expert in choline metabolism than I am.

  57. Beth says

    Chris, will this post be picked up by the Huffington Post??? This is a subject that truly needs to get out into the mainstream more!

  58. Raphi says

    Always a pleasure to read your articles Chris,

    Would you say it is possible or even somewhat likely that a 23 year old male has a TC of 9.74mmol/L, TG 1.18mmol/L, HDL 1.51mmol/L, LDL 7.69mmol/L and ApoB 2.03g/L WITHOUT having Familial Hypercholesterolemia?

    • Rob says

      I personally know several people with cholesterol levels above 7mmol/L (One has a TC of 13mmoml/L). They all have Familial Hypercholesterolemia and are on statins because of it.

  59. Dan says

    Great article. Finally something I can pass something onto my dad – something the layman understands that also goes into the nuances of sub groups (hyper responders) within a population. Thanks

  60. says

    This is the awesome post! I have been telling people that weight loss is about knowing what to eat. Even junk food, people call, could help to lose weight if we know which one to eat. Well, the post like yours can help so many people to lose weight, Thanks for the great post!

  61. Frederik Ackermann says

    While I’m in no way opposed to your message you have not established that eating cholersterol or sat fat does not increase the risk of heart disease – as far as I can see (correct me if I am wrong) – you have established that eating cholesterol or sat fat does not contribute to a ‘worsening’ of biomarkes associated with risk of cardiovascular dieseases

    • Chris Kresser says

      The intention of this series is to debunk the diet-heart hypothesis. The diet-heart hypothesis states that saturated fat and cholesterol in the diet raise cholesterol levels in the blood, and that high cholesterol levels in the blood cause heart disease. In this article I showed that saturated fat and cholesterol do not (for most people) raise cholesterol levels in the blood. In the next article, I’ll show that high cholesterol is not the cause of heart disease (though it is associated with heart disease, and can be a proxy marker for LDL particles, which is the driving factor).

      The question of whether saturated fat causes heart disease via some mechanism that doesn’t involve serum cholesterol is not one I’m addressing in this series. That said, there are large, prospective studies with >300,000 participants that show no association between saturated fat and heart disease. Like this: http://www.ncbi.nlm.nih.gov/pubmed/20071648?dopt=AbstractPlus

      • Frederik Ackermann says

        That’s great – and in total concordance with what I wrote. I have a lot of respect for you and your work – and thanks for the link :)
        Yet it still stands that your penultimate sentence in the article: “We’ve now established that eating cholesterol and saturated fat does not increase the risk of heart disease for most people.”
        is incorrect – you have shown no such thing (unless I have misread something).
        Don’t take this as more than it is – I just thought that you would want to be called out, when you make somewhat overblown claims – everybody needs to be kept in check – even the best of us ;)

        • Chris Kresser says

          There’s never been strong evidence suggesting that eating cholesterol increases the risk of heart disease. Early studies did suggest that eating saturated fat increased the risk, but later, larger, better-designed studies (which I added to this article; see the paragraph beginning with “If you’re wondering…) have not shown an association. Therefore eating cholesterol and saturated fat does not increase the risk of heart disease for most people.

      • says

        It seems strange to me that many (at least 11 out of 24) of the studies included in that meta-analysis adjusted for total cholesterol, and a few even for “blood lipids” or LDL even (see Table 3). Saturated fat consumption causes changes in these things (at least in some people, and driven by this, on average), and these things on their own correlate adversely with heart disease at least in some studies. So “adjusting” for these (depending on how exactly they adjusted) may be inappropriate.

        This is a similar issue to the recently hotly debated issue of whether endurance exercise starts to have negative marginal returns to long-term health after a certain dosage (something like 2-3 hours a week and 8m/mile pace, on avg). Apparently, some of those studies “adjust” for bodyweight, and even blood lipids, both of which are generally positively causatively altered by the treatment variable being studied.

        I don’t know enough about how they are going about these adjustments, but if they are doing it naively (i.e. controlling for them), then this seems statistically invalid.

        Thoughts?

      • Jake says

        “We’ve now established that eating cholesterol and saturated fat does not increase cholesterol levels in the blood for most people.”
        “In this article I showed that saturated fat and cholesterol do not (for most people) raise cholesterol levels in the blood.”
        -This is just inaccurate. You did not show anything other than your interpretation of the data. There is research that shows otherwise: http://www.lipidworld.com/content/10/1/181
        Blood cholesterol certainly increases after eating a high fat/cholesterol meal. The body adjusts to produce less cholesterol and clear it from the blood, but if someone is eating high fat/cholesterol meals on a daily basis, they will have high levels of fat/cholesterol in the blood on a daily basis.
        I support some of the ideas of this article, but it has not shown what it claims to have shown.

        • Mary says

          So right, Jake. Eating lots of fat doesn’t affect people much who already have high cholesterol levels (over 150 mg/dl). Their blood is already milky with fat, in such a state of inflammation already, that the body can hardly respond further to even more fat intake. Since practically everyone on this site has cholesterol over that level, it appears, they are already in the danger of future heart events, according to The Framingham Study, our longest and most reliable heart study. However, if you get your cholesterol below 150 – easy if you are eating lots of vegetables and minimal animal foods (like a great many of the more traditional ‘masses’ over history) – then you can see that fat pushes cholesterol up a lot. The Framingham Study showed that no one who had cholesterol under 150 ever had any sort of heart event. It is our best indicator of risk. I’m not saying it is the CAUSE of heart disease – just a clear indicator.

          • Onur says

            Please check your knowledge on particle size subclasses, and particle numbers versus cholesterol numbers, and also remember that the meal included 15 ml of syrup, which must have increased the triglycerides.

          • John says

            “Eating lots of fat doesn’t affect people much who already have high cholesterol levels (over 150 mg/dl)”

            A cholesterol level over 150 mg/dL is not considered high. High cholesterol is considered to be a total cholesterol level of 240 mg/dL or higher; while 200 mg/dL to 239 mg/dL is considered borderline high. Less than 160 mg/dL is considered low, which is most certainly not healthy. Maybe a cholesterol level below 150 mg/dL does minimize heart disease risk; although there is still some risk of heart disease even with a cholesterol level below 150 mg/dL — and the risk of heart disease actually starts to increase slightly once TC falls below 140 mg/dL. However, the all-cause risk of death is lowest at a total cholesterol level of 180 mg/dL to 199 mg/dL and starts to significantly increase once TC falls below 160 mg/dL. To see the overall mortality risks associated with total cholesterol, go to http://thehealthycow.blogspot.com/2013/05/women-cholesterol-and-heart-disease.html and look at the first chart, which is based on the MRFIT study on cholesterol, which compared the mortality in 350,977 men ages 35-57. I don’t know about you, but I’d rather minimize my all-cause risk of dying rather than just my risk of dying of heart disease.

      • Rob says

        I guess I’m not most people then because saturated fat most definitely raises my LDL. I take fish oil (about 3g/day) so as a polyunsaturated I am assuming this has a lowering effect?

  62. says

    I don’t actually think there’s enough data here to have “established that eating cholesterol and saturated fat does not increase the risk of heart disease.”
    There’s enough to say that it seems unlikely, and that claims that dietary cholesterol and/or saturated fat will increase the risk of heart disease are unjustified.

        • John says

          How to decrease your chances of artery plaque: Limit added sugars, processed foods, and anything with the terms “hydrogenated,” “shortening,” “lard,” or “fractionated” anywhere in the ingredients. Also, achieve or maintain a healthy body fat percentage. You can calculate your body fat percentage and category at https://sites.google.com/site/calculateyourbmi/all-calculators/body-fat-percentage-excel_version . If you already know your body fat percentage, enter your age and gender into the calculator, then go to the “Goal Waist Size Calculator” tab and compare your body fat percentage with the ranges in the table at the top.

          To minimize your risk of having a heart attack or stroke from artery rupture, achieve or maintain a blood pressure below 120/80. However, do not go below 90/60, as that could cause other health risks related to low blood pressure.

          • Allen Bennett says

            John,

            I agree with three of the four terms, but not lard (and I’m Jewish!). Even if the fatty acids in it were mostly saturated, research finds that it still wouldn’t be bad. However, the plurality of fatty acids are monounsaturated, which are the same type that give olive oil its beneficial qualities. (I still feel that saturated fats are best for you, though).

  63. says

    Thank you so much for putting together this 3-part series Chris. This is exactly the information I’ve been sharing with friends and clients for years. Until now, it has been challenging to find a complete review of these topics that the average person could read and understand rather quickly. I have been sending people over to “The Daily Lipid” (which is a great site and information source) but the average consumer cannot easily understand the articles there without a strong background in nutrition and science. Looking forward to the next 2 posts, thanks again!

    • Chris Kresser says

      Thanks, Eric. That’s exactly the point of this series: a concise group of articles in language the layperson can understand. I’ve decided to add a fourth article, which will cover natural prevention of heart disease.

  64. says

    Thanks again for connecting the dots and trying to get the truth out. Came accross the following UK double blind study and all kinds of living anecdotal evidence, including my own in support of your reports this study astounded even me.
    As I understand it as little as 3 servings per week change to grass fed, for 1 month benefited the participants.
    Heart health ( long chain Omega 3’s benefiting blood, body and brain)—Study shows healthy improved blood results after one month of eating grass fattened beef compared to grain fattened–http://journals.cambridge.org/abstract_S0007114510003090

  65. says

    Chris – Some people may not realize that women present very differently with cardiac problems than do men. They have fewer and different symptoms which could be missed even by medical practitioners.
    Sheila

  66. says

    So grateful for anyone who writes about this subject! My blood boils whenever someone talks about being on a “low fat” diet. Much more education is needed. Keep up the great work, Chris!

  67. Evram says

    Hi Chris,

    Great blog. I have several autoimmune diseases including Crohn’s and eczema. I’ve been on the GAPS diet for about 8 months and also using LDN. It took me several months to realize that I was having a severe reaction to organic lard. I am unable to digest any fats; including lard, avocado, coconut oil, etc. I seem to fine with the fat that comes with beef, chicken and duck but only in small amounts. Is this a liver issue?

    Another issue that confuses me is that a few months ago I would be able to enjoy a nice rare steak. Now I am unable to eat any type of red meat unless it extremely well done – meaning absolutely no juices in it. If I don’t I begin to get severely itchy mouth and throat – verging on anaphylaxis. I haven’t been able to find any reference to such a reaction. Do you have any thoughts on it? It doesn’t matter if it is organic or not and also I have tested how fresh the meat is.

    Any help would be appreciated.

    Evram

  68. Heather says

    I can’t wait either. I’ve been Primal/Paleo – ish for the last couple of years – best thing I ever did (thank you Mark Sisson!). Even the healthiest version of the SAD was making me diabetic. Recently learned that while I have typical risk for TIID I have elevated risk markers centered around insulin production (2 diabetic immediate family members, too). But I got my cholesterol numbers for the first time. Total = 210; HDL = 51; Trigs = 45; LDL = 150 (Friedewald formula which won’t work for me – TGs are too low and miscalculates LDL. Iranian: LDL 116. My ratios are good – could even make them better if I was to go 100% strict. I eat hellacious amounts of fat, mostly saturated fat. My carbs are up and down and good and bad. I was completely shocked to learn that LDL isn’t even measured, it’s calculated. Here’s N=1 to eating lots of cholesterol and sat fat will not destroy your numbers. NEXT STEP: VAP test! Meanwhile I’ll be trying to find out why my TSH is 1.000 with everything else smack in the middle of the lab ranges (based on sick people). Thanks to you Chris, I have knowledge that it is probably due to some adrenal issues. I know me and that would make complete sense.

    • Heather says

      And thank you for a comment in an old post about directlabs.com. That is where I’m purchasing my tests.

      • Heather says

        I read that below 1.8 for TSH is out of the “functional” range while still in the lab range. I’m trying to figure out what that means.

        • Chris Kresser says

          It’s true that some people consider TSH lower than 1.8 to be abnormal, but I wouldn’t be concerned if your free T4 and free T4 are normal and you don’t have symptoms, unless your TSH is below 1.

    • Chris Kresser says

      Hold off on the VAP test. There’s a better test for determining your CVD risk. I’ll be discussing this in next Friday’s article.

    • Allen says

      Heather, You said you eat “hellacious” amounts of fat, mostly saturated. I’d like to do this, also–but I don’t want my wallet to yell at me! How do you do it?

      • Thomas Bihn says

        Hi Allen,

        The nutrient density in fat is a lot more than in carbs. When you eat a low carb high fat diet, your satiety increases and don’t find yourself going back for more. I personally am still surprised though how I can drink a bulletproof coffee in the morning and go until 1 or 2 before my body tells me it’s hungry, but on days I decide to have even bacon and eggs, I start thinking about lunch by 11 easily.

        I find by focusing on eating real foods, you tend to spend about the same in the end because you aren’t waiting as much food and you are not eating out nearly as often.

  69. says

    Great article, Chris! Great information.

    Busting this myth is important because, in regards to hearth health, it’s not just cholesterol and triglycerides, but inflammation that puts us at risk.

    What’s really killing us is our modern diet of excess sugars, refined carbohydrates, trans fats, vegetable oils, and excess omega 6 from grain-fed beef and fish — it’s killing us as individuals, and consequently the high cost of poor health is killing our competitiveness as a nation.

    One thing that’s often overlooked with saturated fats is the role of palmitic acid. Excessive palmitic acid has been shown to cause inflammation, increase insulin resistance, kill pancreatic beta cells responsible for the production of insulin, and neutralize leptin–the hormone that signals the brain to tell you when you’re full. And the kicker–when you overeat, the excess carbohydrates in your body get converted through lipogenesis into palmitic acid in your blood, which has the same effect as dietary palmitic acid — essentially giving you a double whammy of negative effects; and that’s the main reason why fast food is so bad for you.

    One thing most people aren’t aware of is that the word “napalm” was derived from its two key ingredients: naphthenic acid and palmitic acid.

    • Richard Patterson says

      I enjoy the new ideas in this post. I did not realize excess carbs turn to palmitic acid, although I wonder how one would estimate excess.

      • Kelvin says

        Yip!!!
        I agree. Met a Malaysian Man who said that Palm Oil is killing them!
        Massively produced and massively protected by Politicians and Taxes on healthy oils.

    • says

      Les, what you may be missing about palmitic acid is the following: when you eat it in your diet (fatty t-bone, etc), palmitic acid is always accompanied by oleic acid, which has been shown to be protective of any deleterious effect palmitic acid potentially has in isolation. However, when produced endogenously (via excessive carbohydrate ingestion), the potentially deleterious effects of palmitic acid that are produced remain unopposed (i.e. there is no oleic acid to offer protection). So, all of these untoward effects of palmitic acid could entirely be predicated on carbohydrates ingestion and not saturated fat intake.

  70. Cookie says

    Does it matter whether or not you’re ‘fat adapted’? I know folks who do not process fat correctly, myself included. And incidentally I feel horrible on a paleo style high-fat diet.

  71. Just me says

    Looking forward to your next article, as dietary cholesterol and/or saturated fat has indeed raised my total cholesterol levels from about 200 to 350, most of which is LDL – about 260.

      • RT says

        is it not more about inflammation of the arteries and other serious markers that we should be concerned about? Also on a high fat diet sugars and whole grains/ carbs will start driving your cholestoral through the roof? Is there enough evidence to suggest that Co Q 10 is important enough in the whole conundrum to negate the use of statins??

        • says

          Heres what you do if you want to experiment on yourself. If you suffer from HIgh cholesterol meaning your LDL and Triglycerides are high and your overweight and on the high carb kick like most of the USA.
          Switch off to a solid protein and veg diet. Or you can say way of eating cut out all veges that have high sugar content and also cut out ALL GRAINS!
          You have to have fats for the body to function properly low fat I have found to be bad for us in the areas of losing weight and staying fit. My cholesterol was high LdL and Triglycerides were high. I quit eating carbs and sugars and all grains cut out of my diet. Here are some changes my cholesterol normalized. My weight dropped 90 pounds. No more heartburn and indigestion, grains cause acid reflux more so then the excuse its over active acid in the gut. I was also told by my dr i must have high cholesterol because of my family has a history of it, thing is not true we only started to have a history of it when we started to over consume grains.

            • says

              Excess protein doesn’t damage the kidneys unless you have excess carbs attaching themselves to the overlarge protein molecule and pulling them through the kidneys. Much in the same way of having a high carb 3 to 1 ration of protein shake after a workout, the carbs will pull that protein into the muscle instead of letting it wander around and just being picked up.

            • Roy Walker says

              If you are afraid of saturated fats then eat other fatsmake sure you get lots of monounsaturated.

    • sue M says

      Hi all. I have familial hypercholesterolemia. Both parents and 4 siblings. All are in great shape. All are on lipitor. All have a super reaction to the lipitor of Cholesterol going from above 300 to mid 100 with only 5 or 10mg of lipitor/day.
      All of us want to free ourselves of stain usage, especially since there is quite a bit of dementia and alizimers in our family.
      I have agreed to be the ginny pig. I am one year Paleo. My Cholesterol is 323, Tri 76, HDL 73 and LDL 234. I like my ratio between HDL and Trig but obviously the LDL is scary.
      My primary dr is ok with thought that I have the lg fluffy LDL. My cardiologist (very old school) is pushing hard for the statins again.
      Thoughts?

      • Onur says

        Your cholesterol numbers are just a small bit higher than my mom’s numbers after 6 months after stopping using lipitor. Her cholesterol numbers were all normal before a part of her left thyroid was taken. Thyroid hormonal activity regulates ldl-receptor activity and her free T3 and free T4 levels were just above the lower end of normal ranges, so I think we will increase her levothyroxine dose from 100 mcg to 125 mcg a day for now. Chris Masterjohn is generally the one to follow and I do not know anyone else that can give more info about it.

  72. Susie says

    What about for apo E4? My cholesterol numbers seem to be greatly affected by a higher fat intake. I have also seen this to be true for my dad. He has always had perfect lipid numbers. I got him going on a low-carb, high-fat (a lot of coconut oil for Alzheimer’s) and his LDL shot through the roof.

    • Chris Kresser says

      As I mentioned, saturated fat and cholesterol do increase blood cholesterol in some people. The question is: does that matter? I’ll address that in the next article.

      • Bob says

        What is cholesterol? What is it you want it to do? What is it you think it will do?
        What test are you going to do to prove your theory?
        How will you interpret the results?
        Are you getting a result? Optimum health??
        If not was a waste of time. Cholesterol= heart disease is an assumption/ correlation. Not the study of cause and effect. In our company we find that it coincides with healing in detox- mercury/ bacterial infection when you start to balance the chemistry.

      • Susie says

        Chris,

        I believe it does matter because there are enough people on the various blogs who report increased LDL particle number with the higher fat diet. It seems that this IS what increases for some of us switching to Paleo. The rest of the numbers are good – the HDL is high, TG is low, inflammation markers are low, but the LDL particle number skyrockets. It seem to be too common to put it off to FH. I would be very interested in further information on this.

          • Susie says

            Sorry Pauleis, my responses that I intend for you keep going below Josh’s post – not sure what I am doing wrong. Anyway, thanks for the info. I did read your 22 June post and the link article.

        • says

          25% of the population are apoe3/4 and something like 10% are 4/4
          This will keep LDL in the blood longer. The gene was selected for in sub Saharan African nomads to keep circulating lipoproteins for longer when undergoing periods of fasting.
          On a modern paleo diet replete w nutrients it WILL raise LDL-P, however it matters not unless it becomes oxidized.
          If you are an apoe4 carrier your greatest concern is not LDL it is inflammatory markers/ oxLDL and fatty acid ratios

          • Susie says

            Not sure if this is true. I eat a low-inflammatory diet. My inflammatory markers are fine, not sure about ox LDL, but almost all of my LDLP are large, fluffy which should indicate low oxidation. After working this approach for about 3 years, I recently experienced a cardiac episode – mild heart attack and now I certainly have to reevaluate.

            • Renato Henrique says

              if the ldl particle size is safe, and you have a good ldl/hdl ratio, then you have nothing to worry about relating to cholesterol thats why i agree with this article. however that doesnt mean youre not at risk for CV because that can be caused by other things also

        • Markus says

          There are different kinds of LDL. Mainly large bouyant (associated with fat intake) and small dense (associated with fats your body produces from carns, especially fructose). LDL as a whole is a meaningless number.

      • Fathima says

        you said that saturated fat intake does increase blood- cholesterol levels in some people. is there a way to know whether it will or won’t? and also, how can one manage high LDL levels with a good diet, to avoid medication?

      • Richard says

        It might not matter much if they are moving from 190 to 230 but it matter if they are moving from 140 to 170.
        Many studies have shown no artery buildup of plaque when the cholesterol is below 150 and the LDL below 100.

        Your studies of people between 185 and 240 prove nothing but that there levels are too high.

        • John says

          You’re wrong.

          A total cholesterol level between 185 and 200 is not too high; that is actually about where the ideal is. Yes, a total cholesterol level of 200 or more is too high, with 200 to 239 being borderline high and 240+ being high; however, 160-199 is actually the healthy range, with 180-199 being ideal.

          Also, even people with total cholesterol levels below 150 are not exempt from heart disease. Take the MRFIT study for example, which compared the mortality rates in 350,977 men ages 35 to 57 at various cholesterol levels. As you can see here , there were cardiovascular deaths observed at all cholesterol values. Also, as you can see in the chart, while the lowest risk of heart disease is in the 140-159 range, the lowest all-cause risk of mortality is in the 180-199 range. I don’t know about you, but I would rather minimize all-cause risk of death than just risk of death from one specific cause, such as heart disease.

    • Carlos says

      The same happened to me. After one year doing paleo with intermitent fasting, bone broths and a good amount of coconut oil my total cholesterol reached 378 last month (TG: 52, HDL: 84). Now I’m totally confused. I find it’s way too high and maybe I should stop eating saturated fat.

      • Chris Kresser says

        Carlos: a total cholesterol this high is often indicative of familial hypercholesterolemia, which is a genetic condition that reduces the clearance of LDL particles from the blood. Please seek out help from a knowledgable health care practitioner, and yes, I think it would be wise for you to eat less saturated fat if you do have this condition.

        • Carlos says

          Thanks Chris, although I had never had these levels, it’s true that I have always been in the high range of the “normal” despite having a good diet, I don’t smoke and I’m skinny and active. My father doesn’t smoke either and also has a good diet but he has always been in the high range too. I’ll repeat my tests in 2 months. I’m eating less saturated fat, we will see. On the other side one thing I noticed clearly when I abandoned sugars and cereals is that my HDL went up and my TG went down. You are doing an excelent job.

          • Susan says

            Carlos, your numbers are very similar to mine. I have apo e4. I also have lp(a). I would be interested to hear how your numbers respond to your decrease in fat. I feel that we have a good laboratory here and I am learning from all of it.

        • Ralf says

          But surely Chris that is the crux of this whole article and the majority of people with Familial hypercholesterolemia will be the ones attracted to this diet in the first place. So basically what your saying is that the people that were going to have issues with inherited high cholesterol are the ones that should avoid this diet in the first place and the people that didn’t don’t need to worry as its not a significant marker in heart disease anyway.. Think you’ve defeated the whole point of this ( very good) article you’ve constructed?

        • Maguerite says

          Sorry doc, but NOPE. I and my family have the disease full on and I could NOT find another person with this disease who tried the diet anywhere in the world, so I did! and the more sat fats I eat the lower my cholesterol goes. I am 58. My total cholesterol for first time since birth came down from 13+ to 6.1. ON pill (which we now no longer can tolerate at all) it’s never ever gone lower than 8.8. So for me and mne, it’s goose, duck, butter, double cream, coconut oil, olive oil (the best on the market), lots of eggs lots of greens, the fattiest lamb and beef I can find (NO wheat products) here and there a hand full of berries. It’s easy for me. I eat head to tail but my doctor was ecstatic with my results. When i lower the fat, the numbers go up! THUS the secret is in the fat. I know this for sure. Have the proof! Cheers and thank you

          • Mary says

            Hi Maguerite,
            That sounds a risky step. Even 8.8 is way into the risk zone for heart events. The Framington study found over 30 years that no one with cholesterol under 3.8 (150mg/dL) ever had a heart event. Here’s a really interesting study showing how much coronary arteries clog over a year on a high protein high fat diet, compared with a high carb high vegetable diet from the British Journal of Nutrition just last year: http://www.ncbi.nlm.nih.gov/pubmed/22850317 Keeping your cholesterol high just isn’t safe in the long term. And the only way to bring it into a safe zone is to increase plant foods (at the expense of animal foods). There is no other clinically documented way to do it – other than severe weight loss…such as if you had tuberculosis, or chemotherapy or a cocaine habit. Those things also lower cholesterol heaps – but I don’t think we’d want to recommend them. Rejoicing at having 8.8 or 6.1 cholesterol instead of 13+ is kind of like rejoicing because a person has breast cancer rather than lung cancer. They’re both dangerous. What you have to aim for is 3.8 max! I can tell you from experience – you’ll feel like a new person at that level, bursting with energy and glowing with vitality.

            • Susan says

              But, the overall incidence of stroke goes up with lower saturated fat and cholesterol, especially in women.

              It seems like 200 is the magic number, for women at least.

            • John says

              Sorry Mary, but I have to disagree with you on that. A total cholesterol level of 8.8 mmol/L (340 mg/dL) is actually much better than a total cholesterol level of 13+ mmol/L (503+ mg/dL). Also, 6.1 mmol/L (236 mg/dL) is much better than 8.8 mmol/L (340 mg/dL) — it’s the difference between having severely high cholesterol (7.8+ mmol/L [300+ mg/dL]) and having borderline high cholesterol (5.2 mmol/L [200 mg/dL] to less than 6.2 mmol/L [240 mg/dL]). Granted it’s still not healthy, but it’s a huge improvement from 13+ mmol/L (503+ mg/dL), or even 8.8 mmol/L (340 mg/dL).

              Also, it’s not 3.8 mmol/L (149 mg/dL) max that you should aim for; it’s 5.1 mmol/L (199 mg/dL) max and 4.1 mmol/L (160 mg/dL) min that you should aim for. Saying that you have to aim for a cholesterol level of 3.8 mmol/L (149 mg/dL) max is like saying that you have to aim for a blood pressure of 84/54 max, or a BMI of 17.2 max — it’s dangerous advice.

              Also, while there may have been no heart events in over 30 years in the Framington study with total cholesterol levels of less than 3.9 mmol/L (150 mg/dL), the MRFIT study lasted only six years, and almost 0.5% of participants with cholesterol levels of 3.6-4.0 mmol/L (140-159 mg/dL) had cardiovascular disease, and slightly over 0.5% of participants with cholesterol levels below 3.6 mmol/L (140 mg/dL) had cardiovascular disease. The MRFIT study also showed that while the lowest heart disease risk occurs with total cholesterol levels of 3.6-4.0 mmol/L (140-159 mg/dL), the lowest all-cause mortality risk occurs with total cholesterol levels of 4.7-5.1 mmol/L (180-199 mg/dL), followed closely by 4.1-4.6 mmol/L (160-179 mg/dL).

              To see what I’m talking about, you can view the chart here:
              http://1.bp.blogspot.com/-BrNwqzHAwFw/UX6xKNueesI/AAAAAAAAApo/qNHDJ-3xx_c/s1600/mrfit_mortality_in_350,977_men_aged_35-57.png

          • Romy JUGROO says

            Hi,In my opinion,a low fat diet may induce the liver to to synthesize much more lipids than needed for normal body functions.The ability to store food reserves in the form of body fat has ensured our survival,not so long ago,when we were nomads.

      • Bob says

        Carlos- we can not look at one marker in isolation with a blood chemistry. If heart disease is a concern what is your hsc-RP, ESR, LDH, CK, Albumin, phoshates, glucose, insulin, platelets, free calcium etc.
        Do you have periodontal disease? Do you have heavy metals? What there other things you do on the side of saturated fat? The human diet is complex and we just don’t follow the paleo approach or high fat diet. What is the ketogenic or paleo diet for that matter anyway? Not tailored to the individuals skeleton, also what is it you want it to do to the chemistry?
        Do you smoke? Are you constipated?
        If you do have the gene what are you going to do about it and how will you interpret the markers around the lipoproteins. If the HDL comes up so too the total cholesterol has to move.
        Don’t forget HDLc, HDL 1 in your calculations. Also depends on what range are you using: a statistical average range of the blood pathology results or an optimum rang to strive for?

        • Carlos says

          Thanks Bob, I would need more exhaustive tests. On the other side I think I carry a pretty healthy lifestyle. I’ll keep learning and tweaking my diet.

        • Chris says

          Bob, I’m interested in your question about periodontal disease. How does that relate to the discussion on cholesterol levels?

          • says

            Chris, I think periodontal disease has been associated with cardiovascular disease in a few studies, which might explain Bob’s question. I’ve also read that there is a potentially valid mechanism involving translocation of bacteria and endotoxemia that could link periodontal disease with CVD.

      • Richard says

        Get a sonar scan or other means of actually checking out the status of your arteries. If they have a significant amount of plaque buildup I would seriously consider a whole plant-based diet like so many recommend. Look at Esselstyn, Ornish, Fuhrman or the Okinawan Diet.

    • says

      You may want to note what type of LDL particle he has. JAMA reported (in the AtoZ clinical study) that researchers noted LDL particle size changes to type A (large) and actually reduces CVD risk. This is despite raising LDL levels.

      • Chris Kresser says

        LDL particle size loses its predictive value after adjustment for LDL particle number. In other words, it’s not the size of the particles that matters, it’s how many you have. This will be the subject of my next article.

        • James says

          Chris. People are only spreading this “Large fluffly harmless LDL” misinformation because people like you propogated it. I wonder how many people at high risk of heart disease were chowing down on sticks of butter thinking their jacked up LDL was large, fluffy and protective.

          • Robert says

            I don’t buy into this large, fluffy LDL stuff. I believe it is just grasping at straws for people that want to hold on to their high fat diets. It gives them a false sense of security.

            • Zorba74 says

              Agree with above two comments. Here is a good commentary on LDL size http://www.athero.org/commentaries/comm564.pdf “Contrary to current opinion, both small and large LDL
              were significantly associated with subclinical atherosclerosis independent of each other,
              traditional lipids, and established risk factors, with no association between LDL size and
              atherosclerosis after accounting for the concentrations of the two subclasses”

    • Derek Michael says

      I would suggest taking a VAP (vertical auto-profile) test or NMR test which will give you a comparison of how much of that LDL is small, dense LDL particles (risk factor for heart disease) or large, buoyant LDL particles (essentially “good LDL used by the cells, tissues, hormones, etc.) Low and behold, it appears not all LDL particles are ‘bad’!

    • says

      SUZIE, apoe4 will show a moderate increase, this is helpful in avoiding Alzheimer’s. The trick if you have e4 is to avoid oxidation of LDL by eating an anti-inflammatory diet and limiting stress, which you are doing.
      Imupro offer an extensive lipid panel that shows LDL subtractions and oxLDL. If you have low small dense particles and no oxLDL you are all good.

      • Susie says

        Thanks. I have had extensive testing through HDL Labs, though I don’t think it included oxidized LDL. My LDL particles were very high, even though by far most were large, fluffy. My rise in LDL with a high fat diet is not modest. In fact it almost doubled. I do try to eat a very healthy diet, of the paleo variety. I have recently picked up my exercise because I understand that apo e4 may be more affected by a lack. Hoping this helps.

        • Susan says

          What is it about exercise that helps? For instance, I primarily lift weights. Is the correlation only seen in runners?

          • Rory says

            Susan
            We discuss this all at http://www.apoe4,info. I respond hugely to saturated fat and Ive posted my lipid results in how dramatically I respond to a reduction in saturated fat in as little as a month.

            We do enough n=1 experiments to prove that yes, saturated fat and dietary cholesterol can have significant negative impacts on our lipid profiles. But, substituting the saturated fats with mono fats, can be the key.

    • Konstantin says

      +1 to APOE 4/4 question!

      It would be really great to see the separate series on the subject! Chris, please, consider researching it thoroughly. You might figure out how to treat/prevent Alzheimer’s while doing so…

    • Ken says

      Your brain needs Cholesterol. Exercise, stay away from processed foods and you’re on the right track. Highly recommend the book “Grain Brain.” Good luck!

    • valerie says

      what kind of oil was used? Organic virgin coconut oil or refined coconut oil? Also what protein was being eaten aswell? Pasture fed beef and poultry or conventional meats? it all makes a big difference. Dairy products should be pastured fed and raw. next best would be organic and pasteurized but not homogenized.

    • Super fat says

      overall only changes I have experienced are changes in Triglceride levels. They’ve halved overall however HDL and LDL are still the same as they were wen I was a carb monster. overall my gp wants me on a low fat diet and exercise.

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