The Paleo Version of High Cholesterol

So far, we have established that eating a Paleo diet makes you feel better—although, most people feel worse initially as there are “withdrawal” symptoms when kicking processed foods...just a little disclaimer :-).  After just a month though, not a single person I have read about or spoken with has said that they did not feel great.  In fact, many vegetarians now eat Paleo and say that they feel far better and more energized than they felt previously. 

We have also established that people who eat Paleo end up looking leaner.  Just Google some before and after shots for proof.  Paleo diet plus exercise equals sexy lady bodies and stud man bodies.  Period.

The big question that remains, though, is around actual health.  Is this lifestyle actually healthy???  Can I really eat bacon, steaks, and vegetables every day to prevent disease and reduce major risk factors???  Instead of speculating or linking to studies and research studies…actually, I am going to do that, also…I decided to first share some of my “numbers” with you all. 
After several months of approximately 70% Paleo compliance, I decided to go full-on for one month: 
Almost immediately afterwards, I had some blood work done.  Specifically, I had some liver tests and a lipid panel (sound familiar, fellow Americans?).  Before I get to my results, let’s talk context.  We will look at: total cholesterol, triglycerides, HDL, LDL, and VLDL.  According to the Mayo Clinic and American Heart Association:

-Total cholesterol number above 240 mg/dL is “High.” 
-LDL above 160 mg/dL is “High” (“Very High” is above 190). 
-HDL above 60 mg/dL is “Best”. 
*HDL is sometimes referred to as “Good Cholesterol” and LDL, “Bad Cholesterol.”
-VLDL is “Normal” between 5 and 40 mg/dL.
-Triclycerides above 200 mg/dL are “High” (“Very High” is above 500, “Normal” is less than 150 mg/dL).

My numbers:
-Total: 302 mg/dL (uh oh!- High!)
-LDL: 211 mg/dL (yikes!- Very High!)
-HDL: 78 mg/dL (wait, huh?- Better than "Best")
-VLDL: 13 mg/dL (Ok. -Normal)
-Triglycerides: 66 mg/dL (???- Super Low)

The parentheses represent my doctor’s thoughts when he reviewed my info.  His review phone call went something like this:

Doc: “So the results were really interesting…”
Me: “Like, how?”
Doc: “You have really high cholesterol, but I am kinda not too worried about it…”
Me: “Please explain…”
Doc: “Your ‘good cholesterol’ is higher than any patient I have, sooooo I guess the ratios would say that you are okay…what do you eat???”
Me: “Paleo, blah, blah, blah”
Doc: “Wow, that sounds like a lot of meat...ok, well your triglycerides and HDL look awesome, but I am gonna check with some older colleagues about your totals.  I think you are good, but let's do some follow ups because we may want to be aggressive with that total cholesterol number.”
Me: “Um, ok.  See you soon I guess. Bye?”

Why would one number be “Awesome” and another number be worthy of possible "aggressive medical attention" (drugs)?  I still don’t have those answers, and, funny enough, neither does my doctor.  But I have been finding quite a bit of interesting info about cholesterol and health since reviewing my test results.  

Apparently the “link” between high cholesterol and heart disease is not as simple as we’ve been told.  This "link" is based on carefully selected study data that disregards certain data sets from populations that don’t support the theory (for example- Australian Aboriginals, Eastern Europeans: low relative cholesterol, high rates of heart disease. Also, young Japanese men: increasing average cholesterol over the last 20 years…rate of heart disease has fallen.—from Malcolm Kendrick’s “The Great Cholesterol Myth”).

The more I read, the more I have trouble believing that my high total cholesterol is a problem.  I have actually found a lot of data suggesting that low cholesterol is actually quite dangerous!

So, at this point, I am questioning the merits of this “Cholesterol Epidemic” and the last thing I will do is take any kind of “aggressive” action (aka statin drug prescription) to fix something that doesn’t seem to be broken.  Next time you have your blood work done, think about investigating what these numbers really mean.  I feel like I have learned a lot.  I decided that I will really only ever be alarmed if my HDL gets low or if my triglycerides get high.

I’ll wrap this up with some interesting data. Lipitor (the most commonly prescribed statin for lowering cholesterol) accounts for $10 billion-a-year in revenue for Pfizer (NY Times, March 7 2011) with tens of millions of patients actively taking this drug.  With that many people on this miracle-drug (there are many others, too) designed to “aggressively” lower their cholesterol levels, the leading cause of death in the US is still--drum roll please--cardiovascular disease.  Either we haven't found the cure to this epidemic or it's one big misdiagnosis.  Maybe I’m better off sticking to the Paleo diet and embracing my high cholesterol.  

Here are some links to some interesting articles/materials on the subject:
The Cholesterol Myths: Exposing the Fallacy That Saturated Fat and Cholesterol Cause Heart DiseaseThe Great Cholesterol Con: The Truth About What Really Causes Heart Disease and How to Avoid It


Erin said...

Nice research! A little additional fat for thought...

LDL, HDL, VLDL are lipoproteins with different ratios of protein to lipid (i.e. fat) They each have a different function.
LDL - called "bad cholesterol" because it takes cholesterol produced in the liver and deposits it into peripheral tissue
HDL - "good cholesterol" does just the reverse, taking extrahepatic (outside the liver) cholesterol back to the liver
VLDL - is a precursor to LDL and transports triglycerides to peripheral tissue (fat,muscle)

This is why the ratio of LDL:HDL is more important than the total number, because the two balance each other out.

Additionally, some people no matter how good/clean their diet is are predisposed to having high cholesterol (defective LDL receptors etc.)- take my father and sister for instance. My dad eats very very healthfully (although he is no Paleo) and works out daily and yet has struggled for years to keep his LDL in check (all the while having an excellent HDL). It wasn't until he was over 50 (age is in itself a cardiac risk factor) that the mention of a statin entered the picture.

You are also correct in that too low of cholesterol is also not a good thing - cholesterol is important for the cell membrane structure of ALL cells in our bodies, vitamin D formation, steroids, bile acid, etc.

Basically, it's not something that is as cut and dry as a number definitively indicating something. A concern for your 302 (which I have none) is totally different than some other person with the same number. If you were 55, a smoker, and your dad had a triple bipass at age 50... that would be a different story.

DBax said...

Good stuff. I was hoping someone who knew their way around this stuff would chime in :) I have also read that the American way of calculating LDL can skew your number if you have low triglycerides...any truth to that in your opinion? Thanks, Erin!

Erin said...

While LDL can be directly measured it is most commonly calculated by the formula Total cholesterol - HDL - (Triglycerides/5) because it is more cost effective and very reasonably accurate. And although TG of 66 is low it is still within the reference range of 10-140... so I don't really know anything about a low TG tripping up the LDL value. Though if you are really interested you could always ask your doc to order the direct LDL.

Anonymous said...

I've been struggling with the same thing, and have come to realize that all you need is more fiber and vegetation in your life, not less meat. I've given up trying to please the cholesterol police, but do know that lots of fiber = lower LDL. Your liver's kicking in it's contribution because you aren't taking any cholesterol in! Add high-cholesterol meats (like liver) and additional eggs to your diet to offset your own liver, then eat more fiber (vegetation) to pull it out of your blood. Another method is to limit your meat servings to 3 oz. per meal, 2 meals with meat/day. This is what "pyramid" doctors use beans and grains for--non-meat protein and a fiber source, and recommend hypercholesterolemic patients become vegetarian...which only makes the problem worse by working the liver to death!

Steve said...

With trigs that low you need to use the Iranian formula to calculate LDL. Yours works out at 180.
Google to find an automatic calclator

Anonymous said...

I recently had a lipid panel done as well after a few months of 85-99% Paleo, and also happening to do a week of Whole30 right before the blood test. The NP said I should see my internist about my "high total cholesterol", but I don't think so.
Total: 248
HDL: 114
LDL: 135
Triglycerides: 43
In my mind, this is an outstanding result, no?
Interestingly, my report said my LDL is high since it's over 130, so apparently different labs have different reference ranges...

I also seem to remember something in Why We Get Fat about how it's really sugars that increase LDLs, so if you eat low-carb, you're good.

DBax said...

Thanks for the great info, guys! Just had another story shared with me...after 30 days of strict Paleo, his triglycerides dropped 50 points and doctor told him he can go off of his meds!

Jannamo- to me, after reading what I have read and obsessing about my own numbers, yours look pretty outstanding, indeed. I am no doctor, but your ratios look quite healthy based on what I have learned.

Adam said...

Good results! Chalk me up as a believer, too!