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Recent Cholesterol Results and What I Eat

6/23/2013

12 Comments

 
Picture
Low carbohydrate diets are often criticized for being high in fat, particularly saturated fat, which is widely believed to raise cholesterol levels and increase risk for heart disease, despite recent  and older studies demonstrating that saturated fat is not to blame. However, many lipidologists believe that LDL particle number (lower number is better) and pattern (larger size is better) do correlate with heart disease risk.

My total, HDL, and LDL cholesterol have always been on the high side, even back in 2007 when I was a pesco-vegetarian who threw out egg yolks rather than eating them. The only time my LDL was in the “optimal” range (less than 100)  was the year I ate a vegan diet. However, I was also very hungry and sick a lot that year.

Recently, someone commented on another blog that “Every low-carb Paleo blogger has nightmarish cholesterol levels," or something very similar.  That’s a pretty broad generalization and one I don’t agree with. In many (most?) cases, elevated cholesterol levels are due to something other than diet. And are moderately elevated cholesterol levels always bad anyway?  From all the research I've seen, it's inflammation that appears to be at the root of heart disease. In addition,  low cholesterol levels have been linked to depression, poor memory, and other health issues. 

But I was still curious to see what my lipid numbers are like now, 11 months after beginning a very-low-carb, high-
fat diet that includes a fairly high percentage of saturated fat. I decided to order an NMR Lipoprofile test so I could get information about particle numbers, size, and pattern, which I've never had measured before, since I believe this is more important than just looking at LDL and HDL.

My results:

LDL Particle Number

LDL-P:    1174                    Reference range:             Moderate 1000-1299 
                                                                                     Borderline High 1300-1599
                                                                                     High >1600
 
Lipids

LDL-C:    124                      Reference range:           Above optimal 100-129
                                                                                    Borderline 130-159
                                                                                    High >160

HDL-C:  97                         Reference range >40

Total cholesterol:226    Reference range   <200

Triglycerides:   24           Reference range  <150

LDL and HDL particles

HDL- P(total):  43.8        Reference range >30.5

Small LDL-P:  103            Reference range  <527

LDL size:    21.7                  Reference range  20.6-23.0 (Pattern A, Low Cardiovascular Disease Risk)

Insulin resistance score

LP-IR score:   1                   Reference range  <45


Honestly, these numbers are better than I’d expected. My HDL has always been good, around 65-70, but it’s increased significantly, while my LDL-C has actually gone down a bit.  The particle size and numbers are also very good, as are the triglycerides.  I guess I shouldn't really be too surprised given research suggesting that a low-carb-high fat diet results in a less atherogenic lipid profile.

My results occurred nearly a year after eating eggs, butter, cream, cheese, and/or coconut oil every single day. Did I also eat a lot of monounsaturated fats in the form of nuts, olives, and avocado on a daily basis and omega-3 fats in fish several times a week?  Absolutely -- I eat a lot of all types of fat.  But I don’t think the saturated fat has done me any harm; on the contrary, I’ve written before about the benefits of many saturated fats. And limiting my carbs to less than 50 grams a day has resulted in finally normalizing my post-meal blood sugar, which I was unable to do at a moderate low-carb level of 80-100 grams.  My weight remains 125 pounds, give or take a pound.

So what do I eat? Here’s yesterday's intake and nutrient analysis courtesy of FitDay.com:

Breakfast:

4 oz sardines
3 cups spinach with ½ tsp sea salt cooked in 2 tsp coconut oil
1 cup blackberries with 1 oz sour cream and 1/3 cup chopped pecans
Green tea

Lunch:
1 sliced red bell pepper with Greek yogurt-guacamole dip (1/2 cup 2% Greek yogurt mixed with 2/3 cup guacamole)
Chia seed cocoa pudding (1 oz chia seed mixed with ½ cup water, 1 Tbsp cocoa powder, ½ tsp sea salt, ½ tsp cinnamon)
Vanilla hazelnut herb tea with 1 tsp half-and-half

Dinner:

Filet Oscar:  6 oz beef filet, 2 oz  crab, 2 Tbsp Bearnaise sauce, 1/2 cup each pea pods and summer squash  (pictured above) 
Water


Calories: 1700

Fat: 117 grams (62%)
Saturated: 33 grams
Polyunsaturated fatty acids(PUFA): 24 grams 
Monounsaturated fatty acids (MUFA): 60  grams 

Protein:  97 grams (23%)

Carbohydrates: 68 grams (16%)
Dietary fiber: 33 grams
Effective carbs: 35-51  grams
(There are different schools of thought on how to count fiber. If subtracting all fiber from carbohydrate grams, effective carbs are 35 grams; if subtracting half the fiber grams, effective carbs are 51 grams) 

This is pretty typical intake for me in terms of macronutrient percentage, fiber, and calories. The majority of my fat intake always comes from MUFA and saturated fat, and most of the PUFAs are the omega-3 fatty acids found in seafood.

So I'm having great results all around on a low-carb, high-fat, whole foods diet. Everyone is different, of course.  I'm not arguing that some people have reported increases in LDL cholesterol after switching to a low-carbohydrate diet, although it seems to occur more often in the initial stages, particularly with folks who lose weight rapidly. But the oft-repeated message that a LCHF approach automatically increases cholesterol and risk for heart disease is not borne out by the research, my  n=1 results, and those of many others. 





















12 Comments
Dan Brown link
6/24/2013 04:57:06 am

Great lipids, Franziska. Congratulations. I particularly like you TG/HDL ratio (o.25)!, one of the best I have ever heard of. I have had TGs in the 20s and HDLs in the 90s, but never at the same time.

One of my early columns, #27, "...the strongest predictor of a heart attack," http://www.thenutritiondebate.com/2011/10/contemporary-medical-literature-is.html talks about this. Anything under 1.0 is very low risk. Yours is fabulous!

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Franziska Spritzler link
6/24/2013 10:36:02 am

Thanks so much, Dan! I'm pretty happy with these results. I know your lipids are in great shape too! Thanks for the link to your column. If only I had time to read all the posts from you and other bloggers I like. Someday :)

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Eddie Mitchell link
6/24/2013 08:21:16 pm

Hi Franziska

Another great post and congratulations on a great set of numbers. Almost all the lowcarb diabetics I know report similar findings when going lowcarb. Blood glucose numbers usually plummet within a few days and HbA1c numbers at three months often show dramatic improvement. In my case from HbA1c almost 12 at diabetes diagnosis to five point five. Cholesterol tests showed a big improvement, trigs down from 2.7 to 1, HDL up. LDL was also increased but offset by the rise in HDL maybe. I believe this is common when a large weight loss is taking place, in my case a 50lb reduction in three months. Having said that, I have not bought into much of the scare mongering from big pharma regarding cholesterol. It seems just as many people have heart attacks with so called good cholesterol as bad, other than people with extremely high numbers such as people suffering with hypercholesterolemia. Of course if a person can obtain good numbers with a healthy diet and lifestyle, it must be the way to go. It is my opinion, ramming cholesterol numbers down with drugs such as statins is not the way to go.

The World Health Organisation set up a huge study called MONICA looking at cholesterol numbers and heart disease. The people with the lowest cholesterol numbers, the Australian Aborigines, had the lowest cholesterol but the highest heart disease in the world. The French have high cholesterol numbers and a heart disease risk 30 times lower. The Swiss have the highest cholesterol in the world but their heart disease is only one third of the UK. See link below, a very short but must watch video from UK Doctor Malcolm Kendrick an expert on cholesterol and its effect on heart disease.

Keep up your great work and keep shining that spotlight of hope on the murky world of junk food and out of date dietary information. The epidemics of obesity and type two diabetes worsen by the day, nothing will change until people stop being fooled by multinational food giants and their partners in crime big pharma. More drugs will never be the answer.

Kind regards Eddie

http://www.youtube.com/watch?v=i8SSCNaaDcE

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Franziska Spritzler link
6/24/2013 09:11:30 pm

Thanks so much for your feedback and helpful info, Eddie! I agree that lower TG and higher HDL values are virtually universal among low-carbers. Yes, as I said above, I think weight loss is a large factor among the people who experience elevation in LDL after switching to LCHF. Congrats on the 50-lb loss and fantastic A1c, BG, and lipids :)

Thanks for the link on Malcolm Kendrick. I remember him from the Statin Nation documentary I watched a couple of months ago. Definitely a voice of reason among all the cholesterol hysteria!

Keep up your great work as well :)

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Bill Lagakos link
6/24/2013 10:51:26 pm

Very impressive, Franziska!

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Franziska Spritzler link
6/24/2013 10:57:05 pm

Thanks, Bill! What more can I say than "I love LCHF"? :)

Reply
cvictorg
7/26/2013 10:31:07 am

Berkeley Heart Lab test results - blood drawn on 10/18/12

TC 242 mg/dL
LDL-C 158 mg/dL
HDL-C 76 mg/dL
Triglycerides 41 mg/dL
Ap- B 104 mg/dL Reference Range <115 mg/dL
LP(a) <2 mg/dL Reference Range 0-30 mg/dL

Lipid SubClass Detail
Berkeley Lab analyzes LDL for 7 sub classes from large buoyant to small dense

LDL I, IIa and IIb are considered large buoyant - As a % these 3 totalled 82.5% - LDL I=51.1%, LDL IIa=16.2% and LDL IIb=15.2%
LDL IIIa+b, LDL IVa and LDL IVb are considered small dense with IVb being the smallest. As a % these totalled 17.5% - LDL IIIa=11.2%, LDL IIIb=3.8%, LDL IVa=1.8% and LDL IVb=0.7%
LDL IIIa+b=15% Reference Range=13.6-43%
LDL IVb=0.7% Reference Range=1.7-9.8%
LDL IIIa=B = 17.9 mg/dL Reference Range=12.0-32.1 mg/dL
LDL IVb=1.0 mg/dL Reference Range=1.5-11.2 mg/dL

HDL is analyzed for 5 subclasses

HDL2b=34%, HDH2a=24%, HDL3a=20%, HDL3b=14% and HDL3c=8%
HDL2b Reference Range 7-30%

Collected 10/5/12 - Shiel Medical Lab - day 14 (before Testosterone injection)

HA1C - 5.6
Fasting Glucose - 100mg/dL Ref Range 65-99 mg/dL
Estimated Average Glucose - 114.5 mg/dL

LDL-P 1430 nmol/L
Small LDL-P 132 nmol/L

HDL-C 69mg/dL
Triglycerides 31 mg/dL
Trig/HDH ratio - .45

LDL-C (Calculated) 199 mg/dL
TC - 274 mg/dL

Estradiol, LC/MS/MS - 4 pg/mL S/B <= 29 pg/mL
Enhanced Estradiol - 22.7 pg/mL Ref Range <39.8 pg/mL
SHBG - 39 nmol/L Ref Range 11 - 80 nmol/L 

Thyroid Panel
Thyroxine (T4) - 10.9 ug/dL Ref Range 4.5 - 10.9 ug/dL
T3-Uptake - 34.0% Ref Range 22.5 - 37%
TSH - 3rd Generation Ultra - 1.47 uIU/mL Ref Range 0.40 - 4.50 uIU/mL
Reverse T3, LC/MS/MS - 34ng/dL Ref Range 9 - 28 ng/dL
T3, Total 81 ng/dL - Ref Range 60 - 181 ng/dL
T4, Free 1.43 ng/d/L - Ref Range 0.80 - 1.80 ng/dL

Vitamin D (25 hydroxy) - 74 ng/dL Ref Range 30 - 100 ng/dL
Cardiac Homocysteine - 10.0 umol/L Ref Range <11.4 umol/L
PSA - 0.42 ng/d/L Ref Range <4.00 ng/dL


Quest Diagnostics - collected 10/8/12 (3 days AFTER the testosterone shot)
Just to show how different labs get different results

Berkley Heart Labs Test

LDL PAttern Size A (Large)
Triglycerides - 41 mg/dL
HDL-C 76 mg/dL
Trig/HDL ratio .54

Apolipoprotein B - 104 mg/dL Ref Range <115 mg/dL


Any thoughts?

Reply
Franziska Spritzler link
7/26/2013 11:52:24 am

I'm not a lipidologist, so I can't really analyze your labs, particularly the subclasses. I can say that your TG and HDL are great across the board and that based on those values you likely follow a LCHF diet. Kudos :)

Reply
Chris
8/11/2013 08:04:43 am

Hello, I've just discovered your blog through a link on Calories Proper where Bill highlighted a few diets, yours being one of them. Several of the diets specifically mentioned sour cream which I've never seen as a staple and it's got me curious. I normally peruse paleo blogs so this may be why this is unfamiliar to me but could you provide more info about why you regularly eat sour cream? I believe on a link to a different blog from the same post a blogger said she increased sour cream consumption to help increase SFA & MUFA intake while decreasing PUFA.

What about sour cream quality? I'm unfamiliar with how it's prepared so maybe there isn't much variability when it comes to sour cream. I'd appreciate any further information you could provide, I'll be browsing your archives in the meantime :) Thanks!

Chris

Reply
Franziska Spritzler link
8/11/2013 05:57:13 pm

Hi Chris,

Thanks so much for your comments and question. I choose sour cream at breakfast over other dairy solely because I like the way it tastes with berries. Sometimes I have ricotta cheese instead. Yes, true Paleo doesn't allow dairy, and I eat at least a couple of servings a day because I tolerate it very well (Swiss ancestry). It would increase SFA and MUFA while minimizing PUFA, but so would any whole milk dairy. I eat a lot of cheese and cream cheese, but because I only posted a one-day menu, those weren't included.

I purchase organic sour cream from Trader Joe's. It's not from grass-fed cows, which would be even better, but as long as it's organic, it's still a good choice.

Hope that helps and that you enjoy reading my blog posts :)

Franziska

Reply
Tim
10/11/2013 08:06:28 pm

Can you get creme fraiche where you live? The real French stuff from Normandy (d'Isigny)? It's an absolute staple for me: utterly delicious, from some of the world's most pampered cows (DEFINITELY grass fed), and usually about 30% sat fat, where soured cream is nearer 10%. Could be one of the world's healthiest foods (even though I live in fear of my local supermarket discontinuing the full fat version - like they have with Total Greek yoghurt - the philistines!).

Franziska Spritzler link
10/11/2013 10:11:52 pm

Hi Tim,

Yes, I've seen creme fraiche at Trader Joe's, although I'm not sure if it's from Normandy. Will check next time I'm there. I'm very happy with sour cream, ricotta, and burrata, but it's always nice to add a new high-fat dairy option to the list :) Thanks for the info. No full-fat Greek yogurt available in my area either, unfortunately.

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