![]() 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
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.
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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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6/24/2013 08:21:16 pm
Hi Franziska
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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 :)
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6/24/2013 10:57:05 pm
Thanks, Bill! What more can I say than "I love LCHF"? :)
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cvictorg
7/26/2013 10:31:07 am
Berkeley Heart Lab test results - blood drawn on 10/18/12
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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 :)
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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.
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8/11/2013 05:57:13 pm
Hi Chris,
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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!). 10/11/2013 10:11:52 pm
Hi Tim,
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