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  • Puzzling cholesterol test results

    I just have a standard cholesterol test done for the first time ever and I'm confused and kinda concerned by the results...

    Total cholesterol = 249
    HDL = 64
    Triglycerides = 58
    LDL = 173

    I'm a male, 38 years old, about 5' 10", 170 lbs. My waist size is around 33" and I'm not over weight, I can barely get a pinch of fat on my stomach when standing up. I don't work out or exercise but I do have a physically active job, on my feet all day, walking to and from, lifting things so I don't have an entirely sedentary life.

    This is a representative sample of my diet. By the way, I'm not 100% paleo/primal but getting there

    Breakfast:

    3 eggs* cooked in 2 to 3 tablespoons of coconut oil
    1 slice of toast* with 1/2 to 3/4 tablespoon of butter
    16 ounces of coffee with 2 tablespoons of sugar

    Lunch:

    1/2 can of tuna with mayo* & spices on 1 slice of toast*
    2 cups red cabbage coleslaw made with mayo*
    1 avocado (often I'll eat 2 avocados throughout the day)
    5 to 8 walnuts

    Dinner:

    1/2 pound wild sockeye salmon
    1/2 pound asparagus
    1 cup sauerkraut

    Snacks:

    Mini sweet peppers
    Pickles
    Kalamata olives
    More walnuts

    *mayo is home made with avocado oil and olive oil, 50/50 mix
    *toast is sprouted sourdough with 2 grams sugar per slice and 16 grams carbs per slice
    *eggs are from local pastured hens, directly from the farm

    Some nights I have breakfast for dinner, maybe 2, sometimes 3 nights out of the week

    My question is should I care that my total LDL is considered high? So many conflicting thoughts on this. I'm considering getting an Ion Mobility test done to see what percent of my LDL are pattern B, also called small dense but I don't know if this test is worth doing though. Is it possible that the majority of my LDL count is from the large buoyant pattern A LDL? I can't find any examples of this happening so I'm curious. I'm a fan of Dr. Rhonda Patrick and I listened to some of her material on this topic and it seems some people have genetic factors which lead them to not handle saturated fat very well. So it's possible that maybe I'm one of those people and I should try eating more poly and mono unsaturated fat and cut out the coconut oil? There are so many variables. One thing I cut out since the test is sugar for my coffee, now using stevia. But I would hate to cut coconut oil if I don't need to, I love that stuff.

    Other than my morning coffee I only drink water. I don't drink any kind of alcohol or beer so that's not a factor. And the only supplement I'm taking is 4000 iu's of vitamin D3 daily. No medications either

    I'm hoping someone can help me understand this better, maybe these test results are fine? I don't know.

  • #2
    These numbers look good to me and your diet is fantastic. Your HDL is slightly higher than your trigs and total is not so bad.

    Comment


    • #3
      It's not the sugar in your coffee, it's the coconut oil and other saturated fat in your diet. If you're interested in lowering your LDL to normal (<100), then reduce your saturated fat. There have been numerous threads on this forum just like this of people having a high LDL due to eating a high fat primal diet. Like you said, some people are susceptible to it. My LDL went up to 203!! And after reducing saturated fats from added oils, butters, fatty meats etc, it's currently around 109.

      Many people have also posted results of their advanced tests to check their LDL-P particle counts or ApoB and they show a correspondingly high risk just like LDL-C. You should do the test to confirm for yourself. Some folks on this forum though will tell you not to worry about it, which is misleading and rather unfortunate.
      Last edited by KimLean125byMar15; 02-18-2017, 07:15 AM.
      *Starting Wt - 151 lbs (January 2015) * Current Wt - 113 lbs (November 2016)
      *95% Plant-Based (from June 2015) ~ *75%Carbs *10-15%Protein *10-15%Fat
      *Exercise ~7-10 hrs/week

      Comment


      • #4
        There is a lot of data that says that you are at higher risk for atherosclerotic disease with higher LDL. It's pretty well accepted science. There are also people who work outside of the lipid field or who do not actually work in research that criticize that science. Clearly, many people here favor the latter group.

        Even though there are 50-60 years of lipid data and studies, it doesn't mean that all of the nuances of lipid profiles are completely elucidated, that high LDL is a death sentence, or that low LDL eliminates all risk. However, given the known information, if you want to lower your risk of heart disease and stroke, you should lower your LDL cholesterol. At this point, the meanings of particle size and other measures are still mostly just speculative. The newer tests are not yet well validated.

        As KimLean said, the easiest solution with the goal of lowered LDL in mind is to eliminate the coconut oil. If you need the additional calories, substitute protein, complex carbs, and olive oil. In addition, you can add soluble fiber for further LDL reduction.

        Comment


        • #5
          Thanks for the replies,

          Kim, I'm curious to know what your triglycerides and HDL were at the time your LDL was 203. Not that it means much but I'm wondering if your profile was similar to mine. I did decide to stop using coconut oil in addition to cutting out the little sugar I was using. You may be right about the sugar but even so it was a bad habit that could only be doing harm anyway. I'm already getting used to my coffee with a little stevia so no big deal there. I'm going to keep my lifestyle and diet pretty similar otherwise but will try to limit eggs to three per day. I don't want to introduce too many changes at once because I want to kinda tease out the main cause, if it turns out there is one. I've already got my follow up labs ordered so in 3 months I'll know if my LDL has dropped. I will do an update at that time. I'm going to skip the advanced LDL tests for the meanwhile, no need to be going down that rabbit hole just yet.

          Comment


          • #6
            During primal (high-fat, low-carb, added oils, butters, some cheese, almost daily meats, eggs (2), etc) it was:

            Total - 287 mg/dl (reference <200)
            LDL - 203 (<100)
            HDL - 65 (>39)
            Triglycerides - 95 (<150)
            At the time I was around 145 lbs, so within normal weight range.


            And most recently (Dec 2016) on low-fat, high-carb (grains, legumes, potatoes, fruits, starchy veg etc), less meat and animal products in general (maybe a few times a month at most) etc. I do however eat ice cream at least once a week.

            Total - 179 mg/dl
            LDL - 109
            HDL - 55
            Triglycerides - 77

            I've been testing twice a year starting 2015 when I changed my diet and it's been almost the same as this (within +/- 10). I've never taken an NMR Lipoprofile test to find out my LDL-P etc, but I'm planning on getting one in a couple months just out of curiosity. I found out that it's "only" $100 on WalkInLab.com or RequestATest.com.
            *Starting Wt - 151 lbs (January 2015) * Current Wt - 113 lbs (November 2016)
            *95% Plant-Based (from June 2015) ~ *75%Carbs *10-15%Protein *10-15%Fat
            *Exercise ~7-10 hrs/week

            Comment


            • #7
              Kim,

              You said your weight was around 145 lbs when eating primal. I'm curious, did you not lose weight when you were eating primal?
              Last edited by friendlyskeptic; 02-19-2017, 04:35 AM.

              Comment


              • #8
                It was a struggle and in 5 yrs on primal, I was in the 140s and 150s mainly because I was unable to exercise consistently. For years I just assumed I was lazy and unmotivated. It never occurred to me that the low-carb diet was to blame because of low energy levels .Primal blueprint says to stay under 100g for "effortless" weightloss. It didn't happen. Now, after adding carbs and no longer struggling to remain active, I lost 35+ lbs and ~8 inches off my waist while eating nearly 300g of carbs, which primal says will result in "insidious weight gain" and a "danger zone" for inflammation, metabolic syndrome and diabetes.

                Well, to be on the safe side, several months ago, after a yr and half of eating nearly 75% carbs, I did comprehensive labs and the test for inflammation, Hs-CRP was 0.22 mg/l (normal range is <3.0 but ideal if <1.0), and diabetes tests showed Fasting Blood Glucose at 81 mg/dl (normal is 65-99), and A1C was 5.2% (normal is 4.8-5.6, pre-diabetic is 5.7-6.4, and diabetic is 6.5+). All the other tests like metabolic/liver/kidney/thyroid panels, B12, CBC, were normal as well.

                This isn't to say primal is unhealthy, obviously loads of people seem to thrive on it. It's just that it doesn't work for some. I think genetics are a big factor and modification of any diet is necessary based on how an individual is reacting to it. For me, a higher carb, lower fat, plant-based diet is just healthier for me than a high fat, meat based diet. Other benefits I've seen are better digestion and I also no longer have cold-intolerance, which is a symptom of thyroid issues commonly related to low carb diets.
                *Starting Wt - 151 lbs (January 2015) * Current Wt - 113 lbs (November 2016)
                *95% Plant-Based (from June 2015) ~ *75%Carbs *10-15%Protein *10-15%Fat
                *Exercise ~7-10 hrs/week

                Comment


                • #9
                  It certainly seems like the primal approach is not ideal for everyone. Especially if when eating exactly what is prescribed by the diet a person is still not losing excess body fat and not feeling any better. From my experience it's the opposite, primal causes me to lose excess fat and I have stable energy levels. All of which comes from the diet alone, no exercising, other than work related physical activity. As far as the cholesterol topic goes I'm not convinced either way yet. I just did a few hours of researching and it seems that LDL-C alone is a poor predictor of coronary heart disease. It seems that the number of LDL particles, percent of LDL-a, and oxidized LDL are the most important markers to look at. I'm going to have my doctor order the NMR LipoProfile to be sure I even have cause for concern. I just read an article from 2009 published in the UCLA newsroom of science & technology stating that in a national study nearly 75% of patients hospitalized for heart attacks had LDL levels within the accepted guidelines and additionally that close to 50% of them have LDL levels that were considered optimal. If that's true then to me it seems the LDL-C number is kind of meaningless. I think I read that no links are allowed on this forum so if you want to read that article just google "most heart attack patients' cholesterol levels did not indicate cardiac risk" and it should be the first result. This topic has my head spinning, the more I read the more convoluted it becomes.

                  Comment


                  • #10
                    Links to studies or sources are allowed on the forum and even preferred in most discussions.

                    And yes, I agree that the basic test may not provide all the necessary information, which is why Mark and others started suggesting folks take the advanced test. Here's an overview:
                    https://www.nhfcpepicentre.org/Porta...id_profile.pdf

                    Here's a forum member bjjcaveman who also had higher LDL on paleo and has done quite a bit of self-experimentation and discussion with a number of pro-paleo lipidologists per his blog.
                    http://bjjcaveman.com/2014/11/17/ket...mas-dayspring/
                    http://bjjcaveman.com/category/lab-t...rol-lab-tests/
                    *Starting Wt - 151 lbs (January 2015) * Current Wt - 113 lbs (November 2016)
                    *95% Plant-Based (from June 2015) ~ *75%Carbs *10-15%Protein *10-15%Fat
                    *Exercise ~7-10 hrs/week

                    Comment


                    • #11
                      Originally posted by JBean View Post
                      There is a lot of data that says that you are at higher risk for atherosclerotic disease with higher LDL. It's pretty well accepted science. There are also people who work outside of the lipid field or who do not actually work in research that criticize that science. Clearly, many people here favor the latter group.

                      Even though there are 50-60 years of lipid data and studies, it doesn't mean that all of the nuances of lipid profiles are completely elucidated, that high LDL is a death sentence, or that low LDL eliminates all risk. However, given the known information, if you want to lower your risk of heart disease and stroke, you should lower your LDL cholesterol. At this point, the meanings of particle size and other measures are still mostly just speculative. The newer tests are not yet well validated.

                      As KimLean said, the easiest solution with the goal of lowered LDL in mind is to eliminate the coconut oil. If you need the additional calories, substitute protein, complex carbs, and olive oil. In addition, you can add soluble fiber for further LDL reduction.
                      Best post ever re cholesterol. Wish it flashed on automatically every time someone asked a question or expressed concern re high cholesterol.

                      Comment


                      • #12
                        I know with cholesterol there is something called Transient Hypercholesterolemia which basically means during weight loss or even rapid adipose tissue loss, cholesterol numbers will rise temporarily. https://www.ncbi.nlm.nih.gov/pubmed/2035468

                        I wonder though if the same applies to LDL, do these also rise temporarily.

                        Also if you are worried about CVD, look at the relationship between calcium, D3, and K2. K2 has been shown to go leaps and bounds at preventing and fixing atherosclerosis: https://www.ncbi.nlm.nih.gov/pubmed/9414028

                        Comment


                        • #13
                          Get that cholesterol check, read your horoscope religiously, and play them lucky numbers!

                          Comment


                          • #14
                            Saying "people with high LDL tend to have more heart attacks" is different from saying "lowering your LDL will prevent heart attacks," which cannot be inferred from the first statement. It's the difference between correlation and causation. Many trials have been conducted in which people lower their LDL by eating less saturated fat and it increases their mortality rate more often than the opposite.
                            My opinions and some justification

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