Cholestrol 101: Eat less carbohydrate, more healthy fats to avoid a heart attack.

27 Oct

Whenever I try to convince a friend to take up Paleo Diet, I always get accusations like “But all that meat’s going to jack up your cholesterol, and then you’re gonna die from stroke!” I wish replying to that is as easy as shoving a good serving of beef and bacon to their mouth, but we are a civilized society, and I’ll let the scientific findings speak for themselves. But the truth is never simple, and as such this article will be long in order to be comprehensive.

It is understood in the scientific world now that fats do not make you fat, carbohydrates do. But we shall only focus “Cholesterol” in this article. For this purpose I shall refer you to the cholestrol explanation in Primal Blueprint p. 73-80.
First of all, if your doctor is suggesting that you avoid red meat to lower your cholesterol, how is that working out for you? If you lower red meat and saturated fat intake but yet maintains a high carbohydrate diet, chances are if anything your cholesterol will keep rising. At some point it reaches a certain threshold and your physician decides to prescribe you medications to suppress it, but even with that comes some other risks – as we will discuss below.

The whole conventional wisdom that eating fat will cause high cholesterol, ergo heart diseases can be refuted by many research studies available today. The most notable one mentioned by Mark Sisson is the Framingham Heart Disease Study. This particular research studied eating habits of 15,000 participants in Framingham, MA over 3 generations (started 1948). The conclusions of these studies are:

  • There is no correlation between dietary cholesterol intake and blood cholesterol levels.
  • Residents who ate the most cholesterol, saturated fat, and total calories actually weighed the least and were the most physically active.

Much reexamination and research has been conducted following the study above, and it is clear now that heart disease is caused by excessive oxidation and inflammation of a certain type of cholesterol that constitutes a small fraction of the mostly beneficial stuff in our bloodstream.

Cholesterol and Lipoproteins

Cholesterol is an essential substance produced constantly in our liver (up to 1400mg/day). We need it for many things, a few examples are given below:

  • Cholesterol is required as part of the structure for all cell membranes in our body
  • Cholesterol is needed to form synapses between brain cells
  • As a precursor molecule for important hormones such as testosterone, estrogen and cortisol
  • Needed for bile acids production to digest and absorb fats
  • Synthesis of Vitamin D for the body in the presence of sunlight

Bottom line, we need cholesterol to survive and function.

Cholesterol are fat soluble and requires special spherical particles called lipoproteins. 3 lipoprotein varieties we are concerned with are VLDLs, LDLs and HDLs (very low-density lipoprotein, low-density lipoprotein, high-density lipoprotein). Each of these lipoprotein carry a certain percentages of cholesterol, triglycerides and other fats.

VLDLs are created in the liver in order to transport triglycerides from the liver to fat and muscle cells in the body to be used as energy. Once they have deposited their load, they become smaller LDLs.

LDLs contain mostly cholesterol and other fats. In a healthy person, most of the LDLs are called “large fluffy” or “buoyant” LDLs (Type A).

The problem comes when you have excessively high triglyceride levels in your blood, which can usually happen with a high-carb diet (even if it is low fat). Why? Excessive insulin drives conversion of ingested carbohydrate into fat (triglyceride). Same thing with moderate-carb high-fat diet, since the high insulin level will ensure that both carbs and fat get circulated in the bloodstream and stored in fat cells.

Why you shouldn’t be eating a low fat diet?
It is true that reducing fat intake reduces cholesterol and triglyceride levels. (As recommended by low-fat diet advocates) However, get this. Your liver makes cholesterol as a raw material for the bile salts that help in fat digestion, so reducing your intake of fats will cause your genes to down-regulate the production of cholesterol. You will be less efficient in digesting fats if you have less cholesterol.

Eating low-fat diet will cause you to eat more carbohydrate by default for your daily energy requirement. This leads to spiked insulin levels, eventually leading to hyperinsulinemia, which is understood now to cause obesity, cardiovascular disease, hypertension and diabetes. However you choose your portions, a high carbohydrate intake leads to elevated triglycerides.

With high triglycerides in your blood, VLDL production shoots up to handle the extra load. This can cause some of the VLDL particles to become a bad LDL form, which is “dense” and “small” (Type B). Type B LDLs has been shown to cause atherosclerosis and heart disease. Type B LDLs get stuck in the spaces between cells lining the artery and become oxidized, propagating atherosclerosis. The oxidation damage causes inflammation and damages your body.

HDLs takes cholesterol back to the liver for recycling. HDLs can also damage any damaged or oxidized cholesterol – including removing the small, dense LDL particles and oxidized cholesterol that have been stuck in the artery walls. HDLs are known as the “good cholesterol” and “nature’s garbage truck”. This is why high level of HDLs in the blood has been correlated with low risk for heart disease. A good way to increase HDLs is to exercise regularly, moving slowly at a frequent pace and often lifting heavy. Also, do eat food high in high antioxidants (vegetables, fruits, nuts and seeds, dark chocolate and wine (in moderation)).

In Summary:
Cholesterol is not bad. The oxidation and inflammation process has no relationship with total cholesterol level or even total LDL levels. Only small and dense LDL is bad.
Eating a low fat diet will not help you avoid heart disease because your high carbohydrate intake will do the work for you. Eating high carbohydrate and high fat diet is the worst case scenario.
You need high HDL level to help fix any oxidation problem in your arteries. Exercising regularly not only increase HDL, but also increase your insulin sensitivity (a good thing).

High intake of saturated accompanied with a traditional high carbohydrate diet – Very bad
High to moderate intake of carbohydrate – Bad
High intake of saturated fat accompanied by low carbohydrate consumption – Very desirable
High intake of saturated fat accompanied by low carbohydrate consumption AND regular exercise  – You’ll be immortal!


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