No blog about LCHF or Low Inflammation Living would be complete if it did not tackle this issue. Yes, HIGH CHOLESTEROL!! The response to carbohydrate restriction varies from individual to individual. For some there’s no change, for others there’s an improvement and for others still, cholesterol goes up, in some cases WAY UP! Why the erratic, seemingly random response between individuals to LCHF? Further, if your cholesterol does go up, should you be worried?
Meet Heather
Heather (not her real name) is 64 and from the USA. She has been keto since 2014 & got in touch with LIHF Living to tell us about her life of strict LCHF and high cholesterol. Heather kindly agreed to tell her story on the condition of anonymity. Her original email is shown below..
Heather’s original email to LIHF Living. Click to enlarge..
Lipids & Bio-Markers
Heather has been meticulous in her record keeping and also sent me an excel spreadsheet with her lipids and bio-markers dating back to 2008.
Heather’s Lipids & Bio-Markers. Click to enlarge..
Conclusions
Heather’s overall cholesterol has increased substantially since going keto in 2014. So has her LDL (“bad cholesterol”). However, her TG/HDL ratio seems fairly steady. No doubt her physician would have her on statins in a heartbeat! Note as well that her waist circumference has fallen during the same period and is currently sitting right on limits for her gender & ethnicity. If you use waist/ height ratio as your guide, she comes in at 0.51, just above limits (0.50). Heather is exercising on a regular basis, remains generally “unconcerned” about her lipids & feels happier & healthier than before.
My views
Heather is doing all the right things as far as I can see. After having exchanged several emails, the only MAJOR difference between her diet and mine is DAIRY..
If I were Heather I would be slightly concerned about my waist, something she admits in other emails is a problem, quote: “I am fighting the waist a bit, I admit.” Something inflammatory is preventing it from coming down to “comfortably” below limits. Mine crashed 5cm when I dropped all industrial seed oils and ghee. My latest lipids/ bio-markers also show an improvement since doing so. I have suggested dropping ALL dairy to see if that helps, which may also improve her lipid panel scores at the same time.
Heather talks about the correlation between her stress levels & LDL. Long-term stress is definitely inflammatory and can be a MAJOR external factor featuring on your Inflammation Pyramid. More on this in future posts..
I know of 2 other people, both health professionals, who are LCHF and have high cholesterol. One of them is also on statins because of a family history of CVD (father died in his forties from a heart attack). Again, the only difference between them and me is DAIRY. I have asked both to come forward with their stories, anonymously if necessary so that we can ALL learn. I appreciate that it’s potentially a sensitive subject and I can’t force them. Only time will tell whether they decide to or not..
My overall view is this: If you have identified EVERYTHING on your personal Inflammation Pyramid, including external factors such as stress, have done everything in your power to both eliminate/ minimize them AND get your waist to below limits, then you have done everything that you possibly can do to reduce your overall levels of inflammation. If after all this you still have high cholesterol, then so be it. In that case you just happen to be a person with high cholesterol, the same as some people have blue eyes and others have brown. High cholesterol in the context of high-carb has different connotations to high cholesterol in the context of lo-carb. However, we need more data on this to be certain. Since LCHF is fairly new, we need LOTS more people such as Heather to come forward with their stories. Only then can we start to draw some solid conclusions, meaning that the entire subject of LCHF and Low Inflammation Living is and remains very much a “work in progress”.
Finally..
I would like to thank Heather for coming forward and providing us all with such a detailed health history.
Do you have a similar story to tell? Then please come forward, anonymously if necessary. Your privacy WILL be respected at all times. We are all here to learn!
I look forward to reading all of your comments..
Good luck with getting some people on board.
Amazing how much crap has been spouted about cholesterol in the media over the years!
Thanks KetoEnd! Appreciate the comments. Yeah, let’s get this ball rolling.. 😉
A couple of points to consider:
1. The waist measurement is possibly the most useful around, BUT … we shouldn’t use (I believe) the same measure for all men or all women. We are really looking for an easy proxy for a desirable body composition. That of someone 180cm should be geometrically similar to that of someone 150cm — so the waist-height ratio is the better measurement. And the boundary is super-easy: 50%. Waist should not exceed 50% of height. By that standard, I now have less than 2cm to go (today I am below 80cm — progress, albeit slow). I find numerous papers on the use of this via Google Scholar.
2. I would be very interested to see your experiment (if you decide to do it) regarding the reintroduction of ghee. I use the USDA nutritional database for my best source; using that, I ran some comps. If you like, you can also run the complete nutritional profile of a food, but the fatty acid breakdowns are not quite identical, so I didn’t want to confuse things. The TL;DR version is that cream and cheese (at least cheddar, though gouda is similar; not sure about mozzarella or parmesan) have much more SFA and much less MUFA and VERY much less PUFA than canola oil (I used Standard Reference values and not any Brand-supplied info). This, I think, complicates your lumping of ghee and canola oil as both responsible for your inflammatory effects. Maybe – need some single-variable data there.
Thanks for your comments & clarification..
It’s not the fats in dairy that are the problem per say, it’s the proteins, whey and casein in particular, as well as bovine insulin which is not removed during pasteurization. These are what I believe are the principal causes of inflammation in dairy (see podcast #0002). Yes, I inadvertently changed 2 variables after my Cretan holiday but rapeseed oil (canola) is a no-brainer for me. That’s a definite source of inflammation for everyone due to high Omega 6 & 9 content so that’s NEVER coming back into my diet! Regarding ghee, well now that I’ve been off it for over a year, the truth is I (we, as a family) really don’t miss it at all (apart from choc mud cake ;)). Making it, although easy and fun, is time-consuming and buying it over here is prohibitively expensive and further, since my bloods, my waist and everything else is finally “just peachy”, why take the risk, albeit it a small one of re-introducing it? I am enjoying “the party” too much to let anything spoil it! 🙂 They say that ghee contains no animal proteins at all. In theory that’s correct but the skeptic in me says I’m not so sure..