im 16 and do crossfit, I eat 3 eggs a day and eat paleo. My mother thinks that i have really high cholesterol because of the eggs and that i’m going to have a heart attack one day. I keep telling her this info but she gets mad saying that high cholesterol is very bad and that she is a nurse and she knows. so, is eating 3 eggs a day bad for me?

thanks, alex

2) No wonder people who fall within the “guidelines” for cholesterol levels are having heart attacks and developing athero … the guidelines are too high. Those were the main points that your first two referenced articles were making. People think they have good LDL levels because their number falls within a certain range. There’s no magic cut off. Historically, changes to the acceptable ranges have been to decrease the margins. And those changes have been made by trial and error. Americans are still dying from athero with the current guidelines. I would venture to say that the guidelines will certainly be reduced again. Additionally, those people analyzed in the studies you linked to had really low HDL levels. And according to numerous studies, HDL levels are more predictive of developing athero than strictly LDL levels.

I’m stoked you have seen benefit from a qualitative shift in your chow. Pseudo-science wins again!!

On another note, my wife & I went totally Paleo 1-1-10 and are seeing a BIG difference. We had been on the Zone…lost weight, but didn’t have the increase in energy that we are experiencing with Paleo. Plus, your comments about “quality over quantity” just make more sense. And I’d rather look like you than Barry Sears any day. We’ve made use of the recipes on http://www.everydaypaleo.com site that your trainer setup…so tell her thanks.

Thanks again for all that you do on this and other sites…you’ve helped me “see the light” when it comes to nutrition. Please finish the book!!!Thanks!!
Brian

I have been taking Cod Liver Oil for some time now (will change to reg fish since hearing podcast 2?) My wife noticed a nice oil slick in the john with my urine. I am 6’2″ 220# and taking maybe 1- 2 tablespoons of the Nordic Naturals a day. I just saw the rainbow shine myself last night….cause for concern? Just got blood work back as well low TG 53, 216 total cholesterol, VLDL 11, LDL 141, HDL 64, and 3.4 CHOL/HDL ratio. My wife is a bit worried but after reading a bunch here and the first 3 podcasts i am thinking commit a bit more to the paleo ie. leaner meats and I am doing alright. I will ask the doc about that LDL ratio and the TG.

Thank You for this amazing resource!

You likely have some other genetic factors at play here but like you pointed out, our other dietary options are not going to improve the situation.

Joined CF one year ago and took the (8 week) Paleo Challenge in June. That was an incredible success for me, good stuff. One side effect was a loss of 15lbs plus, which was not necessarily a goal.

The problem, my cholesterol soared from 225 to 300. My Triglicerids were excellent and my hdl (75) good and ldl (215) bad. How can it be said that high cholesterol is safe? Every doctor I have met “freaked” at those numbers – want to put me statins. I refuse.

One question I have is eggs. I was eating 3 per day. I was also eating bacon once or twice a week. Otherwise I worked hard to comply. I don’t understand what, in the Paleo Diet, could cause this problem. To abandon the diet would mean cheese, grains – along with hypo-glycimia and legumes.

The doctor wants no meat, skim milk and some grains. “There is no such thing as ‘good’ fat” according to the doc. But other than the numbers, the benifits from eating Paleo have been tremendous for me. Any thoughts would be helpful.

“Yes, sprouted grains and beans are a much healthier option. When we ‘sprout grains’ we are allowing the seed to germinate and a shoot will emerge from the seed. This is the part that is cut off and eaten. Therefore, the seed itself is not actually consumed (as is the case with whole grains and wheat flours where the seed proteins and starches are milled and eaten). Since lectins are packaged along with the seed to protect against predation, once the seed sprouts, the lectin concentration diminishes within a couple days. In a week’s time the sprouts should have no residual lectins.

Gliadin and glutenin are the dominate proteins located in the endosperm of the seed. The starchy endosperm is located alongside the embryo (germ) within the seed, and provides nutrients the embryo needs as it is sprouting and growing. Therefore, there should be no gliadin or glutenin proteins in the sprout, but rather primarily non-digestible cellulous (dietary fiber). One can consume sprouted grains and beans without fear of anti-nutrients. However, keep in mind that these are still nutritionally poor in terms of micronutrients. Leafy greens and other vegetables contribute high fiber AND a higher concentration of nutrients-grains are still ‘nutritional lightweights’.

I would like to amend my earlier statement: We can consume GRAIN sprouts without fear of anti-nutrients. However, legume sprouts still appear to contain considerable concentrations of saponins–the secondary compounds responsible for increasing gut permeability. Alfalfa sprouts (which are actually in the pea family) have an especially high concentration.”

Thanks for the link!!! I will give that a shot

While I know it’s not true Paleo and one would be better off not chancing it but do you think sprouted grain products (yup, we’re talking Ezekial bread here) are a decent choice? I would think that it’s better than gluten free stuff.

Also I’d be curious to know if you have ever read any of Matt Stone’s stuff at http://180degreehealth.blogspot.com/ His position is basically eating enough of the right foods (mostly Paleo, he includes dairy, rice, potatoes and some sprouted grains) to repair the metabolism. Once the metabolism is repaired, the body will regulate to where it should be. Makes sense to me as he is a big believer in that proper digestion is the origin of health.

Thanks as Always,
Mark

Of particular interest is the section on saturated fat which indicates weak, if any association with CVD.

http://www.1to1vitamins.com/news/2009/artl7746.html

“Dr. Cinque’s comments: For years, those who have disputed the cholesterol hypothesis have pointed to the troubling statistic linking low cholesterol with cancer as proof that demonizing cholesterol is altogether wrong. And those who have advocated low-cholesterol or no-cholesterol diets, such as Nathan Pritiking, Neal Barnard, and John Mcdougall, haven’t addressed the issue- that I know of. Perhaps they have, but I am not aware of it. And it’s amusing that the medical establishment tries to debunk the idea that low cholesterol could cause cancer- but not because they’re championing starch-based diets but rather because they are hawking cholesterol-lowering drugs. What good would it be to take something to prevent heart disease if it also causes cancer? And, animal research with statins has indeed shown a troubling rise in cancer incidence among animals getting statins, and some human studies have also found the same. Is it because statins are carcinogenic in themselves or is it simply that they are very effective at lowering cholesterol, which (theoretically) protects against cancer? I can’t answer all the questions being raised, but I will say that I think it’s unlikely that low cholesterol achieved through diet causes cancer. All bets are off when it comes to the drugs. Note that even cancer patients who eat a standard American diet (and that includes most cancer patients in the US) tend to have lower cholesterol. When you have cancer, your liver doesn’t work as well, so it doesn’t make as much cholesterol, and your digestive system doesn’t work as well, and so it doesn’t absorb as much cholesterol. Plus, cancer patients, being very sick, tend to lose their appetite and eat less food, and eating less food tends to lower cholesterol. And that, collectively, is why cancer patients tend to have lower cholesterol.”

I am taking a product called Terry Naturally Tri-Iodine.

Here is a link for the product:

http://www.nourishingfoods.com/terry-naturally-tri-iodine-90-capsules.html

“Dr. Flechas has seen that iodine reverses polycystic ovarian syndrome”

DING! Robb, I have PCOS and you previously told me that some women see beneficial results from taking iodine. I cannot, for the life of me find it anywhere. They don’t sell iodine pills at nutrition supplement stores, health stores, grocery stores. I have searched for iodine online and only found it in pill form along with a multitude of other “thyroid enhancing vitamins”, which I don’t really know are necessary. Any input on a good iodine supplement I can take, and where to find it?

Thanks and keep up the awesome work!

Given what you just shared, I’d say she has some obvious cortisol overproduction. THIS by itself can push things towards insulin resistance and shifts the whole system towards the pro-inflammatory side. If I were her, I’d track down a doc well versed in cortisol management. I have a link to Garret Smith in my recent training update, he may be able to help remotely or you may know a naturopath/MD who is savvy to this stuff.

Here is a follow up with my client about the fish oil. This may have some implications.

“Here’s an interesting fact to consider about that… As I told you I have PTSD (Post Traumatic Stress Disorder) – and General Anxiety Disorder. At Duke University Medical Center, I went through a battery of tests & such when it was first diagnosed. Blood work, psychologocal analysis, TONS of questionaires & etc. I was fortunate enough to get to work with the director of the program at Duke – he was just incredible (Dr. Jonathon Davidson). All of that to say… One of the things I learned about anxiety disorder is that most people (who have general anxiety disorder) produce more sebacious fluids in general. It’s like your body’s always on high alert, or overdrive. I think that’s why I’m so sensitive to a lot of odd things. Will tell you more if you’re interested. BTW,I just had a great workout!

Julie”

Jesse

A little context for my questions: I eat meat and fruits and vegetables strictly about 6 days a week. Meat sources are typically grocery store bought grain-fed beef, chicken, and pork with eggs and/ or fish for breakfast and lunch meat for snacks. I’ve had good results athletically with these choices, but I have concerns about my long term health, especially related to my meat choices. I know that grass-fed, hormone free, etc is best but my wallet won’t allow for that. I wonder how much long term damage I’m doing with fatty salty meats if I’m balancing it with fruits and veggies, fish oil, and vitamin D.

1. My concern about sodium is because I eat alot of lunch meat and use some salt on my food at meals. Correct me if I’m wrong, but in Good Calories, Bad Calories Taubes makes the point that high sodium does not cause hypertension like everyone thinks it does and that the body will regulate its mineral levels fairly easily with no permanent damage. Cordain seems to be anti-sodium mostly due to acid overload. Any other reasons to avoid sodium long term? What about additional sodium for athletes, especially sweaty beasts like me? What are some signs of too much sodium intake?

2. I understand the acid/alkaline balance idea of the paleo diet and how it relates to calcium. If you’ve removed dairy from your diet, I understand that you can get calcium from several vegetable sources, but unless you are eating collard greens and spinach in huge amounts each day, it’s pretty hard to get anywhere close to the amount of calcium in dairy. How much calcium does the body need to function optimally (is the number different from the USDA prescribed 1000mg/day) ? With the relatively low amounts of calcium in a dairy-less diet, how does one ensure that they are not leaching bone calcium just to keep blood levels maintained, especially if they are eating large amounts of meat, salted or not? In an earlier post I saw you advise against calcium supplementation. I’d like to avoid supplementation beyond a Centrum as well, but I am concerned about my long term bone health and short term athletic performance as it relates to calcium.

3. In this post you’ve covered cholesterol in the body and how it is not a good indicator for heart disease. If one is supplementing with fish oil to balance the Omega-6s in fatty grain fed beef, are there still dangers in eating large amounts of fatty, grain fed meats from the saturated fats?

Sorry to write a book here, I understand that each of these topics might be better suited to a message board post, but I thought they might each be relevant to the post and comments.

Best regards,
Jesse

Huge hats off to you for your generosity in providing your time and knowledge on this stuff! It amazes me…seriously.

By the way, lost in the discussion of statins is the resulting reduction in CoQ10 levels.

Oh, and I would love to grab a beer with Dr Cordain and ask him about the need for supplements when paleo-ing (ok, not really a word). His books recommend them, but I question their bio-availability and large, single-dose forms. I guess I could marginally sign off on a Cal/Mag/Zinc supplement or perhaps even a B-complex, since Paleo doesn’t seem to afford much in the way of these. But vitamin C? Really?

Maybe Paleo Foods should come up with a vitamin-enriched Patron?!?!

Thanks again for all that you do, Robb.

Now, what I see in our clinical practice is folks emulating a low-ish carbs paleo diet and getting “good” blood lipid markers from nearly anyones perspective. A few folks end up with some slightly elevated LDL (but with a shit towards large variety), but we are seeing triglycerides, CRP, A1c all plummet. That net effect is all good.

I guess where I’m coming from is there are bigger fish to fry than LDL. Emulating a standard paleo diet fries those fish well!

I would not be surprised if the statins are working on different pathways in general. They are anti-inflammatory and decrease fibrinogen and modify calcium signaling, as you indicated. From the perspective of “First, do no harm” I think it’s an easy sell to use N-3 therapy in favor of most of our current tools.

THANK YOU for the input and great info.

Thanks for replying. This is certainly a subject of much debate at the moment. I think the possible benefit of omega-3 supplementation is only now beginning to be understood. What the field lacks at the moment is a clear head-to-head comparison of statins alone vs statins + n-3 vs n-3 alone. This would complement the current research, which shows that omega-3 fatty acids improve outcomes when added to statin therapy (The JELIS study, Lancet 2007). In this study, the effects of n-3 supplementation were particularly large for the subset of patients with impaired glucose metabolism, which I think you would find interesting.

Omega-3 fatty acids have shown some promise both in reducing inflammation as well as in modulating sodium and calcium currents in myocytes and reducing thrombosis. The last two functions could effectively reduce the incidence of atrial and ventricular fibrillations and stroke, two of the largest risk factors for sudden death in patients with CAD and/or heart failure. The latest review I saw showed a clear dose-dependant relationship between n-3 amount and reduced CV events. Whether these pathways are redundant with those targeted by statins remains to be seen.

I think clinicians have been wary in the past of prescribing n-3 supplementation post-MI because of the concern about hemorrhage when combined with aspirin or warfarin (both common CV therapies). These concerns have been laid to rest though, and more and more clinical trials are testing the effects of combining n-3s with standard first-line therapies.

Thanks for a great discussion!
NikkiT

“Nov 17, 2008 … Loren Cordain has written another gem of a paper on the subject. Studying the blood cholesterol levels of hunter-gatherers, Cordain concludes that total cholesterol should range between 70 and 140 mg/dl, while the harmful LDL cholesterol should be between 50 and 70 mg/dl. …”

This looks a bit like the decrease in IGF and it;s dip in MI’s. Interestingly, the dip in IGF is thought to be a causitive factor in the MI, yet the dip in LDL is NOT? That’s interesting!

Statins DO appear to prevent some forms of cardiac death, but at often remarkably high cost (rhabdo, cancer risks). This when we have safe alternatives such as fish oil seems a bit irrisponsible.

http://www.joslin.org/Files/Nutrition_ClinGuide.pdf

http://www.joslin.org/1083_2162.asp

This study was also interesting – done in NZ, where the Zone diet (compared to Atkins and standard high carb) got best results for prediabetic overweight women, it was a year long.
http://www.nzherald.co.nz/section/1/story.cfm?c_id=1&objectid=3605474

The study also concluded that the Zone diet “may be the best overall approach to reducing the risk of cardiovascular disease and Type 2 diabetes”.

Personally I think diabetics need to go lower carb and eat paleo choices, but at least authorities are now going this far.

To use the terms “idiots” when referring to the developers of body of science that has saved countless lives seems a bit contrarian. The field of medicine adopts changes slowly and carefully, and only after outcomes research has been carried out. Ideas that “make sense” are not always true- either that high LDL is the sole cause of CAD or that it has no link at all. And the community is not unaware of the mixed effects of statins- this is the reason the FDA now requires new dyslipidemia drugs to prove efficacy in terms of hospitalizations and deaths rather than changes in cholesterol alone.

The linked article summarizes an interesting study, and Robb’s interpretation of the data is pretty divergent from that of the study’s authors. I would argue that the results of the study don’t really contribute to our understanding of LDL’s significance at all. The established observation by ER doctors, known for over 30 years, is that LDL measurements taken within 24-hours of an acute coronary event will fall well below those of the same patient when tested days later as an outpatient (see http://www.medscape.com/viewarticle/409780 for further citations). So these values are not a patient’s “true” cholesterol reading.

The post takes a stance against statins that I think would be at odds with most cardiologists’ recommendations. Yes, good diet will give you many of the benefits of statins, but there have been many, very large placebo controlled clinical trials that have shown the clear benefit of statin treatment in terms of hard outcomes (deaths, hospitalizations). These improvements are likely to be due to a combination of the anti-inflammatory effects and anti-hyperlipidemic effects of theses drugs. Finally, nobody in the field believes the cholesterol is the sole cause of CVD. There are many risk factors for CVD, including hypertension, diabetes, low HDL, high LDL and smoking.

That said, I do encourage the questioning of science dogma- this is what scientists do as well and it encourages a civil debate that challenges the status quo. I’ve found your articles enlightening and I thank you for helping to bring the ideas of paleo eating to a large audience.

Cheers,
NikkiT

Zone protein levels are pretty damn low but seem adequate for most folks for performance and health. If you were on say, 10 blocks, that is only 77g. I THINK that would be fine and actually well within the guidelines they have set for you.

Keep me posted.

I guess I do…If i want some dark chocolate covered almonds or some carne asada tacos, I go for it. I honestly just don;t want that stuff very often. I “never” have gluten containing items as that ruins me for several days. I get sufficient cross-contamination just being on the road.

Thanks for taking time to answer my questions. BTW I found your site by the way of Melissa Urban’s site.

Again Thanks.

Off subject, but I remember one of your previous posts mentioning how the attendees at your cert had definitely done the pre-cert reading ahead of time. I’m coming to your cert at CF Marina next Saturday and haven’t gotten anything aside from the confirmation email from CFHQ–am I missing out on something?

is there a huge difference between brands of fish oil? i take the 900 mg epa/dha/capsule from sam’s club. 4/day so i get 3.6 g epa/dha/day.

also this is off topic, but do you ever have cheat meals? if so how often?

I have been taking Fish oil for years, eating paleo for 8 weeks, and just started taking Vitamin D because my Doctor told I have low blood levels of Vitamin D.

I heard niacin can raise your HDL. Also iodine and Vitamin K are important for heart health too. Do you any of these three supplements are important?

I replied, “a relatively high fat diet, with most of the non-animal protein fats coming from nuts and avocados, and low consumption of refined carbs.”

His response? “Hmmmm… I don’t understand that, but keep doing what you’re doing!”

Now I feel like an idiot! I’ve been on Paleo for about 1-1/2 yrs, take a couple tblsp per day of Nordic Naturals Cod Liver Oil…but have NOT been supplementing with Vit-D. In fact, at the onset of my change to a Paleo diet, which was done for the expressed purpose of dropping Vytorin, I trashed all the vitamin supplements in the cupboard.

So I have to ask — should I take a chelated type, one with cal/mag as well? How many IU’s?

Thanks,
Mark

Worst was yesterday with diabetic patient who had pre-exercise BG of 94. Was told to give her snack, as her BG “was too low to exercise”. Felt like I was ordered to poison her- HAD to give her 8 oz of orange juice and a package of graham crackers She changed her mind and said she would rather go to cafeteria to eat, could she eat a muffin. The diabetic educator said yes, same time I said no. I backpedaled, suggesting half the muffin, then said even better would be egg whites with spinach (trying to be AHA “healthy”/ mainstream) with some fresh fruit – and I was told later I do NOT know what I am talking about and please leave diabetic counseling to the certified educator. 2 hrs later: her pre exercise BG was 234. Her post exercise BG was 205. Guess what meal she ate? It made me sad. Angry.

Lost 2 patients this week to complications from CAD/DM, had 2 peri-exercise code blues, resulted in ER admissions. This isn’t funny. These people think they are doing the best they can. They are TRYING so hard to eat well, do the right thing. I have been able to make small dents -proud of the fact that I have been able to get most of my patients on fish-oil, CoQ 10, vit D- I had to make a presentation to my boss with all kinds of studies for back up. Except for the diabetic educator, I have support from the entire staff and a reputation for my holistic approach. I even gave a patient some reiki ( I am reiki practitioner) and nobody said anything, so maybe things are slowly changing. Let’s hope.

On a personal note- I have having blood drawn AGAIN on Monday, as one month post rhabdo my creatinin levels are still high. BUN is normal, GFR is low (but thats always estimated) Nephrologist thinks lupus may be playing a part ( I had a pos ANA last year). Everything I read about protein and kidneys scare me- that I should be eating a low protein diet to reduce the load on my kidneys. Do you have any research you could direct me to that will quell my fears of battering my kidneys with too much protein by-product?

Thanks for all that you do.

From and MD/Phd who, If I recall correctly, got Merck busted to the tune of several hundred million dollars for falsifying statin info.

keith

http://bit.ly/3S170M

Reminds me of the cholesterol curve (http://bit.ly/3S170M)….the whole curve (which modern medicine neglects to show). Seems that at 140 and under people are at the same high risk for death just like 240+…..more eggs please. I think it mentions that it is also high rate of suicide when cholest is too low.

Another thing…..more people on statins….more people with too low cholesterol…..more people with brain disorders such as depression and Alzheimers….coincidence????

“Almost 75 percent of heart attack patients fell within recommended targets for LDL cholesterol, demonstrating that the current guidelines may not be low enough to cut heart attack risk in most who could benefit,” said Dr. Gregg C. Fonarow, Eliot Corday Professor of Cardiovascular Medicine and Science at the David Geffen School of Medicine at UCLA and the study’s principal investigator.

http://www.diseaseproof.com/archives/stroke-salt-hemorrhagic-stroke-risk.html

Well, not really if you actually take the time to research the topic. So, I guess from some perspectives, your tinnitus resolution is “all in your head”!! And I guess the 50-60 other folks who have reported the same tinnitus resolution are suffering some kind of paleo hypnosis.

Nordic naturals is VERY good quality. folks who have a fish allergy are typically able to take this brand (read the label to double check). It is more purified than the costco variety…but im not sure that matters for most folks, especially when the price point is considered.

Norwegian fish oil? Any different from what I can get out of the Costco brand?
Great cartoon.

I’d like to thank you for that seminar you did in Bozeman. MT recently. I didn’t attend but my wife did and did she ever come away with a pile of notes and great ideas. She’s instituted some changes in our diet based on that seminar and I’m feeling fantastic.

I’d like to mention that eating Paleo (it’s not a diet for us) has had some unintended but welcome side effects. The tinnitus in my right ear has come under control and the ringing has stopped. Also, my sinuses have cleared up considerably.

I know this is the result of Paleo since we were on a 30 day challenge and after I went back to my old habits for a couple of days and the ringing came back. I’ve since gone straight paleo again and stopped the ringing. I’ve had this for nearly 4 years and I can tell you that utter silence is a blessing.

Really interesting stuff. How long does it take to get a plasma change in LDL of that magnitude? Is the liver changing it’s metabolism in the days leadng up to the MI? The hours?

Just as an FYI…while I didn’t read the methods of the paper you linked stating that a lot of people with MIs have low cholesterol, just wanted to point out that in the acute setting when you see these people, i.e. 24-48 hours after an MI, the LDL is LOW secondary to the MI. It later rebounds back to whatever standard range it normally runs. Interesting, huh?. I’ve had numerous patients on my cardiac ICU rotation presenting with massive MIs, a lipid panel is drawn and their LDL is in the 60s – 70s. My attending loved to pimp residents/students with: Why is this person on statin? If not, Why should we start one, why shouldn’t we, etc… Initially, almost everyone says, no statin, their LDL is 70. WRONG. Their LDL is much HIGHER.

Doesn’t change much of what you said, just wanted to point it out…