About colestrol and saturated fat

Marti

Hi, I am 55yrold woman. I have copd but am well and quite fit. I am slightly under weight since starting Keto in Aug. I go to the gym 2/3 times a week and feel great. My cholesterol is high and my Doctor wants to put me on Statins and Aspirin. They said I have mild disease in two arteries in the heart. I am worried about the mixed messages around saturated fat and cholesterol. I don't want to take Statins but don't want to get ill either. I have made fat bombs but am afraid to eat them. I live in Ireland and always have eaten butter etc. But being told to cut it down by doctors and eat more by keto community. Confused. Help.!!

Susan_RD_101

@Marti and @WellFed

This opens a whole can of worms as health professionals continue to debate low-fat vs. low carb and the role of saturated fat in heart disease.

The American Heart Association's Presidential Advisory on saturated fat is that it should be replaced by unsaturated fats found in whole food sources (think nuts, seeds, avocados, etc.) to lower risk of heart disease and blood cholesterol levels.

It's also important to keep in mind that the overall dietary pattern we follow is more important than the sum of its parts. In my practice, I advocate for a whole-foods, mostly plant-based diet to achieve normalized blood cholesterol levels. This doesn't mean eating a low fat or low protein diet, but one that provides an abundance of healthful nutrients while minimizing those that could be dangerous to our health.

Best of luck!

Marti

Thanks Susan. I am playing it safe and steering more toward plant based diet with some saturated fat until I get cholesterol checked again.

Susan_RD_101

One of my favourite sayings is "nutrition research can't take place in a bubble..." But, unfortunately, it does. Often when researchers are looking at saturated fat, they will look at it's role in heart disease alone, or diabetes alone, or Alzheimer's alone, rather than the combined impact of this type of fat an array of chronic diseases. This is where so much of the confusion comes from.

Overall, the health community hasn't endorsed saturated fat as neutral in all health conditions (as there seems to be a link between certain types of cancer, Alzheimer's and diabetes). However, there might not be as strong as an impact between saturated fat and heart disease, especially if a person's overall dietary pattern is healthy.

My advice to anyone feeling overwhelmed by the confusion is to stick to eating what has always been considered healthy: fruits, vegetables, whole, unprocessed grains, nuts and seeds, and beans. If you feel great, are managing a healthy weight, and have healthy blood vessels, you are doing great!

WellFed

I agree. This saturated fat is good/bad thing has been really confusing for me. It seems there are two camps of thought and you have to pick a side. I'm just going to do what feels right, so for now saturated fat is a part of my diet.

Marti

Thanks , I would happily choose the saturated fat if the Drs didn't tell me I'm at risk of heart problems or stroke. I'm having cholesterol checked next week for first time since being on Keto. Maybe numbers have improved. I will let you know.

WellFed

I recently found out that coconut oil has the highest amount of saturated fat of any of the plant based oils and yet it's celebrated by the low carb community. Since learning this, my gut reaction is to switch to other healthy fats and avoid coconut oil. I wish the debate would end on saturated fats and appropriate cholesterol levels.

Is a higher cholesterol ok as long as HDL levels are high? That's what I have read in the paleo blogs, but modern medicine disagrees, so my doctor will not be pleased if my total cholesterol is 200-220 even if my HDL is high compared to last year since switching from the SAD diet to eating a paleo diet that incorporates a lot more vegetables than I have ever eaten. Who's right, especially when I feel better now than I ever did on the SAD diet?

Marti

Yes I feel really good on Keto but am worried about the saturated fat, which means I am not getting enough fat and am loosing to much weight. Its just a worry as they said I have mild disease in arteries. I am quite fit and healthy otherwise. Would love to know who to trust.

Karen_Cronometer

Some of the confusion regarding cholesterol comes from the fact that we make cholesterol in our bodies when we need it, but we can make less cholesterol in our body when we are getting enough in our diets. Some experts believe that cholesterol may only be harmful when we consume over and above the amount our bodies need – not that all cholesterol we eat is bad.

The reason we call LDL cholesterol the ‘bad’ cholesterol is because it carries cholesterol around the blood to deliver to all the places that need it. When we have all that we need and then consume too much cholesterol, LDL spends more time in our blood stream where it can stick to arteries and start the process of heart disease.

The reason we call HDL cholesterol the ‘good cholesterol’ is because this is the type that picks up cholesterol from around our body and takes it back to the liver to remove or recycle it. Higher HDL means we can remove more cholesterol from around the body and reduces the chance of developing heart disease.

Each person is different and could have high LDL and high HDL, high LDL and low HDL or any combination. Your health care provider will take into account the total, LDL and HDL cholesterol to advise what is best for you.

Marti

Thanks Karen, That's helpful information but the problem is that my health care provider is telling me the exact opposite to Dr Mercola and the Keto recommendations. Health care is telling me to cut back on fat especially saturated fat, Keto is to eat mostly fat hence confusion.

Marti

Thanks Susan. I think your probably right in my case balance might be the key for me. Its a pity as I loved the Keto diet.

snatale42

Seeing as how there has never been an ACTUAL link to serum cholesterol and heart disease, do what feels best for you. A standard cholesterol panel is NOT an indicator of cardiovascular health and it never has been. The AHA has said coconut oil is good, bad, good and now it's bad again and that's just with coconut oil. Either have a lipoproifle done which shows you your LDL sub -types or a Cardio IQ test which will ACTUALLY give you an indicator of cardiovascular health. More than half the people who suffer a coronary event have normal cholesterol, statins have never been shown to lower people risk of a repeat event. No shortage of reputable studies that show this.

Susan_RD_101

@snatale42

Thanks for sharing! You bring up a good point. Our lipid profile is only one of the contributors to heart disease. In reality, what we eat, our physical activity level, smoking, stress, genetics, along with our lipid profile influence our cardiac risk.

Also, regarding cholesterol, you are correct. Most people's blood cholesterol will not change with the ingestion of dietary cholesterol. However, there is a sub-group of the population known as "cholesterol-responders" (I'm one, sadly!) who are at high cardiac risk and for some reason, will respond to cholesterol in food.

Kind regards,

WellFed

I have been stressing out about my cholesterol for no reason. I just had it tested and my total cholesterol is in normal range and down almost 20 points. My triglycerides dropped 26 points! LGL is still high, but I think that's typical for a LCHF diet. Glucose is well within normal range and dropped over 10 points from last year. I'm going to stick with the saturated fats because it seems to be working for me.

Incidentally, I get tested every year and noticed that my cholesterol was the highest when I was eating a high carb vegetarian diet. I was drinking smoothies every day. My glucose was high that year too and I needed an A1C test. Needless to say, I stopped the smoothies right away and went back to eating animal protein.

Susan_RD_101

@WellFed

The target for LDL cholesterol is based on an individual's cardiac risk (i.e. the higher the cardiac risk, the lower LDL cholesterol should be). Genetics also play a significant role in determining an individual's lipid profile.

The American Heart Association recommends replacing saturated fats and refined carbs with unsaturated fats to improve lipid profile. However, I think the most important piece of advice is to consider your overall dietary context. Professionally, I think carbs, fat, and protein are equally important, but the source from which they come from is key. Whole, unprocessed grains have a completely different nutrient profile (and biological impact) compared to refined and processed grains. Similarly, saturated fat that is processed is likely to have a greater impact than saturated fat that comes in natural, unprocessed food form.

Kind regards,