01 Jun The Fat and Cholesterol Myth
Paleo and Cholesterol
If somebody had told me 15 years ago that today I would be preaching the heart health benefits of a diet rich in fats and abundant in meat and absolutely void of all legumes and grains, I doubt I would have believed them. And yet, here I am telling you about the benefits of a Paleolithic Diet for promoting cardiovascular health and correcting dyslipidemia (unhealthy cholesterol levels).
Dietary Cholesterol Does Not Cause Heart Disease
When it comes to health professionals today, the vast majority still practice with the belief that cholesterol is one of the primary “causes” of heart disease; thus recommending avoiding it in our foods and lowering blood levels with statin drugs. It seems that many perceive atherosclerosis as the result of a cholesterol created “sludge” that builds up like grease in a drain pipe. The truth is the build-up of plaque in our arteries actually develops after damage occurs to the arterial wall in the presence of inflammation and only when LDL cholesterol becomes oxidized.
While dyslipidemia does have to do with dietary choices, it has very little to do with dietary cholesterol intake itself. In fact, the true dietary culprits of dyslipidemia are inflammatory trans fats, hydrogenated oils, sugar and processed carbohydrates, as found in the Standard American Diet. Meanwhile, Paleo-friendly healthy fats found in grass-fed beef, cold water fish, organic eggs, olive oil, and coconut oil are very anti-inflammatory, thus beneficial for treating dyslipidemia.
American Heart Association’s Top 5 Risk Factors
Today, in the US heart disease results in 1 in 6 deaths occurring from what we’ve long considered to be the end result of the top 5 modifiable risk factors: elevated cholesterol, hypertension, diabetes, obesity and sedentary lifestyle. While I’ll agree that the other risk factors may have a more direct correlation to heart disease (as they actually cause injury to the vessel walls) cholesterol seems to be incorrectly categorized. In fact, 75% of people who have heart attacks have normal cholesterol levels!
The truth about cholesterol is that it is absolutely necessary (in adequate amounts) for survival. Much like protein is the building block for muscle; fat and cholesterol are the building blocks of the brain, myelin sheaths around nerves, and cell membranes. Cholesterol also promotes immune function, acts as a precursor to all hormones, and supports healthy vitamin D levels.
Now I’m not saying that high cholesterol levels have no link to heart disease as we do know that 25% of those with heart disease have elevated cholesterol levels. However, those using statins to manage dyslipidemia should consider the side-effects of these drugs as 10-15% statins-users experience muscle, liver, and nerve damage, sexual dysfunction, and face an increased risk of diabetes (71% in post-menopausal women)! In addition, a 2007 article in The Lancet found little evidence proving that statins reduce the chance of a first heart attack and have only been shown effective in those with existing heart disease by reducing the chances of a second heart attack, most likely by reducing inflammation and oxidative stress. In the case of Familial Hypercholesterolemia (dysfunctional gene coding), the benefit of statin intervention may outweigh the risks, however these drugs should still be administered AFTER dietary and lifestyle changes are implemented.
In considering the benefits of statin drugs (for those without familial hypercholesterolemia), there really aren’t many besides their ability to lower inflammation and oxidative stress; two key factors with direct effects on cholesterol levels and most health conditions in America today. However, those hoping to reduce inflammation and oxidative stress will have great success with simple lifestyle changes including regular exercise, stress management, adequate sleep, maintaining a healthy body composition, and an anti-inflammatory diet.
Today, the most widely researched and recommended diet for reducing inflammation and oxidative stress and promoting healthy cholesterol levels is the Mediterranean Diet. Like the Paleo diet, the Mediterranean promotes antioxidant rich fruits and vegetables and anti-inflammatory healthy fats. However, unlike the Paleo diet, it still promotes the intake of inflammatory grains, legumes and dairy over protein-rich organic meats and eggs (even going as far as placing red meat in the same category as sweets!). In my opinion, those who are truly serious about reducing inflammation and managing cholesterol levels would be far better off replacing those grains, legumes, and dairy with just a few more antioxidant and fiber rich vegetables and fruits and anti-inflammatory organic meats, as provided in a balanced Paleo-style diet.
Remember, what you put at the end of your fork is more powerful than anything you will ever find in a pill bottle!
-Jason M. Kremer, DC, CCSP, CSCS