High Cholesterol

I've crossed posted this question on other groups (low carb, keto, etc.) I've been told that I have high cholesterol and am now concerned about the fat %. I have macros set at 75f/5c/20p.

Do any of you have high cholesterol? Have you been okay by doing this? I have been eating eggs in the morning and am now wondering what I should eat instead, etc.


  • Dragonwolf
    Dragonwolf Posts: 5,600 Member
    I haven't see the other places you've posted this that I recall, so I'm going to respond here (and apologies for the late response).

    First, "high cholesterol" doesn't really mean anything when it comes to heart disease risk. Total cholesterol is pretty useless for the most part. 50% of CVD incidents are in people with "healthy" total cholesterol, and heart attack rates have gone up since the start of the "low-fat" era. The better indicators are HDL, the HDL:TC ratio, and LDL particle size.

    Second, carbohydrates increase triglycerides, decrease HDL numbers, and decrease LDL particle size. These are all very bad things. Fat, on the other hand, does the exact opposite.

    Third, there is no valid evidence that correlates fat intake with worsening cholesterol numbers, the same goes for dietary cholesterol. Even in so-called "super-reactors" or people that did show a statistically significant increase in response to intake, we're talking 5-10 points, maybe. There is a bit of a caveat to this -- LCHF does increase the LDL number in the standard cholesterol tests, but that's because it increases particle size, not particle number. This is an important difference, because it's the small LDL particles that cause problems, not the big ones (which have attributes more similar to HDL particles). This makes the standard cholesterol test very misleading. Additionally, very low triglyceride numbers (which is common among ketoers) breaks the formula used to calculate LDL in the standard cholesterol panel (that's right, LDL isn't even actually measured, it's calculated). The break causes the number to be artificially inflated. Therefore, it may be a good idea to request that the doctor/lab directly measure all numbers, and request an LDL particle size test.

    Most people I know, myself included, have seen cholesterol numbers improve when switching to LCHF, even (especially?) when they started out high (I was scolded for years about my cholesterol, until I went LCHF and now my numbers are "optimal" nearly across the board). There are a couple of reasons for this. The first, I already stated -- the fats increase HDL and LDL particle size. The second reason is that cholesterol is manufactured in response to injury or inflammation. So if your cholesterol is high, it's very likely that something is causing inflammation in your body (kind of like how your blood pressure is higher if you're in pain, under stress, etc). For a lot of people, going to LCHF/keto also means the elimination or drastic decrease of foods or food types that may have been causing inflammation in the system (gluten, simple carbs, nightshades, etc), which results in less inflammation and ultimately, lower cholesterol.

    So no, don't worry about your fat intake. The idea that fat intake = heart attack is a complete and total fabrication. For an interesting history lesson, check out this video by Dr. Peter Attia --
  • klindema
    klindema Posts: 55 Member
    I haven't logged in in months- been happy to maintain my weight loss without daily tracking. BUT- I just had blood work done and my LDL went waaayyy up... from 130 in August to 190! My HDL increased modestly from 48 to 56, and my vitamin D looks better (from 18 to 23.9) but my doctor was really surprised, too. She is supportive of low carb diets, BTW.
    - Also- my TSH has been getting lower and lower, which started when I switched from Synthroid to Armour, but I'm always surprised to see my dosage decrease after over a decade of it increasing.

    I'd really appreciate your input- my parents both have high cholesterol, so it's partly genetic, but why the sudden change??