Friday smorgasbord

December 10, 2010 in Uncategorized | 8 comments

smorgasbordYou’ve probably noticed that I haven’t been able to write as much lately for the blog. I’ve been incredibly busy with my private practice, launching the Paleo Detox program, preparing and delivering talks locally, developing new content like ongoing class series and an eBook, and of course continuing my research on various topics.

I’ve got one more article to write for the series on diabesity. I’ll discuss what I believe to be the most effective form of exercise for restoring glucose tolerance and insulin sensitivity. I hope to get to that this weekend.

After that, I’ll be sending out a survey to get your input on the next series, as well as several other topics related to the blog and various projects I’ve got in the works.

I hope to get back to a more regular writing schedule at some point, but with everything going on it may take a while. In the meantime, I may try out some new formats, like posting a brief summary of articles from around the web that I’ve found interesting during the week.

Here are a few from this week.

Why Is My Cholesterol So High On This Diet?

In this article, Chris Masterjohn explains why some people see their cholesterol go up (often temporarily) when they switch to a nutrient-dense, whole-foods based diet. His theory, which is plausible from a physiological standpoint, is that the temporary cholesterol elevation is occurs because these folks are curing themselves of fatty liver disease.

In any event, we know that total and LDL cholesterol are weakly correlated with heart disease, so I’m never concerned when I see people’s cholesterol go up on a paleo or nutrient-dense diet. It’s expected. Especially when their HDL goes up and their triglycerides go down, which is the typical response.

Huge Metastudy: “Non Diabetic” Blood Sugars Cause “Diabetic” Retionopathy

Throughout my series on diabesity, I’ve presented evidence that blood sugar levels considered to be “normal” by mainstream standards are anything but, and that they can lead to complications like retinopathy and peripheral neuropathy.

Jenny Ruhl blogged today about a recently published meta-analysis that confirms this once again. In the study, blood sugar levels of 117 mg/dL or above, and an A1c of 6.3 or above (both below current limits) significantly increased the risk of retinopathy. But, as Jenny points out, the safe limits are lower still, because retinopathy is one of the last complications of diabetes to appear. Heart disease risk increases as post-meal blood sugars rise above 155 mg/dL, and increases in a straight line with A1c above 4.7, becoming quite significant as it rises above 6.

Grasse Based Health: Food For Thought

In this video, Peter Ballerstedt argues that animal protein and animal fat are not only superior to grains for human health, but also more sustainable from an agricultural and ecological perspective.

The presentation is quite dry, but the information is solid and it’s definitely worth watching.


Dana December 10, 2010 at 12:16 pm

Re: cholesterol going up: Also, Dr. Eades and other LC writers have noted that LDL is often *over*counted in low-carbers. The reason for this is the Friedenwald equation or Friedenwald formula. LDL is usually *calculated* for lab values, rather than counted directly, which would be more expensive. But if your triglycerides drop below a certain number, that skews the equation and makes the LDL number inaccurate.

There’s something Dr. Eades refers to as “the Iranian formula” which is supposed to be more accurate with low trigs. Alternately, ask your doctor to order the lab test that does a direct LDL count, and also to look at LDL particle size. If it’s large and fluffy, it probably doesn’t even matter what the LDL number is because you’ve got the healthy LDL anyway.

Chris Kresser December 10, 2010 at 12:28 pm

Yes. The ratio of TG/HDL is a surrogate marker for LDL particle size. If <2, it strongly suggests Pattern A (large, buoyant LDL) which is not a risk for heart disease. If >3, it’s indicative of Pattern B (small, dense LDL) which is a significant risk factor for heart disease. I use this measure first, and if a patient comes back with a number above 2, I order the NMR (lipoprotein subfraction analysis).

Marc December 10, 2010 at 6:18 pm

Hi Cris, is it possible that increasing saturate fats increase also triglycerides?
Since introducing meat & more fats my HDL has gone from 42 (my vegetarian period) to 59 but my triglycerides also skyrocket from 40 to 74.
Is there any reason that can explain this increase? something to be concern about?
I always thought carbs where the main culprit on triglycerides rise, but how does my trigs where so low on a heavy whole grain vegetarian CW kind of diet?



Chris Kresser December 11, 2010 at 8:17 am

Usually saturated fats don’t increase triglycerides, but Chris Masterjohn proposed a mechanism by which they could in the article I linked to above. Did you read it? Check it out if you haven’t already.

Rob December 14, 2010 at 12:36 pm

Hi Chris,
I’ve been reading your blog for a while now. It is great. Your thoughts on GERD in particular helped me immensely, such that I am now suffering very little from a condition that has been crippling me for about 9 years (and I am only 29 yo).

I am further provoked to read more because I figure I am at a somewhat high risk for heart disease. My father, a lifetime avid distance runner, non-smoker, and of a very healthy weight, suffered a minor heart attack at 49, necessitating a quintuple bypass procedure. They said he had a lot of blockage, but that his attack was minor because he had developed extra pathways for delivering blood to the heart from all his exercise (don’t ask me, I don’t remember any more than that). His brother, not in such good shape, dropped dead 2 years later at the age of 53.

You said above that “I’m never concerned when I see people’s cholesterol go up on a paleo or nutrient-dense diet.” I’ve been on your low carb diet for a while now, and think it’s possible my cholesterol is higher than before. My father had high cholesterol for a while, although never high blood pressure. I’m wondering if your recommendations about this type of diet, and your concern for people with high levels of cholesterol, are any different people with a background of heart disease, especially me (my Dad is on statins, and I think he is in the small percentage of people they have been shown to help, and I imagine he’ll keep to this regimen). I would like to know if this is increasing risk for me, since I am relatively committed to the low-carb approach for helping with the GERD. Thanks, and keep up the good work!


Chris Kresser December 14, 2010 at 5:52 pm


Watch these two videos. The dietary approach is the same, regardless of whether you’re after prevention or reversal. Heart disease isn’t caused by cholesterol. It’s caused by oxidative damage and inflammation. If statins have any significant benefit at all it’s because they reduce inflammation, not because they lower cholesterol. But of course it’s far better to simply remove inflammatory foods from the diet than to take a drug with serious and harmful side effect.

chuck December 16, 2010 at 12:34 am

What’s your thoughts on choline?

I saw this blog post:

and it seems like it could be rather important.. especially in those that may be genetically prone to it’s deficiency. However, there’s more than 1 form available… do you have an opinion Alpha GPC (L-alpha-glycerylphosphorylcholine) vs regular Choline?

Chris Kresser December 16, 2010 at 9:37 am

Chuck: yes, I read that article and I tend to agree that choline is essential. As always, I recommend getting nutrients from food when possible. Liver and egg yolks are the best choices.

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