I've been having cholesterol tests done for the last couple of years to track my progress and they do actually show a trend. In May 2009, I started logging what I ate and my body stats so that I can compute patterns from the data.
Below. Actual data between Carbohydrate and Low-Carbohydrate diets. The Macronutrient data is an average intake of mine per day over a 30 day period before the blood test (only included when known and not including day of test). Blood levels are in mmol/L and macronutrients are in grammes.
| Date | HDL | LDL | Total Chol. | Serum Trig. | Fat | Carbs | Pro |
| Jan 2008 | 1.31 | 2.11 | 3.7 | 0.62 | - | - | - |
| Dec 2008 | 1.28 | 2.77 | 4.3 | 0.54 | - | - | - |
| Nov 2009 | 1.24 | 2.87 | 4.4 | 0.63 | 60.96 | 309.11 | 90.99 |
| June 2010 | 1.8 | 3.62 | 5.6 | 0.4 | 260.28 | 35.10 | 130.13 |
Observations
Can you see where I started on the low carb diet from the Cholesterol levels alone? I can. I started on the 2nd January 2010. Up until then I was on a carbohydrate based diet for my entire life. I cannot add in the values before May 2009 as that's when I started religiously logging my daily intake. Days where I missed something out of the log are not included, only days with a complete and thorough log are.
According to the Mayo Clinic's Guide on Cholesterol Levels my HDL level is now in the "Best" range (which actually starts at 1.5mmol/L), my LDL and Total Cholesterol is "Borderline high". I must point out that even the Mayo Clinic are calling LDL the "Bad" cholesterol; however without it we would die. I get into this a bit more later.
Exercise
This is a weird area. Since around mid-2008 I have been very active. That includes running, weight training, indoor and outdoor cycling and climbing. I have always been told that HDL increases and Cholesterol levels decrease when you exercise. If that's the case, I would hate to know what my levels would have been if I hadn't have exercised.
That aside, I'm far from being inactive. I cycle to work every day, I cycle recreationally whenever I can and have just started running again. Exercise was a major reason why I lost a lot of weight (read muscle and fat) between mid 2008 and mid 2009. But it also seemingly didn't help to counteract the diet I was on, but that's speculative; it may have helped a lot.
Analysis
What is surprising, however, is that my HDL was actually going down and my LDL and total cholesterol was going up whilst on a normal "healthy" diet and being active. The November 2009 macronutrient values are actually very close to the U.K. GDA (300g Carbs, 95g Fat) and would even be considered "healthier" because of the lower fat intake.
In the end, I would have been placed on Cholesterol enhancing drugs, to get my LDL and total Cholesterol down even though, ironically, I was on a diet that I was told is the best one for me and even more ironically that those drugs would have made my actual health worse.
My increase in all of HDL, LDL and total Cholesterol was very much to be expected and I would have been absolutely shocked if that wasn't the case. What I was pleasantly surprised about was the Blood Serum Triglycerides, they had gone down even further below the NHS range of between 0.6-2.3.
LDL transports cholesterol and triglycerides in the blood to the cells that require them. I'm basing my diet on lipids and not carbs (which do not require a transport protein) so most of my energy comes from lipids and ketones. That is why my LDL has increased.
My HDL has, unsurprisingly, increased in relation to this change too. HDL removes unwanted cholesterol from the cells, transports cholesterol for synthesis of steroid hormones, helps to process vLDL to LDL and also combines with other proteins to combat certain parasites.
We shouldn't be looking at the ratio between HDL and LDL or LDL and total Cholesterol as markers for increased risk to CHD. The best indicator, at the moment, is the ratio between LDL and Serum Triglycerides (ST). The higher the ST:LDL ratio, the smaller the LDL particles such as vLDL. vLDL proteins are the aptly named very-low density lipoproteins and are required for transporting triglycerides in the blood. These are the very small LDL particles that are the actual bane of our health once they become oxidised (free radicals / losing electrons) - but are definitely not the only ones. I will leave free radical production for another post but free radicals are the actual cause of many of our problems on the American Diet. Any molecule can become a free radical; just that when vLDL do, they can cause a lot of problems.
I must note here, however, that the ST:LDL ratio is yet again just another correlative pattern. No study or evidence yet shows that vLDL is the actual cause of CHD. People are yet to look objectively at what makes these natural and standard proteins into little killers or whether it is just another symptom alongside CHD.
My levels of Serum Triglycerides actually fell just over 35% and HDL increased by a whopping 45% whilst on a very Fat-rich diet. You might be thinking; Well you must have been eating a lot of Unsaturated "healthy" fats like Olive oil. Nope, in fact more information is presented in the table below, you'll be surprised.
| Date | kcals | Protein | Carbs | Sugars | Fat | Saturated | Fibre | Sodium |
| Nov 2009 | 2201.16 | 90.99 | 309.11 | 142.09 | 60.96 | 22.49 | 26.93 | 2.91 |
| Jun 2010 | 3006.97 | 130.13 | 35.10 | 22.12 | 260.28 | 148.76 | 3.77 | 2.1 |
| U.K. GDA | 2500 | 55 | 300 | 120 | 95 | 30 | 24 | 2.4 |
That's right, on average at the moment I am eating about 150g a day of saturated fats. That's 58% of my fat intake and accounts for about 1300 of my daily calories.
Again, values are in grammes and are the average per day for 30 days prior to the blood test (not inclusive).
Wrapping up
I've known for a very long time that cholesterol is not bad for you. LDL isn't "Bad", HDL isn't "Good". Saying that HDL is good is relative. They are both required (as are the other 3 types of lipoproteins) which is why the Liver produces them. I'm very glad to see my cholesterol profile is getting better.
Now that I am eating what I should be eating, my body can far more efficiently control chemical levels. Years ago we didn't have nutritional stats, GDAs, blood tests, statins et al. We just ate what came naturally and instinctively to us. Now we have all of these things, our population is getting healthier? Actually no.
Obesity levels in people under the age of 45 have been increasing with a definite correlation with type-2 diabetes. Activity levels have only decreased slightly in the last 15 years and calorie intake has actually also decreased.
One interesting fact comes from studies on monkeys where they were fed a "normal" (read Carbohydrate) diet but had the calories restricted. The levels of cancer, diabetes, cardiovascular disease, brain atrophy and Alzheimer's was severely lessened[1]. But they unfortunately took that to mean lowering the total amount that we ate was better for you, instead of lowering the amount of Carbohydrates. I wish they had controls that were fed normal amounts of calories but of low carb and then seen the results. I'm absolutely sure that it would have shown that both were as good (if not the low-carb being better) at reducing these diseases.
They do, however, actually say that the evidence corroborates earlier conclusions that lower fasting insulin and glucose levels as well as higher insulin sensitivity and LDL profiles were associated with lower risk of atherosclerosis within those calorie restricted animals[1]. Tell me if I'm wrong, but didn't that just sound like they were saying that the effects of lowering carbohydrates were better. Can't they really see that link? They're thinking that restricting calories on a "normal" diet is better for us, but for some reason we still "need" to have a diet based on carbs? There are other solutions.
But also note how they say the diseases were only lessened, not eradicated or never showing symptoms. So somehow some of the monkeys were showing signs of diabetes or CHD even with restricted calories. I just don't understand why they didn't just restrict carbohydrates - liver controls blood glucose by gluconeogenesis - diabetes be gone.
Although I am severely lacking in trust with carbohydrates, we can't really blame them. I was having this discussion with Scott, and it's not the fact we eat carbs, it's the fact we base our lives around them. Carbs are energy, that's all they ever have been for the body. They don't get used in any other bodily function, so we should treat them as such; but we don't.
I can understand why athletes, who need energy, eat more carbs. But why the average person doing the average amount of exercise? Why do they need more energy than the nutrients that actually keep us alive? The body makes it's own glucose from the protein we eat and so therefore regulates blood glucose levels precisely without having to constantly battle with our gluttony. I just don't understand why.
Back onto the topic of Cholesterol..
The liver produces lipoproteins. It would be hard to believe that evolution would have favoured something that so readily kills us as a mechanism for nutrient transportation. It's only since we started to do unnatural things (e.g. manufacture foods) that we have had these problems.
I'll be having another test in a few months and will again post the results. I may also vary the amount of protein and saturated fat to see other mid-term effects they have. I am expecting LDL to stay roughly as it is with HDL to increase slightly.
