Many people assume that a low-carb eating plan increases cholesterol. After all, the stereotype is a diet of meat, butter, and cheese. If you read Protein Power, The Zone, or South Beach, however, getting plenty of vegetables and even fruit is emphasized, in addition to a wide variety of protein sources, especially fish high in Omega-3 fatty acids like salmon, tuna, etc. Animal sources of protein all DO contain cholesterol and so it's only logical that if you're eating more of them, the levels of cholesterol in the blood will increase. As it turns out, though, this isn't exactly true. For one thing your body (primarily the liver) makes the vast amount of cholesterol that's in you. Many of those beginning a low-carb regime, however, do have increases in total and LDL cholesterol. This may have to do with the body readjusting to a new way of metabolizing food, or it could have to do with the fact that those on low-carb eating plans produce more of a large, fluffy, benign type of LDL rather than the smaller dense type. These larger particles may translate into a higher LDL and total count even though they are actually better for you than the smaller ones that don't have the same impact on the standard test. More on this below.

Whatever the reason, many people do initially have increased levels of cholesterol when first starting a low-carb plan. This tends to scare many of us because there is a great degree of hype in the media and from doctors of the danger of high cholesterol levels. Part of this is due to the pharmaceutical companies lobbying for lower and lower "safe" cholesterol levels. They want as many people as possible on their medications so they are going to try to get it down to the point where the entire population would have to be on these if they had their druthers. Let's not forget that if you read the literature for any of these medications, none of them claim to lower heart disease risk. All they claim to do is to decrease cholesterol. Isn't that the same thing? Not really, there are plenty who die of heart attacks with perfectly "normal" cholesterol, and plenty of those with "high cholesterol" who never get heart disease in the first place. Much of this is explained away by the very convenient notion of genetics. This is really just scientific sloppiness - some large segment of the population doesn't fit your model? Just make up a special excuse that takes them out of the equation!

I got my cholesterol checked after about 4 months of being on Protein Power and, as many others have, got alarmed at what I thought were high numbers for both LDL and total cholesterol. Some helpful folks on a Protein Power discussion board calmed me and said that it could take some time to go back down, so after another 4 months I got another check and those numbers were even worse. I decided I would wait a bit longer and after another 8 months, got tested again, with terrific results. Everything went in the right direction, and pretty significantly. Here's the breakdown on all the tests I've had so far:

(Note - Many only think that there is one cholesterol number. Doctors don't always explain that cholesterol is made up of many subtypes. Even those who are relatively knowledgeable about cholesterol and the three main subtypes (triglicerides, hdl, and ldl), generally are unaware that LDL has different subtypes itself - one that is large and fluffy and is considered no risk to heart health, the other small and dense and of high risk. This is one of the reasons why even the standard lipid profile which gives you ldl, hdl, triglicerides, and total, is inadequate. To really assess risk better one needs to know about ldl subtype (and other measurements like homocystine would go even further). So if a person has a high total that sasy nothing about risk, and even a high ldl says nothing. Because LDL is the variable here, any ratios involving it are also unreliable. I posted them up just for the heck of it. The only ratio that is supposed to have some real scientific validity is the one of triglicerides to hdl which should be under 5 and optimally under 2. The reason is that trigliceride levels can actually predict somewhat what the ldl subtype patter will be: those who have more of the smaller dense type of ldl also tend to have higher trigliceride readings whereas those who have more of the large fluffy ones have lower triglicerides. HDL (the "good" cholesterol) has been generally acknowledged to be a good indicator of heart health, and Doctors get very concerned when the levels get lower than 30, some would even say 40. There are tests that will determine the ldl subtype, but they are not widely available, so usually involve a lot of coordination on the part of a doctors office and of course added expense which probably would not be payed by insurance (around $400). Hopefully one day these tests will become more widely done and the whole fear aspect of high cholesterol will become toned down.)

As you will note from the numbers, I now am very close to being back at the initial test in terms of ratios and actually have a better HDL number than I did back then. I have wondered as to why that test taken way back before I was doing PP would be so good. That was 4.5 years ago and at that point I'd maybe been on only two diets in the previous 9 years, both of which were pretty moderate. Also when I had taken that first test I had just switched to a diet of fish as my only animal protein source just a couple years prior. Finally, and perhaps most significantly, I was still in my 20's then and probably more resilient in that sense.

Flash forward to the first test after starting Protein Power. Between that first test and the second one that came after it only 3.5 years later I'd been on at least two rounds of very-low-fat (and very-low-calorie) diets with extremely long periods of intense cardio, including one that was for 9 straight months before starting PP. So one theory is that at some point within those 3.5 years, there was a turning point where my system started experiencing some degree of insulin resistance which helped raise my base numbers, in addition to my metabolism changing a bit due to age. I wish I had gotten a test right before going on PP, but unfortunately I didn't.

The main point to take home here is that if one is concerned about cholesterol going up on a low-carb eating plan, you shouldn't be. You can get your cholesterol shortly after you start the eating plan, but chances are at least the total and ldl will go up initially (triglicerides almost always go down significantly even within the first month!). It can take your body 6-12 months, maybe even a bit longer for some, to readjust and for the numbers to start coming down again. But then they just keep getting better and better and its not due to any drugs (many of which have horrible if not fatal side affects) or a diet that is depriving you of any quality of life!

Copyright © Levi Wallach, 2003