Cholesterol On The Paleo Diet: Is My 130 Better Than Your 130?

Nutritionists say “Eat more whole grains”

Whole grain bread, whole grain pasta – these words sound deceptively wholesome and healthy. But these “wholesome” whole grains have a higher glycemic index (GI) and glycemic load (GL) than table sugar. Just look at the table below.

Comparison of Glycemic Index and Glycemic Load of sugar, bread, rice and other carbohydrate-rich foods

Why should you even care about high Glycemic Index and high Glycemic Load?

Because eating foods with high glycemic index and high glycemic load leads to increased blood sugar. High blood sugar stimulates the pancreas to release insulin. High insulin level triggers the liver to produce large amounts of fatty acids. The liver then floods the bloodstream with triglycerides (TGs). High triglyceride level stimulates production of small LDL (low density lipoprotein) particles.


What are small LDL particles and why are they so bad?

woman thinking cholesterolWhen the liver receives dietary fats from the intestine, it packages them into “parent” particles called VLDL. VLDL then can either give rise to large LDL or small LDL.

In the absence of carbohydrates the balance shifts toward large LDL particles. The really ugly thing about carbohydrates is, even though they themselves don’t contain any fat, they spike the liver production of fatty acids which raises the triglycerides level.

The end result is a lot of small LDL particles. High TG levels are easily sustained when you snack on pretzels, have a bagel or a muffin for breakfast, a turkey sandwich on whole wheat for lunch and a bowl of pasta primavera for dinner.

Small LDL particles, unlike large LDL particles, elude our liver because the liver does not have good receptors to “catch” them.

Small LDL particles therefore last longer than large LDL. They also get oxidized much easier than large LDL and get attacked by our immune system when they circulate in the bloodstream.

These immune attacks cause inflammation in the blood vessels. Small LDLs particle size also makes it easy for them to lodge in the lining of blood vessels. All this contributes to build up of inflamed fat deposits inside the arteries – atherosclerosis.


Humans are not meant to eat carbohydrate-based diets

It looks like evolution did not prepare us for eating a lot of carbohydrates. In my opinion, the fact that our liver does not have a decent receptor to clear small LDL particles triggered by the carbohydrate-based diet gives strong support to this statement.

The liver has efficient large LDL receptors which remove these lipoproteins from the blood stream after they performed their various functions. Moreover, fats and protein from meat do not cause insulin release. This pushes the fate of VLDL particles toward large LDL.

The small and transient increase in triglyceride level after eating meat or butter is insignificant in view of what happens when we eat carbohydrates. To top it off, no liver fatty acid production gets triggered because there is no insulin spike.


My 130 is better than your 130

large LD small LDL If you exist on the carbohydrate-based diet and your doctor is happy with your “cholesterol level”, think again.

Low cholesterol does not tell you anything about what goes on inside your body. If we both have LDL level of 130, you can bet that you have many, many more of those small LDL particles that cause fatty plaques in the arteries.

When these plaques grow, they increasingly block vital arteries that supply the heart and the brain. When the plaques get large enough, they cause heart attacks and strokes.

Now you know that small LDL particles are much more sinister than large LDL particles because:

1. small LDL deposits itself easier into the lining of arteries – the fatty plaque that leads to atherosclerosis

2. gets easily oxidized – free radical formation leads to faster aging, inside and outside

3. is attacked by immune cells in the bloodstream – source of constant inflammation

4. it eludes the liver because it cannot be easily picked up by liver LDL receptors, unlike the large LDL particles – has more time to hang around and cause harm


Bottom Line: Carbohydrate-based and low-fat diets do more harm than good by increasing bad small LDL. The paleo diet, based mainly on meats and vegetables, returns the body to its ideal balance by putting an end to sugar and insulin spikes and giving your body nutrients it was evolutionarily designed to process and harness.



Beyond Routine Cholesterol Testing: The Role of LDL Particle Size Assessment.

The Diet-Heart Myth: Why Everyone Should Know Their LDL Particle Number

Wheat Belly. William Davis, MD


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