high cholesterol and triglycerides but eating TF for 2 years.

[moon mountain mama]

I have had digestive issues which I think are brought on by a parasite which started while I was 6 months pregnant. I have been testing for this for 6 months now. Toddler has it and mother-in-law has it. So, we are getting a metametrix test to help with this. However, in the meantime I find that my cholesterol and triglycerides are high and my liver enzymes are low. I am trying to make some kind of connections with this whole thing. I was vegetarian almost vegan about 2 years ago for about 17 years. I know that I had very low fat in take. Now, my intake of fat is high but of all the good kinds of fat. Raw milk, olive oil, eggs, raw cheese, coconut oil, and nuts.
I suppose my gall bladder could have atrophied from not having to metabolize fat for 17 years.
I'm just not sure where to go with all of this.
I do not feel that a TF diet would contribute to high cholesterol but maybe something not functioning right in my body to metabolize it.
Any ideas.

[jplain]

Do you have the numbers? HDL and trigs are the most informative numbers.

Can you describe your carbohydrate intake? (ie. types, approximate amounts)

It turns out that cholesterol and trig levels are linked much more tightly to carbohydrates than to fats, so don't worry about your total fat or saturated fat intake.

[moon mountain mama]

I'm getting those numbers today. I will post them later on.
I do not limit my carb intake. Maybe porridge or oatmeal (soaked) or eggs and toast for breakfast. Grilled cheese with coconut oil, butter, and saurkraut for lunch and usually I do have some sort of whole grain along with dinner. Too Much?

[moon mountain mama]

Just got the numbers, this is interesting:
triglycerides 172
HDL 82
LDL 165

I have a good number for HDL. I thought that if you have high LDL you probably have low LDL.
Tri is high too.
Could it be from too much grains?

[jplain]

Your ratio of triglycerides:HDL is fine. You'd like to see it less than or equal to 2, and yours comes in at 2. Your ratio of Total Cholesterol:HDL is fine too, assuming the LDL number is reasonably accurate. You'd like to see that ratio at or less than 4, and yours is 3.

The LDL number is unhelpful for two reasons. It was almost certainly calculated rather than measured, which is not terribly accurate. More importantly, not all LDL is created equal. When eating a high carbohydrate diet, you end up with a lot of small and dense LDL (called VLDL), which is considered unhealthy. When you eat a high fat diet, you end up with a lot of large and fluffy LDL, which is harmless. Unfortunately, the test that can determine your LDL type is very rarely used. Your doctor probably doesn't ever order it.

If you want to improve your lipid profile, try lowering your carbohydrate intake. You can see changes in lipid profile in as little as a few weeks, so if you're being hassled to take cholesterol-lowering meds or change your eating habits, it wouldn't hurt to recheck after a month or so of lower carb eating. (As an aside, statins don't appear to lower heart disease risk for women at all. Google for plenty of info that.)

Defining lower carb is the tricky part. If it was me, I'd aim for less than 150g of carbohydrate per day, including fiber. You can use a website like fitday to help you figure out carbohydrate grams until you get the hang of eyeballing it.

I choose to get most of my carbs from vegetables. Since you're eating TF, you might wish to continue getting carbs from grains, but you'll find that it doesn't take a lot of grain to add up to 150g carbs.

So to sum it up, if it was me, I wouldn't freak out about those numbers. They're not terrible. But I would play with my carb intake to see if I could bring the triglycerides down.

Good luck!

[moon mountain mama]

Wow, thank you. This is very helpful. How do you figure out the ratio? Not so great with math.
Are there resources where I can get this info. on cholesterol?
It seems that if I am following a sort of Weston Price Nourishing Traditions diet, traditional info. on cholesterol and triglycerides may not be accurate, I don't know.

[jplain]

A ratio is expressed as one number followed by a colon and then followed by another number, like this:

a ratio of 2:1
or
a 2:1 ratio

When reading it to yourself or saying it out loud, you would read it this way:

a ratio of two to one
or
a two to one ratio

A ratio is calculated by dividing the first number by the second. So for trigs:HDL, your number is 172:82, and when you do the division, it comes out to 2, which can also be expressed as 2:1 (two to one).

Regarding where to get information on ideal ratios, I've picked it up here and there, but I'll look around and see if I can find a concise explanation. Here's one:

http://www.yourmedicaldetective.com/public/523.cfm

Note that rather than using total:HDL, they're calculating HDL:total. So instead of a ratio of 4 or less, they want you to have a ratio of 0.25 or more. That's mathematically the same, just flipped upside down.

Regarding the relationship of carbs to triglycerides, here are a few links from a cardiologist's blog.

http://heartscanblog.blogspot.com/20...lycerides.html
http://heartscanblog.blogspot.com/20...ide-traps.html
http://heartscanblog.blogspot.com/20...lycerides.html

This blog author recommends a lipid profile target of 60-60-60, meaning an HDL of ~60, an LDL of ~60, and triglycerides ~60.

I suspect that it may not be easy to get your LDL down to 60 unless you limit saturated fat more than most would on a NT/WAPF-type diet. But as I mentioned before, LDL on a higher fat, lower carb diet is often large and fluffy LDL, which is thought to be benign. So the LDL number may be much less important to heart health than the HDL and triglycerides.

If you want to know your LDL subtypes, or if your caregiver is pushing cholesterol lowering meds, insist on an NMR LDL particle number test. Be prepared to explain why you want this test, because many doctors aren't well informed about the different types of LDL and their significance. Here are a couple of links from the same blog you might find helpful:

http://heartscanblog.blogspot.com/20...es-of-ldl.html
http://heartscanblog.blogspot.com/20...wald-liar.html

I hope that helps!

[moon mountain mama]

Thanks jplain

It seems so unnatural to have to check my triglyceride levels and cholesterol levels to see if I am eating right and balancing my diet right.
I've always thought that I was really good at this.
Of course being pregnant and nursing I took in a lot more fat and protein and probably cholesterol than normal.
But, we do stick to a pretty traditional diet.
All grains soaked, bread is homemade sourdough, all dairy is whole and raw.
I'm still so confused. because of course the most important thing is that we all are healthy. Seemingly I look it, perfect weight for my body size, fertile, and I have regular amounts of energy if the babies are letting me sleep.
This makes me wonder about the rest of my family. DO they all have this seemingly high cholesterol triglycerides profile?
Or, is it just my body type that is reacting in this way, or of course could it be from a vegetarian lifestyle for 17 years prior to this that makes it hard for me to digest fat?
But if I do have an issue digesting fat because my gallbladder is not working optimally, would that equal high cholesterol in my blood?
I wonder what Sally Fallon would say.

[jplain]

Your numbers really aren't so bad. You aren't going to die of heart disease next week or next year. In fact, you could change nothing and perhaps never develop cardiovascular disease. Assuming you aren't at risk of developing type II diabetes (ie. high or borderline fasting blood sugar, significantly overweight, family history), you probably only need to do a little tweaking with your diet. But be honest with yourself. If you are at risk of type II diabetes, make major changes now, in order to give yourself the best chance of maintaining good health.

If you had trouble digesting fat, it would just go right through you, and wouldn't cause high cholesterol. And if your gall bladder wasn't functioning properly, you'd eventually experience discomfort when consuming large amounts of fat.

Saturated fat isn't the problem and protein isn't the problem either. Some types of vegetable oils can be problematic though, so if veggie oils make up a large part of your fat intake, I can tell you more about that.

Difficult as this may be to accept, I am confident that carbohydrates, even if properly prepared, are the reason your lipid profile isn't yet ideal. But again, it isn't terrible.

What would Fallon say? I think she'd tell you to read her other book.

Eat Fat, Lose Fat

I'm pretty sure this book has been discussed here too, so you might want to search the archives. The diet plan suggested in that book does ask you to limit carbs.

Or check out Primal Blueprint 101 for a more restricted but still completely TF-compatible approach.

[moon mountain mama]

JPlain your awesome. Thank you.
I've been freaking out over this all week.
You've helped me a lot with all your info.
I definately will read both books.

There are a lot of you nutritional smarties out there. Maybe in a couple days I will post a sample menu of mine so you all can give me your thoughts on it.

[jplain]

I forgot to comment on your low liver enzymes. Hopefully you aren't worried about those, but in case you are, they're probably due to your digestive issues. Diarrhea is a common cause of low liver enzymes. If the digestive issue gets straightened out, liver enzymes will probably normalize. If they don't, investigate further.

(BTW, liver enzymes are not used for fat digestion. The enzymes used to digest fat are lipases, which are made by the pancreas. The liver does make bile salts, and the gall bladder secretes them. Bile salts are important for fat handling, but they're not enzymes.)

Just a thought...have you tried going gluten-free to see how that affects your GI symptoms?

With long-standing GI problems, I'd be worried about leaky gut. (Plenty of info in the archives here about leaky gut.) Even if gluten wasn't the cause of the leaky gut, it may be exacerbating the situation now, and putting you at risk of future autoimmune disease.