Paleo Diet: New Data Shows HDL Might Not Be So "Protective"

Cholesterol molecule

Model of the cholesterol molecule. Image created by RedAndr. Courtesy of

Ask five different “experts” about cholesterol, and you’ll no doubt get five very different answers. Sure, the overall “Paleo” view of cholesterol’s relationship to health and longevity is very different from the mainstream ideology, but even many ancestral health aficionados don’t have a firm grasp on what those famous numbers actually mean.

Who does know? That’s a great question. There are several people that THINK they know what it’s all about, but there are still many un-answered questions, and lots of un-proven theory.

Regardless of all of the persistent confusion, for a while now it has been generally accepted that a high LDL number is not good, because it is indicative of systemic inflammation, and a low HDL to LDL ratio is also not good, because HDL was thought to be “protective”. Therefore, a higher HDL number is desirable for the avoidance of heart disease……right?

New Data Shows HDL Might Not Be So “Protective”

An article was published on the website on May 16th 2012, called “Doubt Cast on the ‘Good’ in ‘Good Cholesterol’”, that damages the idea that we were actually beginning to understand this whole cholesterol thing.

“Now, a new study that makes use of powerful databases of genetic information has found that raising HDL levels may not make any difference cheap viagra online to heart disease risk. People who inherit genes that give them naturally higher HDL levels throughout life have no less heart disease than those who inherit genes that give them slightly lower levels. If HDL were protective, those with genes causing higher levels should have had less heart disease.

Researchers not associated with the study, published online Wednesday in The Lancet, found the results compelling and disturbing. Companies are actively developing and testing drugs that raise HDL, although three recent studies of such treatments have failed. And patients with low HDL levels are often told to try to raise them by exercising or dieting or even by taking niacin, which raised HDL but failed to lower heart disease risk in a recent clinical trial.”

“The study’s authors emphasize that they are not questioning the well-documented finding that higher HDL levels are associated with lower heart disease risk. But the relationship may not be causative. Many assumed it was because the association was so strong and consistent. Researchers also had a hypothesis to explain how HDL might work. From studies with mice and with cells grown in the laboratory, they proposed that HDL ferried cholesterol out of arteries where it did not belong.

Now it seems that instead of directly reducing heart disease risk, high HDL levels may be a sign that something else is going on that makes heart disease less likely. To investigate the relationship between HDL and cardiovascular risk, the researchers, led by Dr. Sekar Kathiresan, director of preventive cardiology at Massachusetts General Hospital and a geneticist at the Broad Institute of M.I.T. and Harvard, used a method known as Mendelian randomization. It is a study design that has recently become feasible with the advent of quick and lower-cost genetic analyses.”

“Dr. Kathiresan said there were many things HDL might indicate. “The number of factors that track with low HDL is a mile long,” he said. “Obesity, being sedentary, smoking, insulin resistance, having small LDL particles, having increased cholesterol in remnant particles, and having increased amounts of coagulation factors in the blood,” he said. “Our hypothesis is that much of the association may be due to these other factors.”

“I often see patients in the clinic with low HDL levels who ask how they can raise it,” Dr. Kathiresan said. “I tell them, ‘It means you are at increased risk, but I don’t know if raising it will affect your risk.’ ”

That often does not go over well, he added. The notion that HDL is protective is so entrenched that the study’s conclusions may prove hard to accept, he and other researchers said.

“When people see numbers in the abnormal range they want to do something about it,” Dr. Kathiresan said. “It is very hard to get across the concept that the safest thing might be to leave people alone.”

And that may be the best advice that I’ve ever seen in an article of this type, “the safest thing might be to leave people alone”. Exactly! What good can it possibly do, to give people drugs to alter their levels of cholesterol, when we really don’t know what it all actually means?

The data over the last 30 years shows that people with high, middle or low cholesterol numbers have been dying with almost exactly the same frequency from heart attack……so what do we really know about cholesterol?

If you read the article, you’ll notice that it basically says that raising HDL through artificial methods, doesn’t necessarily do anything, but naturally possessing a high HDL is potentially protective……so until we figure out exactly what prompts an elevated level, in these people with naturally higher levels, it won’t do us any good to try and push HDL up with drugs. It seems that the people who already have higher HDL are healthy for a reason…..maybe it’s because they eat a diet based on whole foods?

To me, this is just another reason to eat according to our ancestral model. When we eat so much industrially processed and synthesized food, we generally see lessening health. Let’s face it, the only reason we began scrutinizing cholesterol numbers was due to the diseases of civilization…..which are almost certainly due to our crappy modern diet. If we just practiced eating what we evolved to eat, surely we would have no need to track and attempt to alter our Cholesterol levels.

Maybe manipulating cholesterol does absolutely nothing, and eating real foods in line with our ancestral model will do everything to make our health better. That’s where the Paleo diet Template comes in!


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Barry Cripps is a Paleo-based, Certified Nutrition and Wellness Consultant, who operates out of Bowling Green, Kentucky.

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