Cholesterol effects of carbohydrates

Let's take a hypothetical person, say, a 50-year old male. 5 ft 10 inches, 160 lbs, BMI 23.0. He's slender and in good health.

Our hypothetical man eats a simple diet of vegetables, some fruit, nuts, and meats but avoids processed industrial foods. By macronutrient composition, his diet is approximately 30% protein, 40-50% fat, 20-30% carbohydrate. His starting lipid panel:

Total cholesterol 149 mg/dl
LDL cholesterol 80 mg/dl
HDL 60 mg/dl
Triglycerides 45 mg/dl

His starting lipids are quite favorable (though I don't often see this kind of starting panel nowadays except in athletes). We begin here because this hypothetical man is going to serve as our test subject.

We ask our hypothetical man to load his diet up on "healthy whole grains." He complies by eating whole grain cereals for breakfast, whole wheat toast; sandwiches made with whole grain bread; dinners of whole wheat pasta; snacks of granola bars, whole wheat pretzels and crackers.

Three months later, his lipids show:

Total cholesterol 175 mg/dl
LDL cholesterol 130 mg/dl
HDL 45 mg/dl
Triglycerides 150 mg/dl


You can see that LDL cholesterol has increased, HDL has dropped, and triglycerides have increased. This wave of change is the hallmark of carbohydrate excess, but more specifically of overreliance on wheat products. Beyond his lipid panel, the man has gained 10 lbs, all concentrated in a soft roll around his abdomen, his blood sugar is now in the "borderline range" of between 110 and 126 mg/dl, i.e., pre-diabetic.

If we were to examine this man's advanced lipoproteins (e.g., NMR from Liposcience, or VAP from Atherotech), we would see that there has been an explosive increase in small LDL particles, along with a shift of large HDL to small, and the appearance of multiple abnormal classes of particles called VLDL and IDL (signalling abnormally slowed clearance of dietary by-products from the blood).

Familiar scenario? The "after-carbohydrate" situation is the rule among the people who I first meet who claim to be eating a "healthy" diet, though their patterns are usually much worse, with higher LDL, lower HDL, and much higher triglycerides, an exaggeration of our hypothetical man's abnormalities.

What if our hypothetical man now goes to his conventionally thinking (read "taught medicine by the pharmaceutical industry") physician? What will likely be the advice he receives? Reduce his saturated fat intake, eat plenty of healthy whole grains, take a statin drug.

Although my illustrative man is hypothetical, I've seen this scenario play out many thousands of times. It happens in real life all the time. It is predictable, it is highly manipulable. Sadly, it is rarely recognized for what it is: the result of excess carbohydrates, or what I call "Carbohydrate Intolerance Syndrome."

The misinterpretation of this condition has created 1) an epidemic of diabetes and pre-diabetes, 2) a nation of frustrated obese Americans, 3) a $27 billion per year statin industry, 4) another growth opportunity for the drug industry in diabetes drugs.

Comments (31) -

  • Mark

    3/24/2009 1:16:00 PM |

    Great stuff as usual. Dr. Davis, would you say that this general approach to nutrition is the path to health:
    EAT REAL FOOD = Meat and vegetables (starchy tubers included), fruit, nuts and seeds, oatmeal/oat bran, quinoa, white rice, and properly soaked beans

    I come to this conclusion based on how the body is able to digest food, info I learned from the Whole Health Source blog. I'm still unsure about peanuts and dairy (not raw dairy, the regular store stuff). If you have an opinion on this approach and on peanuts/dairy, it would be great to hear. Thanks!

  • bee

    3/24/2009 1:30:00 PM |

    from personal experience (As someone who eats whole grains, but has cut down my overall cab intake recently), this is so true. than you explaining why this happens.

  • Anonymous

    3/24/2009 1:48:00 PM |

    Your hypothetical man matches me perfectly! I am lighter by about 25 lbs. My doctor has me on Lipitor and I am struggling to keep my sugar levels under 100.

    When will we ever get to understand medical issues better?

  • Tom

    3/24/2009 5:24:00 PM |

    The blood panels show a correlation --
    but don't we also need an *explanation* for why whole grains are bad?

    Nearly all of nutrition science seems to involve looking for, and thus inevitably *finding*, correlations.

    Is it to do with lectins?

  • Scott Moore

    3/24/2009 6:01:00 PM |

    Anonymous - A couple things...

    We do understand the medical issues pretty well. It's just most doctors don't understand nutrition at all. Seems weird, doesn't it?

    Unless you have already had a heart attack, you should probably get off the Lipitor. (I am not a doctor, but I play one on the Internet.)

    Get off the carbs, especially wheat and food with refined sugar, right now.

    You should buy, and watch, Fat Head by Tom Naughton. 100 minutes, easy to understand, profound message.

    Then you should read Good Calories, Bad Calories by Taubes and Protein Power by Eades & Eades. The first is a long read, dense but well-written, and pays back your efforts 100-fold. The second is an easier read and will feel more practical and applicable to your daily life.

    Then start reading these blogs to point you in the right direction, and keep you on the path: this blog, Protein Power, Mark's Daily Apple, Jimmy Moore's blog.

    You can thank me later. ;)

  • JPB

    3/25/2009 2:39:00 PM |

    Check out the blog "Spark of Reason."  Dave has written 2 pieces on the ill effects of eating wheat.

  • Anonymous

    3/26/2009 2:18:00 AM |

    http://jn.nutrition.org/cgi/content/full/136/2/384

    Trevor.....re-evaluating 15 years of veggieism

  • Trinkwasser

    3/26/2009 6:59:00 PM |

    BTDT.

    The one thing that put me on the Path Of True Dietary Enlightenment was my BG meter.

    This taught mt that the dietician actually WAS trying to kill me.

    By doing the exact opposite from what she told me I now have BG mostly in a normal range, and following on from that my BP came down and lipids normalised. Also I lost all the weight she caused me to gain.

    I already ate "real foods" but based everything around Healthy Whole Grains and washed them down with fruit juice. Now I avoid them and eat more of everything else, especially those yummy saturated fats which keep my HDL up. Somewhere around Primal/Protein Power (see the links Scott provided) is my sweet spot. I guess everything is toxic in overdose but the overdose level of carbs is way lower than most people believe. For me, about 60 - 100g a day keeps the insulin level down which improves the metabolism of everything else.

    What I found is, if you eat the carbs you manufacture them into far more fat than if you'd just eaten the fat in the first place.

  • Heidi

    4/2/2009 4:08:00 AM |

    Hi, I'm new here and find this blog fascinating and very informative.  A few things:  I'm at a loss as to where to start with a low-carb diet and what to eat for meals, especially breakfast.  And how to get my two-year-old to eat it?!  Does anyone have any thoughts on this?  We are starting to do the research and trying to figure out the heart-healthy lifestyle.  Would this exclude ALL grains (and sugar) ALL the time?  Or can we still have them in moderation?  I mean, I don't want my kids to be too deprived, we've already been on a gluten-free diet for a few years and are now embarking on low-carb as well per our doctor's recommendation.  It's mostly for my husband who has the heart disease in the family and the poor cholesterol ratio and would like to take preventive measures but we all want to be healthy too....
    Any ideas?  Thanks!

  • Trinkwasser

    4/3/2009 1:10:00 PM |

    Breakfasts

    http://loraldiabetes.blogspot.com/2006/10/breakfasts.html

    I base mine around fish and salad

    Things you can pretty much eat ad lib

    http://www.diabetes-support.org.uk/joomla/free-veggies

    Basically I replaced the carbs with more of everything else. Check out

    http://www.proteinpower.com/drmike/

    http://www.marksdailyapple.com/

    just for starters, then follow on to the other blogs referenced from here and those sites, you will soon be overwhelmed with ideas

  • Klimbsac

    4/9/2009 5:51:00 AM |

    I recently came accross your blog and have been reading along. I thought I would leave my first comment. I dont know what to say except that I have enjoyed reading. Nice blog. I will keep visiting this blog very often.


    Joannah

    http://myscones.com/

  • Kelvin

    4/10/2009 12:54:00 PM |

    I recently came accross your blog and have been reading along. I thought I would leave my

    first comment. I dont know what to say except that I have enjoyed reading. Nice blog. I will

    keep visiting this blog very often.


    Joannah

    http://myscones.com/

  • VLDL Cholesterol Range

    7/15/2009 6:24:31 AM |

    Very informative blog on chlesterol effects of carbohydrates.  Looking forward to read more on cholesterol, here.  Thanks for sharing.

  • Anonymous

    10/25/2009 6:37:38 AM |

    I never know whether this limited carb stuff applies to me.  I am 54,6foot tall, weigh 145 pounds and my measured body fat is 11%.  My family complains I am too thin.  I run very intensively (160 heart beat) 6 times a week for fourty minutes (5 miles).  I eat every day a huge portion of pasta with tomatoe sauce(no cheese ever, I hate cheese).  Is what counts the amount of pasta (carb) intake even if I burn it that same day and never store fat.  I have found that reducing my carbs causes me to run poorly and crave sugar after my runs.  If I skip the pasta,I am sluggish.  Should even I be concerned that my carb intake increases cholesterol?

  • Physician Answering Services

    2/10/2010 12:02:18 PM |

    Many people have high blood cholesterol levels and therefore they are exposed to heart disease. Age, gender and genetic heritage are all factors of risk in heart disease due to high blood cholesterol levels. Men are more predisposed to having abnormal blood cholesterol levels than women. People with ages over 50 also have cholesterol problems, as their bodies can’t eliminate the surplus substance. Overweight people, people with internal disorders and people with diabetes have high blood cholesterol levels due to overproduction of this substance inside the body.

  • tareq

    2/14/2010 5:05:36 PM |

    same thing happenned to me
    and I had to go on statins

  • high cholesterol foods

    2/15/2010 3:37:55 PM |

    aren't wheat products considered complex carbohydrates?... does that mean complex carbs contribute to the increase of bad cholesterol?..

  • Mike

    3/19/2010 9:19:03 AM |

    People who are highblood are prone to heart disease.  No matter what your age is, you can still have a highblood.  Basically, people should watch their food intake (diet) at an early age.  In this way, they could avoid any possible disease they might acquire in the long run.

  • Anonymous

    4/6/2010 11:52:36 PM |

    This has probably been addressed in another blog post ... sorry ...

    My understanding:  cholesterol accumulates on arterial walls as a patch for damage to the arteries.  The damage is caused primarily by insulin spikes, which occur with the ingestion of large quantities of carbohydrate (of any stripe).  Blaming blood cholesterol is silly, it's just the patching material.

    My question:  if one stops ingesting large quantities of carbs (and therefore theoretically stops creating new arterial damage), what happens to arterial plaque?  Does it decrease, stay the same, or does cholesterol in the blood continue to accumulate on top of the existing plaque matrix?

    My thought:  if the answer is that it continues to accumulate, we're basically still at the mercy of drugs and a low cholesterol diet to stem the build-up.  So I'm wondering:  once exposed to enough carb damage to create arterial plaque, are we doomed to the same fate as those who keep on eating big-carbs?

  • Edwin

    4/12/2010 6:47:19 PM |

    The amount of wheat we as a society consume is mind-numbing - for all the diversity of food we have at our disposal, it's unreal how restricted most diets are.  It only makes sense that any problems with such overconsumption would gradually reveal themselves as lifestyle epidemics. Get gruel (or maybe just some nice oatmeal with cinnamon) back in the schools, I say.

  • Cholesterol Institute

    7/24/2010 5:30:57 PM |

    As we get older we tend to experience certain health conditions that some may consider as part of the aging process, like having high cholesterol due to amount of the carbohydrates that we usually take in. Getting the right food, exercise and knowing the ways to lower your cholesterol naturally brings a lot of advantages to prevent or at least control them.

  • christopher

    8/28/2010 6:39:53 AM |

    Very informative article! I told my friends to visit your blogsite too! I am learning a lot from the things I read online, I never thought that we should take high level of cholesterol seriously because it will impact our health.

    Diet for Lowering Cholesterol

  • Anonymous

    9/14/2010 5:09:04 PM |

    Hi there,
    I'm a doctor called Amr Ebied.
    I believe in the power of prevention of diseases, and taking that into account, writing about cholesterol has always inspired me.

    I have a new post about the first step of nine to act if you think you have high cholesterol.

    I'll be glad if you all visited it and give me your feedback.

    The url is:
    http://aeonlineclinic.wordpress.com/2010/09/10/nine-things-to-do-if-you-think-you-have-high-cholesterol/

    Or you can visit my other blogpost:
    http://online-health-shop.blogspot.com/2010/05/when-it-comes-to-cholesterol-there-is.html

    Thanks.
    Amr Ebied.

  • kurtis

    10/4/2010 5:29:30 AM |

    Thanks for the heads up. I am also working out for my cholesterol level to normalize. I am on a strict diet for months now.

    Diet for Lowering Cholesterol

  • buy jeans

    11/3/2010 3:19:00 PM |

    We ask our hypothetical man to load his diet up on "healthy whole grains." He complies by eating whole grain cereals for breakfast, whole wheat toast; sandwiches made with whole grain bread; dinners of whole wheat pasta; snacks of granola bars, whole wheat pretzels and crackers.

  • ultrasonic liposuction guide

    1/18/2011 6:30:04 AM |

    Try having a vegetarian meal made with beans or tofu and vegetables instead of a meat based meal from time to time.Eating simple carbohydrates can increase your chance of becoming insulin resistant. Insulin resistance is diagnosed when you meet certain criteria.

  • liposculpture guide

    1/24/2011 5:24:20 AM |

    Eating simple carbohydrates can increase your chance of becoming insulin resistant. Insulin resistance is diagnosed when you meet certain criteria.

  • mike

    2/28/2011 7:03:12 AM |

    The trick to achieving a normal cholesterol range is simply to change one's lifestyle. You should eat healthy and exercise more.

    Through better nutrition, LDL cholesterol levels can be greatly lowered in no time. Failure to do this will result in a huge risk for coronary heart disease, atherosclerosis, and stroke.
    Reference:
    ldl cholesterol how to reduce them
    hdl cholesterol levels

  • people searches

    3/5/2011 4:05:38 AM |

    I am new here and find this fascinating and informative blog. A couple of things: I'm at a loss as to where to start with a diet low in carbohydrates and to eat for meals, especially breakfast. And how to get my two year old to eat?! Does anyone have any idea about this? We're starting to do research and trying to understand the lifestyle heart healthy.

  • Anonymous

    3/20/2011 1:13:08 AM |

    I'm a 55 year old woman & had just been prescribed a statin, as my chloresteral was 255 in Jan 2011.  My son help me with a low carb eating plan as follows:
    tripled my fish oil intake, oatmeal only 2x/week (I added nuts, raisins, lots of cinnamon & no sweetener), started drinking whole milk, ate some protein @ almost every meal, had spiniach salads w/lots of veggies & hard boiled egg & a simple homemade vinegar & olive oil dressing, stopped all processed carbs except oats, bread about 1 time/week (found a bread w/just 6 carbs) or occasional lo-carb whole wheat tortilla, lots of nuts (walnuts, pecans & almonds), lots of green veggies, some beans, unlimited amounts of tomatoes & limited amounts of fruit...  One month later my chloresterol was 188.

  • types of cholesterol

    3/24/2011 10:58:46 AM |

    A study conducted by Columbia University in 1998 showed that consuming excess levels of simple carbohydrates may lower your HDL cholesterol. Having lower HDL levels may increase your risk of heart disease.

    Read more: http://www.livestrong.com/article/333087-effects-of-simple-carbohydrates-on-cholesterol/#ixzz1HVtprUZm

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