Should You Be Worried About High LDL On Carnivore?

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The Big Red Flag Of Low Carb Diets

best of steak

You’re tucked up at the doctor’s office, watching bespectacled eyes roam back and forth across the sheet. It doesn’t take long. The quizzical expression drops into dismay. After a month of foraying into the carnivore diet, the signs aren’t good.

You feel great, the waist has dropped by three inches, and your big lifts are starting to go up. But never mind that, there are greater things at stake. Your LDL is skyrocketing deep into the red.

This puts you at a crossroads. Do you listen to your body, or the one bit of hard science that’s screaming at you not to go on? 

Cholesterol is a perplexing molecule. It might be necessary for the synthesis of your sex hormones, and cell structure, but it’s also the one being implicated in the risk of your arteries getting clogged. 

This molecule isn’t inherently evil, just some of it. It typically works as a boat to help fatty acids cross your bloodstream. These boats are divided into High-Density Lipoprotein (HDL), Low-Density Lipoprotein (LDL), and Very Low-Density Lipoprotein (VLDL). HDL is universally painted as ‘good’, LDL gets treated with the ‘bad’ brush. VLDL doesn’t share the same limelight, but high levels are associated with high blood triglycerides.

Moving VLDL to the side, you could conceivably have high total cholesterol, but remain heart-attack free as long as the HDL: LDL ratio remained within bound. 

Medical boards worldwide seem in unanimous agreement that having high LDL is fraught with danger. Our very own NHS recommends keeping LDL below 3mmol/L, or 116 mg/dL.

That’s a stance that doesn’t mesh well with low carb high-fat diets, which can significantly jack up the LDL count. Especially when it’s coming from saturated fats. Hence why your local physician might have a hard time taking in your latest blood panels.

But let’s look at just why LDL gets this rap. Athlescelerosis arises when the artery walls are repeatedly damaged, resulting in LDL being shuttled to the area to help clean up the mess. The LDL in turn can form into blood clots that aren’t cleared away, resulting in plaques building up and thickening the arterial wall, elevating the risk of cardiovascular disease (CVD).

An Alternative Take On Cholesterol

cholesterol on low carb diet

On the face of it, LDL might look like the prime suspect. But there’s more to the picture. It turns out that it’s glycation and oxidation of those LDL particles that compromise their intentions and lead to plaque formation. In other words, that’s sugar and seed oils, with their respective contributions to glycation and oxidation.

That would imply that your LDL count doesn’t implicate CVD risk, since it’s the damage to those LDL particles that causes havoc. To back up that theory, fasting can double the LDL in lean healthy subjects, while having no effect on obese subjects. In another study, higher LDL was shown to actually reduce all-cause mortality. And yes, you’re reading that right.  

So as your doctor looks at you with pleading eyes, it might be worth attempting to explain that having high LDL isn’t necessarily spelling out an early death bed.

Let’s drive the point home with a few more studies. Here’s one showing saturated fat having little effect on LDL numbers in obese people. Then there’s saturated fat resulting in reduced progression of atherosclerosis. None of this fits the NHS hymn sheet. The reality is, the problem isn’t the LDL, and thereby the solution isn’t to lower the LDL. That’s why statins, the reigning champions of the prescription industry, only extend the average lifespan by 3-4 days. You’d be better off keeping the money.

So What Causes Heart Disease?

does carnivore cause heart disease

That also would explain why the seismic global shift from saturated fat to seed oils had no effect on stemming the irresistible tide of heart disease. Despite the fact that seed oils, also known as vegetable oil, factory fats, or cancer, were efficient at lowering LDL.

The issue is with what creates the damage in the first place, and what subsequently impairs the  LDL firefighters. Glycation, the product of high blood sugar, would certainly be aggravated by a diet stacked in refined sugars. Oxidation, which can come from numerous sources of inflammation, key amongst them the chemically extracted, rancid on arrival, seed oils.

As an aside, you might be thinking that this is a case against pork, due to its higher seed oil content. But I’ve come around on that subject, since it’s the processing of seed oils that causes rancidity. You don’t get that issue with seed oils in meat.

Back to the heart crisis, I’ll put things even more succinctly, it’s not about how much cholesterol is in the blood, the problem is in how much cholesterol leaves the bloodstream to form plaques on arteries.

If anything, a diet like carnivore actually drastically improves that outlook through the process of fat adaption, where cells become increasingly efficient at utilising triglycerides and ketones. Hence why blood triglycerides actually go down on a low carb diet.

Why Carnivore Gets You Metabolically Healthy

carnivore diet sama

In a fat-adapted metabolism, characterised by the continued presence of low insulin, low leptin, and depleted glycogen, the body gets a lot better at clearing triglycerides. The rapid turnover of triglycerides in the form of VLDLs leads to increased levels of HDL and LDL. Effectively as byproducts of fat metabolism. 

This controversial phenotype is particularly prevalent in those practising carb restriction combined with low body fat and high fitness levels, otherwise known as Lean Mass Hyper Responders (LMHR). These people often register with high HDL levels, dangerously high LDL, and low triglycerides. A giant allegedly-red flag wedged between a litany of positive health markers. 

Ultimately your LDL numbers shouldn’t be the cause for concern. But a low HDL to triglyceride ratio can be disastrous. That implies that the body is resistant to fat metabolism, limiting its blubber burning capabilities, increasing circulating triglycerides, and elevating your risk of atherogenic diseases.

Likewise, high fasting blood sugar also points to a system that’s unable to process and dispose of glucose, leading to all sorts of smoke due to the inflammatory load of unwanted sugar. Those are two important markers of metabolic dysfunction, the breeding ground for chronic disease and feeling like a hot mess. 

Thankfully there’s a diet that consistently outperforms the rest when it comes to improving both metabolic markers: ketosis. Of which, I feel carnivore is the optimal version. You just need to be able to look past the red herring that is LDL.

So it may be time to look your doctor in the eye and inform him in a firm, non-condescending manner, that you simply know better. Just because fat can clog your kitchen sink, does not mean it can do the same to your arteries.

Key Takeaways

  • High LDL has long been seen as a risk factor for heart disease
  • Saturated fat, especially in a low carb diet, can raise LDL
  • But the risk is negated by a favourable rise in HDL and lowering of triglycerides
  • Meanwhile, the issue isn’t the number of LDL, but the glycation and oxidation on the LDL
  • Fortunately, you don’t have to worry about either on carnivore
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4 months ago

Nice article. Thanks. You asked for comments so here goes. IMHO, the LMHR phenotype is a distraction. Pretty much anyone who is too lean on a low carb diet will be oxidizing dietary fat like crazy, producing lots more ‘boats’ to get the lipids where they are needed. On a lean body, there isn’t a lot of localised fat to supply cells. That’s why LDL rockets. Put on a few % more of fat, the LDL drops and the phenotype is no longer LMHR. So it isn’t really a phenotype at all, rather it is simply not enough body fat.

4 months ago
Reply to  Asar

Excellent point! Which is why the research shows that lean individuals raise their LDL levels during a fast. Not enough bodyfat to go round.