Category: Nutrition

Higher Dietary Carbohydrate Associated with Lower HDL

HDL is commonly referred to as “good cholesterol,” as clearly higher levels of this carrier protein are associated with a reduced risk for accumulation of atherosclerosis within the walls of arteries, especially the arteries that supply blood to the heart.

While so much attention is focused on total cholesterol, as well as LDL, which unfortunately has been given the name “bad cholesterol,” it seems clear that it is fair to explore what can be done to raise HDL since it is so important for vascular health.

As it turns out, diet does in fact playing important role in determining a person’s HDL level. In a study appearing in the American Journal of Clinical Nutrition, Canadian researchers evaluated the diets of 619 Canadians of either Aboriginal, South Asian, Chinese, or European descent who had no previously diagnosed medical conditions.

The researchers were particularly interested in the amount of carbohydrate intake in comparison to HDL,  and what they found was really quite profound. In comparing those who diets were highest in carbohydrate consumption with those who favored a lower carbohydrate diet, those who ate the least amount of carbohydrates had an HDL that was, on average, 11% higher.

So this is a very interesting report in that it again validates the importance of a lower carbohydrate, higher fat diet in terms of, in this case, an important cardiovascular risk marker, HDL.

In this day and age, when lipid profiles tend to pave the way for pharmaceutical intervention, it’s really nice to know that there is good science that validates the notion that food does and should factor into the equation.

  • Sarah Carnes Huber

    What cholesterol numbers should we maintain to be healthy?

  • Patricia

    Personal Observation – After 8 months of low carb eating, my cholesterol total went up 20 points, HDL went up 21 points, LDL remained the same and still 60 pts. over target, Triglycerides remained the same, and in good range, and blood pressure dropped to the lowest in 8 years.

  • CommonSense

    That’s definitely been my experience as well, a consistent increase in HDL since adopting a ketogenic lifestyle with a dramatic jump between 8 months and 14 months of keto, even without continued weight loss. My HDL is 105 now, it will be interesting to see if it continues to increase or if it starts to level off.

  • RussMason

    Might be profitable for Dr. P to check out Dr. Joel Wallach about cholesterol – which continues to get a bad rap.

    • Meg

      Dr. Wallach also talks about the same things Dr. P does. Sounded incredible when I first learnt about it. Today I have 4 soft-boiled eggs a day and lots of organic butter, coconut oil and kefir. My HDL never crossed 28..today it is 57. And it’s just been 3 months! No more hypoglycaemic events. Much more energy. Vision has improved. No more crawly tingly feet!

  • Nechama

    Ok, so what carbs do we omit (or lower intake), and what carbs do we eat more of? I eat a lot of green salad, with tuna, parsley, dill, olives. But veggies are harder to handle. Broccoli and cauliflower are already part of the diet.

    • David Perlmutter

      Focus on vegetables, and avoid grains/flour/sugar, etc.

    • Mary

      Today’s tuna is high in mercury so please be aware of that.
      Small fish tend to be lower.

  • Joe D.

    I have eliminated all carbs and gluten from my diet. However, recent results indicate that my white blood count is down significantly from just a year ago. Is there any correlation and, if so, what is recommended?

    • CJ

      White blood count rises when people consume allergenic foods. So a ‘normal’ white blood count for you when chronically eating carbs and gluten (or other foods that your body finds toxic) will be higher than when you have eliminated those.

  • tannngl

    Husband’s HDL after 1 year on ketogenic diet shows HDL in earlier years from 28-32. Last month his HDL was 57!!!!!! This is the highest it has ever been in his life and I’ve kept test results since the early 1990’s!

    Thanks so much for your book, Dr. Perlmutter! I have gifted it to 12 people, 1 who is in the UK. He, in turn has gifted it to a friend in the UK who was just diagnosed with DM2!
    You are changing lives. Giving health!

  • Joey

    In the past, when I was on a low fat diet, my HDL cholesterol dropped significantly. On a low carb diet, my HDL always increases.

  • Greatdanes

    My wife and I have been gluten free for 10 months now and have been low carb and heavy on coconut for 8 months. Our fasting glucose levels have gone up by more than 10 points and are now sometimes over 100 in the morning. Does anyone know what can cause this or what is going on? We keep carbs below 70 gr. every day and around 50 gr. most days. We expected a drop in fasting levels and instead have a significant increase.

  • Gecko

    I can attest that being vegan on a low carb diet is both doable and workable. Just using coconut oil, avocados, and fresh nuts for fats, and relying on greens, mushrooms, quinoa and beans/lentils in moderation, has changed my lipid profile in a way that has amazed my family doctor. While my cholesterol was ok to start with, it wasn’t as wonderful as it should be for a vegan. The only food I was eating that seemed to be the problem was wheat and all the other vegetable oils. Of course, there was a lot more unintentional sugar in my diet before I understood the gluten-free and low-carb approach. Just because you don’t seem to have diabetic symptoms doesn’t mean that sugar isn’t an issue.

    I have coconut oil with my only cup of coffee in the morning, and don’t feel hungry until about six hours after rising. Then I have a main meal of greens, mushrooms, nuts, and veggies, with avocado and lemon juice. For early afternoon, I eat more greens and veggies, plus a small amount of quinoa and some type of lentil or bean dish, with Indian style spices and a nut butter/coconut milk sauce. In the past two years of eating this way I’ve eliminated a persistent sinus problem, and avoided any colds or flu. I’ve been a vegan for over 20 years and wish I’d given up on wheat, corn, soy and sugar a long time ago.

  • I totally agree about the benefits of a lower carb, higher fat diet! I recommend that to my patients as well and anyone who will listen.

    Yet, when I went on a program to repair my metabolism 20 months ago (100% food based), I was able to increase my intake of carbohydrates, which is totally counter intuitive. I was able to eat fruits and hadn’t been able to for years due to the sugar. It repaired my chronic, unrelenting hypoglycemia too!

    After following the program for 4 months, my A1c levels came down and my fasting glucose came down. The diet I was on before this program was super low carb, it was basically paleo with the occasional kombucha (the one with 4gms of sugar per bottle). But I still wasn’t happy with these numbers and they improved.

    I never had any cholesterol issues, but noticed a lot of other health benefits.

    Thank you again for sharing your knowledge Dr. Perlmutter! I will continue to share your information.

    • David Perlmutter

      Yours is a wonderful story of success Kara.

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  • Rachel S

    What are your thoughts about gluten free nut crackers? I are referring specifically to the Blue Diamond Almond Nut thins but there are others. I like crunchy crackers with my salads. Also, is there type of rice or non-gluten flour that can be used to make a gravy? I make my own stock and braze roast in it. I would love to be able to take the pan juices and make a gravy. I just bought the book and am trying to stick with it. I have been low carbs for a while, but am learning there are sneaky sources of gluten.

    • David Perlmutter

      I tend to say that if there has to be a gluten-free version of it, you should shy away. However, it also depends, in this case, on the ingredients.

  • HelpmeinLA

    I am a 62 year old woman, and due to 2 hip replacements and knee surgery, I’ve been largely inactive for the past 3 years, resulting in a 45 lb increase in weight, and newly acquired high BP, terrible HDL/LDL and Trigylicerid numbers, as well as a “prediabetic” condition, according to my doctor. I tried a “cholesterol” diet wherein you eat low fat and high carbs like oatmeal, but I’ve gain even more weight! I tend to have alot of edema, swelling of the legs/feet, sinus problems, dietary upsets, and headaches. What can I do to straighten myself out according to your way of thinking? I’m a bit lost with all the information on this website. How do you know when gluten is problematic, and how can you tell a product contains it?

  • joywt

    Halleluah! Just saw your show on PBS. I have had high cholesterol since 1980. Always active and pretty good diet. Tried Lipitor and Zocor which caused me to lose words and caused hip problems. Now total cholesterol is 360 and HDL is 95. Feel great and exercise, Never stopped eating egg yolks–free range for 20 years.

  • Martha M.

    I have always had a total cholesterol number around 240 ever since I was first tested in a pilot study for my school for the senior class. I was 17 years old. I am now 57. My total number has varied a little but not much. My HDL number is usually around 65. From what I get from you I should strive for that number to be higher? They put me on Statins more than once when something new would come up and I can not take any of them. I hurt all over and it is not worth it.
    Also, last October I was diagnosed with CLL (Chronic Lymphatic Leukemia) sorry for the spelling if not right. If I go gluten free and follow your diet is there any research that this could help the CLL? Thank you.

  • Jeannine

    What was the LDL of the low carbers vs high carbers? What was their risk ratios? Also the link you provided for the study takes me to another page on your website which has a copy of some of the text from the study but not all.

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