Why High Fat?
The most important take-home message is to only increase your fat intake once you lower your carbs. And remember it is healthy fat we want to increase such as avocado, butter, olive oil and coconut oil, not ‘fatty foods’, there is a difference.
If you increase your fat and don’t lower your carbs, all you are doing is ending up on the Standard American Diet (SAD) which is high-fat high carb, and the cause of all the modern health problems such as obesity, T2 diabetes, heart disease, stroke and cancer.
If you increase your fat but don’t cut back on the bread, cakes and biscuits, you are going to end up with weight gain, poor appetite and poor biomarkers, pretty much where you probably started off. This is the most critical step to get right.
Do not to go for low-fat products. When fat is removed, so is much of the nutrition and it is generally replaced with some form of carbohydrate. For example, low-fat cream cheese has 15% carbs whereas regular spreadable cream cheese has only 4%. You will go through a period of reading every label, but you will soon recognise the brands and the foods to buy.
Buy the least processed, freshest, closest to nature foods as you can. If it has a long expiry date, ask yourself why? Food shouldn’t last months or years, buy food that rots, buy food that your grandmother would recognise and buy ingredients, not products. Simple rules, simple food.
The fear of fat and cholesterol are the foundation of our dietary guidelines for the past 2 generations. It is wrong and there is no scientific basis (see links in the navigation bar for more articles). I encourage you to read these and learn how research regarding cholesterol has changed over the past decade.
This is a great page on Authority Nutrition which briefly summarises Diet, Cholesterol and Lipoproteins. It explains how cholesterol is essential to all humans and really it is not cholesterol which is the problem but the proteins that carry cholesterol around the body. The great visuals show LDL, LDL size, LDL particle count and the bottom line is that cholesterol is NOT the enemy.
I have embedded a clip at the bottom of this page for those who want to delve deeper, but here is a brilliant presentation by Dr Andreas Eenfeldt which brilliantly summarises the science behind LCHF and why we have got it wrong about reducing fat.
Another article by Professor Grant Schofield talks about how hard it is to challenge the establishment. My favourite quote in the article,
“science isn’t a democracy. We don’t have a vote and the most popular hypothesis wins. We deal with evidence”
For a full in-depth explanation of the relationship between carbs, lipoproteins and inflammatory factors HDL, LDL, triglycerides… read “The Art and Science of Low Carbohydrate Living” by Volek and Phinney. It explains the complex picture and relationship between carbs, fat, LDL, HDL, TG.
For decades we have been told to reduce our fat intake, especially saturated fats to reduce cholesterol and our risk of cardiovascular disease (CVD). Yes reducing saturated fats and butter etc from our diet reduces your cholesterol, but it mainly reduces HDL which is your good cholesterol and makes smaller LDL (bad cholesterol) which is more damaging.
The majority of cholesterol circulating in our bloodstream is low-density lipoprotein cholesterol (LDL). The proposed link between LDL and heart disease is the basis behind restricting cholesterol and saturated fat intake, and the use of statin medication. Studies have now shown you can indeed reduce LDL by dietary restrictions, or by the use of statins, but the reduction does not actually reduce the incidence of heart disease or reduce mortality rates.
“People have been recommending low-fat diets for 30 years, and then it turns out to be completely wrong! There is no proven correlation between saturated fats and CVD”. Fredrik Nyström, Professor of Internal Medicine, Linköping.
“It’s time to face the facts. There is no connection between saturated fats and CVD”. Peter Nilsson, Professor of Cardiovascular Research, Lund.
“Two generations of Swedes have been given bad dietary advice and have avoided fat for no reason. It’s time to rewrite the dietary guidelines and base them on modern science”. Göran Berglund, Professor of Internal Medicine, Lund.
When fat is removed from our diet, it is usually replaced with carbohydrates. Eating fat allows you to feel full, fat is full of Vitamins A, D, E and K, cholesterol is the basis of our hormones.
LDL/HDL ratio
LDL (bad) carries cholesterol and other lipids from the liver to the body and the organs.
HDL (good) carries cholesterol and lipids from the body back to the liver for disposal.
So too much LDL can lead to an accumulation in circulation, arterial walls, plaque formation and arterial disease – or is it? New studies have shown that reducing LDL by a low-fat diet or a high-fat diet, the high-fat diet does a better job at reducing the real incidence of heart disease. So much so, the Lyon Diet Heart Study was terminated early due to the dramatic decrease in mortality with the group that ate the 40% fat Mediterranean type diet vs. the American Heart Assoc Healthy Diet. Another study of postmenopausal women showed reducing dietary fat intake reduced LDL but had no effect on cardiovascular disease (stroke, heart attack, and overall mortality) after 8 years.
LDL quality vs quantity
It is also known that LDL is only part of the picture of lipid profiles. Smaller LDL particles are more atherogenic (dangerous) than larger ones. And yes LDL concentrations increase as a result of a low carb diet, BUT low carb diets significantly increase the LDL particle size and the compelling new data associates small LDL particles with increased rick of CVD.
Furthermore, you should not be concerned if on a low carb diet your LDL remains the same or slightly increases. IF other lipid and inflammatory markers dramatically improve, generally your small particle LDL decreases, serum triglycerides reduce and HDL increases. All potent factors which reduce your overall CVD risk.
Statins and low carb diets
If your LDL is raised, the standard protocol is to decrease dietary cholesterol and saturated fats and possibly begin taking a statin. There is no question that statins reduce LDL but new studies are indicating their effect to reduce CVD is due to their anti-inflammatory effect rather than reducing LDL.
It is a difficult decision to start using a statin drug. The benefit of the anti-inflammatory effect, against the major side effects of dementia, fatigue, muscle pain and increased risk of diabetes. New figures show that up to 87% of the patients taking statins may be unnecessary. This is something that needs to be discussed and researched further.
Volek and Phinney state that if lowering your LDL is your main goal, then a low-fat diet and a prescribed statin make sense BUT should just lowering your LDL be the correct aim?
A low carb diet, however, improves LDL particle size, raises HDL (good), reduces triglycerides, lowers insulin resistance, lowers inflammatory markers and lowers blood pressure.
Triglycerides
Raised fasting triglycerides (TG) are a clear risk factor for heart disease, they also are an early sign of insulin resistance and your bodies inability to metabolize carbohydrates.
The body generally has 5g of glucose circulating, but an average meal may contain 100g carbs. Anyone who is insulin resistant will convert these excess carbs into fat (via de novo lipogenesis) rather than converting the excess glucose into glycogen (which is self-limiting). These are turned into triglycerides which if they are not released from the liver, will build up and cause fatty liver disease (hepatic stenosis).
TG containing saturated fats are associated with insulin resistance more than those TG containing essential fatty acids. It is simplistic to think the saturated fats we eat are to blame for insulin resistance and CVD. However, with insulin resistance, the liver readily converts carbs to fat and the main product is saturated fat!! When excess carbs are eaten, saturate fat VLDL particles are produced by the liver, which in circulation are converted to small particle LDL (remember the dangerous, reactive ones). Therefore a high saturated fat content in your TG is directly related to your carb intake!! and how well your body processes it.
Raising HDL
This is the lipoprotein that takes the lipids from the body back to the liver for disposal. It is one of our best indicators for long-term cardiovascular health. HDL is the lipid scavenger.
HDL also increase the bioavailability of nitric oxide (important regulator of vascular function and blood pressure), is an antioxidant, anti-inflammatory, antithrombotic, all contributing to its anti-atherogenic properties.
Summary
The basic understanding that dietary intake of saturated fat and LDL levels, predict CVD is to say the least, questionable. The current model of reducing fat intake (and increased carbs) has a marked negative effect on TG and HDL.
The TG/HDL ratio is a broader assessment of risk and its relationship with insulin resistance, making it superior and more accurate than focussing on LDL.
How do we improve the TG/HDL ratio? By reducing carbs we improve all CVD risk factors
- decrease TG
- increase HDL
- increase LDL particle size
“low carbohydrate diets are unparalleled by any other lifestyle intervention or even drug treatment, and therefore represents the most powerful method to improve this ratio”.
The Cochrane Collaboration (a review of all studies published) came to the conclusion “… no significant evidence for concluding that dietary saturated fats are associated with an increased risk of CHD or CVD”.
One final video to watch for those who want to know the nuts and bolts of cholesterol, here is Dr Peter Attia. For more videos, take a look at my YouTube Channel.
“atherosclerosis is NOT a lipid mediated disease, atherosclerosis is a lipoprotein mediated disease”
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Thomas Thibault says
How to explain study like this? https://www.ncbi.nlm.nih.gov/pubmed/1804476
Libby www.ditchthecarbs.com says
I would have to see exactly what oil they consumed (seed oils, trans fats, saturated fats etc), how the study was designed, what other confounding elements affected results, what as the absolute or relative risk, who funded the study, were they high fat and high carb, was it refined carbs ….??? There is always so much more to a study than meets the eye.
Eric says
“And remember it is healthy fat we want to increase such as…butter…”
Lmao. Get out of here with that nonsense. 7g saturated animal fat and 31mg unnecessary cholesterol per tbsp. Healthy fat, right.
Libby www.ditchthecarbs.com says
I beg to differ. And may I ask what you are basing your assumptions on? You may wish to read this by the president of the World Heart Federation regarding healthy fats and full-fat dairy being protective, and carbohydrates being harmful.
C. Horton says
Thank you for this great information and the video of Andreas. However, I do have question actually fired up by the commentots who mentioned their TG/HDL. I was put on a statin 2 years ago against my protests. Off medication my my stats were TG/HDL 87/99 =.87. At that time my cholesterol was 258. On the statin my stats are 56/119=.47. Total cholesterol was 220. I have a very high HDL and alway have and the doctors will not take into consideration that this high HDL number affects the total cholesterol. All they want to do is shove statins down my throat. After reading your article and watching the video plus another clp you offered I feel as if I should follow my own judgment and skip the statin. Just moving ahead with LCHF WOE now. Your thoughts, please.
Libby www.ditchthecarbs.com says
I would follow Dr Aseem Malhotra, one of UK’s leading cardiologists, Zoe Harcombe’s article “Worried about cholesterol and/or statins” and Cholesterol Clarity to truly make your decision an informed decision.
Prayer says
Morning.I recently joined and I’m very confused right now.May you please advise on the typical breakfast,lunch and supper that I need to take .I’m 36 years old and weigh 93kg,im 1.8m tall and I’m not happy with my weight and belly.I urgently need help.
Libby www.ditchthecarbs.com says
Welcome, why not come and join us in my Low-Carb Support Group? You can see what everyone eats each day and little questions they have.
Sylvie says
Hi, I’m contemplating starting a low carb diet but after following a low fat diet for so long I’m not a lover of fats, cream etc. I also have an under active thyroid, will this hamper the potential of losing weight?
Libby www.ditchthecarbs.com says
This is a useful article to read regarding low carb and hypothyroid.
Leo Tat says
Hi Libby,
Back a few years in 2014 when I started a low carb high fat diet, I tested my blood after 4 months.
TG/HDL = 70.88/69.66 = 1.05
My wife started at the same time as me, took the test too and got
TG/HDL = 70.74/69.66 = 1.15
These are pretty much perfect figures.
Libby www.ditchthecarbs.com says
That is superb, well done. If only more people could be given low carb as an option from their health professionals instead of medication. Congratulations.
Kevin says
I’ve been the LCHF thing now for a little over three weeks and I’m quite satisfied with my weight loss, I’ve no issue with hunger or side effects or the number of carbs I’m taking is working out a little under 20 and that’s without really trying. I eat twice a day and its enough.
What is causing me confusion, and a little worry, though is my Fat and Protein content. My goal, using MyFitnessPal (4 gams Carbs, 40g Fat and 218 g Protein) but my Fat count is always way over and my Protein count is always way down. What could I be doing wrong. I prepare all my own food
Many thanks for any advice you feel able to offer.
Kevin
Kevin says
Opps above my post should have been goals 45g Carbs 103 g Fat and 218 g Protein (my five is sticking 🙂
Libby www.ditchthecarbs.com says
Are those your goal macros per meal or per day? They seem a little confusing. If you need more protein, hit the eggs. They are a really easy way to get good quality protein. The aim is to eat fat until full, not overdo it. Go through your MFP and see where the fat is coming from and where you can amp up your protein. I don’t count anything any more as I have had decades of points, calories, lists etc etc and LCHF is the easiest and most sustainable way I have ever found. The macros are there to guide you but don’t be a slave to them. You are incredibly successful already, so stick with it. Your appetite is in control, your weight is dropping, and without really trying. Awesome work x
Kevin says
The goals are per day.
Let’s put a bit more flesh on the bones. I’m 67, in good health and have an active retirement and it’s my goal is to loose a stone and a half (21 lbs)
I’m careful about what I’m eating now but just picking bits and pieces of information up on the Internet on sites like this as I go along. Slow and steady would be my mantra
Here’s a typical daily food list. Morning 2 scrambled done in butter with some cheese grated in. If I have a tomato then I’ll have one of those. I’ll eat nothing again until about 7.00pm save a small handful of blueberries with a little cream.
For diner I’ll have something like a quarter of a cauliflower, a good serving of home cooked chicken, maybe 50 grams. Some cheese and a hard boiled egg
Of course I’ll have several cups of tea/coffee throughout the day and at least 2 litres water. I’ll put cream in the coffee and milk in the tea
That’s sufficient to keep me fired up all day and it does seem sensible but for two meals like that the protein count seems to around 100 g. I must be doing something wrong
Libby www.ditchthecarbs.com says
The protein is low because you are eating so little and almost intermittently fasting throughout the day apart from your creamy teas and coffees. Read this article on how to calculate protein requirements more accurately using lean body mass. You may be hitting your targets already.
Terri S. says
I am feeling frustrated as it seems my scale doesn’t want to move. I am 52 years old, 5’4″ tall, 209 pounds I am eating LCHF and keeping track on Fitness Pal. I try to keep my ratios at 75% fat, 20 % protein and 5 % carbs. Ideally eating 15 grams or less per day of carbs. My calorie intake is anywhere from 1200 to 1350 per day. The only sweetener I use is liquid Stevia in my tea with a splash of cashew milk. I typically eat eggs for breakfast. An example of lunch would be sliced ham, with cream cheese rolled up with asparagus spears. Dinner may be a chicken breast with 1 tablespoon of ricotta cheese, 1 tablespoon of fresh parsley, spices, rolled and wrapped with 2 bacon slices. Cesare salad on the side. Snack may be a homemade fat bomb. I am drinking on average 4 glasses of water per day. Take a 50 billion probiotic every day. If I feel I am not getting enough fat I will eat 1 tablespoon of olive oil mixed with organic lemon juice. Sometimes I’ll go to bed feeling hungry and wake up still feeling hungry. The only time my carbs were slightly higher was at Easter and on my birthday. Though I still ate healthy. The scale just keeps looking back at me with the same number, refusing to move. What am I doing wrong?
Libby www.ditchthecarbs.com says
It sounds like you are doing everything correctly. Are there any other health issues going on? Medications that may need assessing? For some people it takes a while for your appetite and weight to stabilise, especially if you have been on a high carb diet for years. Your insulin sensitivity needs to improve and that may take a bit of time. Be patient, whilst you may not be losing weight yet, you are no longer on a high carb damaging diet. Your health, energy and vitality will absolutely be improving in the meantime.
Terri S. says
Thank you, I appreciate the advice. I do have severe osteoarthritis awaiting for my second knee replacement surgery in the fall. Originally, I lost 48 pounds, then I allowed a bit of carb creep (though healthy foods), and gained 16 pounds back. I got strict again and added gut healing to my daily rituals. In the past month I lost 7 pounds, but now the scale is refusing to budge or else it’s a snails pace. Can you or some other people give examples of what your eating in a day, so I have something to compare too? I know this way of eating is healthy as I shrunk my liver one inch, lowered my blood pressure and I can’t remember my last cold. People at work will get a cold sometimes 2x a year and I have not been infected. Coincidence? Maybe, but I doubt it.
Libby www.ditchthecarbs.com says
Terri that is great news on the health front. To reduce your liver, lower BP and improved immunity in itself is phenomenal. The weight may take a while to budge but what keeps everyone so focused on LCHF is that even if the scales don’t shift quickly, your health has improved in the meantime. As a guide I generally have breakfast only a few days a week, normally starting my day with tea or creamy coffee. Lunch I may have a snack or some leftovers or scrambled eggs and butter, dinner is our family meal. Last night I made lettuce wraps (burritos I guess) with loads of sour cream, avocado, salad, mince/ground beef etc etc. It takes a while for your appetite to reduce but in the long term it is worth the effort to wait. Low carb is a lifestyle change forever not just a quick fix which is why I am convinced it is so successful long term compared to low calorie diets/low fat etc where only weight is measured and you end up feeling deprived, hungry and miserable. You’re doing brilliantly and be proud of all the improvements so far. Libby.
Terri S. says
Thank you for your kind comments Libby. You’re an inspiration to many of us trying to figure out the LCHF lifestyle. Perhaps I am being too hard on myself because in the beginning the first 40 pounds came off so quickly, and a 7 pound loss in 30 days is still a move in the right direction. I am a firm believer in this way of eating and I know it works.
Libby www.ditchthecarbs.com says
Years ago when I wanted to lose weight after baby #2 I drew a graph and looked at how far I came each week. My thinking was if the scales never moved again, there is no way they would go back to here I was (sadly I did because back then I relied on W. Watchers – epic fail). I was so happy with how far I came.
Louise says
Hi,
I am now in my third week of LCHF, and I’m done with the first weak days. I’m feeling great and see a lot of good changes. But I love hanging out with friends to grab food, and sometimes my job organizes meals when we are on big projects. I am wondering if I will need to re-adapt if I eat ponctually a HC meal.
Thank you!
Libby www.ditchthecarbs.com says
If you have a slip up then just get back on track with the very next meal. We have to lose our feeling of guilt over food. There will be occasions where meals are beyond our control so don’t sweat it. One bad meal won’t make you unhealthy, just like one said won’t make you healthy. 🙂
Monica says
Hi
Just wondering, once we are in ketosis and we are using fat for fuel,
If we eat more fat than we use is it stored? How? Is it excreted??
TIA
Libby www.ditchthecarbs.com says
Excellent question. It is hard to truly overeat fat if we are eating only to fullness and our appetite is regulated. The fat will all be used as fuel as long as your carbs are low enough. There is a good article on overeating fat on Diet Dr. As long as you are maintaining or losing weight, it will appear fat is excreted by being exhaled! Here is a great article explaining that. If you are gaining weight through possibly eating too many carbs, it is being stored as fat.
eby says
I have gone through this suggested article. It explains where burned fats goes to. The question here is what happens when u consume excess fat. Is the excess stored ?