The HDL cholesterol value is one of the four values on any conventional lipid/cholesterol panel, along with total cholesterol, triglycerides, and calculated LDL cholesterol (what I call “fictitious” LDL because of its incredible inaccuracy when compared to superior measures).
The HDL cholesterol value has some unique characteristics not shared by the others, however, and can serve as an index of overall health. Very high HDL values, for instance, are associated with extreme longevity. Centenarians typically have values of 90 mg/dl or higher. Higher HDLs are also associated with less risk for diabetes, hypertension, cancer, and dementia. Conversely, low values for HDL cholesterol can suggest that some bad things are going on in health.
When I was in my 30s, I made the mistake of eating an ultra low-fat vegetarian diet. I only ate vegetables, fruit, low-fat dairy products, and whole grains, while avoiding all meats, fats and oils. After several months of my vegetarian lifestyle, my cholesterol panel showed an HDL of 27 mg/dl and triglycerides of 350 mg/dl, while my blood sugars were in the diabetic range (161 mg/dl fasting–very high). As I came to understand diet and converted to a high-fat diet minus all grains and added sugars, my HDL increased to 94 mg/dl, triglycerides dropped to 47 mg/dl. (NMR lipoprotein analysis also showed zero small LDL particles, something I did not assess 25 years ago when I had the awful HDL/triglycerides, but small LDL back then was likely sky-high). I take no medication to improve these values, but use only the strategies I’ll discuss.
While HDL values are under genetic influence (e.g., CETP variants, Apo C3, others), there is plenty you can do to raise it. While it is not entirely clear whether it is HDL particles themselves that are responsible for longevity and protection from disease or whether they are simply associated with some other factor(s) that are responsible for the benefits, you can still view HDL as a gauge of the quality of your lifestyle. The same strategies also increase HDL size and number of HDL particles, yielding HDL particles that are more protective and provide, for example, better anti-oxidative protection.
A dramatic rise in HDL values is common following the Wheat Belly wheat/grain-free lifestyle. However, note that recent weight loss causes an initial drop in HDL, sometimes dramatic, that “rebounds” over time. HDL can also respond slowly. A typical response, for example, for a 240 pound man who starts with an HDL value of 35 mg/dl would be a drop to 27 mg/dl while losing 40 pounds, rebounding to 40 mg/dl 3 months after weight loss has ceased, then 63 mg/dl 1-2 years later. So time and patience is key.
During my busy cardiology practice days, I consulted in an area called “complex hyperlipidemias,” i.e., complicated lipoprotein and cholesterol abnormalities. Among the conditions I managed was something called hypoalphalipoproteinemia, a group of conditions associated with really low HDL values, e.g., 25 mg/dl. People who are overweight or have diabetes or pre-diabetes (metabolic syndrome) also commonly have low HDL values typically ranging 25-40 mg/dl. Following the strategies used below, I witnessed such powerful rises in HDL in these and other people that I abandoned the use of conventional treatments, such as niacin and fibrates (gemfibrozil, fenofibrate) used to raise it. HDL values of 60 mg/dl or higher were achieved with ease–no drugs required. Because the effect of the strategies below is so powerful, I no longer recommend any nutritional supplements to raise HDL, either, beyond those in this list.
Among the strategies that help raise HDL and thereby potentially protect you from multiple chronic health conditions, or at least provide a gauge of improved overall health, are:
- Wheat and grain elimination–HDL is reduced by wheat and grain consumption, especially if gliadin, gliadin-derived peptides, wheat germ agglutinin, and other proteins trigger inflammation–exceptionally common. In addition, the amylopectin A of wheat and grains fuels high triglyceride levels in the bloodstream (via the process of liver de novo lipogenesis, the same process that causes fatty liver) that results in more rapid clearance of HDL particles, reducing the HDL value. Remove wheat and grains and watch HDL go up over time.
- Limit carbohydrates–Just like grain amylopectins, sugars reduce HDL by the same triglyceride mechanism. Adding no sugars, avoiding sugar drinks and foods, while limiting carbohydrates, as we do in the Wheat Belly lifestyle, allows HDL to rise. Banishing the excessive consumption of fructose, as in high-fructose corn syrup, also helps raise HDL. We limit carbs in this lifestyle to 15 grams net carbs (total carbs – fiber) per meal or your individual carb prescription obtained by checking fingerstick blood sugars aiming for no change pre-meal compared to 30-60 minute post-meal peak.
- Fish oil supplementation–As a source of omega-3 fatty acids, EPA and DHA. The omega-3 fatty acids reduce triglycerides (fasting and after-meal), thereby making them less likely to contribute to accelerated HDL clearance. This effect is maximized with an EPA + DHA intake of 3000-3600 mg per day (divided into two doses).
- Don’t restrict saturated fat–Eating fatty cuts of meat, not trimming off the fat, eating more eggs with the yolks, using more butter, and adding coconut oil and other healthy oils all raise HDL.
- Vitamin D–Vitamin D can contribute to substantial rise in HDL, though it is a slow process. I use the blood test for 25-hydroxy vitamin D to gauge dosage needs, but most adults need 4000 to 8000 units per day in gelcap form (never tablets) to achieve a 25-hydroxy vitamin D level of 60-70 ng/ml.
There are some other strategies that make smaller contributions to HDL rises, such as modest alcohol consumption (e.g., dry red wine) and exercise.
Be aware that substantial emotional or physical stress can work against you by reducing HDL values, as can many common drugs (e.g., Lipitor, beta blockers like metoprolol and atenolol, diuretics such as hydrochlorothiazide). But, given the above strategies, combined with the tincture of time, you can watch this wonderful index of overall health called HDL climb higher and higher.
I have been following a wheat-free diet for three years, and have lost 60 pounds. I am having a stubborn time losing any more. I am maintaining a low carb load, trying to keep it under 45 carbs a day. My latest lap work shows this:
A1C: 5.7
Triglycerides: 206
Non-HDL Chol: 264
LDL-Chol: 223
HDL-Chol: 57
Cholesterol: 321
Chol/HDL Ratio: 5.6
My question is, why do my triglycerides continue to be high? I know what I am eating, and with some exercise and supplementation (I am off my Metformin, with my doctor’s permission; and take 3600 Omega 3, 1200 Magnesium, 5000 Vitamin D and a multivitamin every day.)
I plan to use one of the labs in your Total Health book to get an NMR assay of my LDL.
Thank you, Dr. Davis. I’ve come so far, and would like to get to the end of these high triglycerides and LDL.
A1C: 5.7
Triglycerides: 206
As you probably know, the WB targets for these are:
5.0% max for the HbA1c and
60 mg/dl max for the TG.
The two main things that can elevate these numbers are on-going weight loss and net carb intake.
Since your complaint is a stall in weight loss, that suggests that your net carb intake might be higher than you think it is, which could be as simple as some food containing more available carbs than you suspect. Investing in a glucometer, and checking fasting/postprandial BG should clarify matters:
https://drdavisinfinitehealth.com/2014/10/blood-sugar-tool-fingertips/
re: … and take 3600 Omega 3 …
DHA&EPA, I presume, because if the product doesn’t say, it’s ALA, which we rarely need to supplement.
I am using Nordic Naturals Omega 3, five capsules in the morning and five in the evening. The only sugars I eat are in the berries and vegetables I eat. I make baked goods out of nut flours, mostly from Dr. Davis’s books, and use Swerve as a sweetner. I do take my blood sugar readings regularly, and my fasting sugar was 74 this morning.
re: … fasting sugar was 74 this morning.
That’s outstanding, but on this issue, a series of postprandials may be useful.
re: … use Swerve as a sweetener.
I’m wondering if there might be a response to the fructan (oligofructose) in that formulation. There are bacteria that can convert fructans to fructose in the gut, allowing the fructose to be directly absorbed. Fructose is the enemy of weight loss:
https://drdavisinfinitehealth.com/2011/11/goodbye-fructose/
and it’s pretty stealthy, because it doesn’t immediately provoke BG, but I would expect it to provoke TG and HbA1c over time.
Sugar researcher Richard J. Johnson has identified a number of these bacteria (in a recent paper I can’t locate at the moment), and also said in his book “The Fat Switch”, that those who are overweight (and presumably formerly overweight) are more likely to harbor these bacteria.
If the Swerve turns out to be the problem, there are multiple alternative sweeteners available. Attending to gut flora might also drive down or eliminate the fructan-loving critters.
Let me add to Bob’s wonderful thoughts:
1) An EPA + DHA intake of 3600 mg per day, divided in two, is the dose for full triglyceride-reducing effect.
2) A full program of cultivating bowel flora is essential. The small dose of inulin in Swerve is a start, but only a start.
3) Consider a period of ketosis, given you high HbA1c. This can help undo fatty liver that may be adding to your insulin resistance.
4) Consider an apo E genotype. If, for instance, you have Apo E2, it would shed some light on why this is happening.
5) Should all the above fail even after several months of effort, then what I do is assess your postprandial (after-meal) response to various fat challenges to gauge whether you have a genetic disorder in fat metabolism. This is complicated and beyond the scope of what we can handle in a blog discussion, but will require the knowledge of an experienced lipid expert.
Thank you, Bob and Dr. Davis.
When I was 240 pounds, I was on Lipitor, Metformin and Lisonipril. I am no longer on any of these now, and I weigh 180.
I am very aware of the inulin content of Swerve, green plaintains, raw potato and jicama. I do make it a priority to ingest at least one of these or add inulin to a meal every day. My bowel movements are very good, much better than before the Wheat Belly program. I also take a probotic about once or twice a week now, after two months of daily use of a probiotic.
I also take Flonase and Zyrtec before I go to bed. Although my allergies have almost disappeared, I notice an increaase in nasal phlegm when I don’t take the Zyrtec for a while. I read somewhere that Zyrtec could affect the progress of weight loss.
With the Omega 3, I believe what I take will deliver the proper amount of Omega 3, as the normal dosage is two capsules for 690 mg.
https://www.lipidcenter.com/pdf/lipidaholics/Lipid_Cases_2009.pdf
“Why does the Dean Ornish extreme low fat diet so effectively reduce all cholesterol levels? Well
the initial substrate from which cholesterol is synthesized is acylCoA (acetoCoA, acetylacetyl
CoA) which is derived from fatty acid breakdown (oxidation). So eliminating fat from the diet will
drastically reduce endogenous cholesterol synthesis and all cellular cholesterol levels will lessen.
As cellular cholesterol synthesis reduces, less is effluxed via ABC family transporters into HDL
particles: HDL-C will lessen. Also in people significantly restricting fat intake, the liver will have
less cholesterol (less chylomicron delivery of fat, less production, less being brought back to the
liver in HDLs: the results is when the liver makes VLDLs and IDLs, they carry a lot less cholesterol (less VLDL-C, less IDL-C and this will ultimately result in less LDL-C. Of course
Ornish showed that by drastically reducing TC levels (as well as LDL-C) via fat restriction
angiographic improvement occurs in persons with CHD. It mattered little that because of reduced cellular cholesterol, HDLs were no longer being fully lipidated (thus reducing HDL-C).”
re: Why does the Dean Ornish extreme low fat diet so effectively reduce all cholesterol levels?
Why does the Dean Ornish extreme low fat diet substantially raise your risk of dying from something weird, not uncommonly cancer?
My user name here has a link to a recent mention of Ornish on this blog. I’m not sure we want to bestir Dr. Davis on this particular topic.
Here’s Tom Naughton being somewhat more blunt:
http://www.fathead-movie.com/index.php/2015/03/26/sorry-dr-ornish-the-jig-is-up/
One thing you don’t mention above is your age–after 50, our converters of all types don’t work as well, and we’re left with an inability to get more than about a 70-80 HDL. I. too, had blowout HDL before menopause (a high of 110) because I was eating high Omega-3 vegetation along with grass-fed meats and taking fish oil. After menopause, my HDL dropped to the 70’s, even though there was no change in diet. Why? I was no longer converting the veggie Omega-3 from the ALA form into the DHA form.
Men have it worse–they never HAD an ALA-to-DHA converter.
These days, I have honed down my fish oil to just a DHA-only supplement, and am now on a zero-carb diet. My HDL is 61–better than last year’s 52 (while on LCHF), and still improving. As you say, patience is clearly needed here.
re: One thing you don’t mention above is your age–after 50, …
Some say 40. Getting Vitamin D from sunlight is an issue there too.
re: … our converters of all types don’t work as well, …
Which converters are you speaking of?
re: I was no longer converting the veggie Omega-3 from the ALA form into the DHA form.
In the specific case of Omega 3 ALA, reliance on conversion is grossly insufficient. Even for someone who is an efficient converter, getting the WB suggest amounts of DHA & EPA would result in an ALA overdose.
This is a big issue for vegetarians, who are often either unaware of the need for Omega 3, or think that the plant-sourced ALA form suffices. They really need to be relying on marine algae sourcing to get adequate intake of DHA & EPA, but few do. Non-vegetarians have it easier, and can use fish oil, or just eat ample seafood.
Product label alert: when you see “High in Omega 3”, with no mention of DHA or EPA, assume it means “ High in Omega 3 ALA”. We need ALA, but usually get enough without much deliberate effort.
re: … I have honed down my fish oil to just a DHA-only supplement, …
If you are only going to do one Omega 3 supplement, DHA would be it. But it appears that the jury is still out on DHA-only vs. DHA+EPA.
In my case, it seems that my age has had no adverse effect on my HDL. Two years ago, at age 66, it was 99. Shortly after having it checked, I eliminated grains and added more good fats to my diet. When it was checked again last month, at age 68, it was 140 with triglycerides at 55. This has led me to wonder if there is an upper limit for HDL after which one should be concerned.
I only use liquid fish oil in a combo of Barleans Orange fish oil and Green Pastures liquid fermented cod liver oil. By taking a liquid you know it is fresh by taste. You won’t know if taking a pill if it is oxidized and nasty. Plus you limit the quantity you get with tiny pills.
Great article by the doctor. Some of questions:
1. Wouldn’t it be better to consume omega 3s and vitamin d-3 via cod liver oil?
Since it’s natural, I would think it would be more effective than chemically manufactured pills at the same dosage.
2, If I go the pill route, can someone suggest good fish oil and d3 brands?
3. Any truth that krill oil’s omega 3s are eight times more effective than fish oil?
Dear Dr Davis
Last year prior to my pregnancy my HDL was 71 , now 3 months after having my baby my HDL is now low at 46 . Does pregnancy affect HDL level ?? Also can starting the contraceptive pill again affect HDL levels ? I have not yet started it .
Cholesterol runs in my family my total cholesterol last year was 259 , but my total cholesterol/hdl ratio was good . It currently is really poor .
I’ve started eating a wheat free diet for the past 3 weeks . Any advice would be very much appreciated .
Many thanks
re: Last year prior to my pregnancy my HDL was 71, now 3 months after having my baby my HDL is now low at 46.
I have no insight on the role of pregnancy, but do you happen to have the TG (triglyceride) numbers for those two labs? And perhaps HbA1c.
re: Cholesterol runs in my family …
That suggests familial hypercholesterolaemia (FH). Have you had a one-time genetic test for that?
re: … my total cholesterol last year was 259 , but my total cholesterol/hdl ratio was good. It currently is really poor.
The standard lipid tests are pretty worthless, with TG and HDL being the only meaningful numbers. Since you might have FH, the next time request an advanced lipoprotein panel, that reports things like LDL-P.
re: I’ve started eating a wheat free diet for the past 3 weeks. Any advice would be very much appreciated.
Wheat-free is just the start. The Wheat Belly Total Health approach is also low net carb, high fat (with attention to specific fat types), low-inflammatory, attentive to gut health, and mindful of certain micronutrients. All of this is beneficial to cardio health.
re: 1. Wouldn’t it be better to consume omega 3s and vitamin d-3 via cod liver oil?
Apparently not. Cod liver oil contains excessive amounts of the retinol form of vitamin A, which blocks the beneficial effects of vitamin D. At the levels of Omega 3 suggested, the A might even be directly toxic.
re: Since it’s natural, I would think it would be more effective than chemically manufactured pills at the same dosage.
The products recommended by Wheat Belly Total Health (p179) are natural fish oils, and not chemically manufactured.
re: 2, If I go the pill route, can someone suggest good fish oil …
Capsule, not pill. Ascenta NutraSea and Nordic Naturals.
re: … and d3 brands?
I haven’t discovered a published brand/product recommendation, just that it be the cholecalciferol (D3) form, in an oil-based gelcap.
re: 3. Any truth that krill oil’s omega 3s are eight times more effective than fish oil?
The problem with krill is mainly economic. You’ll get sticker shock at what it costs for 3000-3600mg per day. Also, the potency claims are based on conjectures about the benefits of the astaxanthin, which may just be marketing puffery.
Hi Bob, thanks for your generous responses.
I found this product http://www6.netrition.com/nordic_naturals_ultimate_omega_d3.html , Nordic Natural with D-3. Would this one qualify as per your recommendations?
re: Nordic Natural with D-3. Would this one qualify as per your recommendations?
It would depend on your personal situation. To reach the 60 to 70 ng/ml optimal blood levels recommended in the article above, most people are going to need 4000-8000 IU of D3, which is 4 to 8 of these particular capsules, which would be way more Omega 3 than you need (you only want 3 of these capsules a day for n3).
If you are getting a lot of sun, or D3 from food sources, these capsules might do.
Unless NN has another product with higher D3, using a separate product for the additional D3, or all the D3, might be the way to go.
Keep also in mind that D3 dosing is what’s called a “U-shaped” response. You don’t want too little or too much, and the metric is actual blood concentration, and not mere daily intake.
Why avoid Vitamin D in tablet form? Best wishes.
re: Why avoid Vitamin D in tablet form?
Oil-based gelcaps are recommended, for absorption, based on remarks in Wheat Belly Total Health.
Beyond that, Vitamin D tablets are going to contain other ingredients, and may be loaded with worrying levels of calcium compounds in particular. Here’s a random one:
OTHER INGREDIENTS: Calcium Carbonate, Cellulose Gel, Maltodextrin, Croscarmellose Sodium, Stearic Acid, Magnesium Stearate, Gelatin, Corn Starch.
There are several other troubling ingredients in that example as well.
http://news.yahoo.com/good-cholesterol-whats-number-110000281.html
‘Good’ Cholesterol: What’s in a Number?
“A small town in northern Italy between Milan and Venice called Limone sul Garda provides a perfect illustration of this paradox. The region is well-known for its many centenarians who make it into old age with plaque-free, healthy arteries despite HDL levels that hover around 10 to 15 milligrams per deciliter. We now know that these people carry a particular genetic mutation, dubbed Apo A1-Milano, marked by very low HDL levels and high triglycerides — another fatty substance known to fuel cardiovascular damage — but no heart disease. Why?
The leading theory is that people who carry the mutation have a form of HDL that is super efficient in removing cholesterol and reducing plaque. Their HDL is rapidly ferrying cholesterol from the arteries to be dumped in the liver and purged from the body. This rapid movement and high efficiency renders their circulating HDL levels in the blood very low. In this case, lower HDL signals higher performance and better cardiovascular health.”
Interesting article, Charles. The author makes case that depressing marker metrics with meds may not improve actual health. This is sound advice for the majority of conditions today treated with metric-pushing potions.
Apparently without realizing it, the author also made a case for how useless statins are. The author also is unaware of just how useless LDL-C is as a marker for anything. It would have been thoughtful to provide the reader with some clues on checking for “dysfunctional HDL”, oh well.
Anyway, on the
“A small town in …”,
a trendy notion in pop nutrition is to “eat like a Blue Zoner”, but increasingly, we learn of the Blue Zones
“We now know that these people carry a particular genetic mutation …”.
So, eat like Blue Zoner, if you are a native Blue Zoner.
In some more rational nutritional future, optimal diet recommendations are apt to hinge on a combination of:
• elected of definition of “optimal”
• genotype
• phenotype
• epigenetic status
• age
• gender
• present health
• lifestyle preferences
Dr. Davis’ article here mentions the genotype issue. Of course, if we check most consensus dietary recommendations (such as the USDA), we get no such granularity – and we get a recommendation for a single diet-for-all that promotes metabolic syndrome, and inflammation, leading to the heart disease under discussion here.
I had blood drawn on 5/11/15 – I take 20 mgs Atorvastatin QED, injectable testosterone 2x/week, WP thyroid ED and a boat load of supplements
Some of the results
TC – 129
HDL – 54
TG – 36
Direct LDL – 67
LDL-P 873
Small LDL-P 160
Medium LDL-P 144
LP(a) <10
Fasting Glucose – 96
Free T4 – 1.1
TSH – 1.02
Total T3 – 78
Vitamin B12 – 905
hsCRP – 0.5
HA1C – 5.6
Vitamin D – 46
Magnesium – 4.5
Homocysteine – 10.3
Insulin 6.8
NT-ProNB <13
ApoB 62
LP-PLA2 301 (Area of concern that I will discuss with my cardiologist)
need help– my husband is 90% grain-free but I can’t get him to break away from the 2 slices of peanut butter and jam toast in the morning . Does anyone have a bread recipe that isn’t dry dry dry
I have tried many recipes and waffles but he just spits it out stating the bread is to dry
He re-wheated himself this last weekend – ate bread with his evening meal 4 slices and was sick all day on Sunday — He really want to be 100% grain-free but I still haven’t found the prefect “bread”
Diana,
this is my favorite recipe for wheat free bread, I actually make about 9 or 10 small rolls, to bake faster and have some portion control. The original recipe is from Maria Emmerich’s blog, you can find many other breads there, but this is really my favorite. I like making it with a variety of different seeds, like caraway, sesame, sunflower etc. Hope your hubby likes it – nothing with wheat and yeast is going to taste exactly like that product, but knowing how unhealthy it is, I think he might be swayed with this one.
Psyllium Bread
1/2 cup coconut flour
5 Tbsp Psyllium husk powder (I use NOW brand ordered at amazon)
2 tsp baking powder
1 tsp salt
2 1/2 TBSp cider vinegar
4 eggs
1 cup boiling water
Mix the dry ingredients with eggs and vinegar, to form a dough, add the boiling water last and mix quickly into a nice smooth doughy ball. Have oven preheated to 375 degrees, and a baking sheet lined with parchment paper. Form the rolls and place on baking sheet, they will not spread much at all. Bake until nice and brown, I like to over bake rather than undertake these. You can sprinkle them with some sunflower seeds, and also add some to the dough, I like that version best right now.
To store, you can put them in a container without cover, they tend to get a bit soggy if put in plastic, so I just leave them in the fridge that way. You can also freeze them, they are better when you “toast” them a bit after freezing.
Let me know what you think, when you’ve made these once, and see how fast and easy it works, you will not mind baking them every week. I share them with my family, and for myself I slice one roll into thin little slices, sort of like a bagel chip – and put butter, cream cheese, liver wurst etc. on when I feel like having a little “sandwich”.
Best ~ Barb
PS – forgot to add baking time is about 40 to 50 minutes. And I form the rolls with two spoons, the dough is a bit sticky, so to avoid getting fingers all messy, I just scoop out some dough, and push it off on the baking sheet with another spoon. Then you can shape them a bit, to look better, if you wish.
I use this very recipe to make my pizza crust. All I do with the dough is flatten it really thin with a rolling pin coated with olive oil. I squish it down to 1/4″ thickness (or maybe a bit less). If you don’t want to make pizza, just bake the dough and then cut it up into pieces that you eat as bread. You can even toast these pieces the next day if you prefer eating toast.
This bread is also super easy to make and while it’s not very low carb, it’s better than ingesting wheat, at least in my mind. Give it a try, it toasts very well!
I am going to try and share the link here, he gives great instructions and I think there is even a youtube video to see how it’s made, if you do a search.
http://www.fathead-movie.com/index.php/2012/10/15/too-good-bread-and-almost-paleo-bread/
Is there reliable data showing that fish oil supplementation to raise hdl is actually effective in reducing cardiovascular disease? A lot of things I’ve read claim there is no benefit to taking fish oil.
My hdl is 103 from a combo of low carb (grain-free) diet and fish oil.
re: Is there reliable data …
… for anything? That might be the real question these days.
http://www.drugawareness.org/editor-of-lancet-medical-research-is-unreliable-at-best-or-completely-fraudulent/
And that’s medical research. Nutrition research may not even rise to that level, and may often be little more than intellectual junk food. Consequently, such papers must be read with great care and skill. On the issue of fat consumption, including fish oil, I’d expect the common full-time glycemic diet context to be a major confounder, for example, and I doubt vitamin D status is tracked at all.
re: … showing that fish oil supplementation to raise hdl is actually effective in reducing cardiovascular disease?
Wheat Belly Total Health (2014) recommends fish oil (p177, 200) for a variety of reasons, only one of which is CVD. If you want to check the cites on those recommendations, the footnotes are visible on the Amazon LookInside feature for the book. See footnote 21 on page 370, and 15 on page 373. Each of these references multiple papers.
re: A lot of things I’ve read claim there is no benefit to taking fish oil.
A paleo blogger just posted this week on the topic, and listed a variety of conflicting studies. In nutrition, if you want to be confused, it’s easy to find papers supporting that posture :)
re: My hdl is 103 from a combo of low carb (grain-free) diet and fish oil.
That. The real bottom line, however, is results. I assume that Dr. Davis not only knows how to parse papers, but would not be recommending fish oil unless he was seeing unmistakable results in his clients – not just in improved labs that matter, but in material reduction of ailments and adverse events.