Help! My husband is a high cholesterol triathlete

Hey Grant
I’m a bit stuck what to do and would appreciate your opinion on something:
My husband Bob is 43, weighs 80kgs, is a builder, very active (does half ironman etc) with me at triathlon club, seems to deal with work/stresses etc very well and yet every year is told that he has high cholesterol. Traditionally this would mean really watching the fats, butter etc, which we have done, but the readings never change. Obviously we need to look at trying something else but I’m not sure about the LCHF way for him. I already follow a lot of the principles and he will try whatever I give him quite happily.
Your thoughts?
Grant: Yes very interesting.
A few things to consider:
1. How much of a risk factor is high total cholesterol anyway? TC is really meaningless; I would want to see the numbers, especially the triglycerides to HDL ratio. LDL is also pretty meaningless as it is really LDL particle size and number which provide the risk. So it may well be that high cholesterol is not something he actually needs to worry about.
2. Inflammation can be a problem. That’s CRP on the blood test, and that is often exacerbated by loads of triathlon training, a very active job, a high carb diet and consumption of polyunsaturated fat. That’s really the main risk factor for heart disease and all the other metabolic disorders, like diabetes, cancer etc.
3. LCHF is probably a good option, but with a strict fat adaptation phase with reduced training and heaps of coconut oil, just to prove his body can run on ketones and that you can defeat the need for loads of carbs. That is a great self experiment. Then my advice is to stay with that basic approach but supplement with carbs as he sees fit. That way
you get the best of both worlds. But it’s a self experiment every human should do in my opinion – get fat adapted and prove to themselves that they can have a stable mood and energy, with dietary fat as the major source of dietary calories.
4. The LCHF approach is anti-inflammatory, which is great for reducing chronic disease risk factors. A modified “paleo” like LCHF, where you supplement more carbs, is also anti-inflammatory, so long as the carbs are things like kumara (sweet potatoes and yams also). All the work so far shows that this is the best way of reducing health risk for chronic
5. Being a fat adapted highly active person, who also trains for triathlons may, at least in my opinion (more research needs to be done for sure), reduce the inflammation and oxidative stress and cellular damage done by loads of glycogen -burning chronic cardio exercise. This is that moderate intensity training that triathletes engage in for hours on end. I’m not convinced that this is risk free for health. The heart damage seen in several high profile endurance athletes is some evidence of what I’m talking about. It’s likely that relying more on fat in training reduces this stress. It also forces you to do some really short, high intensity work because you simpy don’t have the available glycogen for higher
intensity threshold intervals, which are the most stressful on the body (e.g. 8 by 1 km running at race pace is stressful, but how about 10 by 1 min sprints instead?) Again, more research needs to be done, but it’s my contention that triathletes could be healthier by eliminating that mid-range chronic cardio training. You might lose a little race pace
speed, but that will be offset by not getting sick as much and being fat adapted for racing, which has significant benefits.
So that was just a few, now longish, thoughts. Good luck and get back to me if you have any other questions…..
Thanks Grant. So if he were to basically follow your usual eating programme (first blog) , also with some kumara/yams, this would be a good place to start?
Yes. Diet also has some more lengthy resources which I aspire to get up myself in due course
To increase coconut oil usage, what would you do -besides using it to fry with?
Yes, extra virgin coconut oil to fry with is great. It goes well at high temperatures. Best of all it’s a medium chain triglyceride (MCT). MCTs can’t easily be stored as fat; they are burned intra-muscularly or in the brain too. They likely have anti-inflammatory effects, even if it’s just because they burn with less oxidative stress than carbs. You can use coconut cream and/or coconut milk to make “fat” smoothies. Berries, coconut cream, some ice – yum! Some people also add butter and/or coconut oil to their coffee in the morning. This is the so called “bullet proof” coffee. Not sure about the name but it’s a cool way to get extra fat.

You mention reducing poly unsaturated fats, is this not oily fish, nuts etc? I thought they were good to have…

I’d avoid trans fats and manufactured poly unsaturated oils, like canola, peanut oil and other “industrial seed oils”. I would (and do) use copious amounts of olive oil, avocado oil, macadamia nut oil, butter and coconut oil. Oily fish (Tuna, Salmon, Sardines, Mackerel) is awesome and eat plenty. Nuts are great too. Some researchers think that nuts are quite high in Omega 6 fats which are inflammatory and compete with Omega 3 fats (oily fish). I actually eat quite a lot of nuts, mainly almonds, and should probably eat slightly less of these. Cashews are one to watch as they are quite high in carbs. They can be good for long runs and bike rides though.

Quite a bit to get the head around with only a small amount of knowledge on my part! I’ll continue to follow your blog, I’m finding it interesting and I’m slowly getting there!

My view is that it is worth taking some time to get up to speed with some of this stuff. I’ve spent most of my personal life and professional career thinking exercise is the most important thing you can do for your health. I still think it is important, but the nutritional context is by far the most important part of human health. While some people seem to go alright on high carb diets, others just don’t. Many seem to have trouble controlling their weight on such diets even though they are doing all the “right” things according to the healthy eating guidelines (low fat, eat grains, etc). The reasons seem to be a combination of chronically high insulin (their biology is easily overwhelmed by carbs), and/or intolerances, to wheat in particular. It doesn’t mean full blown celiac disease, it just means their body works better when they eliminate wheat. Much more research needs to done in this field. That’s mainly why I’m immersing my self in it.


  1. Hi. I have a life-time problem with weight and its affect on health. I eat recommended foods – plenty of friut and veges, oily fish, limited red meat, minimal sugar, no wheat, limited dairy. I am on cholestrol lowering medication and blood pressure pills. I’m 67, 102 Kgs have sleep apnea (I use a F&P CPAP unit), a sedentary job with deadline stress, knocking on the door of type 1 diabetes, and very low energy. Exercise is limited to weekend gardening and building renovations. Keeping my weight to the 100Kg zone is very difficult and it keeps getting away on me. I will try the idea of working more with low cabs and worrying less about fat intake.

  2. Yvette Maneke · · Reply

    I am very confused. I have type2 diabetes but also high cholesterol (438) with high ldl and low hdl (good). I also have heaartt disease. What is the risk of lchf diet for me?

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Richard David Feinman

Richard Feinman, the Other

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