Keys mainly considered low intake of saturates in lowering LDL cholesterol.
This is obviously not enough which Loren's Eskimo example shows.

To add further to the evidence: Among subsistence horticulturalists of
Kitava, Papua New Guinea
[http://www.panix.com/~donwiss/paleodiet/sl1.shtml], saturated fat intake
was similar as in Sweden (16-17% of daily energy intake, en%) but serum
total cholesterol was lower, especially in the males (4.8 vs 5.8 mmol/L)
[1]. Likewise, total cholesterol in healthy subjects in rural Sri Lanka was
only 4.7 mmol/L despite that saturated fat from coconut provided 19 en%
[2]. And total cholesterol in middle-aged traditional Polynesians from
Tokelau was only 5.0 mmol/L in males and 5.5 in females, despite an
estimated 45 en% saturated fat, also mainly from coconut [3, 4]. In
urbanised males and females who had migrated from Tokelau to New Zealand
and decreased their intake of saturated fat to 21 en%, TC was 5.6 and 5.8
mmol/L, respectively, further indicating that other factors than saturated
fat and dietary cholesterol are of importance, such as the above. The same
argument may be applied to the much higher TC in urbanized than rural
Masai, despite a higher intake of saturated fat from milk among the rural
group [5, 6].

In this group Loren and Jennie suggest that LDL may decrease by high
protein and/or low glycaemic index diets through improved insulin
sensitivity. I believe this is important and underestimated. But isn't it
possible that any satiating (e.g. nutrient dense, voluminous, water rich
etc.) diet by way of reduced caloric intake and reduced (abdominal) obesity
could lower your LDL independently of these factors? If so it could in a
sense be more important to avoid empty calories than to find the best
proportions of CHO, fat and protein.

Regards

Staffan

1.      Lindeberg S, Nilsson-Ehle P, Terént A, Vessby B, Scherstén B.
Cardiovascular risk factors in a Melanesian population apparently free from
stroke and ischaemic heart disease - the Kitava study. J Intern Med 1994;
236: 331-40.

2.    Atukorala TM, Jayawardene MI. Lipid patterns and dietary habits of
healthy subjects living in urban, suburban and rural areas. Ceylon Med J
1991; 36:9-16.

3.    Stanhope JM, Sampson VM, Prior IA. The Tokelau Island Migrant Study:
serum lipid concentration in two environments. J Chronic Dis 1981;
34:45-55.

4.    Prior IA, Davidson F, Salmond CE, Czochanska Z. Cholesterol,
coconuts, and diet on Polynesian atolls: a natural experiment: the Pukapuka
and Tokelau island studies. Am J Clin Nutr 1981; 34:1552-61.

5.    Day J, Carruthers M, Bailey A, Robinson D. Anthropometric,
physiological and biochemical differences between urban and rural Maasai.
Atherosclerosis 1976; 23:357-61.

6.    Ho KJ, Biss K, Mikkelson B, Lewis LA, Taylor CB. The Masai of East
Africa: some unique biological characteristics. Arch Pathol 1971;
91:387-410.


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Staffan Lindeberg M.D. Ph.D. Dept of Community Health Sciences, Lund
University, Mailing address: Dr Staffan Lindeberg, Primary Health Care
Centre, Sjobo, S-22738 Sweden, +46 416 28140, Fax +46 416 18395
http://www.panix.com/~donwiss/paleodiet/sl1.shtml
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