Florida man eats diet of butter, cheese, beef; cholesterol oozes from his body

High cholesterol is considered 240 mg/dL. The man's was over 1,000 mg/dL.

What could go wrong with eating an extremely high-fat diet of beef, cheese, and sticks of butter? Well, for one thing, your cholesterol levels could reach such stratospheric levels that lipids start oozing from your blood vessels, forming yellowish nodules on your skin.

That was the disturbing case of a man in Florida who showed up at a Tampa hospital with a three-week history of painless, yellow eruptions on the palms of his hands, soles of his feet, and elbows. His case was published today in JAMA Cardiology.

The man, said to be in his 40s, told doctors that he had adopted a "carnivore diet" eight months prior. His diet included between 6 lbs and 9 lbs of cheese, sticks of butter, and daily hamburgers that had additional fat incorporated into them. Since taking on this brow-raising food plan, he claimed his weight dropped, his energy levels increased, and his "mental clarity" improved.

Meanwhile, his total cholesterol level exceeded 1,000 mg/dL. For context, an optimal total cholesterol level is under 200 mg/dL, while 240 mg/dL is considered the threshold for 'high.' Cardiologists noted that prior to going on his fatty diet, his cholesterol had been between 210 mg/dL to 300 mg/dL.

The cardiologists diagnosed the man with xanthelasma, a condition in which excess blood lipids ooze from blood vessels and form localized lipid deposits. The escaped lipids would normally be taken up by roaming white blood cells called macrophages. But, in cases with xanthelasma, the amount of lipids is too large for the macrophages, which turn into foam cells with the excess cholesterol, leading to visible deposits.

Such deposits are often seen around the eye (a condition called xanthelasma palpebrarum), which often strikes people with lipid abnormalities, such as familial hypercholesterolemia. It's thought that continuous blinking of the eye over a person's life can eventually weaken capillaries in the area, allowing for lipid seepage. But, while this may be a more common presentation of the condition, lipid deposits can occur anywhere in the body.

Xanthelasma—especially xanthelasma palpebrarum—is not always associated with high cholesterol and heart risks, but having high total cholesterol is strongly associated with coronary heart disease.

The case study doesn't provide information on the man's outlook. However, the authors write that the case "highlights the impact of dietary patterns on lipid levels and the importance of managing hypercholesterolemia to prevent complications."

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