Comments on the Dave Feldman episode


(Bob M) #1

Just listening to this episode, part way through. Was glad to hear about Ketofest 2017, as I was at the presentation part and loved it. Dave, Ivor, and Amber were some of my favorites.

Anyway, please, please, please STOP saying meat is high saturated fat. It’s not. The example was bacon and pork. Here’s the info on a pound of bacon:

In what way is 34% of the fat from saturated fat being “high” saturated fat? It’s not. It’s high MUFA (and PUFA, but that’s a different topic).

You don’t get saturated fat above 50% until you get into dairy or suet or coconut. For meat, suet (a particular beef fat) is the ONLY “meat” I know of that’s “high” in saturated fat.

Dave Feldman also remarked about our use of FFAs (free fatty acids), and particularly the heart’s use. If you want even more research on the heart, note also that the failing heart LOVES ketones. Easy to find many studies indication this. (Not sure about FFAs; no one seems to study that.)

I believe that my body’s use of FFAs has improved over time, which has led to my very low ketone (BHB, breath) levels. Or at least this is what makes sense to me.

Anyway, this has been a great episode so far, and these are a few minor comments I have. I’ll update once I hear the whole thing.


(Bacon is a many-splendoured thing) #2

It’s like 30% of calories coming from carbohydrate being considered “low” carbohydrate. It’s all relative. I believe that the dietary recommendation is a maximum of 12% saturated fat (or something like that), which makes 34% very “high” indeed.

The logic is that ketones, being already partially-metabolised fatty acids, require less oxygen to metabolise, hence they are a benefit to muscle, the oxygen supply of which has been compromised.


(Bob M) #3

I realize it’s relative, but to what? It’s really just a way for vegans and vegetarians to denigrate meat, as meat is “high” in saturated fat.

And I specifically tried to eat a “high” saturated fat diet, while trying the croissant diet. After I stopped eating carbs+sat fat, I tried a low carb sat fat diet. But to eat a high sat fat diet, you have to eat:

  • beef suet
  • cacao butter
  • certain dairy

Other than this, nothing is high in saturated fat. (Coconut is high in saturated fat, but it’s mainly short-chain fatty acids, which according to Hyperlipid won’t cause a satiety effect.)

Now, those are actually high in saturated fat.

But this leads to comparisons like this one:

3Tbsp olive oil (easy to eat on a salad):

6 ounces of top round:

image

Which one is “high” saturated fat?

Granted, meat is higher – percentage wise – then olive oil, but this simple example shows one can get the SAME EXACT amount of saturated fat eating both.

To me, this renders statements like “meat is high in saturated fat” to be meaningless.

Also, Dave was speaking about how he could tailor his lipids based on what he ate. But in terms of saturated fat, that’s really hard to do.

Consider the example I showed above. There’s no difference in saturated fat.

Whenever you eat real food, you’re going to have a wide variety of fats. Even if you went “zero” fat (say, the Pritikin diet I was on for years, where I ate hot cereal, pasta, brown rice + beans, rice cakes, egg whites, chicken breasts, etc.) then went to an all meat diet, are you now eating a “high” saturated fat diet? No, you’re not. You’re eating a high MUFA diet.

Say you test your lipids and LDL (or whatever) changed. What caused that? The “high” saturated fat? It’s impossible to tell.

Every time I see a statement like “high saturated fat causes LDL to increase”, 99.99999999999 % of the time, there are too many variables involved to ascertain what caused the change.

As a scientist, I cannot abide by these types of generic statements that really have no meaning.

As for FFAs and the heart, I have an interest in everything related to the heart since I was diagnosed with cardiomyopathy 8+ years ago.

There are many studies indicating that ketones are preferred by the failing heart (just don’t ask your cardiologist whether you should go on a “high” saturated fat diet by eating all meat…). But someone like me has very low ketones, so something else must be making up for that.

Unfortunately, the studies of FFAs in heart failure are conflicting, and none of them study me…someone low carb/keto for almost 8 years and with heart failure.

In fact, no one studies those of us low carb/keto for this long.


#4

Good quality olive oil has polyphenols in it and good quality grass fed meat has carotenoids. These antioxidants have been down to prevent LDL oxidation and increase HDL.

Poor quality meat/fish from diseased animals will cause disease.

I’ve noticed Omega 3’s are a lot more important for heart failure.

Trout/mackerel/wild salmon + walnuts and I’m doing great but it’s hard finding good quality fish and walnuts.
(https://www.eurekalert.org/news-releases/926438)

I’ve noticed that everything coconut is bad for heart failure. Either C8 or C10 fatty acids worsen the heart… I don’t remember the mechanism but will post when I remember.


(Bacon is a many-splendoured thing) #5

I don’t disagree with you, but others do feel that “high in saturated fat” is a phrase that has meaning. We need to understand their point of view and their underlying assumptions, if we are to have any hope of changing their understanding. For instance, we can define “low-carb” as “a daily intake low enough to avoid stimulating sufficient insulin secretion to inhibit ketogenesis.” It’s not a precise amount, but it takes individual variation into account. A similar definition of “high fat” should be possible.

BTW, I am not up on the most recent developments, but in several lectures available on YouTube, Phinney states that saturated fat is the only dietary substance capable of raising HDL. He cites his experience working on a drug that would raise HDL, a project that had to be shelved when it was discovered that said drug had unacceptable side effects. It this still the current understanding?

Also, the statement that saturated fat increases LDL seems odd to me. I thought it had been shown that it was carbohydrate intake that raised LDL and triglycerides. Of course, anyone who still believes in the diet-heart hypothesis is going to refuse to accept that evidence. (My favourite Upton Sinclair quotation applies: “It is difficult to convince a man of something, when his salary depends on his not understanding it.”)

My own feeling is that we should be eating our fats in the proportions in which they occur in the diet we evolved to eat. This basically, to my mind, means heritage breeds of animals raised on what is essentially the diet they would have eaten in the wild. Let’s call those the “normal” percentages and base “low” and “high” on that.


(BuckRimfire) #6

Darn, I’d like to be in the LMHR study. My lipid numbers (see below) just barely qualify (pre/post LDL ratio just makes it into their criterion), but, by the online calculator I just looked up (http://www.cvriskcalculator.com/), my CVD risk calculation comes out at 5.7% and they say <5% is the cutoff. If my blood pressure was as low as it was in 2017, I would barely make the cutoff by this calculator.

edited to add: I doubt I behaved atypically in terms of caffein, exercise, etc, before my last physical, so maybe I could bring down my BP by being very sedate for a couple of days and avoiding caffein? I don’t remember for sure, but I tend to drink lots of black tea every day, so I probably was somewhat caffeinated.

Since the calculation of CVD risk is strongly age-dependent, my conclusion is that most of the people who qualify for the study will be younger than myself. Any thoughts about the study using mostly people in their 40s vs older cohort?

4/3/17 TC 214 HDL-C 65 LDL-C 137 TRIG 61 blood pressure 114/75
Went keto/low-carb 6/23/18
5/21/20 TC 305 HDL-C 89 LDL-C 208 TRIG 41 blood pressure 124/74


(Bacon is a many-splendoured thing) #7

Wow! Your numbers, both before keto and after starting keto, look great. In particular, your ratio of triglycerides to HDL is under 1.0, when 2.0 or under is supposed to indicate minimal cardiovascular risk.

While I can’t comment about the possibility of your getting into that study, you are definitely correct about the risk calculators. The algorithms don’t take diet into account (except for “fat bad, carbohydrate good”), so the notion that cumulative damage over time from a high-carb diet is irrelevant, in their eyes, to the association between age and cardiovascular risk.

A number of people have commented that the risk calculators also appear to be designed to put everyone on a statin. (I wonder why?)


(BuckRimfire) #8

Yes, I’m very happy with my trig/HDL. But I’m one of those hateful people who can eat almost anything and find it impossible to gain weight, which might explain why my lipid panel numbers have always been “good” except for LDL-C.

Surprisingly, that calculator didn’t want to put me on a statin (output below as an image). This one did, though: https://tools.acc.org/ascvd-risk-estimator-plus/

CVD risk 5.21.20.pdf (64.6 KB)