Effects of fasting on A1C and cholesterol


#1

So i started Keto about 6 weeks back and achieved incredible results in terms of weight loss. However, when i went in for my blood work my bad cholesterol actually spiked significantly to the point my doctor knew i was on keto before i had even opened my mouth. So i cut out eating crazy amounts of red meat and have moved more over to a Mediterranean diet where i’m consuming more poultry and fish.

When i first started i’d intermittent fast from 8pm to 12 noon the next day. Over time my hunger has been suppressed to the point where i can skip both bfast and lunch and just have 2 or 3 green teas during the day and have some nuts and lots of water while driving around. I am essentially having one decent sized meal a day but i’m not feeling overly hungry.

Now the question is am i damaging my long term health by fasting for such long periods? i had heard fasting spikes blood sugar levels. Will this cause my A1C to increase? because one of the reasons i started keto was to decrease my A1C from pre-diabetic back into the normal range. Also, does this fasting have any effect on my bad cholesterol? Only other thing i want to note is that my good cholesterol also increased


(Bacon is a many-splendoured thing) #2

First of all, the numbers you get at six weeks are effectively your baseline numbers (yes, they’ll be a bit different from a real basline taken before you went keto, but not that different). Wait until you have been eating a ketogenic diet for six months before taking any action on the numbers you get. It takes that long for things to settle.

Secondly, why are you worried about your cholesterol? The only number that has any predictive value for your risk of cardiovascular disease is the ratio of triglycerides to HDL. If you want to lower your triglycerides and raise your HDL, you need to eat saturated fat. Polyunsaturated fat will lower your LDL cholesterol, but at the cost of doing other damage. The only polyunsaturated fatty acids that you need to eat are ω-3 and ω-6, and not too much of the latter, because it is inflammatory. So stay away from seed oils, which are all high in polyunsaturates, and cook with butter, lard, tallow, bacon grease, or fruit oils such as avocado, coconut, or olive.

Third, did your doctor order an NMR test to see what pattern of LDL you have? It may be too soon to all be pattern A, but it would be good to know where you stand. As far as all the research has shown, cholesterol level is not related to risk of cardiovascular disease. Many people with familial hypercholesterolemia (a genetic predisposition to elevated LDL) never develop heart disease, never have a heart attack or stroke, and die at perfectly normal ages from perfectly normal causes. And most people admitted to hospitals with a heart attack have low LDL.

All this tends to indicate that cholesterol does not cause cardiovascular disease. In fact, a number of large, significant studies have shown that higher LDL actually seems to correlate with a lower risk of heart disease, especially as we age. What seems to give cardiovascular disease to people with FH is mutations that make certain clotting factors (in particular fibrinogen and factor VIII) more active, increasing their risk of a blood clot. If you want a real measure of your risk of CVD, ask your doctor to order a CAC scan, since even sticky blood is less likely to be a problem if your arteries are undamaged.

Last, each period of fasting, whether it’s days or only 12 hours between one meal and the next, is a period of low insulin, so fasting should have a positive effect on your HbA1c. However, HbA1c is a measure of how glycated your hemoglobin is, and since red corpuscles generally live for three months, it is not going to change all that much in six weeks. It is a good indicator of your stroke and heart disease risk, because glycated red corpuscles are stickier and therefore more likely to form an obstructive clot.


#3

I would echo everything Paul said but add one more thing: your numbers 6 weeks into Keto aren’t just baseline numbers. If you were actively dropping weight at that point, they’re going to be quite high, likely much higher than where you’ll naturally settle on Keto. You just can’t use lipid results from blood taken while you’re losing a lot of weight.


#4

Reason for my concern is that my LDL levels were 3.99 prior to keto and they now shot up to 5.27 and my HDL was 1.7 and it increased minimally to 1.8

I will mkae dietrary adjustments and work on that such as cutting out red meats and other foods high in fat and move over to fish and poultry.

But my question ahs more to do with the 14-16 hours between meals and if they have any negative effect on A1C or LDL or any other major bloodwork metric?


(Bacon is a many-splendoured thing) #5

Each period of fasting, whether it’s days or only 12 hours between one meal and the next, is a period of low insulin, so fasting should have a positive effect on your HbA1c.


(traci simpson) #6

I’ve been fasting from around 4pm until 1130 or so the next day. Weekends are usually from around 7pm until almost 7pm which is really good but my A1C is still high. The occasional treat can’t raise my A1C an entire point can it?? My glucose level is 86. Is that bad or good?


(Bob M) #7

What’s “high”? Amy Berger just drafted an article about HbA1c:

One issue is that if your red blood cells live longer, you’ll get a higher HbA1c.

Is that glucose level in the morning or at some other time? If that’s in the morning, that’s a great level. I’m 20+ points higher. Even if it’s at another time, that’s still a great level.

I learned from wearing a FreeStyle Libre continuous glucose monitor that my blood sugar is lowest around midnight, then goes up all day until about noon, then goes down all day. I’m over 100 in the morning, but much lower at night.


(traci simpson) #8

I emailed Dr. Saladino and he said that it was probably too much protein. I found this little bit of info:

Too much protein will have gluconeogenesis creating so much sugar that you’ll end up with high blood sugar levels and large amounts of insulin being released. Counteracting the purpose of omitting carbs and sugar from your diet in the first place.