Hacking your LDL

(Carl Keller) #1

If you really want to lower your LDL score, it’s as simple as eating nothing but bread and processed meat. Dave Feldman’s “Prison Food Diet” experiment demonstrated how eating Wonder Bread and lunch meat lowered his LDL from 296 to 83 in 7 days.


But before you get all excited about dropping your cardiologist’s jaw, you should note that while lowering his LDL score dramatically, Dave Feldman’s triglycerides shot from the mid 70s to above 200 and his HDL cholesterol dropped almost 20.

What does this prove? It proves you can have a “healthy” LDL by eating garbage. It proves that looking only at LDL as a predictor of heart disease is flawed. It proves how easy it is to manipulate LDL scores and that freaking out over a high score is unnecessary when you don’t consider HDL and Triglyceride scores.

Wife’s Cholesterol
(Monique) #2

Thanks for sharing this @CarlKeller

(Jody) #3

Good info! I was just listening to an early Dave Feldman podcast last night!

I’m curious what my numbers will look like when I see my doctor early May. I have it on my calendar to stop fasting about a week prior and go back to TMAD leading up to my blood work.

(aka Nick) #4

The whole LDL thing is the medical testing business version of an inside joke. Everybody gets it tested, but it would be more useful to measure eyelash diameter.

My understanding is that the best predictor of heart disease and heart attack risk is the the Coronary Artery Calcium score (CAC score). This is an MRI of your actual arteries to measure plaque, then comparing your CAC score to a few thousand previous patients who have been tracked for heart attack events over the following years. Your CAC score allows a Dr. to estimate your 10 year heart attack risk.

There are a couple parameters that are entered into the CAC risk model to calculate heart attack risk. I’ll post the table so you can see what drives the model and how they are weighted. A slice of bacon for anyone who identifies a strangely absent parameter. Well, it’s not that it’s missing so much as there was no correlation between the measurement and the outcome. Look at the hazards ratio for each of the parameters. The larger the number, the more dangerous the risk factor is, and the more weight it has on your CAC score.

Two strips of bacon for anybody who can spot the single best predictor of a heart attack. It’s more dangerous even than having a family history of heart attacks, or smoking. It dwarfs HDL, LDL, and cholesterol combined!

CAC score is really fascinating. Here is a link to a simple online calculator that gives you your risk score.


Here is a link to the original research, on how the model works:

(Jody) #5

I have T2D and family history and it’s scary AF. I am going to ask my Dr about the CAC test when I see her. I’ve NEVER even heard that until I started listening to the 2dudes podcast.

(aka Nick) #6

She may not authorize the scan. You are high risk for HD based on traditional risk factors, ergo she may say the scan is unnecessary. My understanding is that prevailing wisdom holds that only folks with intermediate risk should get one. This is because it was assumed that folks with low risk based on traditional risk factors won’t have calcium, and folks with high risk based on traditional risk factors have already been identified.

Those assumptions have been proven wrong by Silverman et al. Using traditional risk factors, roughly 15% of the predicted “low risk” group for plaque actually had dangerous levels of plaque. Conversely using traditional risk factors roughly 35% of people predicted as “high risk” actually turned out to have minimal measured plaque. Hopefully you are among the latter. Outdated risk models that use thing like LDL result in over-medication and often miss folks at serious risk of HD.

Here is a simple summary article that covers some recent research on why CAC scan is important regardless of traditional risk factors:


Here is the actual medical journal article:

(Jody) #7

Maybe I’ll bring this to my next appt. I would spend the $ to get the scan if insurance didn’t cover it, assuming it’s not $5k. I’d like to know how much damage I’ve caused. For me, this is the kind of info to keep doing what I’m doing.

I’m working my way through the old 2dudes podcast library and I remember one of their guests getting this scan, he thought he was super healthy as an athletic guy but ended up with bad results and changing his life.

(Khara) #8

Last I checked in my area (west coast US), the test was $99. So definitely doable for someone to pay out of pocket. This was before the healthcare changes so I hope it hasn’t been negatively affected and hopefully too we can still just go and get them ourselves without needing a doctors orders.

(Alec) #9

:clap::clap::clap:. My friend, you have just taken the lead in my favourite forum quote to date. Bravo. :joy::joy:

Shame the highest risk factor was being male. Really must get that sorted. :see_no_evil::scream:

(KCKO, KCFO) #10

I just got one on a special deal for $200 on Wednesday. Anyone can call them and make an appointment, no drs. order required. Lots of places do this now. I’m in the Denver area and went to a place in Boulder for that. Results will be mailed to me in 7-10 days. It also scans about 40% of your lungs, so a peek at what is going on in those as well, never a bad thing.

Do a google search for your area.

(aka Nick) #11

Actually, you probably already have. Consider that a woman with typeII diabetes has the same probability of heart attack as man with a < 6 A1C. Sorted. :smile:

It’s common knowledge to doctors that men have double the heart attack risk as women using “traditional risk factors”. What do you reckon it says about doctors that the traditional risk factors don’t include diabetes!

Remember kids, extended fasting is dangerous! Even if your risk for the #1 killer in the world doubles (heart disease), it’s much safer just to keep the diabetes than it is to skip a few meals a week.


(Carl Keller) #12

Here’s another interesting video by Dave Feldman. In it, he talks about his theory that LDL particles can be broken down for repair and growth. He conducted a N=1 experiment in which he ate the exact same thing every day for 20 days straight and measured his LDL every morning. Once he began an excercise routine in which he tried to make his body sore, he noticed that his LDL levels began to fall.

Dave says this might explain why elderly folks with higher LDL live longer than those with lower levels.

(J) #13

He lost me (the fatemperor.com) when he referred to the Norwegians in the Framingham study. :woman_facepalming:

(Alec) #14

What was the context? Ivor usually knows what he’s talking about…

(J) #15

" After ten years of monitoring 52,087 Norwegians (ages 20-74), The Framingham Heart Study had a massive amount of data on subjects — and they were able to exclude anyone receiving lipid medication. Look at what their data showed:[11]"

When I first started reading, I was excited because I am looking for good, consumer-friendly, breakdowns of the science, but seeing a glaring error like this turns me off because Framingham is THE American study of merit-- and studies people from Framingham, MA. A suburb of Boston.

(Todd Allen) #16

Yes, that is a mistake. I’m unable to follow your link to fatemperor.com but I found the mistake here through the link posted at the top of this thread:

Note, this link is to a blog post by Mike Roberto. Not Ivor Cummins the FatEmperor. Also, it’s not a huge mistake, I suspect he meant to write North Easterners not Norwegians or misheard North Easterners as Norwegians in a podcast.

(Carl Keller) #17

@mamaJ @Alecmcq

It is indeed a mistake. He’s mixing studies. The study with 52k Norwegians was the HUNT 2 Study and here’s the link to that if you are interested:

In order for his blog to be correct it should read:

After 24 years of monitoring 3,590 men and women (or Americans), The Framingham Study…

(Todd Allen) #18



Nice sleuthing!

Here’s the link to the Framingham study referenced by (11) too:

(Carl Keller) #20

Thanks. At first, I wondered if Framingham was locally known as “Little Norway”. :smiley: