I know there are and have been a number of posts on this subject but this is my experience. I started Keto in 2013 before that I was Paleo for a couple of years. I had been a jogger for years and strength trained 6 days a week. Started incorporating cycling road and mountain in 2014. I started Keto for the purpose of using ketones for energy as opposed to carbs. My son was going into junior HS and was starting to run track and cross country and also took up racing bikes road and mountain. I began to work with him on his training using materials from Joe Friel and other trainers who promoted a Keto plan nutritionally moving him towards a low carb way of fueling his endurance sports. I always had high lipid panels once I started Keto but was never alarmed by it because that was the norm on the Keto eating plan. My recent blood work in July was a little high and my doctor wanted me to start on a statin. I refused saying my panels are always on the high side. His response was that he wanted me to take a CAC scan. My CAC score came back 1114!!! I am blown away my doctor says it is most likely genetic. So my questions are do I change my eating to minimal saturated fats which definitely would not be Keto? I donāt want to take a statin but feel with a score this high that I should. Really at a loss right now. Not looking for medical advise just wondering if anyone might have an experience close to this and what your plan of action was?
High CAC Score
Wow! That CAC score would have gotten my attention too!
But I donāt know if statins directly correlate to calcium already present.
Iāll be anxious to hear what our wiser members have to say.
Chime in, guys!
Mike
I have no direct experience of your issue (my CAC scan score was 10), but my advice (in the form of what I would do) is below:
- I would decide to stay the course and double down on carnivore. I would minimise carbs as much as feasibly possible and I would remove all plant matter from my diet.
- Most importantly, I would be taking another CAC scan in 3 months and then every 3 months to see what the trend isā¦ it is the trend that is important hereā¦ if you can stop the increase in your CAC score, your risk of a CV event goes down a lot.
- Worrying about it is not gonna help. I would be devising and working a plan to overcome thisā¦ working a plan is very therapeutic when faced with a major health challenge.
- I would be looking very closely at the work of Dr Malcolm Kendrick about the real root causes of CVDā¦ inflammation and viscous bloodā¦ Read āThe Clot Thickensā. I would be testing for blood viscosity, and if necessary try to get some blood thinning drugs. I think aspirin does this.
- Of course I would be searching the web (and especially these forums) for āhow to reduce high CAC scoreāā¦ I remember reading a few articles and posts on this very issue, and from what I could gather from these articles, all is not lostā¦ there is stuff you can do.
- I would also go and look at Ivor Cumminsā early videos, he was originally sponsored by a rich bloke who had CVD, and Ivor is an advocate for CAC scansā¦ I am sure he has some articles and videos on what to do with high CAC scores.
Thatās itā¦ thatās all I got. Best of luck, please let us know how you go and what you decide to do.
Cheers
Alec
My understanding is that statins do not reduce the plaque that is present in the arteries. Statins prevent/help the liver from producing more Cholesterol.
Alec
Appreciate the reply. In response to your plan or what you would do.
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āDoubling down on carnivoreā that would definitely jack up my cholesterol numbers. I went carnivore
in 2022 for a period and on my next lipid panel my total cholesterol went up to 290. -
Yes, CAC scans about every 3 months. I just had a nuclear stress test I am waiting for results.
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I am not a worrier. My immediate plan is to continue to do what I have always done; cycling, strength
train, walk and golf. -
I will look up Dr. Malcomās work. I did start taking the statin 2 days ago and a aspirin.
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I have been researching on how to reduce CAC score. Iāve been Keto since 2013 not sure if there is
enough tested science in the Keto/Carnivore arena to emphatically say that it is the best course to
continue in my situation. Plus, unless you are eating completely free range grass fed/grass finished
meats than you are getting the very things you say you want to eliminate from your diet. -
I will look up Ivor Cummins.
Much appreciation,
Mike
Mike
High cholesterol is NOT the root cause of CVDā¦ in fact it is protective. So, higher cholesterol is a good thing here. I would not be taking a statin.
Cheers
Alec
Not sure why you say this. Are you claiming that I am eating carbs/plants if I eat non grass fed meat??? Thatās a weird claim.
Oddly, statins cause CAC scores to go up, but there is debate as to whether this is good or bad. See here for instance:
Saturated fat has nothing to do with anything, really. The idea is that āsaturated fatā raises āLDLā, which is ābadā. But āsaturated fatā isnāt monolithic (there are many types of saturated fat), and itās unlikely from what I can see that saturated fat raises LDL (but likely that seed oils might lower LDL). This is a list of saturated fats:
Supposedly, palmitic acid raises LDL but stearic acid lowers LDL. If I eat a steak that has both, what happens to my LDL?
Are you lean?
What āgeneticsā did your doctor say you have that contributes to high atherosclerosis? (I think genetics could play a role, but I donāt know what that would be.)
Some people have lowered their CAC scores by taking large amounts of vitamin K2 and through other techniques. Ivor Cummins was describing these at one time (though I stopped following him once covid hit). I know that they were using athletes for some of this, because their CAC scores often were high. There was discussion whether reducing CAC scores using K2 (and more) was good or bad.
Also, you can eat keto without high saturated fat, but it may or may not lower your LDL. Nick Norwitz eats very low saturated fat yet has extremely high LDL. This is Nick:
This is one of his articles:
Letās not forget,
āA coronary artery calcium (CAC) score, also known as a calcium score or cholesterol artery test, is a type of indirect cholesterol screening that measures calcium levels in the arteries. This calcium buildup, called plaque, is made up of cholesterol, fats, inflammatory cells, scar tissue, and other substances in the blood.ā
Is there really any direct evidence that cholesterol is the guilty party here?
If the animal is being fed grains to fatten it then yes I would say that it is in the meat itself. That was something I have always heard from Keto proponents.
My understanding at this point is that statins do cause the CAC scores to go up because it calcifies the plaque.
The high lipid panels was something I always viewed as normal because I was on Keto so it wasnāt a concern. But now with the CAC score not sure as what is best for me at this point. Most likely genetics but what does that impose.
I know insulin levels play a role but that is something I have been on top of for years. I mention saturated fats but it is just my thoughts at this early stage in my moving forward.
āitā is the food the animal is fed with for itās life span before it is butchered and put in the market. You donāt have to agree with that but I believe most Keto proponents would say the same thing.
I think thatās one of the unanswered questions - is it better to have calcified plaque, or is it better to try to reduce it (my understanding is that K2 may pull calcium out of the plaque and direct it toward bones, which also seems like an unclear strategy ā¦ is it better to have soft plaque that might dissolve or decrease or is it better to firm it up with calcium so it doesnāt go anywhere?)
My suspicions of statins are potentially unfounded, but it seems to me that every time science (read: Big Pharma) discovers a way to tweak a metric with a drug, it mysteriously becomes essential to tweak that metric and the whole definition of āhealthā suddenly shifts to everyone focusing on tweaking. Note that we werenāt all that concerned with cholesterol scores, and upper acceptable limits were much higher, before we discovered what statins could do. In short, what came first, the āproblemā or the solution?
I do understand your concern, thatās a scary number, and Iāll be reading along to see if we can discover anything new. Hang in there!
Ok weāre crossing wires here. Of course the food being fed to the animal is in the animal. What is the substance youāre referring to when you tell Alec āitā is in the meat? I mean grain per se is not in the meat. The omega profile is different for grain fed animals, much higher Omega 6.
Thanks for the informative reply. It is really all Greek to me at this point. You get so many opinions on these forums which are helpful but not necessarily correct. Agree that drugs are always the first and only solution from doctors. It took me 2 weeks to start the statin after it was prescribed to me and I have only taken it for 2 days. Thatās hard for me because I am not nor have been on any prescribed medications.
They feed the animal a high grain diet then fatten it before it is slaughtered. When an animal is in a slaughter house it knows what is happening itās adrenalin is high heart racing pumping all that into itās body I believe that effects the meat. If I am wrong on that then I have misunderstood the Keto proponents I have read over the years.
I can totally relate to your reluctance. Although I have strong convictions, I also have everyone elseās underlying wiring - maybe a multi vitamin is a good idea. maybe a statin is a good idea. maybe low fat is a good idea. I reject these ideas, but when the chips are down itās pretty nerve wracking to walk the talk in the face of social and medical pressure (after all, the protocol could be right, even if the logic or motive is wrong.) 
Again, try not to worry too much - hah - and see where your exploration takes you. N=1!
You may want to look into Vitamin K2 supplementation
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7238900/
There have been some recent studies that say supplementation with K2 did not decrease CAC scores, but there was also no dietary intervention done with the participants. I would imagine taking a bit of vitamin K isnāt going to make a difference if one continues to eat a crap diet. Itās possible, keto and K2 could make a difference?