Lipid analysis

science
(Maj) #21

@PaulL @Pjam @SomeGuy @kib1 @velvet @Alecmcq @Janie
CC @richard

Thank you all for your inputs. I had a chat with an specialist today on my lipid analysis so I thought I drop a few lines here as it is only fair to let you how it went.

Since 2017 that I started ketogenic diet and moved in to low carb since 2020 (50-70g daily), this was the most pleasant, educational, positive and respectful 45 minutes conversation I had with a doctor on this matter. It was really good.
**His concern:**There is no long term study on hyper-responders for this diet so going by the existing studies, if you carry on with this diet there is chance of CVD in the next 10-20 years as the blood becomes thicker and thicker.
My reply: If CVD is the concern in the long run, total LDL does not mean much but we can look at calcification by CAC score to identify if there are a lot of oxidated LDLc particles in order to conclude if the high total LDL is to concerning.
His conclusion: I wouldnā€™t even suggest a table to reduce your high total cholesterol (8.3) or high total LDL (5.9) because all the rest of the markers are good and we have a perfect level from 2013 (3.9) plus there is no genetic issue and you donā€™t smoke. If you want to reduce the total cholesterol then you can introduce some carbs such as up to 100-150 grams a day to reduce this. I had a patient similar to you in this diet and we achieved cholesterol reduction with introduction of some carbs.
Going forward Because I have no underlying health issues, am not diabetic or insulin resistance, I accepted his suggestion and we are going to test my blood work next year and follow up with him to talk about the result next year. My carb introduction is going to be sourdough bread that I make for my darling wife for the last 3.5 hears which has a good level of broken down gluten due to 48 hours fermentation process. I might find a different alternatives or am happy for suggestions.

Big shout out to good doctors. Medical professionals are catching up with science and that is truly great news and that a doctor is having patientā€™s interest in heart.

(Alec) #22

Good for you that you feel comfortable with his advice and you have a plan going forward.

However, I am not at all convinced by anything he said (like none of it). He is singing off the same old hymn sheet that is just plain wrong. If any doctor suggested to me I should eat more carbs to lower my cholesterol I would be running away fast.

(You've tried everything else; why not try bacon?) #23

There is no long-term study on the high-carb, low-fat diet, either, but that doesnā€™t stop people from recommending it. (And the evidence that does exist shows that low cholesterol actually correlates with worse health outcomes.)

That bit about ā€œ. . . as the blood becomes thicker and thickerā€ makes no sense to me. I wonder what heā€™s thinking of. Given that the anthropological and paleontological evidence strongly suggests that our ancestors ate meat and very little carbohydrate for the two million years before the agricultural revolution began 12 thousand years ago, I think it highly unlikely that a low-carb diet is going to kill anyone.

(Joey) #24

@Geymakh Many thanks for the update.

Sounds like your doctor makes diet recommendations by applying outdated ideas that lack scientific support about various subjects like ā€œbadā€ cholesterol (?), need for some level of carbs (?!), thickening blood (!?!) and who knows what else. Heā€™s clearly not up on what peer-reviewed science is currently available.

In any event, I wish you good luck with the changes you are making. If they largely reflect your doctorā€™s choices, well, based on his outdated belief system, this might be a rather flimsy basis on which to trust your own health.

Still not sure what problematic issues youā€™re trying to address but I find it hard to see how eating (even the most delicious home-baked bread) will resolve them.

Best wishes! :vulcan_salute:

(Michael) #25

Some of the top standard practice lipidologists have written papers spouting their success at lowering LDL through introduction of ā€œhealthy carbsā€ and lowering saturated fat. They then tout the lower LDL as proof of success and pat themselves on the back for saving that persons life, while publishing a paper noting their success (as opposed to the damage they are inflicting by encouraging a diet that forces the body to run off sugar). /Sigh.

(You've tried everything else; why not try bacon?) #26

It sure is depressing. I wonder if eating too many carbs has perhaps addled their brains. :grin:

(KM) #27

Well, at least you got more comfortable having an informed conversation with your practitioner. At least it was informed from your side! (Does he actually think people take blood thinners because their blood gets thick? Scary.)

Are you reintroducing"healthy" carbs because you would prefer a diet with carbs in it? Because medically speaking, as has been pointed out I suppose, thereā€™s no reason for it and itā€™s going to remove you from any kind of keto benefit.

#28

If you get a chance, Google Dr. Allan Sniderman. Dr. Allan Sniderman is a highly acclaimed Professor of Cardiology and Medicine at McGill University and a foremost expert in cardiovascular disease. I recently heard him speak and explain the many risk factors used to predict atherosclerosis, including triglycerides, cholesterol, and lipoproteins, and he makes the case for ApoB as a superior metric that is currently being underutilized. Sniderman expresses his frustration with the current scientific climate and its emphasis on consensus and unanimity over encouraging multiple viewpoints, thus holding back the advancement of metrics like apoB for assessing CVD risk, treatment, and prevention strategies. Finally, Allan illuminates his research that led to his 30-year causal model of risk and explains the potentially life-saving advantages of early intervention to prevent future disease. One of his main points is that the 10-year risk window is inadequate and outdated.

(Joey) #29

You are not what you eat. You are what you donā€™t poop, but retain.

Cholesterol performs various functions and plays an essential role as it circulates. If LDL were simply understood as part of the broader life-sustaining transport system that it is, weā€™d all be in a better place. (Thoā€™ statin sales would plummet.)

(You've tried everything else; why not try bacon?) #30

And in combination with what your body does with what it retains.

(Maj) #31

I have spoken to few doctors in the past and while I donā€™t remember everything word by word we talked about I felt he is genuinely responding positively for every point I made about cholesterol and low carb. So I credit him on that.

(Maj) #32

Yes about the blood thickening part, Iā€™ve never heard that before, from either side actually, so I gave him the benefit of the doubt. In fact Iā€™ve never heard from the keto community either so that was a bit news for me.
About the food, true, meat and fat have been the main part of our ancestors diet. That said we canā€™t rule out that our ancestors didnā€™t other type of foods. One thing is known for sure and that since wheat has been in humans life, tooth decay has been seen in the human, such as old Egypt, if Iā€™m not wrong.

(Maj) #33

Yes it felt like heā€™s sometimes giving some outdated methods. One thing was clear. He was all up for keto diet without any hesitation but I noticed he was diplomatically saying some sentences that didnā€™t quite add up with his other sentences and thatā€™s when I realised he had to play by the book but he also recognises, respects and responds positively to why I am doing what I am doing.

(Maj) #34

I am not sure if proper doctors and scientists pay any attention to them anymore because it is obvious whatā€™s their motives by stating incorrect science talking a blanket term good cholesterol bad cholesterol.

(Maj) #35

I felt he listened to what have got to say and he responded not like he has made his mind up. He responded very positively to my criticism of some of his sentences about total cholesterol and total LDL.
I am not entirely sure if I want to introduce more carbs but I would like to see my bodyā€™s response if I did. But the carb that is more acceptable such as nuts and cheese and similar, even though I said in my post I am thinking of sourdough bread but I would like to consider low glycemic types.

(Maj) #36

You have a valid point. This was a point that I made to him very clearly and he even didnā€™t tried to argue about it instead he respectfully accepted it and added to it.

(You've tried everything else; why not try bacon?) #37

Actually, a radio-isotopic analysis of the bones gives us a pretty good idea of what our ancestors ate. And with the invention of agriculture, the farmersā€™ skeletons are shorter, with a smaller cranial capacity, and many degenerative diseases. The huntersā€™ skeletons are taller and stronger, with damage from accidents, not degeneration. In many ways, agriculture has benefitted the human race, but our health is not one of those ways.

(Joey) #38

Most definitely.

Historically, agriculture was an innovation to feed the masses - being easy to scale, store, transport, and distribute the harvest throughout the seasons. As a result, it allowed civilizations to grow their populations and raise armies.

But donā€™t overlook the fact that throughout the ages the rulers ate the meats. In Biblical times, those at the apex of the social pyramid fed upon the livestock. (Even the priests were compensated with portions of the temple sacrificial offerings.) Same with royalty spread across all the continents over thousands of years.

Grains/rice/potatoes were grown primarily for one reason only ā€¦ i.e., to fill the stomachs of the masses and quell hunger-fueled uprisings. I believe the same is true today. (The World Food Program doesnā€™t handle much meat, does it?)

Today, itā€™s primarily those at the top of the economic heap who promote the idea that the worldā€™s population should minimize the eating of meat. What do you think is on their plates?

The expression ā€œfat of the landā€ made agricultural products sound more valuable as animal fat was always well understood to be the most-prized food. Lions (ā€œkingsā€ of the jungle) savor the fatty organs, leaving leaner muscle behind for scavengers.

Ultimately, thereā€™s one sad reason that impoverished people eat little if any meat. Theyā€™re poor.

(KM) #39

I just think if heā€™s advocating the addition of real bread but also ā€œsupportiveā€ of a ketogenic diet, he knows nothing about ketosis, because you canā€™t have both ketosis and any notable quantity of unadulterated grain flour at the same time. Of course if ketoā€™s not your aim, the suggestionā€™s not totally unreasonable, Iā€™d just think other carbs might be less problematic or more nutritional bang for your buck.