Mitigating elevation of LDL on a ketogenic diet

(Larry Lustig) #3

I’m bookmarking this fascinating and important thread.

#4

Peter Attia and some others have suggested that if you have high LDLp and it’s the small types, that reducing saturated fats and increasing monounsaturated fats will improve the profile.

I’ll have to go dig up some links…

@DaveKeto has a link to some interesting information about LDL on keto, in addition to his own research.

http://bjjcaveman.com/2014/11/17/ketosis-and-high-cholesterol-according-dr-thomas-dayspring/

From Peter Attia’s blog:

"So, on balance, he consumed about the same number of calories and even total quantity of fat, but his distribution of fat intake changed and he heavily swapped out SFA for MUFA.

The result?

His LDL-P fell from >3,500 nmol/L to about 1,300 nmol/L (about 55th percentile), and his CRP fell from 2.9 mg/L to <0.3 mg/L (and for the lipoprotein cognoscenti, both desmosterol and cholanstanol fell)." http://eatingacademy.com/cholesterol-2/random-finding-plus-pi

(Richard Morris) #5

There is an advantage in Australia to having Total Cholesterol over 6.0 … the government will subsidize a lipid subfraction analysis for you on Medicare.

(Maia Doherty) #6

Thank you for this post. I’m one of those people on a ketogenic diet where my cholesterol went right up. I had my blood work done 8 months in to keto and received my results a couple of days ago (so I am now 9 months in). I had assumed that any rise in cholesterol would have dropped by now but nope.Everything in my blood work is excellent except for my LDL-C. My doctor said that it was “crazy” and wanted to put me on meds. She asked me if I was aware of the risk of heart attack. I told her that I was and that I will change some things in my diet and have blood work done again in 3 months. Total cholesterol (mmol/L) was at 8.3. Triglycerides’s at 0.94. HDL at 1.66. LDL (Calculated) at 6.21. Non-HDL at 6.64.

I understand from my Trig to HDL ratio that my LDL particle size is likely quite big and I have no need to worry, but I can’t help but worry slightly. I realize that I have been getting the majority of my fats from saturated fats (2, sometimes 3 BPC’s a day with coconut oil and butter), among other things. My plan is to cut down the saturated fats and increase the monounsaturated, start taking Omega 3’s which I have not, and if I can get my butt in gear to start exercising. We shall see how things go! I too am curious as to if my LDL would have ever increased in that manner if I wouldn’t have eaten so many saturated fats.

(Keto in Katy) #7

That is my understanding as well. I don’t remember what my LDL number was but a couple years ago I had the VAP (Vertical Auto Profile) blood test done and it showed that my LDL particles were mostly Pattern A, the large fluffy type, and so the conclusion was that this was generally seen as protective and not a concern.

(Charlie Herbert) #8

I’m in the same boat. After 7 mos, TG down, HDL up, total C and LDL-C UP. I’m cutting back on BPC, no more added fats to coffee. But not changing exercise routine – 3-5x/wk strength trng. Looking to get tested again soon (it’s been about 2 mos since last test).

Note there’s another calculation for LDL-C that might tamp down the heebiejeebies. Re: Iranian forumla. See Did your LDL-Cholesterol go up on Keto? Interesting article

(Dennis Herrera) #9

Great thread. Im gearing up for my doctors visit to get blood work done and wanted to look in the forum and see what tests i should request so what that high cholesterol is found there is some science and understanding. Im 7 months into my Keto and my keto is strong, the fat is melting away and i feel great most of the time. On a daily basis i will typically eat one solid meal a day, usually some meat with greens on the side and for most days thats the only food i typically eat. However…I do drink 3 BPC’s in the morning with 1 tbs KG butter, 1 tbs Heavy cream and 1 tsb coconut oil so thats a pretty fatty breakfast. After reading this thread im a bit nervous on my results regardless of what tests i ask for. Maybe i need to back the BPC’s down. Thank you for the insight.

#10

Today I have received the results of my first ever blood test and they appear to be pretty bad, so I’m worried and a bit confused right now. My doctor is downright discouraging of my continuing with the ketogenic diet.

I have been following keto for nearly 9 months and love it. I came to this through my training at the gym. I’m very active, training up to 6 times per week and plan to compete in my first bodybuilding comp this year.

My results are:
TG: 1.6
HDL: 3.24
LDL: 7.9
Total: 11.9

I have no starting point to compare these to. I am in my early 40’s, 5’2", and weigh around 49KG. I’ve never felt so good as I do now on keto, so would appreciate any further advice from others. From what I’ve researched, the particle testing for LDL is not available in NZ, or certainly not common, which is where I live.

(Jacquie) #11

@Bloss I’m the same height and weight as you. :slight_smile: My last lipid panel in 2015 was - Cholesterol 9.17 mmol/L, HDL 3.49 mmol/L, LDL 5.22 mmol/L, Trigs 1.02mmol/L. I’m not worried at all. My trig/HDL ratio is good and your might be a bit high. We both have high HDL, a good thing. I can’t get particle testing either in NS (Canada). I’ve been keto over 2.5 years and plan to do so for life. :slight_smile:

@DaveKeto may have some further input for you.

(Roberto) #12

@bloss so your ratio of total cholesterol divided by HDL is 3.67 which seems pretty good-- have you read Jimmy Moores book “cholesterol clarity” ?

(Roberto) #13

If you are in the USA you can request this test by quest labs: Cardio IQ® Lipoprotein Fractionation, Ion Mobility and if you have any heart disease in the family (or if not) also read about getting homocysteine & crp (or HS CRP) as a measure of inflammation-- i always get these plus a carotid ultrasound from my cardiologist as well- my blockages in my carotids have come down from 40 percent to 30 percent over 2 years (YAY!!!)

(Roberto) #14

ps my bad cholesterol was high last test but my cardiologist (being low carb) is thrilled with the carotids clearing up AND my weight loss and lowered blood glucose…she’s just not concerned with it…

#15

Thanks for that :slight_smile: The last thing I want to do is go off keto! Hoping to make some small changes and perhaps see some improvement. I found these articles which seems to suggest a few of us can be susceptible to raised levels of cholesterol on low-carb diet, but to try switching out some saturated fats for more monounsaturated. Looks like no more BPC for me prior to training :pensive:

#16

Hi there, no I haven’t, but would love to. I think I better make that a priority… and maybe lend it to my doctor!

(Jacquie) #17

@Bloss I wouldn’t jump to that conclusion just yet. Check out @DaveKeto’s website first. You and I are probably hyper-responders, like Dave. :slight_smile:

#18

Thanks Jacquie, I’ll definitely look that up :blush:

(Michael Wallace Ellwood) #19

One inexpensive experiment people might try, in order to try to reduce LDL, is to take at least 6g (6,000 mg) of l-ascorbic acid (i.e. vitamin C) per day, in divided doses over the course of the day, ideally with about the same amount of l-lysine (an essential amino acid).

Note that the powdered form (dissolved in water) is better than tablets, with all the fillings and binders, etc.

If desired, one can mix it with about half as much sodium bicarbonate (baking soda), to make a fairly refreshing fizzy drink. You are then drinking sodium ascorbate, which is as effective as ascorbic acid (which can also be called hydrogen ascorbate), since it is the ascorbate ion which is the effective part.

For more information see:

“Practicing Medicine Without A License?”
by Owen Fonorow (2008).

(Maia Doherty) #20

You have a terrific triglyceride to HDL ratio (suggesting that your LDL is large, fluffy and not harmful). This article states that a ratio below 0.89 is optimal. Yours is 0.49! Looks like you are doing very well!

http://www.docsopinion.com/2014/07/17/triglyceride-hdl-ratio/

(Stephen Price (Lythix)) #21

It appears I’m a hyper-responder as well. Cholesterol went up (HDL was 1.4, LDL 7.3 which was up from 5.2 taken late last year. 9.6 Cholesterol total).My doctor freaked out and wanted to put me on statins and I was like hell no. Changed doctors to one who supports LCHF.
I did have a Heart CT scan though and just found out all is normal, calcium score of zero.
So as @daveketo mentioned just because there is cholesterol in your blood doesn’t mean it’s actually being used.

I have this analogy I use. If a house is on first (the inflammation) then the firemen are the Cholesterol. You wouldn’t shoot the firemen that turn up, you would let them deal with the fire. (Statins wipe out the firemen). If the heaps of firemen show up but the house is not even on fire then they eventually leave and go look for the next fire. The blood test shows how much cholesterol there is (how many firemen) not how many are fighting fires. There might be no fires at all (no inflammation). The heart CT test shows how much damage from fires there are.
It was pretty expensive ($560Aus) but I feel better knowing. Medicare doesn’t cover any of it so goes to show how much the Government doesn’t care about reducing heart disease.

btw, my second opinion doctor said my blood works looked fine except for the cholesterol and even then the jury is out if that actually means anything relating to heart disease. There are two sides disagreeing what it means. In my book that means they have no idea, really.

(Richard Morris) #22

Congrats on the 0 CAC. That test sees the disease rather than looking for markers that are more likely to be seen in people with the disease.

But speaking of proxy markers of disease. Your circulating triglycerides number is a good indicator for whether your LDL is dangerous. Above 1 mmol/l and there is a better chance that it is small dense atherogenic. Below and you have mostly pattern A LDL.

Vldl vs Pattern B