My current thoughts on cholesterol

#1

So I’ve been spending the last few days (early mornings and late evenings given it is half term for my boys) reading up on cholesterol and found my way to the cholesterol code run by Dave fieldman and Siobhan Huggins. I’ve read both optimistic and sceptic posts and then compared these to Norwegian studies and articles.

And now my (still very limited) understanding of cholesterol runs more along these lines:

  1. Why would some people who go on a low-carb or ketogenic WOE and experience weight-loss experience an increase in LDL-cholesterol? Well, could it be that LDL which has the task of transporting the cholesterol has to work a lot harder? When you eat sugar it easily dissolves in the blood, like when you dissolve sugar in water. But fat doesn’t dissolve in the blood easily, think fat in water, and thus the LDL-cholesterol (or the transporters) have to work that much harder carting that fat around. Particularly in the case of saturated fats.

The question is whether this raises the risk of CVD. But in terms of the LDL transporters having to work harder, if this is correct, would alternating the saturated fats with polyunsaturated fats and DHA rich foods like fish, seafood, make that transport any easier? And would that even matter?

  1. Going on a HF/LC WOE significantly lowers the insulin, and primes the body for full on repair mode. That repair mode may also then cause a sharp increase in LDL cholesterol as cholesterol also has the task of addressing and repairing any damage/inflammation that might have occurred in the body as a result of too much sugar, too many unnecessary carbs.

What are your ideas? Agree/disagree? Counterpoints?

Lastly, whether you eat keto or carnivore, what are your experiences with cholesterol? Do you monitor that at all? I understand if there’s an increase of HDL cholesterol and a lowering of triglycerides then the LDL-cholesterol being higher doesn’t necessarily present a problem? But there are many opposing views regarding this, and more research is needed. Have any of you discovered your cholesterol numbers change, and if so, how would you/did you address that?

Thank you.

#2

I only can answer this. Nope. I couldn’t care less about it, it’s my body’s job to keep itself in good shape, I just try to eat and exercise well. It worked this far. I have read enough about cholesterol and LDL that I know they are vital and trust my body with them not going overboard :slight_smile: My diet is very high cholesterol since more than a decade (it probably wasn’t exactly low before but my SO says I didn’t eat 7 eggs a day in average decades ago. yep, I can see it was only a few) so it’s nothing new to me and my body.
I think and occasionally worry about certain things in my life but as long as my body is happy, I don’t worry about these things (anything about fat except overeating fat but I am working on minimizing it except minimizing protein has priority over it) as long as my body seems happy enough.
But it’s me, worrying about nutrition would harm my health and I have good genetics and my body tells me if it really is bothered I suppose… Obviously the approach of someone else is and possibly should be different.

#3

Hi Shinita, I only really started looking into all this when my mom contacted me to say she was highly concerned regarding my carnivore WOE and all the saturated fats I consume, stating calcification has been discovered recently by the doctors of the arteries in her heart, and her cholesterol was 5, last time it was checked. She didn’t share any other numbers. She also told me her mother had high cholesterol, and now she believes it to be hereditary, she may be right. So I feel I owe it now to myself, to my family and SO, and our children the most, that I look into this.

Overeating fat or protein doesn’t concern me as my body appears to regulate satiety and hunger signals well. But it’s confounding when the body is feeling this good, inflammation is down and all is well that this new conundrum with the cholesterol is added in as a kind of roundabout you get stuck in, with the subsequent thoughts what if … I believe more research is needed to solve this mystery and dissolve (perhaps needless) fears and doubts, but it’s harder finding studies written for the laypeople that are meaningful and conclusive enough.

#4

I would have been an easy time there as I eat just as much (or more) saturated fats on a carbier diet…

The hereditary thing is different, yep, I understand you are careful there and wish to know more (knowing things is good anyway and diet plays a huge role in health, obviously)…

Oh I overeat anything with wonderfully working hunger and satiety signals too… I blame my epically overeating past.

Well I wish you luck though as often when we say this, it’s not that, you do research diligently, good! I just skimmed the surface cholesterol and LDL wise when I have read about it years ago to be sure, that was enough for me regarding my eggs but I trust my genetics and body very much, my family was pretty healthy and I felt my new woe is so much better than the old one (but of course there are many ways to eat very low-carb, it can be done wrong too).

(You've tried everything else; why not try bacon?) #5

As I understand it from Dave Feldman’s site, the primary job of the lipoproteins is to distribute triglycerides (energy); the cholesterol is just along for the ride, so that it will be available to cells that need a bit more than they can make on their own.

The triglycerides made from the carbohydrate we eat are distributed by chylomicrons (very large, buoyant lipoproteins); the triglycerides from the fat cells are distributed in VLDL particles, which become progressively smaller as they discharge their cargo.

It is worth noting that only a smallish percentage (about 30%?) of the population responds to a keto diet with elevated LDL, and the LDL level seems to correlate inversely with the percentage of body weight represented by fat mass—assuming I understand Dave Feldman correctly. Dave’s contention is that in lean-mass hyper-responders, this elevation of LDL carries no increase in cardiovascular risk. I believe he is in the middle of recruiting test subjects to determine whether that hypothesis is in fact correct.

The connexion of LDL with cardiovascular disease is being hotly debated at the moment. There is plenty of evidence to suggest that the connexion is not causal. At best, we can say that the lipid numbers are markers for cardiovascular risk. And it is certainly true that the ratio of triglycerides to HDL correlates much more strongly with cardiovascular risk than any LDL level.

My LDL was borderline high, the last time I had blood work done. I have a checkup tomorrow, so we’ll see what the doctor says this time. But given what I’ve learned about cholesterol since going keto, I am not particularly interested in what my LDL does, so long as my triglycerides/HDL ratio is good.

(You've tried everything else; why not try bacon?) #6

The original thought, back in the 1950’s and 1960’s, was that saturated fat caused coronary heart disease. The saturated fat was blamed for raising cholesterol levels. Interestingly, it was the same researcher who believed this idea and promoted it, Ancel Keys, who was also the one who determined that cholesterol in the diet had nothing to do with cholesterol levels in the blood.

The original diet-heart hypothesis has remained unsubstantiated by scientific data. The original study published by Keys selected 7 countries to report on, out of 22 countries studied. When the data from all 22 countries are analysed, the much-vaunted correlation between saturated fat consumption and coronary heart disease vanishes; it appears that Keys selected those 7 countries to report on, because they were the only ones that appeared to support his hypothesis.

Interestingly, there is a strong correlation between sugar consumption and coronary heart disease in Keys’s data, both in the 7-country data and in the full 22-country data, but Keys dismissed this correlation as irrelevant. It is also interesting that it was around this time that the sugar industry was paying nutrition scientists, several of whom were Keys’s friends, to play up the dangers of eating fat and play down the dangers of eating sugar. (This is documented in recently-published internal memos of the Sugar Research Foundation.)

Since then, several large, well-funded studies have been conducted to provide data in support of Keys’s hypothesis. They all ended up showing no correlation or an inverse correlation. One of those studies, the Minnesota Coronary Study, was designed by Keys himself, but he took his name off the study when the data failed to support his hypothesis. The other principal investigator, Ivan Franz, delayed publishing the results for 17 years, and finally published in an obscure journal that no one in the field read. When asked about all this he reportedly said, “There was nothing wrong with the study; we were just disappointed in the data.” After Franz’s death, his son found the original data tapes in his father’s basement and turned them over to the NIH. A re-analysis shows that there is indeed an inverse correlation between LDL cholesterol and cardiovascular risk.

Recently the focus has been shifting from the cholesterol carried by the lipoproteins to the lipoproteins themselves. The current concern is with oxidation of small, dense LDL particles, which are now supposed to be particularly damaging. We shall see if this hypothesis is supported by the data.

#7

Hi Paul, thank you for your reply and valuable input, and for sharing your knowledge with me. Both my knowledge and understanding of this is very limited, and I’ve much to learn. My main issue with this was my mom’s strong concerns regarding my carnivore WOE and high intake of saturated fats. She tells me she can picture my arteries getting blocked. The doctors discovered recently calcification of an artery in her heart. And she told me her mother had high cholesterol. My mom’s cholesterol last time it was checked was 5. I don’t know what mine currently is, or whether it even matters. But I had all my bloods done 12 Oct 2022, the same day I decided to start my ketogenic WOE, with a view to curing my lipoedema. And all bloods including cholesterol was considered by my GP fine. I can’t remember the numbers, but I do have that sheet somewhere, so I’ll know my starting point and will have this to compare with when I have my cholesterol tested again. Yes, I’ve read the small particles are particularly dangerous. But I’ve also read lowcarb or keto and saturated fats could improve them in enlargening the particles’ size so they can’t make it through to the endothelium, is that right?

That you say only a smallish percentage experience elevated LDL on keto, is very interesting. Is that the same for those who do carnivore, or do you think the result there would be different? I’ve been feeling really good on carnivore, relishing the delicious foods on this WOE, but I feel I owe it to myself and my family, but most of all my children, to find out more about this WOE and whether there could be a link between carnivore, which would constitute a lack of polyunsaturated fats, and CVD. At the moment I feel I’m pretty much wading in a sea of opposing opinions.

(You've tried everything else; why not try bacon?) #8

Yes, arterycloggingsaturatedfat (all one word, lol!) is an intuitive picture. It just happens to be wrong. The amount of free fatty acids in the blood is actually determined by how much carbohydrate we eat. Who knew?

Calcification is part of the process of repairing damage. The process begins with soft plaque, which is more dangerous, because it can break off and travel to where it can block blood flow. Calcification stabilises the plaque. Fortunately, time on a ketogenic diet has been shown to help the process, and the calcification eventually reduces.

A lot of the processes that cause damage are related to high insulin-resistance, with attendant hyperinsulinaemia and hyperglycaemia (in the later stages). This causes LDL particles to remain in the blood stream longer, so they become progressively smaller and more damaged. Eating a ketogenic diet encourages processes that keep the particles from getting so small and becoming damaged, yes.

I don’t know, but I assume it would be the same. However, the body behaves differently enough in the complete absence of carbohydrates, so it is hard to predict. The Cholesterol Code site might have some information on this.

Welcome to the world of nutrition research! :scream:

My own take on the matter is that the idea that saturated fat/cholesterol/LDL/apoB causes cardiovascular disease has not been solidly established. It has nevertheless become entrenched in scientific thinking, so it is hard for people to look at the data objectively. For example, it has long been known that well over 50% of the people presenting in the emergency room with their first heart attack have either normal or low cholesterol. Some people would argue that this means that their cholesterol probably was not the cause of their heart attack. But I have also seen the argument that this just means that cholesterol is even more damaging than we thought, and our safe limit should be even lower. Granted this paper was sponsored by a statin manufacturer, but it is still representative of thinking that is out there.

(Robin) #9

Look to your left, I’m bobbing along in that sea beside side you.
My mind can only take so much data and science, then it surrenders and I am only left with knowing I feel fantastic, am down over 70 pounds, have energy to spare and am active. And 68 feels better than 38 did.

It’s tempting to stop doing any tracking of my lipids and just go with the flow.

#10

Hi Robin, I too am feeling great compared to how I felt on my HC/LF WOE, though because of Tamoxifen I still have fatigue. But my muscles and joints used to ache all the time and my lipoedema tissues would feel tender, and now all that’s gone. The question I am asking myself now is, although I really love the carnivore WOE and I feel great on it, if the risk of high LDL could be mitigated by swapping some of the saturated fats for polyunsaturated (nuts, avocado) and adding more foods rich in DHA (fish), cooking with olive oil instead of butter, and adding a small amount of carbs back in such as said nuts, avocado and a few vegetables. My mom tells me high cholesterol is in my family, that my mom has it and her mom had it, so I feel I have to consider this.

In your case, where vegetables and plants in general, would bring back your diverticulitis, I understand that’s not a choice. It is a matter of weighing up the risk and all the benefits. But I believe how you feel in your body matters, and that inflammation surely would be felt, I’ve lived with chronic inflammation for years, it caused me brain fog, forgetfulness, aches, all of which is better now, though still not perfect, because of Tamoxifen. But perfect health doesn’t exist, that’s a dream, and what it comes down to is risk/benefit - quality of life.

(Robin) #11

Yes. It’s a never ending balancing act. In the end, we do what we can. We choose our path and try to ignore the old programming and trust our body to point the way.

Until it doesn’t… lolol.

I feel your pain with the Tamoxifen. I had brain fog, aches, fatigue, etc.
But those are the same side effects I get with many drugs.
I recently agreed to give statins a short go again just to see what happens with ldl and inflammation.

BUT… I am once angain experiencing brain fog, short term memory crap and a new one; dizziness. The other day I was walking the dog and just suddenly started listing to the left and I couldn’t correct it. Had to hug a tree till it passed. I probably looked drunk.

So… I’m hanging it in there with the statin for four more weeks till my next labs. Then I’ll take it from there.
But I am not willing to head into Alzheimer’s for the sake of my ldl.

Oops. Just vented all over ya! :thinking::heart:

(Joey) #12

Check! Another Lean Mass Hyper Responder, here. We need that LDL to feed our happy little mitochondria … as we have scant body fat to fall back on.

FWIW, three (3) internists have each looked at my Trig-to-HDL ratio (now stabilized @ 0.5x. Not a typo: Trigs roughly 50 mg/dL, HDL topping over 100 mg/dL) and no longer give a hoot over my eye-popping levels of huge, fluffy LDL. They’re like little spy balloons floating around my veins. Pattern A rules. :+1:

(Bob M) #13

The one “exception” for people who are lean and keto/carnivore but aren’t LMHRs are people (men?) who have a lot of muscle mass and use that mass. Dave Feldman has a theory about why that is, but I don’t believe it was tested (at least I didn’t see it when I was still on Twitter – pre Elon Musk).

I say “men” because the primary people were Shawn Baker and Jerry Teixeira, both muscular and lean but with lower TC and LDL.

#14

It really is a balancing act, I agree Robin, and I feel, quality of life must come first. That’s why I’m considering quitting Tamoxifen after three more years, I know that’s a risk as my oncologist wanted me on it for ten years, but quality of life is more important, and I feel the ketogenic WOE has given me a chance at this. Dizziness does not sound good. I’m not very familiar with statins, but I’ve read they have many side effects, I suppose that’s the case with a lot of pharmaceutical drugs though. Though I don’t notice many side effects from my doxycycline (slow release) 40mg which I take for my roseaca. At that low dose, it only addresses inflammation, and is working very well. Ideally of course, none of us would require any medication, and would be able to both manage and completely reverse our illnesses with the right WOE and lifestyle. And perhaps, if doctors became more aware of the link between diet, lifestyle and health, such things could be achieved for the next generation. But there is a long way to go for the medical society, and can we ever see a world Big Pharma would have less influence over?

So yes, all we can do is do our best and choose our path, and hope we are apt to follow the sign posts along the way.

(Alec) #15

All my reading on this leads to this conclusion. I think the balance of evidence supports this view. One of the key things to think about is why would the body (the liver specifically) churn out all this LDL cholesterol (because that is what it does… dietary cholesterol is irrelevant) if it was bad for us and would turn us into walking heart attacks waiting to happen?

The answer is that this natural and crucial substance called cholesterol is not harmful at all: the body produces copious quantities of it exactly because it is vital for our health and is a crucial building block of almost every cell in our bodies.

What does make sense is that a substance known to damage cells by glycation is actually the real root cause of CVD… glucose (caused by eating excess carbs). The body controls blood glucose very carefully because it needs to… excess blood sugar is damaging. This IS well known and IS proven by the science.

It seems to me that there have been plenty of opportunities for the medical and scientific community to develop some proof of the diet heart hypothesis over the last 60 years, and it simply has not been done. Study after study has failed to prove the case. Therefore it is now very clear that this hypothesis is wrong and should be thrown out.

The problem is that there is a MASSIVELY profitable industry making squillions from the medical community belief that high LDL causes CVD. And that vested interest uses every avenue it has at its disposal to keep the money rolling in. And it succeeds. Statins are bad for us, and should be refused if you are ever offered them by a well-meaning, but erroneous Doctor who has simply been taken in by what they were taught at doctor school (that is very likely to be financially supported by the drug industry… but that of course has nothing to do with what they are taught… ahem :-))

(You've tried everything else; why not try bacon?) #16

Not to mention that it is essential to the proper transmission of brain signals, which is why the statins capable of crossing the blood-brain barrier can cause so much brain fog.

(Robin) #17

Aw, dang it!

(You've tried everything else; why not try bacon?) #18

Here is a talk by Dr. Robertr Lustig that contains a great deal of useful information. Once he gets past the introduction, which involves dental caries (cavities), he goes straight to matters relevant to this thread. And actually, the stuff about caries ties in towards the end, in a way most people don’t think of.

(You've tried everything else; why not try bacon?) #19

A new lecture by Dr. Paul Mason:

#20

Hi Robin, I know the vegetables and plants in general might bring a flare up of your diverticulitis, but what about increasing your fish and seafood intake instead? I discover when I try to bring back carbs my lipoedema tenderness quickly returns, and I start to notice the side effects of my Tamoxifen more. So what I’m thinking now is to make sure I eat equal amounts meat and fish (as well as other seafood) as a preventative tactical approach to the potential LDL-problem, as some studies show foods rich in DHA don’t affect cholesterol as much.