My progress, saturated fat, cholesterol, and the long term

ldl
blood
science
fat
cholesterol
(Siobhan) #8

Unfortunately, people we like and respect can be (and often are) wrong. The important thing to consider is the science - not the people. Which, luckily, is exactly what you’re looking for!

You also have to consider that we, as in everyone studying and learning about it, still don’t understand everything that’s going on. I come across many cases of studies - recent ones - outright saying “We don’t know why it works this way” and I don’t find it uncommon, either.

To be honest this is still a developing science, so we have to make educated guesses and work with what we have.
So we know… there are people like you who, despite having high LDL and particle count, are completely medically healthy by all other known markers like CRP, CAC, fasting insulin, etc
We also know that LDL in itself is not even correlative as a symptom for athersclerosis, and that healthy LDL does not cause foam cell formation - the precursor to atherosclerosis.
We know that as an n=1 @daveketo despite having astronomical LDL and particle count has a 0 CAC score and shining results for other tests of plaque development after 3 years of keto. An abnormality? Possibly, but we also know he can manipulate his cholesterol scores through diet and exercise and they fluctuate day by day. We also know his data can be reproduced by other people which is important because it tells us that there are multiple factors involved for LDL and particle count regulation.

So, if those are big question marks and not clear for whether theyre reliable markers then what are?
High fasting insulin. Insulin Resistance. High HBA1C. High CRP. CAC is also a good marker for disease progression/existence - a 0 gives you a 15 year “warranty” iirc.

LDL is flat out unreliable, and if it does go down via lots and lots of fat consumption - and CRP stays the same - that tells you youre likely a hyper responder (a ? in the system for now) and if all other reliable markers are okay that says there is some other mechanism going on that we don’t understand… yet.

Lots of people are basing their conclusions on symptoms (high blood pressure, high LDL partially, particle count, Lp(a) levels, etc) which only tells us something is possibly disrupting the system but not why.
It is a mistake (for people looking into this and advising others) to draw definitive conclusions from symptoms instead of root causes.

Which… is really not what you asked, huh?
Okay point being is it is complicated and we don’t fully understand how it works yet, so theres going to be a lot of very smart well respected people who are going to be wrong as we learn more about the system and how it works. That’s science.

For the time being, if it really bothers you and you arent comfortable with being unsure (understandable) switch to fish and mono saturated fat and keep an eye on other markers. If it is stressing you out it may be worth it just for the peace of mind assuming your other markers stay okay.

Sorry for the long kind of rambling post… again. It is a topic I’m very interested in but it is complicated. I completely understand if you decided to follow doctors orders until people finally get this all figured out!

I wish I could give you a better answer but the truth is we don’t know why hyper responders are hyper responders yet - that’s what me and @daveketo are curious to find out!

#9

For me personally, I am only happy consuming fat that is within the cooked product and not outside of it. I will cook eggs in butter, but I don’t need to pour what is left in the pan on top of my eggs. I fail to see the point in consuming empty calories.

Things like pork rinds I consider a treat, not a staple

I am seeking out foods like fatty fish, Shrimp, Avocado, and trying to keep red meat to no more than twice a week. I want foods that are natural, but nutrient dense. I don’t want fat as empty calories.

(Gabe “No Dogma, Only Science Please!” ) #10

I was certainly not referring to the Lustig article. The second one looks like some kind of crowdsourced peer-review process. Doesn’t look at all legit to me.

#11

Gotcha, @gabe. It’s the British Medical Journal, been around for 150+ years, and that article was peer reviewed, so it’s legit. That being said, the link posted is a PubMed literature review only, not an actual randomized controlled study, so if there’s stones to be thrown at it, that’s one that can be thrown, for what that’s worth.

(Gabe “No Dogma, Only Science Please!” ) #12

Yep well one of my respected sources just emailed me back and said he doesn’t know much about LDL. So there goes that. Now all I have is my doctors themselves, and we’re back to disputed science vs the medical mainstream.

My gut feeling is that I’ll continue doing what I’m doing and re-test in a year. I may be a hyper-responder, but right now my LDL isn’t sky high; it’s borderline high. I can live with that, I think.

@siobhan it sounds like you’ve done a lot of reading on this. Did you study this formally?

(Gabe “No Dogma, Only Science Please!” ) #13

You may be right, and I’m at work now so can’t get into it – but the link is “openbmj.” I’m guessing there’s a chance that BMJ set up an open, online platform for online peer review. My spidey sense is tingling.

(Siobhan) #14

Sounds like a plan! Be sure to keep us updated (if you are comfortable doing so) as you may present some interesting data!

Haha, no! I’m just a nerd! I met Dave at ketofest and he sparked my curiosity about the lipid system, and I’ve been studying (textbooks, studies, reviews, etc) since the bus back home from conneticut. About 3-5 hours a day, sometimes more. It’s really quite fascinating stuff and I want to share what I’ve learned with others because it could have quite the impact!
Because there is so much uncertainty I try to make sure everything I say is backed up by what I’ve read and if I speculate I try to make sure I state it is speculation.
I have been interested in the science of keto since I started a year ago though, so I’m not unused to deep diving into rather complicated and mind numbing science at least :wink:

#15

Ah, fair enough. Spidey sense is always good - skepticism is the mother of confirmation!

(Gabe “No Dogma, Only Science Please!” ) #16

Yeah I’m very interested in the science too. I’ve ordered the book Ivor recommended, “The Chemistry of Life.” Very interesting subject.

(Siobhan) #17

If you’re not too up on the basic functions (like me when I started) I would also recommend Therapeutic Lipidology (a book Peter Attia recommends in his “Straight Dope on Cholesterol” series), and I also read “Clinical Lipidology” after that (a textbook). Read everything with a critical eye. “Sure they say it’s this, but could it also be something else? What do the actual mechanisms show it is actually doing?” And of course if you come up with any ideas be sure to try and prove or disprove the idea, not just prove! Definitely PM me if you come across anything interesting in general, I love this stuff!

I’m sure you will be confused a lot if you’re anything like me, but the more I have learned about it the more I have found what a truly complex and yet efficient system it is. So many mysteries, too.
Have fun on your studies!!!

(Michael Wallace Ellwood) #18

Gabe,

You are aware, are you, that the fat in beef is only about 50% saturated?
It’s about 41% monosaturated, with a small amount of polyunsaturated.
(Exact ratios partly depend on how the cows were fed).

This distribution of fat is generally true in all animal fats, so the generally-held view that animal fats are all saturated is simply incorrect.

The most saturated fat is of course coconut oil at around 90%.

(Not that I personally think there is anything wrong with saturated fat. The fact that it has no carbon double-bonds means that it is the most stable form of fat, e.g. much less likely to be oxidised than unsaturated forms of fat).

(Gabe “No Dogma, Only Science Please!” ) #19

Just listened to this episode of Tim Ferriss’s podcast with Peter Attia (show notes for this episode and one related episode are here). Around the 8:30 mark, Peter explicitly says that elevated LDL-P, and especially LP(a), heighten cardiovascular risk. A little later in the podcast when discussing the ketogenic diet, he specifically says that he’s had some patients that he took off keto when their biomarkers didn’t go in the right direction.

It looks to me as if LDL is something on which even the keto community is far from settled on. For all the claims that it’s not LDL itself but the co-pathologies that come along with elevated LDL that are the worry (for instance, in Therapeutic Lipidology this is mentioned quite explicitly in the mainstream literature as a possibility) – it’s far from settled.

@siobhan

(Siobhan) #20

Yes I would agree it is far from settled, either way. I would classify Lp(a), and particle count as possible markers or symptoms. I would be willing to bet that in cases of athersclerosis they can be symptoms of an underlying issue - like high blood sugar in diabetics. If we quantify it as a risk we may knee jerk react to giving them insulin instead of looking for possible underlying issues.

Lp(a) in particular is pretty interesting, especially regarding how little we actually know about it. The stuff we do know is enough to warrant a raised eyebrow. I think it would be unwise to go after lowering Lp(a) (via medications etc) because what I’ve seen so far it is a part of the immune system we may need.
Like, for example, inflammation is a risk (marker) too but it is in reaction to an irritant.

That is why I am trying to look at mechanisms of the system so I can begin to truly understand what is going on. The better we understand the mechanisms the less we can blame markers and instead find root causes.

In short… yes it is possible high ldl-p is a marker (among many) but if there are other reasons it could go up that are not detrimental (lean, athletic people who are fat burners needing more circulating energy? possibly) we need to understand that too because it tells us how reliable of a marker it is.

For now, we don’t know, and that is part of why there is not a clear consensus on it.
Warrants lots and lots and lots more research though
@gabe

(Flametree ) #21

Thank you for the input, and I have a similar story except I’m 72. I’ve been a keto low carbs for 16 months and lost 44 lbs within 4 months and all my Metabolic syndrome issues except for one are gone. My LDL and Total Cholesterol has gone up and my Triglycerides are creeping up as well, they are still in the safe zone, but?. Like you I believe that maybe its due to my saturated fat consumption. jeez, the fatty parts are like candy from heaven, I can’t get enough! Well, my next phase on low carbs is to limit my red meat consumption and see how that works for my next blood test?
Also, the medical personnel here in the Delaware valley are all about prescribing Sta-tins and are really in throwing the “Medical Expertise” around! The last PA I saw berated me, suggesting, “your not a doctor”, I responded, “well, you’re not a Doctor either”. Well, just and FYI, I’ve been a practicing nurse for over 48 years and I have been know to do the research on “occasion”. So, if you kind and knowledgeable people have any suggestion or advise and am open. I’m also open into find a new medical clinic in the Delaware valley.

(Bacon is a many-splendoured thing) #22

Your PA should know that the best indicator of cardiovascular risk is a CAC scan, and that the next best is the ratio of triglycerides to HDL (under 2.0 or 0.9, depending on where in the world you are). The absolute values of triglycerides and HDL are not nearly so important.

My late mother, also a nurse, always used to say that the difference between God and a doctor is that God doesn’t wake up in the morning thinking he’s a doctor!

(Bob M) #23

Let me ask you some questions.

  1. If you eat a ribeye steak (the fattiest steak), do you get more monounsaturated fat (MUFAs) or saturated fat?

  2. Does olive oil have saturated fat in it?

  3. Olive oil’s main MUFA is oleic acid. What other fat has more of this fatty acid than any other fatty acid in that fat?

You might be surprised to find out:

  1. MUFAs
  2. Yes, about 14-17% or so saturated fat. You can do fun things with this, like compare certain cuts of beef and olive oil at 100 grams each, and get less saturated fat from the beef.
  3. Lard (rendered pork fat) is over 50% oleic acid. That miracle fat found in olive oil.

So, I’m hesitant to say that “saturated fat causes LDL to increase”. See this, for instance:

If anything, I think plants (partially unsaturated fatty acids, PUFAs) might decrease LDL, not saturated fats raise LDL.

I also wonder about this logic: I’ve lost X weight, feel the best I’ve felt in years, boundless energy…but my LDL went up and that’s trying to kill me. Huh?

(Flametree ) #24

Thank you for your response and the information. I will look into the data you’ve suggested. I am still a “baby Keto” enthusiast and I still have much to learn. I just wish I could find a medical “expert” that can work and understand at least a little bit on what I’m doing! 16 months ago I had 6 conditions anyone of them would have killed me. Today I only have the one condition to worry about and eventually I’ll figure out what to do about my LDL and triglycerides.

(Bacon is a many-splendoured thing) #25

I suggest not worrying about them as a possible course of action. Just so you know, there is a group of internationally-respected researchers who call themselves “The International Network of Cholesterol Sceptics” (THINCS).

The more we learn about cholesterol and its role in the body, the less I am inclined to want a low cholesterol reading of any kind.

#26

I have been eating a ketogenic diet since 2014, I didn’t have any blood work done before I started and haven’t since, I feel the best I’ve ever felt my entire life, almost like class A drug like.
I once got paranoid about how much red meat/fat I was eating and decided to try eat a ‘normal diet’ and soon realised that eating same diet as my wife all I was doing was adding bread /pasta /potatoes etc to each meal. I still ate red meat I still ate fat. I soon started to feel sluggish and tired and the weight slowly started to creep up
Now I’m back eating my one meal a day of meat and vegetables and feel great, I have no idea about any lab work I don’t care to be honest, I’m sure my wife doesn’t care about her lab work the same as nearly everyone else who is a healthy weight the only thing different in her diet is she eats breads pasta rice and potatoes in her meals I don’t.

(Gabe “No Dogma, Only Science Please!” ) #27

Recent update: How I broke my 3.5 year stall