U-shaped curve for HDL

#1

I’ve started reading about cholesterol and found this interesting.

#2

Interesting. I just brought up the concern of increased health risks associated with extreme physiological values at either end of the spectrum in another thread. I think this is very important to consider. I need to read this paper more carefully, but one potential criticism of cause-specific mortality as an outcome is that you have to die of something. If it’s not CVD, it’s more likely to be cancer. I tend to think all cause mortality is the most meaningful outcome (unless you have a genetic predisposition to either cancer or CVD).

#3

Interesting. I just brought up the concern of increased health risks associated with extreme physiological values at either end of the spectrum in another thread. I think this is very important to consider. I need to read this paper more carefully, but one potential criticism of cause-specific mortality as an outcome is that you have to die of something. If it’s not CVD, it’s more likely to be cancer. I tend to think all cause mortality is the most interpretable outcome. Looking at age-specific mortality helps address the issue.

#4

I’m a new face, but been lurking in the shadows for a while, I decided to finally make an account just to add that this study is applicable to a diet which has carbohydrates as a staple.

You have to ask what proportion of the 42,145 in the study were on a ketogenic diet. It wouldn’t be far fetched to assume that the number would be statistically insignificant if not negligible.

When someone is fat adapted and in ketosis/gluconeogenesis the metabolism and utilisation of cholesterol and lipids is different.

It also annoys me that people take recommended daily allowances of each micronutrient for the S.A.D diet and apply it to a keto diet. The requirements are vastly different. We should all know this from experience with electrolytes, but other nutrients are the same as well.

It’s crazy how intertwined all the hormones in the body are with insulin, a vast change in insulin can change requirements dramatically.

So this study is very interesting at showing a possible relationship between cholesterol levels and mortality at different concentrations for people on a carb-heavy diet, but for ketosis it’s still uncertain.

(Bob M) #5

What happens on a keto diet, though, is that HDL goes up. I’m not sure I’ve ever seen a case where people go from SAD to keto, and HDL does not go up over time. My HDL was 37 (even on keto after 6 months), and I know I had multiple HDL readings 37 or below for years/decades before going keto. Now, and for many years (keto 9 years), my HDL is generally in the mid 50s.

And some “hyper-responders” can have insane levels of HDL, even >100, on keto.

I don’t know how that would affect that J shaped curve. For instance, I’m “only” at the mid 50s. Is it better to be in the mid 60s? (Though apparently, I’ll never get there, as I’ve been in mid 50s for years now.) Not sure.

I’m also not a big fan of looking at single markers. It’s more the whole person. What’s CRP? Fasting insulin? HbA1c? Trigs? Etc.

(Joey) #6

@_Andy Welcome to the forum … and what a grand entrance!

You are spot on point with your insights about this research paper - and much other SAD-context research to boot. In reading that paper, I had a very similar reaction, started writing a post to reply, and then cancelled the effort as I didn’t like the sound of my own complaining voice.

But your observations are perfect, just as expressed.

There are other issues I had with that particular research paper, but I’ll refrain for now, as my larger point was to welcome you and hope you continue to contribute to the discussions underway around here. :vulcan_salute: