Active Low-Carber Forums - View Single Post - Why did your LDL go up on Low Carb?

Here's a super-nifty article about why LDL is not necessarily scary. Only the small LDL but the test your doctor gives you, doesn't show you!

The misguided war on fat

Quote:

Well, no. With this extrapolation, scientists and policymakers made a grave miscalculation: They assumed that all LDL cholesterol is the same and that all of it is bad. A spate of recent research is now overturning this fallacy and raising major questions about the wisdom of avoiding fat, especially considering that the food Americans have been replacing fat with—processed carbohydrates—could be far worse for heart health.
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Last year, Ronald Krauss, director of atherosclerosis research at the Children's Hospital Oakland Research Institute, teamed up with researchers in Sweden to tease out some of the more nuanced characteristics of LDL cholesterol and its role in heart health. The term "LDL cholesterol" refers to the cholesterol housed in low-density lipoprotein particles, and these particles come in a range of sizes. Krauss and his colleagues analyzed the LDL particles they found in blood samples taken a dozen years earlier from 4,600 Swedish men and women and discovered that concentrations of the small- and medium-sized LDL particles best predicted whether the subjects later developed heart disease. Larger LDL particles, they noted in their study, which was published in Arteriosclerosis, Thrombosis, and Vascular Biology, were essentially neutral with regard to the subjects' heart health.
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This finding is particularly interesting in light of what Krauss had uncovered years earlier: Men who switch from a low-saturated-fat diet to one high in saturated fat experience an increase in total blood LDL cholesterol, as expected. But the change is mostly the result of a spike in the concentration of large LDL particles, not small. In other words, saturated fat consumption typically boosts the number of particles that Krauss has shown to be harmless.

Recently Dr. Davis, Heart Scan blog doctor/cardiologist, wrote this:

Cut the carbohydrates in your diet and what sorts of results can you expect?

Quote:

Decreased triglycerides--Like reduction of small LDL, the effect is substantial. Triglyceride reductions of several hundred milligrams are not at all uncommon. In people with familial hypertriglyceridemia with triglyceride levels in the thousands of milligrams per deciliter, triglyceride levels will plummet with carbohydrate restriction. (Ironically, conventional treatment for familial hypertriglyceridemia is fat restriction, a practice that can reduce triglycerides modestly in these people, but not anywhere near as effectively as carbohydrate restriction.) Triglyceride reduction is crucial, because triglycerides are required by the process to make small LDL--less triglycerides, less small LDL.

Less small LDL... why is that important? Because that's the stuff that causes heart disease, the big LDL does not.

Quote:

Reduced small LDL--This effect is profound. Carbohydrates increase small LDL; reduction of carbohydrates reduce small LDL. People are often confused by this because the effect will not be evident in the crude, calculated (Friedewald) LDL that your doctor provides.

If doctors were truly practicing Evidence based Medicine they'd use evidence that actually meant something, not the crappy Friedwald test that shows nothing of use (except triglycerides).