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  #1   ^
Old Sat, Mar-25-17, 12:12
teaser's Avatar
teaser teaser is offline
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Plan: mostly milkfat
Stats: 190/152.4/154 Male 67inches
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Location: Ontario
Default Dietary fat and blood lipids on a ketogenic diet

https://www.youtube.com/watch?v=jZu52duIqno

Interesting video. This fellow tracked the effect of dietary fat on various blood lipid numbers while on a ketogenic diet. He found the more fat he'd eaten the last three days, the lower his cholesterol and ldl were. Ldl particles had a lag, reflecting the last five days consumption, but again--the higher the fat, the lower the particle count. He shows the effect in subject after subject after subject.
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  #2   ^
Old Sun, Mar-26-17, 09:46
RawNut's Avatar
RawNut RawNut is offline
Lipivore
Posts: 1,208
 
Plan: Very Low Carb Paleo
Stats: 270/185/180 Male 72 inches
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Progress: 94%
Location: Florida
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There was a woman who commented on his blog that she had familial hypercholesterolemia. Going on a keto diet gave her normal cholesterol numbers for the first time ever. She probably gave her doctor a heart attack if she mentioned it.
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  #3   ^
Old Mon, Mar-27-17, 10:30
Squarecube's Avatar
Squarecube Squarecube is offline
Senior Member
Posts: 877
 
Plan: atkins/paleo/IF
Stats: 186.5/159.0/160 Male 5' 11"
BF:
Progress: 104%
Location: NYC
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Great video, with some very important information. Amazing stuff. His website is worth a visit 4 days before your next checkup.
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  #4   ^
Old Mon, Mar-27-17, 10:46
teaser's Avatar
teaser teaser is offline
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Posts: 15,075
 
Plan: mostly milkfat
Stats: 190/152.4/154 Male 67inches
BF:
Progress: 104%
Location: Ontario
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Just don't schedule a glucose tolerance test for the same day.
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  #5   ^
Old Tue, Mar-28-17, 08:10
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Nancy LC Nancy LC is offline
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Plan: DDF
Stats: 202/185.4/179 Female 67
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Progress: 72%
Location: San Diego, CA
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One time I had a test with sky high LDL. I'd been very closely adhering to low carb and had been eating A LOT of fat. I think at the time I'd been having loads of coconut oil. I just don't bother getting my cholesterol tested any longer.
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  #6   ^
Old Tue, Mar-28-17, 08:38
teaser's Avatar
teaser teaser is offline
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Posts: 15,075
 
Plan: mostly milkfat
Stats: 190/152.4/154 Male 67inches
BF:
Progress: 104%
Location: Ontario
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The exception that proves the rule, I guess. What a silly saying.

He is talking about pretty high intake of fat, though. His initial experiment involved going from 224 grams of fat per day to 329 grams. A few years ago I did a 4:1 ketogenic ratio experiment on myself, like they do for kids with epilepsy, that's about 90 percent calories as fat,. I was eating around 2500 calories a day,that was to appetite, that's about 250 grams of fat per day. 329 grams a day--that would be an overfeeding experiment for me. Which is what maybe makes it more of a hack to trick your doctor/insurance, rather than a practical intervention. It works, maybe, because it is overfeeding--and greatly reduces the liver's role of supplying triglycerides to various tissues.
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  #7   ^
Old Tue, Mar-28-17, 09:17
khrussva's Avatar
khrussva khrussva is offline
Say NO to Diabetes!
Posts: 8,671
 
Plan: My own - < 30 net carbs
Stats: 440/228/210 Male 5' 11"
BF:Energy Unleashed
Progress: 92%
Location: Central Virginia - USA
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I doubt that Nancy was eating 5000 calories a day. I think that eating loads of fat (a significant energy surplus) with a healthy metabolism (being fat adapted) is what may be driving that LDL score down. It was when I was eating < 1800 calories a day that my cholesterol shot up (LDL-C 243). I was eating fat as 75% to 80% of those calories and plenty of it was saturated fat. 1800 calories a day was a significant energy deficit for me at the time as I weighed 293 pounds.

I just had my cholesterol checked this month. I had stellar cholesterol results (LDL-C 62 on an NMR, LDL-C 59 on a standard lipid test). Based partially on Dave's information and me reading up on fasting's effect on LDL I made a point to eat plenty in the days before these tests. I didn't load up on fat. I ate at my usual macros C 15%, P 25%, and F 60%. I just ate more - enough to insure that I was not losing weight. I did no fasting in the week prior to the test - even eating some up to 10pm to shorten the overnight fasting window. I did do the 12 hour fast before the blood was drawn. The results were amazing. Just last December my LDL-C was 144 on a standard lipid test. I had just ended a fast (4 days) the night before the labs were taken. In March 2016 my LDL-C was 109. I think the fasting also plays a significant roll in cholesterol levels, as several studies have shown.

It amazes me how easy it is to change that LDL number. It really makes me wonder how they could put so much weight on its value for CVD risk. Averaging the data from thousands of people may very well indicate a risk factor for the average person with continuously high LDL. But I think the value of 1 reading without a discussion of diet in the week prior to the test is pretty pointless. Dave's experiments show that diet (and dieting, IFs and fasting) leading into a cholesterol test can greatly affect the results. One study I read showed that participants average LDL C (103) rose by 23 after a 24 hour fast. They tested 24 hours later (after eating) and the LDL was still up an average of 13 points. Another study I read showed that after a 7 day fast LDL had risen an average of 66% (+/- 6%).

Last edited by khrussva : Wed, Mar-29-17 at 09:19.
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  #8   ^
Old Tue, Mar-28-17, 10:33
teaser's Avatar
teaser teaser is offline
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Posts: 15,075
 
Plan: mostly milkfat
Stats: 190/152.4/154 Male 67inches
BF:
Progress: 104%
Location: Ontario
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Something I'm not certain is addressed here--you can get various changes in cholesterol levels just by swapping saturated fat for monounsaturated or polyunsaturated, or even different saturated fats--coconut fat's fat is mostly saturated, but also very different from the palmitic acid that's primary in dairy. Stearic acid tends to increase hdl vs. palmitic, etc. But that's swapping out fatty acids. How do you decide what had the effect? Swap palmitic acid for omega 6 linoleic acid, cholesterol goes down--did it go down because you decreased palmitic acid, or because you increased linoleic acid? What is the effect of simply increasing calories, eating what you've been eating, but simply increasing linoleic acid? Dave may characterize his diet as high in saturated fat, and the increase in fat intake as an increase in saturated fat intake--but does that mean the increased saturated fat is what caused the lipoprotein changes? Whatever fat you might be eating, double consumption of it, and you're doubling your polyunsaturate fat intake, as well. People think of lard as saturated, but today's pork fat is about 20 percent polyunsaturated. Butter is only 4 percent, coconut oil only 2 percent--if polyunsaturated fat were having a strong effect on lipids with a higher fat diet, it would be less of a factor if coconut was the chosen fat.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4323808/

This study overfed 750 calories, half from fat, as muffins. Overfeeding saturated fat muffins barely moved things, though mostly in the opposite direction to the polyunsaturated fat muffins, most of the difference looks to be due to the addition of polyunsaturated fat to the diet.

One interesting thing is that hdl went up with polyunsaturated fat muffins--replacing saturated fat with polyunsaturated fats or carbohydrate with calories the same, you'd expect hdl to go down, not up.
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  #9   ^
Old Tue, Mar-28-17, 12:30
khrussva's Avatar
khrussva khrussva is offline
Say NO to Diabetes!
Posts: 8,671
 
Plan: My own - < 30 net carbs
Stats: 440/228/210 Male 5' 11"
BF:Energy Unleashed
Progress: 92%
Location: Central Virginia - USA
Default

You clearly know a lot more about this subject than me. All I can really report is what I did and what happened. But if I miss the right details (such as fat composition), I may miss the cause & effect relationship (if there is one).

When I got my worse "bad cholesterol" number (LDL-C 243) in March 2015 my lipids were the following in the weeks before the test:

Total fat: 148g
Saturated: 53g
Mono Unsat: 56g
Poly Unsat: 17g

Prior to my December 2015 NMR (LDL-C 162):

Total fat: 132g
Saturated: 38g
Mono Unsat: 46g
Poly Unsat: 32g

And this last NMR in March 2017 (LDL-C 62)

Total fat: 171g
Saturated: 50g
Mono Unsat: 58g
Poly Unsat: 39g

In December 2015 I was really working on keeping my saturated fat down. I was avoiding CO. I lighted up on the saturated fat restrictions after that, but with my dairy free trail prior to that last NMR I was eating no dairy fat. Fat was coming primarily from meat, olive oil and CO. I try to avoid high omega 6 oils and have for some time. The only other oil I use is peanut oil on rare occasion for frying.

The shift up in polyunsaturated fat happened when I added flax muffins to my daily routine. They contain olive oil, flax, chia seeds, hemp hearts, and an egg as the base for all my muffins. My "bad cholesterol" has improved in line with my increase in polyunsaturated fat. However, I also increased fiber intake in each subsequent test. I also increased calorie consumption. My HDL was much better this past test when I wasn't eating dairy fat. So I still can't explain such a huge drop in LDL C & P. Who knows? Maybe eating at an energy surplus and not doing fasting of any kind had more of an effect than anything else. Our bodies have a lot of moving parts.

Last edited by khrussva : Tue, Mar-28-17 at 13:10.
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  #10   ^
Old Tue, Mar-28-17, 12:58
Squarecube's Avatar
Squarecube Squarecube is offline
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Posts: 877
 
Plan: atkins/paleo/IF
Stats: 186.5/159.0/160 Male 5' 11"
BF:
Progress: 104%
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Quote:
Originally Posted by teaser
The exception that proves the rule, I guess. What a silly saying.

He is talking about pretty high intake of fat, though. His initial experiment involved going from 224 grams of fat per day to 329 grams. A few years ago I did a 4:1 ketogenic ratio experiment on myself, like they do for kids with epilepsy, that's about 90 percent calories as fat,. I was eating around 2500 calories a day,that was to appetite, that's about 250 grams of fat per day. 329 grams a day--that would be an overfeeding experiment for me. Which is what maybe makes it more of a hack to trick your doctor/insurance, rather than a practical intervention. It works, maybe, because it is overfeeding--and greatly reduces the liver's role of supplying triglycerides to various tissues.


I can't wait to try this and just checked out his site again, he didn't really give any menus, but I love his cartoons. I regularly have beef tallow around, farmers pork skin/fat, and the usual avocados, coconut oil, etc. Fish? I could slide the sardines and the olive oil right on to the plate, with a bit o kale for a garnish. My favorite LC version of BLT, is a chopped salad with bacon, mayo (avocado oil), and the rest. I have used bacon fat to make the mayo in the past, but maybe I could just mix in extra bacon fat with the mayo. This could be fun. Of course, I,m 36 hours into a fast right now, so maybe I shouldn't be thinking about all this eating.
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  #11   ^
Old Wed, Mar-29-17, 02:09
DaveKeto DaveKeto is offline
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Plan: Keto
Stats: 208/170/185 Male 6'3
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Hi guys!

As it happens, this forum was one of the first places I came to when I was first doing the research. (Peek at my history if curious)


~teaser:
Yes, my plurality of fat is saturated (probably around 40%), although I did do an 11 day experiment where I swapped it with mono and slightly higher poly. The results weren’t too significantly different. Plus, I felt generally puny and tired throughout. Not sure why.

And yes, the higher fat protocol is not a diet plan so much as it is a demonstration of the dynamism of the lipid system. My own cholesterol numbers are around 40-45% determined by the three day windows I mention in the video and on my site.

~khrussva:
Awesome! Glad to see another trying the protocol and seeing the pattern play out.

>”But I think the value of 1 reading without a discussion of diet in the week prior to the test is pretty pointless.”
This single quote is one of the major drivers in my life. I know so many people now who go on lifelong cholesterol lowering therapy from a single annual blood test. Setting aside the question of risk, at a minimum they should know how fast that number changes and whether they were unintentionally spiking it by avoid fat in the days before the draw.

~Squarecube
Glad you’re enjoying the comics from the Simple series. I hope to have Part III up pretty soon. That content was the result of my racking my brain for a long time trying to think up a way to make the lipid system funny and/or interesting for the layperson. And sure enough, it’s the most popular posts I have on my site. (In fact, I’ve had more doctors ping me about it than patients!)
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  #12   ^
Old Wed, Mar-29-17, 03:08
GRB5111's Avatar
GRB5111 GRB5111 is offline
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Posts: 4,036
 
Plan: Very LC, Higher Protein
Stats: 227/186/185 Male 6' 0"
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Progress: 98%
Location: Herndon, VA
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The video explains a lot. My last two NMR Lipid Panel results are good examples. The first when I was on a multi-day fast, 4-5 days at the time of the blood draw showed LDL-C extremely high, yet my HDL & Tri numbers were very much in the healthy range with HDL being higher. For my most recent NMR LP, I eliminated dairy for 30 days, but consumed my normal combination of healthy fats (saturated, mono, and omega 3s & 6s) and did a standard 12-hour fast prior to the blood draw, and received results that showed everything being in a very healthy range (based on today's interpretation of what represents lipid health) with a much lower LDL reading.

It made me realize I can control the results by diet and caused me to question whether blood lipids are really a valid health marker without considering other variables. Since my CRP in the last test was 0.4, it also made me realize that dairy could likely be causing inflammation for me. By doing a straight 12-hour fast and dairy elimination prior to the blood draw, I can make my numbers look great and avoid the inevitable statin discussion with my doctor.
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  #13   ^
Old Wed, Mar-29-17, 05:15
teaser's Avatar
teaser teaser is offline
Senior Member
Posts: 15,075
 
Plan: mostly milkfat
Stats: 190/152.4/154 Male 67inches
BF:
Progress: 104%
Location: Ontario
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Hi Dave, thanks for the info.

With the polyunsaturated fat--if polyunsaturated fat as a percentage of fat intake only went up slightly, I could still see the higher total fat intakes having more of an effect on intake of polyunsaturated fat than the percentage. Not that I'm tied to polyunsaturated fat being a driver here, it just seems like something to wonder about.

One thing that came to mind watching your video is Jimmy Moore, his latest lipid panels showed great improvement in his particle count, his ldl cholesterol is down as well. He's been doing some long fasts--if he's not calorie restricting when he's not fasting, his appetite and fat intake is likely to be increased over what it was when he was doing ketogenic ratios.
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  #14   ^
Old Wed, Mar-29-17, 09:24
andante andante is offline
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Posts: 178
 
Plan: Atkins 20
Stats: 237.6/150/155 Female 5'9"
BF:
Progress: 106%
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Hey thanks, GRB -- I too need to circumvent that statin discussion.

10 months into low carb, 70 + pound weight loss, and my ldl had shot up to nearly 200. (A few years ago -- last time tested -- I was very overweight, but my LDL was only 108.)

I think it may be because I am still losing weight and in ketosis, hence blood lipids are reflecting the fact that MY fat is fueling me and in my bloodstream????

My HDL had gone up to 69. Triglycerides were in the normal range -- 140 -- but that is too high for low carbing.

So I am now doing the flaxseed muffin thing, and am cutting back on dairy and upping the fish oil, sardines, fish consumption, avocados, and olive oil.

I am close to my goal weight and am hoping my cholesterol profile looks better.

My doc is MOSTLY on board with low carb, but he has some traditionalist blind spots (like about bacon!!!) and LDL numbers... however, he is willing to wait and see where I stabilize, and also order a particle size test. I am pretty sure when I do all that, and am at goal weight, the issue will resolve itself.

I am NOT going on statins, no matter what... but I wouldn't mind getting those numbers at least in a less "smoke alarm" range.
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  #15   ^
Old Wed, Mar-29-17, 09:31
Squarecube's Avatar
Squarecube Squarecube is offline
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Posts: 877
 
Plan: atkins/paleo/IF
Stats: 186.5/159.0/160 Male 5' 11"
BF:
Progress: 104%
Location: NYC
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Quote:
Originally Posted by DaveKeto
snip
Glad you’re enjoying the comics from the Simple series. I hope to have Part III up pretty soon. That content was the result of my racking my brain for a long time trying to think up a way to make the lipid system funny and/or interesting for the layperson. And sure enough, it’s the most popular posts I have on my site. (In fact, I’ve had more doctors ping me about it than patients!)

Oh please, don't tell the Docs about this.

I like cheating. I only want to do this to cuz I read/learned over the years how little these numbers mean and I'm tired of hearing 'bout my fantastic HDL, my fantastic Trigs, but oh, dear your LDL is a bit elevated. Yes, your site makes it clear changing these numbers isn't to improve health, but to illustrate how dynamic they are

And yes, I too, want to be an old lady. I have an 80 year old neighbor, female, whose total Cholesterol is slightly elevated, now she's on statins
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