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  #1   ^
Old Sat, Jul-05-14, 22:14
zmktwzrd zmktwzrd is offline
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Posts: 42
 
Plan: Ketogenic
Stats: 290/192/175 Male 5'11
BF:
Progress: 85%
Location: Central PA
Default Dr. Dayspring Acknowledges Significant LCHF Contradiction/Concern

I am a long time low-carb zealot who has recently become troubled by something seemingly contradictory in the literature.

What I am referring to are some discussions and writings by Dr. Thomas Dayspring. He has noted “there are some people who go on a low-carb high-fat diet that experience worsening of their cholesterol markers." I am not just talking about the (significance disputed) LDL levels and total cholesterol, but more import, the LDL-P or “particle” counts.

https://www.lecturepad.org/daysprin...licsCase291.pdf

More troubling is that some of these folks have seen marked improvements by adding carbohydrates and cutting saturated fat in their diets! Why is this troubling? Because According to Dr. Thomas Dayspring dietary intake of fat has little to do with the fat levels in our blood because our liver produces most of our blood cholesterol. If true, then cutting saturated fat in the diet should have little to no effect on those levels in the blood, right? Is it possible that maybe dietary fat intake DOES create a significant impact on blood cholesterol levels?

It reminds me of this great quote:

“The most exciting phrase to hear in science, the one that heralds new discoveries, is not “Eureka” but “That's funny...” —Isaac Asimov (1920–1992).

Indeed, after having been indoctrinated with the idea that dietary carbohydrates are what regulate blood cholesterol levels I find it “funny” that someone who is adding carbohydrates and cutting saturated fat intake is experiencing such a strong cut in serum cholesterol levels and particle counts.

If Dr. Dayspring were not credible, I would disregard this information as being from a biased processed food industry-funded study, but he is clearly IN the LCHF camp.

What led me down this path was a concern I have about my LDL-P. After more than a year of a disciplined ketogenic diet, I went in for an NMR blood test (as recommended by Dr. Dayspring) and my jaw almost hit the floor when I saw my particle count; it is 3200!!!!

My HDL is good, and my triglycerides are good, but my total cholesterol is over 300. The total cholesterol level alone does not cause me concern (I know some studies would say higher is better). My big concern is the particle count. According to Dayspring, it is the particle count that is the most important number in predicting heart disease.

How can this be? How can I be on a ketogenic diet, which according to my own beliefs and those of many of those in this forum be the most health healthy option, yet I generate a particle count that is seemingly so unhealthy?

Also, how it is that others in the same situation have “fixed” this problem by ADDING carbohydrates and cutting saturated fat intake? Their experience is contrary to “our” entire argument!

Until I can get an appointment with the right expert, I am self-medicating this with Slo-Niacin as suggested by Dr. William Davis (Wheat Belly).

http://www.lef.org/magazine/mag2007/mar2007_atd_01.htm

In my opinion, this observation raises significant questions about what we all believe about the LCHF diet and or what we believe about the value of LDL-P levels.

Feedback, thought's, opinions?
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  #2   ^
Old Sun, Jul-06-14, 00:21
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ojoj ojoj is offline
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Plan: atkins
Stats: 210/126/127 Female 5ft 7in
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Location: South of England
Default

I'm not a trained medic, but I have read so much on the cholesterol issues and for the life of me, I still cannot see that high cholesterol is anything more than a "red herring" and proves nothing. I once heard a cardiac specialist say that blaming cholesterol is like blaming the fire brigade for a fire because they're always at the scene. Cholesterol may only be prevalent cos its trying to help and heal when theres a problem, rather than the other way round

On a personal (and some might say morbid) level, as I'm getting older, I sincerely hope that I do have an EoL heart attack. We all have to "expire" and for me, something quick is preferable to a long lingering, incapacitating, pill dependent end!

Jo xxx
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  #3   ^
Old Sun, Jul-06-14, 02:22
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Karhys Karhys is offline
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Plan: Primal-ish
Stats: 172/158/132 Female 5'2"
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Location: Rural NSW, Australia
Default

Chris Kresser talked about this issue recently in his podcast, you might find it interesting listening (or reading, I prefer to read the transcripts).
http://chriskresser.com/does-your-d...olesterol-level

Basic take-home message: there is no "one idea fits all", not even for cholesterol. Nothing works 100% the same for everyone. You have to decide for yourself how seriously you want to take the blood test results, and whether you want to treat them or not.
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  #4   ^
Old Sun, Jul-06-14, 02:39
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JEY100 JEY100 is online now
Posts: 13,371
 
Plan: P:E/DDF
Stats: 225/150/169 Female 5' 9"
BF:45%/28%/25%
Progress: 134%
Location: NC
Default

The LowCarbDietician, Franziska, had similar concerns recently and wrote a very comprehensive post with links to many expert views about your concerns, including another Dr. Dayspring article that should be considered, and what she has done since to adjust her LC diet. A thoughtful review of the information about results like yours. http://www.lowcarbdietitian.com/blog.

My own NMR results were good and like Jo, I haven't bothered to even get a cholesterol test lately, but my husband has had a number of them. After reading an article by Dr. Davis about how responsive LDL tests are to what you eat in the days before the blood draw (http://www.cureality.com/blog/post/...-particles.html) he has seen wide swings in LDL-P merely by watching food intake five days. Which makes me wonder how valid the whole idea of delving further into lipid sub-fractions is if so easily manipulated. So while I read all these articles about LDL-P, without good answers from the experts, I focus on low TG and high HDL which is almost a sure thing with low carb.
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  #5   ^
Old Sun, Jul-06-14, 10:38
Bonnie OFS Bonnie OFS is offline
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Plan: Dr. Bernstein
Stats: 188/150/135 Female 5 ft 4 inches
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Progress: 72%
Location: NE WA
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Quote:
Originally Posted by ojoj
On a personal (and some might say morbid) level, as I'm getting older, I sincerely hope that I do have an EoL heart attack. We all have to "expire" and for me, something quick is preferable to a long lingering, incapacitating, pill dependent end!

Jo xxx


A hearty AMEN to that! I've seen too many painful, drawn-out deaths. I want to go fast. So does husband.

I had an epiphany a few years back when I fell on ice & knocked myself out (just like Dr. Atkins, but I survived.) It was fast and painless - until I woke up.
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  #6   ^
Old Sun, Jul-06-14, 11:51
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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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In truth, these are just numbers that may or may not have anything to do with our future health. This so-called evidence-based medicine is based on crappy science. That's why they think they need to treat numbers with statins. Yes, the numbers go down, but mortality goes up.

I love that modern medicine can do a lot of things well, but this sort of predictive screen... they suck at it.
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  #7   ^
Old Sun, Jul-06-14, 12:44
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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

Have you seen this thread?

http://forum.lowcarber.org/showthread.php?t=461375

RawNut links to this video;

https://www.youtube.com/watch?v=fuj...eature=youtu.be

And RawNut's first comment here;

Quote:
This is something I hadn't heard of before. At 56:30 he talks about a study showing that high Apo B particle numbers hardly raise risk in those with fasting insulin below 12. Over 12, particle number matters... a lot! This would explain the Jimmy Moores of the world with high particle number yet still no disease.


Sort of addresses Dr. Dayspring's concern. Here's the question as I'd pose it;


I've seen it written/said in various places that cholesterol/triglycerides/apoB can go up sometimes when people go on a lower carb diet. The usual explanation is that, for a period, excess lipids--not just triglycerides, but also cholesterol--is being released from the fat tissue. There's another thread started by Jey100 with videos from a conference on the Pacific Coast, with videos by Drs. Volek, Phinney, Westman and Wortman, one of the videos mentions a study done by one of the participants (probably Phinney or Volek, Volek's talk was on lipids) where it was shown that the increase in cholesterol on a low carb diet came largely from the fat cells.

Go on a higher carb diet? Cholesterol improves? (At least by some person's judgement), What use is that--if cholesterol improves, yet the diet change increases insulin, and if that increase of insulin, as suggested in the video posted by RawNut, makes the cholesterol that is in the blood more dangerous? Who is to say which situation is more dangerous, lower cholesterol, high insulin, or high cholesterol, low insulin? I'd err on the low insulin side.

Especially for a person like Jimmy Moore. What are his choices? He can increase his carbs and have high triglycerides, low hdl, high insulin--the situation that has basically ravaged his family. Or he can stay ketogenic and have a high particle count, low insulin, and cross his fingers. This isn't a rock and a hard place for people like Jimmy, it's a rock and an increasingly plausible safe haven. If insulin really does turn out to be the major culprit--and on the standard diet, the lipid risk factors that most low carb physicians including Dr. Dayspring still acknowledge as valid, triglycerides, hdl cholesterol and particle size/number generally track with hyperinsulinemia--then fixing cholesterol at the expense of insulin seems anything but prudent.

edited to change "low" to "lower" in one place.

Last edited by teaser : Sun, Jul-06-14 at 13:10.
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  #8   ^
Old Sun, Jul-06-14, 19:27
Dodger's Avatar
Dodger Dodger is offline
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Plan: Paleoish/Keto
Stats: 225/167/175 Male 71.5 inches
BF:18%
Progress: 116%
Location: Longmont, Colorado
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I gave up on chasing numbers a few years ago. I see no downside to low-carb eating.
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  #9   ^
Old Sun, Jul-06-14, 21:28
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CMCM CMCM is offline
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Plan: Keto / Atkins VLC
Stats: 173/148.6/135 Female 5'6"
BF:23.9
Progress: 64%
Location: N. Calif. Sierra Nevadas
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Quote:
Originally Posted by Dodger
I gave up on chasing numbers a few years ago. I see no downside to low-carb eating.


My thoughts exactly!
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  #10   ^
Old Sun, Jul-06-14, 23:25
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aj_cohn aj_cohn is offline
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Posts: 3,948
 
Plan: Protein Power
Stats: 213/167/165 Male 65 in.
BF:35%/23%/20%
Progress: 96%
Location: United States
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Quote:
Originally Posted by Dodger
I gave up on chasing numbers a few years ago. I see no downside to low-carb eating.


About 5 years ago, I would have agreed with you without reservation. After following the Perfect Health Diet Blog for awhile, though, I have to allow that for some people, a VLC WOE and/or a LC WOE (where all carbs consist of vegetables) will cause problems for some people: higher insulin levels, hypothyroidism, decreased mucus production.
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  #11   ^
Old Mon, Jul-07-14, 15:10
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deirdra deirdra is offline
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Plan: vLC/GF,CF,SF
Stats: 197/136/150 Female 66 inches
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Location: Alberta
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I wouldn't call the Perfect Health Diet VLC or LC, since it is 3/4 vegetables by weight, or 600 calories (150 g carbs)/day, which would be "moderate" level carbs compared to the SAD.

These moderate (or higher) levels of carbs may be what is pushing up insulin levels and causing reductions in thyroid levels. My insulin levels went down and my thyroid levels went up into the normal ranges when I went truly VLC/VHF (<10%carbs, >65%fat).
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  #12   ^
Old Mon, Jul-07-14, 15:10
Zei Zei is offline
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Plan: Carb reduction in general
Stats: 230/185/180 Female 5 ft 9 in
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Family member's blood test at doctor came back way, way out of range on triglycerides, resulting in scare, prescription pills, etc. But later turned out to be an apparent lab error. Misplaced decimal or something. Not saying your number was in error; just my thought of something to watch out for because of this.
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  #13   ^
Old Mon, Jul-07-14, 19:50
Bonnie OFS Bonnie OFS is offline
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Posts: 2,573
 
Plan: Dr. Bernstein
Stats: 188/150/135 Female 5 ft 4 inches
BF:
Progress: 72%
Location: NE WA
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Quote:
Originally Posted by Zei
But later turned out to be an apparent lab error.


I hope things have changed in the last 35 years - I used to work in a hospital lab. I wasn't a tech - I was the computer person. I don't know how many times the techs would take off on break and tell me to write down the number on this or that test when the timer rang. That scared me! What if I wrote the wrong number? Other times they would just take off and timers would ring, and I just let them ring. No idea what was supposed to be recorded.

Hopefully, a lot more of the lab tests are computerized.
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  #14   ^
Old Mon, Jul-07-14, 20:10
zmktwzrd zmktwzrd is offline
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Posts: 42
 
Plan: Ketogenic
Stats: 290/192/175 Male 5'11
BF:
Progress: 85%
Location: Central PA
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First, thank you guys for the excellent responses and links, a few of them were VERY helpful.

The bottom line seems to be that as it stands we simply are not sure which markers matter the most. So the idea would be to err on the side of caution and try to improve ALL the markers if possible, right?

The key question for those of us who have seen their LDL, LDL-P and TC rise on the LCHF diet is this; Is there a way for us to keep all the benefits of our LCHF diet AND lower our LDL-P?

Here is my current action plan….

1. Continue my current ketogenic diet but substitute more monounsaturated fats in place of saturated fats (IE: Macadamia nut oil in my bullet-proof-coffee rather than butter and coconut oil)

2. Add a B3 (Niacin) supplement to my diet (Specifically Slo-Niacin to offset some of the Niacin risks and side effects)

3. Add Omega 3 supplements (salmon oil and krill oil)

4. Add vitamin D and K2 supplements

My understanding from the literature is that all the above steps can be beneficial to cardiovascular health for those on a LCHF diet.

The final and possibly most important part of this new plan takes place tomorrow when I get my first coronary calcium scan. The score will give me a baseline to know where I stand, and just as important, let me know over time if things are getting better, worse, or staying the same.

Any feedback & opinions on my action plan are encouraged and welcome. More often than not I find the input on this forum valuable.

Thank you
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  #15   ^
Old Tue, Jul-08-14, 04:38
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WereBear WereBear is offline
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Posts: 14,608
 
Plan: EpiPaleo/Primal/LowOx
Stats: 220/125/150 Female 67
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Progress: 136%
Location: USA
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Quote:
Originally Posted by zmktwzrd
Any feedback & opinions on my action plan are encouraged and welcome. More often than not I find the input on this forum valuable.


Have you done a C-reactive protein test? Because inflammation is what kills ya... not cholesterol.

When I started eating low carb, I was coming off of an entire lifetime of never using my fat-burning mode. I guess it's a tribute to resilience that almost all of us do drag that out that rusty engine and it works!

I've come to believe that low carb can heal a lot of our metabolic woes. But first, it might expose them to the light.

Yes, some people feel better with more carb... and it might be that they have reached the limit their fat-burning engine can handle. Remember, ALL THOSE STUDIES were done on people who were NOT eating low carb. So they have pertinence only for people who are still eating SAD.

Probably not for us.

Myself, I've got high cholesterol AND a mysterious, and serious, problem that has baffled two doctors so far. This very morning I'm going in for a new barrage of tests. But from what I've read, modern medicine has a lousy track record in this area, so I am simply not surprised. And I figure the cholesterol is a symptom of the fact that I'm sick. As it so often is.

And that's kind of how I look at their approach to heart attacks. All that fussing over not eating fat, all those expensive statins, and those miserable people jogging along the road on doctor's orders... and what they've done is increased the chances of someone not dying from their heart attack. That's all.

So I'm thinking they don't know that much about it. Why should I torment myself over some hair-splitting nonsense about particle sizes when the OP doesn't know their state of inflammation? THAT is what they and their doctor should be worrying about! Or, not.
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