«

»

Jan 19

A Simple Guide to Cholesterol on Low Carb – Part II

In A Simple Guide to Cholesterol on Low Carb Part I, I gave a very broad overview of LDL particles and their important cargo along with common misconceptions about this subject within a low carb, high fat diet.

Without question, the guide was the most visited post on my blog. And many of my followers have remarked on how helpful the graphics were in getting across the information. So I decided to get ambitious with Parts II and III and tell it more as a visual story. In short – more graphics, less blog text. Enjoy!

cover

Page_01

Page_02

Page_03

Page_04

Page_05

Page_06

simple_guide_7b

Page_08

Page_09

Page_10

Page_11

Page_12

simple_guide_13a

Leave a Reply

87 Comments on "A Simple Guide to Cholesterol on Low Carb – Part II"

avatar
  Subscribe  
newest oldest most voted
Notify of
Luke
Guest

Simple and to the point. Look forward to the part 3.

Hyper-Responder Neville
Guest
Hyper-Responder Neville

Using cartoons to explain lipid metabolism is so cool! really great work.
In case anyone’s interested (apart from the above series ^), this is probably one of the best explanations of this topic [https://www.youtube.com/watch?v=998r-MyEEPc] that i have come across.

Wim Tilburgs
Guest

Great article shared it in the Dutch Low Carb community.

Nicole recine
Guest

Thanks so much for this Dave. Am I right in understanding that the LDLs become small and dense when they are lacking in cholesterol and have a lot more trigs to drop off?

michael pollard
Guest

Can’t see any way to subscribe.

Dr Z
Guest

Excellent site and excellent illustration!!

Any info on Wellbutrin use and elevated cholesterol? Long and complicated history, but would love any leads if you have come across any associations in your research. Thanks again and keep it up! This information needs to get out!

Megan

Joe
Guest
Hello Dave…. We chatted quickly on Twitter the other night, we had similar numbers and weight loss on LCHF. Here are my numbers again, before LCHF and one year later on LCHF. You said that you are taking no steps to lower your cholesterol at this point but told me to comment here for further explanation…Very interested! Thanks….Joe Jan 2016 Jan 2017 Weight 206 173 Cholesterol 223 373 HDL Cholesterol 65 92 Triglycerides 101 79 LDL / Cholesterol 138 265 Chol / HDLC Ratio 3.4 4.1 Non HDL Cholesterol 158 281
Gale
Guest

Hey Dave,

Just wanted to say what a great job you did presenting at the Low Carb Conference.

Keep up the great work.

Gale Bernhardt

Eric
Guest
Dave Love your work also loving LCHF. Got Lab work back after being LCHF for several months. Stopped 10mg Lipitor after taking for 15 -20 years six months ago. HDL-C 71 was 46 on HCLF +10mg Lipitor LDL-C 170 was 95 on HCLF + 10mg Lipitor Triglycerides 65 was120 on HCLF + 10mg Lipitor HDL-P total 34.5unmol/L first time measured Small LDL-P 625umol/L first time measured Large LDL-P 1552umol/L first time measured Total -C 254 was 161 on HCLF + 10mg Lipitor Only number that I don’t like is the Small LDL-P which is just slightly out of range it’s… Read more »
Eric
Guest

Do you have any concern over Large LDL-p?

Lita Santos
Guest
OMG I’m so glad I found you. Just heard your Breckenidge talk. I’m Jill. I’m her. 7 months on keto and took the cholesterol test and almost fell off my chair. I couldn’t believe it had shot up so much. total cholesterol went up, LDL went up, HDL went up but not by much. My ratios were worse I couldn’t see a way to explain it favourably. I wrote to Dr Ken Sokardis, Gary Taubes, Jimmy Moore, Dom De’Agostino, Stephen Phinney, Malcolm Kendrick and a few others. Most wrote back some with good news others not so much. How can… Read more »
Brian Williams
Guest

Hello Jill,

I have exactly the same situation. The important things are the two ratios: TotCl/HDL and TG /HDL

As long as they are ok, I don’t worry about cholesterol. You can improve HDL with fish oil EPA & DHA.

I use this for my guidelines: “Cholesterol Conundrum – Know Your Metrics” on Youtube https://www.youtube.com/watch?v=YRFRRqe0vrE

Good luck,

Brian

Pat
Guest

Do you follow Dr. Peter Attia at all? He has had quite a change of position on Ldl(a)-P in the last few years mainly I think through lots of feedback from Dr Tom Dayspring. Large particle number=arterial damage. Any comments?

Pat
Guest

Hi Dave–Do you follow Dr. Peter Attia’s Eating Academy blog? Nice detail and for sure he has an increasingly negative standpoint re Lp(a)-P. I think from more in-depth conversations with Dr Tom Dayspring. It is indeed a hot area of research but Dr Attia seems to be settiing the tone of high-P=artertial damage (no matter the particle (i.e. any Cholesterol). Any thoughts?

Ben
Guest
Very cool illustration. One detail seems to need attention, though. Perhaps I’ve missed something somewhere, but from what I understand, small LDL particles and vLDL are not the same thing. I used to think they were, until I was called out on it, and did more some research on it. Further research showed me that there are actually five major groups of lipoproteins: (1) chylomicrons, (2) vLDL, (3) LDL, (4) IDL (intermediate density lipoprotein) and (5) HDL. LDL particles vary in size and density, as we know. Larger, less-dense particles are referred to as Pattern A LDL, whereas smaller, dense… Read more »
Ben
Guest

Thanks for the clarification. It just seems easy to misunderstand from your sixth slide, which states that there are two types of LDL, and it seems to say that one form of LDL is vLDL. The 7th slide seems to state that the other form of LDL is the chylomixron. Glad to hear that this is not truly what you were trying to communicate.

Brian Williams
Guest

Hello, this is a great series! Any idea when Part 3 will be out?

Thanks!

Rafael
Guest

So basically I don’t have to worry about having a 321 mg/dl cholesterol and a 240mg/dl LDL right now?

greylearning.com
Guest

Foods like oatmeal, apples, prunes, and beans are high in soluble fiber, which keeps your body from absorbing cholesterol.

rebt.com
Guest

Foods like oatmeal, apples, prunes, and beans are high in soluble fiber, which keeps your body from absorbing cholesterol.

stan straub
Guest
I have been on LCHF for about a year. I have lost weight, feel good. I had a cholesterol PARTICLE test done. My doctor who ordered it then called, and said “we need to do something about your cholesterol”. Before I started LCHF, my cholesterol levels were moderate, NOT high (according to the standard cholesterol test and my doctors opinion). Now they are high. But I’m not able to interpret the results, and I’m a little fearful. My doctor won’t help me interpret the results…..he just sees “high”. If I give you the results, can you help me with deciphering… Read more »
Michael Lawson
Guest
Your numbers are very similar to mine. I too have been LCHF for about a year and half now and feel great because of it. My reason was not so much weight loss ,but to get relief from post concussion syndrome, which it helped greatly. I was concerned about the LDL-P being high after reading Dayspring/Attia thoughts on this, but Jimmy Moore says high LDL-P isn’t necessarily a problem as he has carried an absurdly high LDL-P (over 3000) with a CAC of 0 and CIMT scan showing no arterial blockage. This doc also shares the same sentiment on LDL-P:… Read more »
Craig
Admin

Thanks for sharing that your numbers and that link, it was a great read. Certainly relevant for my situation.

Craig
Admin
This is the rabbit hole many of us have fallen into, finding out that establishment nutrition/health practitioners have serious flaws in their understanding of cholesterol, but not sure what to do about it. If your concern is CVD, from my understanding of the research, the best test is to get a calcium score from a CAC. LDL is only very weakly predictive and possibly only so because its a marker for insulin resistance. For me, my wife is in the category of concerned and not (yet?) well-read. Getting the CAC test (assuming my result is good) will be sufficient for… Read more »
Pieta
Guest

Hi,
I am a medical doctor from South Africa. Hyper-responder on LCHF. Cholesterol now at 9mmol/l (360)
would like to partake in your study.

Pieta

Vaduvur Kumar
Guest

Part 1 & 2 are really informative.

carmelchamba.org
Guest

Foods like oatmeal, apples, prunes, and beans are high in soluble fiber, which keeps your body from absorbing cholesterol.

kk lim
Guest
Hi Dave, My mum have been on LCHF for close to 10 months now and a comparison of her lipid panels shown below (before and after LCHF): (in mg/dL) Total Cholesterol : 313 to 444 Triglyceride : 242 to 102 HDL : 50 to 60 LDL : 214 to 364 TG/HDL : 4.84 to 1.7 1. Is she what you would consider a “hyper-responder”? 2. Obviously the worry here is the upshoot in her LDL. But I told her that all her other important markers have improved – increased HDL, reduced Triglyceride, improved TG/HDL ratio. Her BP is normal and… Read more »
Chuck W
Guest

Dave,

Enjoying your blog, videos, and cartoons!

I had a couple questions regarding lipoproteins:

Are VLDLs/LDLs _delivering_ cargo to fat tissue, _picking up_ cargo from fat tissue, or a little bit of both?

During conditions of fasting and/or low carb dieting, what is the primary energy transport from fat tissue to other tissues of the body? LDLs? HDLs? Free fatty acids?

Thanks!
-Chuck W

Craig
Admin
Chuck, Glad you found us! Fat is continually cycling through the body. To adipose (fat tissue): 1. VLDLs deliver TG from the liver to various parts of the body, including adipose. 2. Chylomicrons deliver TG from the gut to various parts of the body, including adipose. From adipose: 3. Adipose releases FFA (free fatty acid), which gets picked up by Albium and returned to the liver. Other tissues can tap into this stream of energy, but I’m not sure the exact uptake mechanism. I don’t haven numbers or ratios, but I my guess is VLDL are going to be doing… Read more »
Chuck W
Guest

Craig,

Thanks for the reply, I had trouble finding this info from other sources.

So from the perspective of the adipose cell, release of FFA is the only “way out” for fat energy?

Thanks,
-Chuck W

annie
Guest
Hi Dave – I think that I’m a hyper-reponder as well and would be in a study if possible. I realize that you’re not a Dr but you do have lots of experience reading the #s and I would love your opinion. I’m 55, female and have been on a keto diet for 7 months. I’ve lost 35 lbs and am within 5 lbs of my maintenance weight. My bloodwork prior to keto was all great. Last week I had my first blood work since keto and some of the #’s are now through the roof. Cholesterol 302 TG 60… Read more »
Annie
Guest

Thank you, I appreciate your response!

Jim
Guest

Just watched your presentation at Low Carb Breckenridge and thought it was great. I will be starting (again) a LCHF diet in January and will get some blood work for your “study”. I am going to lef.org to purchase the CBC panels for $35 each. I think that is the best price around for blood work. Do you know of another I should look into?
Just started following you on Twitter as well. Thanks for your work

jim
Guest

Thanks for the info…and here is what Life Extension does for the $35…they do an annual sale too where you can buy a years wort of tests: http://www.lifeextension.com/Vitamins-Supplements/itemLC381822/Chemistry-Panel-Complete-Blood-Count-CBC-Blood-Test

jim
Guest

Just noticed they call it this: Chemistry Panel & Complete Blood Count (CBC) .. Sorry for the confusion

Craig Daniel Doussett
Guest
Craig Daniel Doussett

Awesome

Liz
Guest
I’ve put my numbers into your calculator (total cholesterol 7, triglycerides 2.38, HDL 1.1, LDL 4.8 and the result seems to be “high risk”, which seems ominous! However, not sure what the implications are or what I can do about it. Been LCHF for 7 months. Was 198lbs, Hba1c of 68, cholesterol 5.6 (not sure of breakdown, but triglycerides around 7, despite long-term fenofibrate and simvastatin. In December (still on drugs, but low carb AND relatively low fat – due gall bladder flare) Hb1ac was 32, total cholesterol 3.7 and triglycerides 1.6. Since Xmas, have upped the fats, but still… Read more »
Julie
Guest
Hi Dave, thank you so much for the awesome research that you are doing. I’m a 56 yr old female. I’m a runner but have not been running much the last 3 months. I’d been training for a marathon and got up to 15 miles and crashed on energy levels. I also lift weights and do yoga. I’m not lean. 5’0 124lb. I’ve been doing keto for almost 5 months. BMI 24. I’ve only lost 3 lbs. I just got my fasting bloodwork results. glucose 59, ketones 2, A1C 5.0, CBC WBC 7.7, total cholesterol 494, Trig 79. HDL 153,… Read more »
Jenny
Guest

I’m ready for part III! Maybe you can also explain glucagon’s role in fatty acids?

Alex
Guest

I just saw both posts part 1 & 2 and they’re amazingly simple! Great job Dave! Looking forward for part 3 =D

Michael Tranchina
Guest

I love your “disruptive” research Dave…I have been looking for answers to the cholesterol puzzle for many years…You have broken the code…I am not surprised that a systems engineer would be the one to do this…

Unless I missed it, I am trying to better understand the “inputs” that affect HDL-C blood levels…I am following your energy model with the LDL- and LDL-P, but I am still not clear on the factors that affect HDL-C?

Dawn
Guest
Sorry I am a little confused about some terminology, I hope you can help me. Is LDL-C the Cholesterol or is it LDL in my blood work? I wish I could include a graphic with my question. But I will try to explain why I am asking. In your cartoon picture on this site you show “everyone boarding a blue circle” that is being called Low Density Lipoprotein” also know as LDL and the passengers are Triglycerides, Cholesterol and Fat soluble vitamins. Then in this presentation at https://www.youtube.com/watch?v=jZu52duIqno&t=2178s&list=WL&index=16 at min 12:33 you ask “What is the cholesterol in this?(the boat)”… Read more »