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Nov 06

Basics of Cholesterol on Low Carb – Part I

I’ve been meaning to do this for a while and I’ve finally come around to the first installment. This is to be a series of short videos (5-10m) covering topics related to cholesterol and from a very simple, layperson perspective.

I’ll have several more to come as shown on the new page I’m adding for the series.

As always, you can do further reading with my Simple Guide series as well.

12 comments

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  1. Hassan Ahmed

    I am a hyper responder when i changed to low carb diet (high total and LDL) and my Trig dropped to ~1.0 for several years but lately when i went strict keto for about three months my Trig shot up to ~3 i was on very high saturated fat before the test, I searched for help and i had three reasonable answers, first is to reduce sat fat with mono which i did for a couple of months then tested my Trig it only dropped slightly ~2.8 . Second and third is not tested yet but would like your opinion on these. Second is to not heat the sat fat and use them cold, third is to fast for at least 14hrs and reduce or stop sat fat for 18hrs before test ( i normally fast 12hrs before sampling)

    Which one of these answers would you go for?

    1. Dave

      In my opinion, high TG in the blood is typically a sign of energy surplus, or what I often call being at the “overage point”. Just as with people who are hyperinsulinemic and past their personal fat threshold, there’s more incoming energy than the body can work with leaving either excess glucose or excess TG (and usually both) with longer residence time in the blood.

      Within my own family and friends, I have two recent cases where they went low carb, high fat — but were at an energy surplus. In one case the member was having 80g of carbs which he thought was closer to 30g until we went through his food closely. After bringing that down much lower, his TG and fasting glucose improved a lot. The other family member was actively adding lots of fat in multiple ways that were liquid or oil based, which we had her change to real food. This naturally limited her intake total. Her TG is now one of the lowest in the family.

      This isn’t to say there aren’t other reasons for higher TG, just that it is the first place I’d start.

  2. David griffin

    Dave, I imagine you are really busy but I have a million things I would like to talk to you about as we have been basically doing the same thing. Here are the similarities: 1) I’m an engineer 2) I have been recording every bit of food and drink (since 1996, I’m a bit older) 2) I went Keto for 9 months and my cholesterol went from 170 to 405, LDL 100 to 289. I took a different path in response to this. 3) I’m a runner, consistently for 8 years and race nearly every weekend ( I record lots of stuff on that too like heart rate recovery, HR Max, Pace etc ) 4) I have had numerous blood work done, just about everything on lipids and the heart and even check my cholesterol at home with the CardioChek device. Probably many other similarities I can’t think of right now. I have been monitoring all my food and exercise for all these years as an attempt to manage my weight, improve an ongoing allergy problem and improve my running performance, all of which I finally have under control for the first time ever. I think maybe the best way to compare notes would be to sit down somewhere and have a talk with you. I usually go to Vegas about twice a year maybe we could meet and compare notes or maybe we could just do it here a little at a time as I have a lot I would like to talk about. Before I type a whole book here, What do you think? What would be the best way to share a bunch of ideas and results with you? Gotta Run….literally 🙂

    1. Dave

      Very cool, David. Sounds like we have a lot of parallels. Sure, feel free to ping me when next you’re coming to Vegas, perhaps we could grab lunch. 🙂

  3. Louis Hernandez

    Dave,

    Good evening hope all is well. I have just started keto 3 months ago and I just had my first blood test come back with my LDL at 283. Of course my doc wants to put me on meds asap. what is the best way to reduce this naturally. Could you please point me in the right direction?

    Thanks!!!

    1. Dave

      Hi Louis—

      My research is definitely exposing how the lipid system is highly influenced by sources of energy. Per my presentations, fat-based energy in the form of triglycerides (TG) “ride shares” with cholesterol in Low Density Lipoproteins (LDL). Thus, there’s actually a lot of mechanistic reason for higher LDL when keto, particularly if one is lean and or athletic ( see: http://cholesterolcode.com/are-you-a-lean-mass-hyper-responder/ )

      If your only interest were lowering LDL, you might want to consider upping your carb intake. As you derive more energy from carbs (and thus glucose), you necessitate less energy from fat (and thus TG) in circulation.

  4. Louis Hernandez

    Dave,

    You are the man!! I have been reading your post and I am truly dumb founded that all my markers are right in line with your analysis. I am 43 yrs old and I am practicing IF workiing out 5-6 days a week cario and weights in a fasted state. I am asking my MD to order a Genova CV Health plus genomics test ASAP. I could share my results for you to look at if you would like!!

    Keep up the GREAT work!!!

    1. Dave

      Thanks, Louis!

  5. Bob Niland

    Allow me to share perspectives from another program (Dr. William Davis’ Undoctored, which started out as Track Your Plaque).

    TC: Largely concur with “irrelevant”.
    If the number is at what consensus med thinks are alarming extremes, it just indicates that some real lipoprotein testing is needed, including genetic and genetic-associated markers.

    TG: 60 mg/dL or less. 150 is too high.
    Ideally, a TG this lowis also concordant with a low HbA1c (5.0% or less), low FBG (90 mg/dL or less), and postprandial BGs never above 100. Yes, this requires a low net carb diet, which the program is, but it’s not chronic keto. The program has had this 60 target for over a decade.

    HDL: 60 mg/dL or higher. 50 is a bit low.
    This is also a long-standing target. The blog article linked here summarizes nutritional elements that drive it.

    LDL: What LDL?
    “LDL” is no test in particular, usually no actual test at all, and I would encourage you to be more precise about what you mean when you use that abbreviation.

    If LDL-C, that’s not a measurement. It’s a fiction — a calculation (the C), but needs to be clarified as to whether Friedewald, Iranian, or something else.

    If DLDL or Direct LDL, aka LDL-D, that needs to be stated, perhaps extending to identifying the test process.

    A much less likely possibility is (LDL-P Particle Number)÷10, a way to express “LDL” as a number familiar to consensus practitioners, but if you’ve got the source number for that, you’ve got other values on that NMR advanced lipoprotein panel that are vastly more informative than the mythical LDL-C.

    1. Dave

      Interesting additions, Bob.

      To be sure, this is meant to be more of a 101 series, not an in-depth one. Optimizing these numbers can (and often does) require more than what I can cover in a 5 minute video.

  6. Colleen

    Maybe one of the videos will address the parameters for “low inflammation.” Or if you have another post on this you could direct me to. You have great info!!

    Another question to someone who has done so much testing, any thoughts on LabCorp versus Quest? I have had some contradictory test results. (Ferritin 300 at one, then 25 at another 2 months later). Not possible. What to trust? I thought about running the same tests at both on the same day 1 hour apart but if contradictory results, I still wouldn’t know which test result if either would be reliable.

    1. Craig

      One good measure of inflammation is hsCRP.

      I don’t have any opinion on Labcorp versus quest, but I think they are generally doing the same exact labwork in most cases.

      2 months is a lot of time for something to change! We’ve discovered many ways cholesterol can change in the short-term. I think there might be some similar reasons that Ferritin could spike.

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