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Oct 31

Infographic of Prediction Experiment

For more details on this graphic and the story behind it, see the post following.

highspeeddrop

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  1. Diego Espinosa

    Hi David,
    Remarkable, but in many ways not surprising. We need lots more biohacking experiments like yours — millions, actually! My start-up, Healthcoin, is seeking to document them on a blockchain. The idea is we can use that “certified proof” of prevention to channel recognition and rewards to those that are proving prevention right. We want to create a vast, “Living Chain” of proof, one that scales across the globe and over lifetimes, and can be accessed by medical researchers.

    If interested, I’d like to include you in an early pilot of the technology. Please email me for more details.

    Thanks,
    Diego

    1. Dave

      I applaud your endeavor! Obviously I’m a big fan of advancing our data as much in the aggregate as possible.

      At the moment, I’m a bit hammered between business and the current experiment I’m on. But if things loosen up more in the coming months, I’ll definitely reach out. 🙂

  2. Annlee

    Reminds me of Dr. Atkins – when weight loss stalled, he’d advise a “fat fast.” Jackie Eberstein has commented on it.

    1. Dave

      Very true. You might be interested in what happened with my weight over this period, which will be outlined in coming Part II.

  3. Pam Forrester

    Hi Dave,
    I just found your site. I am a hyper responder. I have been LCHF for 6 years. I hate to go to the doctor who wants to put me on a statin, which I will not do. But why does this happen? Can you point me to the link where I am sure you explained it. Also loved loved loved the illustrated Simple Guide to Cholesterol. Is part III up yet?

    1. Dave

      As to why some of us are and some aren’t hyper-responders, I don’t yet know. In my case I have an especially interesting situation where both my dad and sister are on the diet but I’m the only one of us who saw a dramatic increase in my lipids (they both saw a very marginal increase). This opens to the door to it being behavioral or circumstantial. But thus far I don’t have a lot more than that. There appears to be a slightly higher proportion with ApoE4 carriers and a slightly higher proportion with lean and/or athletic over heavier/sedentary — but each of these are still pretty loose.

  4. Patrick Fannin

    Dave, I am 48 and have been on a ketogenic diet for about 5 years. I recently had a coronary CT scan that my doctor wanted me to do because of high cholesterol and because of my diet. My calcium score was in the 70th worst percentile for for calcium deposits. I am wanting to consult with someone in the keto community who can help me understand why I have high levels of calcium deposits and what to do about it. I don’t want to go back to my pre-keto life but this test result has scared me. Thanks for any guidance or referral.

    1. Dave

      Hi Patrick-

      Sorry to hear about your CAC score. One of the unfortunate difficulties of getting it now is the inability to determine how much of the score attributes to the lifestyle before the diet vs the lifestyle during. I’ve talked with many in the low carb community who (like you and I) have very high cholesterol but have maintained low or 0 CAC scores in spite of this. But this is anecdotal and to my knowledge there isn’t a sizable study with regard to CAC sampling with a LCHF diet.

      I myself have a 0 CAC (from Feb 2016, 1 year into keto) and just got another this last Tuesday of 0 as well. But I considered the first one a baseline and will likewise want to see it again five to seven years later.

      Ivor Cummins of thefatemperor.com has many great articles and presentations on the CAC test and risk assessments. One key point you’ll be interested in is that your standing score doesn’t matter as much as its *progression*.

      I’ll reach out to you offline with some doctor recommendations.

    2. GCGeo

      What is your LDLp? My personal experience has been that high LDLp drives the process that eventually shows up as CAC score > 0. Keep in mind that CAC shows up late in the game so even with a score of zero you could still be subject to a long term ongoing disease process that may not manifest for yet many years. Check out Davis’ book “Track Your Plaque.” It was written some years ago but still has a wealth of useful information. At the time the book was written, Davis counseled low saturated fat along with his no wheat and low carb recommendations. I wonder what his take on saturated fat is today. Good luck. Keep us posted on your situation.

  5. Dwight

    Hello Dave

    Your data is interesting though scary. Your calories per day (high days) are too high. Your cholesterol numbers freak me out.

    You appear to be a “youngish” man meaning that because your coronary arteries start with a wide diameter they are closing. You can’t tell because of starting diameter. I’m betting the smaller coronary arteries are closing. Penis and peripheral arteries.

    If you continue to be low carb obsessed My suggestion is to Check degree of closure of coronary arteries by non invasive means like PET and so on. You might be one of the lucky folk who are not fat sensitive. Robert Atkins said about 1/3 of people (I think) have to be careful about fat intake.

    A major problem with large fat intake i.e. High calories from fat is that you are not getting the phytonutrients necessary. Towards the end of Atkins life he was asked what he would do differently if any. He said he’d eat a lot more greens. Fat has a very low nutrient density.

    With respect you seem to be missing the forest for the trees.

    1. Dave

      Hi Dwight-

      – Yes, I’m tracking both blood indicators for atherosclerosis and having many ultrasounds (CIMT) and scans. In fact I just got back from NY where I completed one of the most advanced ct heart scans in the world, the 640 slice.

      – Not sure about the “necessary” phytonutrients you’re speaking of. I do eat broccoli, salads, spinach, etc — but the most nutrient dense food I eat is liver, which I’m actually trying to eat more of as well.

      – Not all fats are the same nutrient profile, many are nutrient poor. But this is likewise true for greens as well.

      Interesting comments, Dwight. 🙂

  6. Eric Rodgers

    Dwight

    Interesting comments do you have any links to Atkins comments where he said he’d eat a lot more greens?

    Thanks

    Eric

  7. Miguel

    Hello Dave,

    What you are doing is amazing! Thank you for your work! I am interested in your food log for the higher calorie days. I see your macros percentages but what foods did you intake to achieve such a higher saturated fat and protein? I would like to follow your experiment myself and I currently use Cronometer to track my foods. Thanks!

    1. Dave

      I ate a lot of cheese, eggs, heavy cream, AdaptMeal, burgers, Nathan’s skinless hotdogs, peanut butter and my low carb pizza to name a few.

      Try to fashion something you yourself would like to eat but still meets those macros. And try to do it with real food as much as possible. (i.e. don’t get the vast majority from, say, bulletproof coffee)

      1. Miguel

        Thanks! And, avoid coconut and MCT oil but what about Brain Octane Oil, coconut milk or cream? Would these effect lipid results?

        1. Miguel

          And is Extra Virgin Olive Oil ok?

  8. Jorge Estevao

    Monosaturate fats and fish oil are known to increase HDL and decrease LDL. Have you tried to increase these instate of satured fat on your diet and watch the results?

    1. Dave

      I did an 11-day experiment where I upped my MUFAs and reduced my SFAs early last year, but didn’t see a substantial change. That said, I’d like to do another that would be much more tightly controlled and this time I’d have the benefit of the CardioChek for more frequent testing as well.

  9. Gary

    just got my first panel back after starting Keto in July. went from 305 to 404, and all my other indicators, except tri’s and HDL are red flagged to the extreme. not quite sure where i am going to go next.

    fat is up/carbs down, fiber down from about 150/day to 20-25/day, sat fat up but not markedly.

    now it’s all a process of elimination but the testing cycle is a pain, I don’t have a lab I can pound blood into easily.

    1. Craig

      Gary,

      It sounds like you are comparing a pre-keto lab to a 2-months into keto lab. What all did you have tested? Could you post the TC/HDL/TG/LDL for those two tests? (We should have an article on recommendations for what labs to get, soon)

      My LDL-C and TC are also “flagged to the extreme”, but after doing a bunch of research and some additional testing, I’m not too worried. If TG dropped and HDL went up, those are very positive developments.

      Craig

  10. Diane

    Has anyone who is not routinely low-carb tried your experiment? I’m on more of a high protein, low fat body-builder type diet and wonder if this would still work for me. I just want my doctor off my back. I refuse to take statins.

    1. Dave

      Sorry for the late reply, Diane — I just saw this…

      No — I don’t know that I’ve seen a lot of high protein, low fat and low carbers. But I am interested in your numbers if you’d like to post them. Of the few I’ve seen, there seems to be a slightly higher predominance of lower HDL relative to a typical LCHFer.

      1. Diane

        I have not tried your hack but my last test my numbers were:

        TRIG: 78
        Cholesterol: 312
        HDL: 77
        NON HDL CHOL. (LDL + VDL): 235
        LDLCALC: 219
        VLDL Cholesterol CAL: 16
        CHOLHDL: 4.1

        1. Dave

          The numbers look pretty standard for a hyper-responder on low carb — which is interesting given the protein-centric aspect of your diet.

          Thanks for the contribution, we’ll have Craig add to the data set.

  11. cibele

    Hi Dave, I just found out about you and your blog online and I’m already amazed.
    i did the keto diet for 3 months and at the end I have high cholesterol. I also have polycystic ovary syndrome and my doctor asked me to stop this high fat diet.
    Im on a regular diet, still low carb, but I definitely loved the keto diet…I was feeling amazing every single day, with a lot energy any time of the day.
    I started to google today about it since I really would like to go back to the keto diet at least during the week (5 days a week).
    what do you thing about this approach?
    maybe I should stay way from Saturated fat for a month and test my cholesterol again?
    you comments will be very important for me. thank you so much for sharing all this information.
    Thank you, cibele
    [DAVE NOTE: I removed your email as this site is crawled by spambots quite a bit!]

    1. Dave

      Hi Cibele,

      If you don’t mind, I’ve “referred” you to a fellow low carber who has PCOS and had tremendous success with keto. She’s fantastic and very insightful/researched on this ! 🙂

      1. Sofia

        I am interested in that too as I am Leto 8 months but pcos and hipo..thank you

        1. Dave

          Now that I have her permission, the one I’m referring to is Carolina Carier. You can reach her through her FB page here: https://www.facebook.com/CarolinaRevoWellness

  12. amy

    Question:

    Please forgive me if the answer is here on the site somewhere–I’ve crawled around and can’t find it.

    For the cholesterol drop protocol, during the high calorie part, does the ratio of saturated to unsaturated fat seem to make a difference? Or is that something no one has looked at?

    thanks!

    – Amy

    1. Dave

      Generally not looked at too intently yet. I did do an 11 day experiment last year replacing SFA with M/PUFAs and didn’t have a high significant change, but I’ve heard of several (particularly ApoE4s) see a change.

      With regard to how this fits into the protocol, I’d say try to stick with whatever fats you’re mostly using anyway. If your diet is 10% saturated fats, try to keep it at 10% saturated fats at the higher quantities. If it’s 25%, shoot for 25% and so on.

      The idea is to be sure the composition is roughly the same to control for the variables. If you change the composition, that becomes one more thing that might have made a change in either direction that can’t be accounted for very easily.

  13. Traci

    From Healthcoin “Our mission is to allow employers, insurers and governments across the globe to incentivize and manage their population’s lifestyle change.”

    Don’t we need less management from the government, our employers and insurers?

    1. Dave

      I’d prefer that, sure. But I’m much more about health (and health plan) ownership than most.

  14. Daniel Bullen

    Dave – Please help!!!

    I just want to make sure I understand this. I’ve been on a ketogenic diet for 3 months – with no cheats. I recently got my lipid panel and my Dr. and Fiance were extremely worried about my LDL and total cholesterol levels… (Total: 360 and LDL: 303). My Dr. asked me to eat less red meat and come back again in a month. He said I didn’t need the NMR Lipid profile ( I requested).

    If I consume high fat/cals for 3 days leading up to the next test, I should notice a drop in LDL? I just don’t want them on my case about my LCHF diet, as it has been the best thing I’ve ever been on.

    Please let me know…

    Thanks,
    Daniel

    1. Dave

      Hi Daniel-

      Firstly, it’s worth posting your triglycerides (TG) and HDL as they also tell a lot more about your lipid pattern and standing than just LDL alone.

      The protocol write up is here: http://cholesterolcode.com/extreme-cholesterol-drop-experiment/ — but as always, use at your own risk, it isn’t medical advice. It has about an 85% success rate, but that likewise means it has a 15% failure rate, so bear that in mind, of course.

      1. Daniel Bullen

        Dave thanks for your prompt response… My doctor kind of freaked out, asked me to cut back on red meat ( I was eating 80/20 grass-fed beef daily) and wants me to come back in a month. I posted my numbers below and will check out that link you posted to the write up.

        Here were my results:

        Total: 360

        Triglyceride: 39

        HDL: 49

        LDL: 303

        1. Dave

          Ah — a TG of 39 is great! It strongly suggests you’re not only metabolizing your energy properly, but I’d speculate it means your LDL is *necessarily* high because you need that many LDL particles to traffic that energy. Check out my easy guide that explains this here: http://cholesterolcode.com/a-simple-guide-to-cholesterol-on-low-carb-part-i/

          I know this all seems out of left field, but this mechanistic understanding is how I’ve gotten to where I’m at with this research. It’s why I press (over and over again) that this is an energy distribution system above all else, and cholesterol is along for the ride. If you’re athletic and high energy demands, you require more “boats” to ship around that energy when fasted, which ultimately remodel to LDLp — but again, this makes mechanistic sense.

          Your HDL is a *little* low for a low carber (not getting enough saturated fat?). I’d want to keep an eye on it and see if it rises over time.

  15. Daniel Bullen

    Dave,

    Wow – thank you for sharing that guide with the comic. It is extremely helpful in helping me understand what all of this means. As far as the HDL, I will take a closer look at my saturated fat intake and see where else I can add some in to my macros. I am so happy I stumbled upon this blog and I am super appreciative of you taking time out of your day to help me understand all of this.

    Thank you!

    Daniel

    1. Dave

      Thanks for the kind words, Daniel — glad the blog has helped you out! 🙂

  16. Kristof

    Hello, interesting here! I just got my results from my blood analysis and was worried. I’m on the ketogenic diet for two months together with IF and am feeling great. But my blood analysis shows a high total cholesterol: 280 mg/dL and high LDL 194 mg/dL. Triglycerides are low: 58 mg/dL and HDL is ok (74 mg/dL), non-HDL-cholesterol is 206 mg/dL (too high!). So my doctor was very worried…
    I’m lean, train 3 to 4 times with weights and with a bike, body fat (i guess) is about 14 %.
    There’s one more thing i don’t understand: I read that when you are on ketosis, your glucoselevel is between 50-80, mine is 102, so i’m not on ketosis? (I did not eat for the blood analysis).
    Many thx and love this blog!
    Kristof

    1. Kristof

      Edit: bough myself a glucometer and started testing my glucose. My first reading was 74 mg/dl, with is much lower than the lab test (102).

    2. Dave

      1. You’re markers are very close to a LMHR. If you haven’t already read this, be sure to: http://cholesterolcode.com/are-you-a-lean-mass-hyper-responder/

      2. Higher fasting glucose levels are VERY common (even for those on keto) given your body is looking to meet your higher energy demands. For example, my BFG is notably 5-7 higher in the mornings when I’m training/running than when I’m out of season. This is very common for low carb athletes and you can look up more on it by searching “adaptive glucose sparing.” Worry when/if glucose rises and *sticks* either post-meal or in the morning.

  17. Maryann D

    I came to your site from Megan in the IDM program. I was/am doing low carb, high fat (but was still having sugar and carbs infrequently) and at my six month mark had the following numbers:

    Total Cholesterol 288
    Triglycerides 156 (in the past they have been in the 200s)
    HDL 63
    LDL 194
    CRP 0.64

    I won’t take statins which my doctor has been pushing on me for several years and just did my calcium scan, awaiting results. I don’t understand the fat grams-461 and saturated fat grams-274 listed in your protocol. Are the saturated fats part of the total fat gram or separate. I really want to try this for my next blood draw. Also, not sure I am APOE 4, but think I am 4/4 because of intrepreting my results through Prometheus. Thanks.

    1. Dave

      Hi Maryann–

      – First, don’t feel you need to reach my numbers with regard to the protocol. I’m 6’3 and at the time was doing distance running, thus much higher appetite potential than most. The protocol basically has you go to as high as you reasonably can and that’s very individualized (and probably lower than mine).

      – I myself am a 3/4. I do find ApoE4s do have a slightly higher propensity toward higher LDL, but on LCHF, I think the single highest correllation is lower body fat (lean) and energy demands (athletic). This has been so far confirmed with Lean Mass Hyper-responders http://cholesterolcode.com/are-you-a-lean-mass-hyper-responder/

      – I’m happy to hear your lipid numbers are improving with TG going to 156 from the 200s. I hope the trend continues. 🙂

  18. Maryann D

    Gosh, Dave, thank you for getting right back to me. My Cardiac CT scan is 200. I am really excited to have this baseline and would like to do the higher slice test that you did in six months, after I go to 0. Can you tell me the facility you used. My current test was a 64 slice multi-detector. Thank you for your work. Whew – it such a relief to know that “I’ve Got This” after my doctor is trying to scare the hell out of me. Best!

    1. Dave

      Hi Maryann–

      Well, as always, I qualify that I’m not a doctor or a medical professional, don’t take this as medical advice, etc.

      You said your “Cardiac CT scan is 200” — by that you mean your *calcium score* from the CT scan is 200? (Typically referred to a CAC). If so, you should know it will almost certainly progress to a higher number perpetually, not regress. In fact, the progression is the key thing to focus on. For instance, I’d rather have a CAC of 500 with 3% progression year over year than a CAC of 50 with a 50% progression.

      The advanced 640 slice CT scan I got was at Northshore University Hospital in New York. It is arguably the most advanced, non-invasive heart scan you can get. In fact, I literally flew there just to get that test.

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