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Nov 29

Lowering Cholesterol as a LMHR

Introduction

As our resident Lean Mass Hyper-Responder (LMHR) on the site, I have been an outlier so far with my Lipids. Despite an additional 200g/day of fat, my LDL was effectively unchanged in the Ketofest experiment. I knew exercise was potentially a confounder given Dave’s experiments with distance running, but I had a full training schedule this year leading up to my first marathon earlier this month.  Now, with a fat-fueled, goo-free, finish in the books, I decided to overlap some science with a forced period of rest.

Background

The Inversion Pattern is a theory about the impact of short-term diet on blood lipids (TC, LDL, HDL, Triglycerides). For LDL cholesterol, the supposed “bad” kind, it can be simply stated as:

All else being equal, LDL-C is inversely related to the dietary fat consumed in the 3-days prior to the blood draw

The implications of this pattern are profound. If blood lipids are not static, but instead highly dynamic from short-term factors, all conclusions based on a single sample are suspect. It would be like concluding you lived in a desert from a single sunny day.

Here’s the complete set of relationships from the Inversion Pattern:

  • Total Cholesterol tracks with inverse of dietary fat for the 1-3 days before the blood draw. (87% inverted correlation)
  • LDL-C tracks with the inverse of dietary fat for the 1-3 days before the blood draw. (90% inverted correlation)
  • LDL-P tracks with the inverse of dietary fat for the 3-5 days before the blood draw. (80% correlation)
  • HDL-C tracks with dietary fat for the 1-3 days before the blood draw. (74% correlation)
  • HDL-P tracks with dietary fat for the 3-5 days before the blood draw. (correlation not calculated)
  • TG tracks with the inverse of dietary fat for the 1-3 days before the blood draw. (61% inverted correlation)

Note: Correlation numbers are based on Dave’s data through 4/8/16 and don’t include subsequent experiments where additional variables were introduced.

Goals

The goal of this experiment was to replicate the Inversion Pattern using the Feldman protocol.  If that held, I would use this data as a baseline to compare against my earlier tests that included exercise. And, just for fun, I would be able to see the short-term variability of a number of other metrics in a controlled setting.

Experiment Design

I adapted the 4-test version into a 2-week schedule following my race. The first two days were a washout period with ad lib food. That was followed by a 5-day low-calorie phase and a 5-day high-calorie phase. Throughout, I refrained from all exercise. I even switched to riding the subway instead of my normal bike commute.

For measuring cholesterol, I got both a Nuclear Magnetic Resonance test (NMR) for particle counts, and the standard lipid panel (for redundancy).  I followed my own advice on testing and also got hsCRP, Insulin, Metabolic panel, and WBC.

Predictions

To evaluate the performance of the Inversion Pattern, we’ll score it based on how it does predicting which test shows the highest and lowest values for each of the metrics.

Here are the predictions:

Lipid Score Highest Test Lowest Test
Total Cholesterol (TC) Test 2

From days 5-7 (Low Cal x2, Fast)

Test 3

From days 8-10 (High Cal x3)

LDL-C Test 2

From days 5-7 (Low Cal x2, Fast)

Test 3

From days 8-10 (High Cal x3)

LDL-P Test 2

From days 3-5 (Low Cal x3)

Test 4

From days 8-10 (High Cal x3)

HDL-C Test 2

From days 5-7 (Low Cal x2, Fast)

Test 3

From days 8-10 (High Cal x3)

HDL-P Test 4

From days 8-10 (High Cal x3)

Test 2

From days 3-5 (Low Cal x3)

TG Test 2

From days 5-7 (Low Cal x2, Fast)

Test 3

From days 8-10 (High Cal x3)

 

The Experiment

Food Journal

Overall, I managed to stick to the schedule pretty well.  I managed a 40-hour fast on Day 7 during the low-calorie phase (calories: a coffee with cream and a spoonful of fish oil). On Day 11, I had some unexpected family travel, so it ended up being a Medium Calorie day. Fortunately, there were enough blood draws to still get a sample after three High Calorie days in a row.

 

 

My go-to meals during the experiment, easy to vary the quantity.

  • Breakfast: Bacon and Eggs (with HWC, butter)
  • Lunch: Bunless Burger salad (with Olive Oil)

Results

Total Cholesterol (TC)

First, let’s look at Total Cholesterol.

Finally, Feldman drop achieved! As predicted, TC peaked on Test 2 after the 40-hour fast.  Three days later, TC dropped 112 points to its minimum value. Interestingly, the Medium Calorie day allowed a difference in dietary fat between Test 3 and 4, which showed a small increase of TC, as predicted.  

Prediction Score: 2/2

LDL-C

Next, let’s look at LDL-C, the “bad” cholesterol that everyone is worried about.

Similar to TC, LDL-C peaked on Test 2 after the 40-hour fast.  Three days later, LDL-C dropped 100 points to its minimum value for Test 3, as predicted.

For comparison, my normal LDL-C with regular exercise was in the 210-230 range. For those keeping score at home, that’s a 200 point difference from the peak of this experiment.

Prediction Score: 4/4

LDL-P

Next, I was eager to see LDL-P. In Dave’s results, LDL-P has both a higher correlation and a trickier formula.

Boom. Exactly as predicted. From Test 2 to 4, LDL-P dropped by an impressive 1200 in 5 days. I found it particularly interesting how large the change was between Test 3 and 4 in LDL-P, even though the LDL-C went in the other direction in that interval. Clearly, LDL-P is a lagging indicator from LDL-C.

For comparison, my normal LDL-P (from one NMR in August) was 1597.  In this case, the total net difference was 1700. Without medications.

Prediction Score: 6/6

HDL-C

On to HDL-C the “good” cholesterol.

At first glance, HDL-C doesn’t seem to move much. However, since going low-carb, my HDL-C has been in a pretty tight 110-115 range, so 102 was actually a low-outlier, as predicted.  The two highest fell within my normal range and didn’t appear in Test 3 as expected. Maybe it takes a little bit more time to spin up my reverse cholesterol transport to above 110.

Prediction Score: 7/8

HDL-P

After the first prediction miss on HDL-C, my expectations were lower for HDL-P.

Wow. HDL-P moved from 31.3 to 36.9 exactly as predicted by the Inversion Pattern. Even if the cholesterol cargo in HDL has some additional variability, the particle counts (and thus emission and/or clearance rates) clearly have short-term diet as a driver.

For comparison, my one previous NMR in August showed HDL-P of 34.7.

Prediction Score: 9/10

Triglycerides (TG)

Triglycerides also played along and followed the 3-day fat intake as predicted.  At first I thought the higher TG in Test 1 and 2 might have been due to the lingering expectation of energy needed for exercise, due to my sudden drop off in activity. However, their correlation with 3-day fat matches the Inversion Pattern and implies a more responsive dynamic.

For comparison, my TG tests have typically ranged from 50-70, going back to before my low-carb diet.

Prediction Score: 11/12

Insulin

Insulin is a key hormone that I was interesting in following during the protocol.

Here I plotted against 3-Day Fat, but protein was similar. Despite keeping Carbs generally below 40g (except days of 73g and 56g), I still managed to have a 6x change from min to max. Clearly, Insulin is responsive to non-carb nutrients. I wonder how much of the later results were driven by late-night dairy (e.g., 4-oz of half-and-half at 10pm).

For comparison, my Insulin from August was 4.3.

hsCRP

I tracked High Sensitivity C-Reactive Protein to see how inflammation would track as I recovered from my first marathon.

I was extremely sore for several days following the race. I was feeling better by Test 1 on day 6, but still had somewhat higher inflammation. As expected, inflammation declined as I rested and healed.  My previous CRP reading in August was 1.01, so it’s possible that the 0.89 minimum was because I excluding some inflammatory food from my diet. Dairy is the most likely culprit, and it would be interesting to exclude it and check my CRP again.

Summary

This experiment was a clear confirmation of the Inversion Pattern for all lipid scores except HDL-C. Short-term diet was demonstrated as an input factor was able to move LDL-C by 100 points. In previous tests, exercise during the 3-days prior was sufficient to confound a similar change in diet. In addition, infection, injury, and other short-term inputs have known or theoretical impact on these numbers.

One of my takeaways is that the lipid system is much more dynamic than conventionally understood.  For those who are getting advice to change their lifestyle or take medication from someone ignorant of this fact, I would encourage you to learn more first. For those who need a low LDL or TC score to get cheaper insurance or to get their doctor off their back, I would encourage you consider using the protocol yourself.

Another takeaway is that my blood lipids are quickly reacting to serve essential bodily functions. Some of the missing LDL-C from my exercising tests were likely used for muscle repair via endocytosis, reducing my recovery time. In addition, the four hours of marathon running without goo was only possible because of VLDL distribution (and possibly even HDL to some narrower vascular channels after CETP). I’m grateful I have a “hyper-responding” lipid system to get the job done.

In the future, this data should prove valuable if I decide to continue with further experiments. They might have to study the impact of exercise, though, since the prolonged rest was difficult for me.

29 comments

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  1. bill

    Great. Thanks.

  2. Mike

    Good article! Very informative.

  3. bonnie lee

    Craig, thank you for doing this and then sharing the info! I am on day 4 of the Feldman Protocol and trying to get all the fats/calories in. I had my first set of blood work checked yesterday after 3 days of near fasting. I’m alarmed at how high the TC and LDL are! So is my doctor who called me this morning. My TC was 12.53 (484), LDL 9.61 (371), HDL 2.35 (91) and TG 1.26 (111)

    I am 64 years old, 136 lbs. and although not an athletic by any stretch I am in pretty good physical shape I think. I have been on Keto since last May

    Pursuing this topic has obsessed me a bit, I read everything I can get my hands on, listen to podcasts and youtube videos of conferences like Breckenridge, Ketofest, etc. I would not be so concerned if my lipids were even twice the high limit … but it is even higher than that. I dont see extreme high LDL results fully discussed anywhere. … I cannot find any information about why just the LDL is high when I am not doing any great physical exercise and all other markers are good. I’ve had HgbA1C, thyroid, CBC, electrolytes, CRP done, all are well within the norm.

    Im writing this half way through the 6 day Feldman protocol and will update once I get my next set of lipids results. Fingers crossed that these results are really high because of fasting and the next set will be closer to norm. I go to the US for the NMR Lipid panel as I live in Canada and this is not available to me (well, might be but at an extremely high cost)

    1. Craig

      Bonnie, thanks for sharing. Your numbers from the low-calorie phase are right in the range that I had, so I wouldn’t be surprised if your high-calorie numbers looked similar too. Let me know how it turns out!

      As far as “why is LDL high when everything else is great”. One possible answer is its a normal result of energy status, which we’ve explored a great deal on this blog. The conventional answer just looks at LDL and assumes a disease state, which I think is a little short-sighted.

    2. BobM

      Bonnie, you have to pay for the first test yourself — don’t give it to your doctor! 😉 The second test, after the high fat period, that’s the one you give to your doctor. Although if your doctor gets both, and sees what a dramatic change there is, he or she will completely change his or her mind about cholesterol. Just kidding! There’s a snowball’s chance in heck of that happening.

      Personally, I wouldn’t be worried. Many studies indicate that HIGHER cholesterol is good for women. Also, an HDL of 91 is impressive. Did you know that HDL became the “good” cholesterol mainly because women developed less heart disease, and this was a way of explaining that? But there are indications that HDL is a marker for other things, mainly insulin resistance, and with an HDL that high, your insulin resistance is likely really low.

      As for fasting, I made the mistake of getting an official test after 4.5 days of fasting. Not good. I subsequently took a test after 12 hours of fasting and then after 4.5 days fasting (same week), and the 4.5 days skews everything. For me, it raised triglycerides, total cholesterol, LDL, basically all the “bad” stuff, while lowering HDL (the “good” stuff). A double whammy! I now know due to Dave that this occurs probably after 3 and not 4.5 days, but I didn’t know at the time.

      1. Dave

        It’s comments such as yours, Bob, that really give me extra strength every day. I’m so happy this site and our work has helped you to understand what was happening and how to change it.

        I feel genuinely sad knowing there are so many out there who are dropping their dietary fat or multi-day fasting before a test because they presume it will give them the lowest cholesterol scores… not realizing they are actually spiking them!

    3. Dave

      Hi Bonnie–

      I’m excited to see your forthcoming results from doing the protocol.

      As always, I caveat that I’m not certain of higher LDL-C/-P given a healthy keto lifestyle is safe, only that it makes perfect mechanistic sense. Give you’ve watched all my media, I’m sure you’ve seen me explain it quite a number of times. 🙂

      You may be interested in a few of my upcoming articles and my current series of experiments, which I hope to have completed by the end of the year. So stay tuned!

      1. Bonnie

        Hi Craig and Dave. As noted Nov.29, “ I had my first set of blood work checked yesterday after 3 days of near fasting. I’m alarmed at how high the TC and LDL are! So is my doctor who called me this morning. My TC was 12.53 (484), LDL 9.61 (371), HDL 2.35 (91) and TG 1.26 (111)

        Now I have both sets of results. My average fat intake for the first 3 days was 46 gm (83% of total daily calories) and the results are as above. My average fat intake for the next 2.5 days was 275 gm. (84% of total daily calories) that was really hard to do.

        And, it did make a difference, albeit not as significant as some others. My LDL went from 371 to 360, my HDL rose from 91 to 110 and my triglycerides dropped from 111 to 75.

        The second set of numbers came from lab work done in Seattle as I cannot get the NMR lipid test covered in Canada. The first set of numbers was a simple lipid profile. As an aside to these numbers, I can also compare the NMR lipid Panel done in September in Seattle to the one i just did – my LDL-P went from 3492 to 2800, not much difference in LDL, ….. both HDL and Triglycerides good. My small LDL-P went from 374 to less than 90! My LDL size is firmly in the large, Pattern A range. BUT my C-reactive protein went from 2.39 to 3.56! Perhaps thAt is a temporary rise, perhaps it is an error or just another lab result to be concerned about…sigh…

        I’m open to any and all input from all sources. I’m leaning toward low carb rather then strict Keto In light of a LDL that seems way off the charts compared to rest of bloodwork. I did a cardiac scan recently and my score was 60 which might reflect previous years of my life when I had a poor diet and less healthy lifestyle. My weight has ranged from 135-160 over my adult years currently at 136 since Keto, off BP meds from over 20 years and feel fit and healthy. But those LDL numbers are so high! I just don’t know really what to do. I’m thinking maybe let my doctor know I want to try another 6 months of dietary change to see. Id be interested in what others think as to utility of getting the APO e test done

        I don’t expect medical advice, I appreciate this forum and an opportunity to converse with others on this subject. I feel some reassurance that I am not the only one with this kind of response to LCHF.
        Anyway, I wanted to report to you the results of my experience with Feldman Protocol. I’ll take these results to my doctor on Wednesday and see if her interest is piqued or if I get the response, “omg, your LDL is going to kill you!l
        Bonnie

        1. Dave

          Hi Bonnie–

          – Sorry you didn’t get more traction from the protocol. I’m sure you were looking forward to a much larger drop in LDL than you had. Two side questions:
          —– 1. You did water fast (no coffee) before each lipid test for at least 12-14 hours, yes?
          —– 2. You avoided coconut and/or MCT oil per the instructions…?

          – The slightly higher C-reactive protein may have been activated by the stress of the protocol, which I have seen before (particularly if you were actively concerned about doing it right + the outcome = likely higher cortisol, etc).

          – As always, I want to give all my readers the tools to make an informed decision and I’ve certainly had several who were/are in the I’d Just Prefer To Lower LDL perspective. Absolutely respectable and defensible — this is YOUR health decision and no one else’s.

          On that note, my current phase of research centers around *swapping* fat out for carbs to find what thresholds the body is looking for in glycogen stores. The theory is that at a certain degree, it will feel less need to mobilize energy from fat, thus resulting in less cholesterol that “ride shares” with it in LDLs.

          You may want to read this: http://cholesterolcode.com/cholesterol-research-breakthrough/ and this: http://cholesterolcode.com/energy-status-experiment/

          But PLEASE NOTE this part of my research is VERY preliminary. I suspect this will take quite a bit more work to isolate out than the Inversion Pattern.

  4. Ingrid

    Craig or Dave,
    Help me to understand base on my lab test results what Pattern I am A or B, the more I read the more confuse I get. Also, what is the best approach to lower the LDl-P it’s my understanding this is a key marker that contributes to cardiovascular disease given the fact that my father had two heart attacks one in his late forties and the other one at 80 years old. He got to live 40 more years after his first one..

    Ever since I went low carb my numbers have crippled; could it be that I fall under the hyper responder or will be because of my family history of high cholesterol? I’m physical active, doing IF daily, no smoking or drinking, not a perfect diet but 90/10 almost all the time. When I was eating a more liberal carb lifestyle my numbers were okay (although I never checked my LDL-p before just last 2 or 3 years), a calcium score of 0, and H1AC within normal levels. I am aware that people with higher cholesterol levels live longer but I get worry with a high LDL-P.
    How can I improve my levels? Statins are out the question….of course!

    What is your take?

    Began keto
    11/14/14 11/13/15 9/23/16 9/6/17
    H1AC 5.3 5.5 5 5.1
    TSH 1.34 1.66 1.85 1.39
    Glu 77 66 79 79
    Cholest 447 262 330 437
    HDL-C 113 113 92 128
    HDL-P 33 35.7 30.1 32.6
    LDL-C 325 144 221 298
    LDL-P 2,697 2,037 2,376 2,265
    LDL-Size 21.7 21.7 21.9 22.1
    Sm LDL-P 231 90 90 90
    Trig 47 24 86 54
    H-CRP 0.5 0.66 0.78
    Vit D 26.5 37.4 24.5 24.9
    Lpa 152 126
    Ferritin 97

    According with my doctor all other test results were okay.

    thank you,
    Ingrid

    1. Annie Q

      According to the lipids panel report I just got, an LDL particle size of 20.6 or greater is Pattern A. Yours seem to have been Pattern A throughout with your best score being the most recent. Also, the reference range on my report shows that a Small LDL-P of below 117 is considered very low (low is desirable) so your Small LDL-P scores of 90 are very good.

      My LDL-P has skyrocketed also, and I don’t know whether to worry about it or not. I have been losing weight pretty steadily for the last six months, but I have reached my goal now. I’m giving it six months to stabilize and then I’ll worry about LDL-P.

      1. Ingrid

        Thank you so much Annie Q for your input!

    2. Craig

      I think those numbers look pretty good and indicate good health. High Pattern A LDL is normal and not uncommon on LCHF. You’re found a good place to learn more about LDL and evaluate its role in disease. My opinion’s is similar to Dave’s on LDL-P, see this video where he explains.

      At the end of the day you’ll have to decide what diet/lifestyle/medications to choose based on the big picture.

      As a tweak, my opinion on Vit D is that levels in the 20’s are ok, but not optimal. Consider some more outside time!

      1. Ingrid

        Thank you, Craig! During summer I spent a lot of time outside and I thought that my Vit D levels were going to be
        high so I have been supplementing my Vit D.

      2. Dave

        I essentially agree with everything Craig says — but with some extra emphasis on Vit D. There are many sources that will explain in detail why this vitamin is extremely important.

        Your numbers actually fit for a Lean Mass Hyper-responder. In case you haven’t read it already: http://cholesterolcode.com/are-you-a-lean-mass-hyper-responder/

        1. Ingrid

          Thanks, Dave!

  5. George Henderson (@puddleg)

    (and possibly even HDL to some narrower vascular channels after CETP)

    Almost certainly one of the functions of HDL is its ability to redistribute TGs from larger species in this way.

    1. Craig

      Thanks George, always happy to get your insights! I really should read through your entire blog. 🙂

      Just speculating, but I wonder if this might be *the* driver of LMHR. LM individuals will have much less NEFA to pick up the slack getting energy to remote tissue. Thinking about reverse-engineering the bookkeeping of cholesterol, high CETP would raise LDL-C for a constant LDL-P. I’m less clear on how the HDL-C would work out. In my case HDL-C was pretty darn steady, despite big changes in HDL-P.

    2. Dave

      Of course, this one is a real biggie for me. I’m pretty confident this is the case, but not confident enough to include it in my presentations just yet.

      Anecdotally? It makes 100% sense given what we’re seeing with LMHRs.

  6. Anne

    Hi Craig,

    Thanks for showing all those diagrams illustrating the inversion pattern, it really shows the relationshiip between high fat and the lipid test clearly.

    Is there any post that is ‘short’ enough, if you get my meaning, that I can show medical professionals ? My lipids behaved exactly as Dave predicted (I am a lean hyper resonded btw). I told my endo that I had eaten more fat “recently to try and put on wieght” (wink) and was surprised at the lipid result (wink). He wrote in his report what had happened – he was surprised enough to write that I’d eaten higher fat and got lower total and LDL. I would love to be able to show him the science behind this, bearing in mind that doctors don’t have much time to read.

    Anne

    1. Craig

      From a doctor’s perspective, there are many sources of information:
      1. things they learned in school
      2. things they observed over time in their patients over time
      3. things they read in recently published studies
      4. things they hear from their patients.

      I think most doctors think of category 4 as the least reliable. Patients read crazy stuff online and come in asking for funny tests and demanding obscure treatments. I think most also have a skeptical eye towards category 3 (as do I), as new stuff might be wrong and has yet to be contextualized.

      I think the only way to persuade them might be to pique their curiosity. I think I might bring my stack of 4 lab results to my next appointment and just hand the over and say “btw, I had some labs done last fall thought you might want to look over as my doctor”. If you I get “wow, that’s an amazing change, what did you do”, then we might have a good convo. If I get “omg, your LDL-C is gonna kill you, let’s talk statins” that’s another story.

  7. Yoav

    Hi Craig, Dave.
    I wanted to write you an email, but could not find your email address.

    I’ve sent the question below to Ivor Cummins about two weeks ago, but did not get a response yet.
    I hope you can help me clear up some of this, or maybe point me to someone who can.

    3 months ago I learned of the Keto diet. Everything I’ve read and heard about it made perfect sense, so I decided to go ahead and experiment.
    I have been doing Keto since, and have listened to many (many!) videos, including yours about the subject.

    Recently, I’ve tried listening to “the other camp”, including the starch solution by John McDougal, and many other vegetarian/vegan proponents (I was a vegetarian myself for many years before starting Keto a few months ago…).
    To make a long story short, I’ve seen this video – https://www.youtube.com/watch?v=MzHLAqyO7PQ – which seems to show lots of research going against low-carb and Keto diets specifically.

    But most troubling is this research paper – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5479812 – which to my unprofessional understanding (I’m a software engineer), undermines many of the health claims that LCHF lifestyles promote, by showing that High-Fat diets are as damaging as High-Glucose diets.
    Are you aware of this study?
    What do you think?
    Am I misinterpreting its findings or data?

    Appreciate your take on this,
    Yoav.

    1. Dave

      Hi Yoav–

      – First, kudos for listening to “the other camp” — as you may have seen in my many comments and tweets (including today, ironically, https://twitter.com/DaveKeto/status/938482570584395776), I encourage EVERYONE to research all major sides of any meaningful subject. Keep it up!

      – Yes, I’m very familiar with Mic the Vegan. In fact, I’ve watched many of his videos to date. While I can’t unpack everything he’s talking about, I can speak to where the bulk of it comes from (which he concedes early in the video 1:47-ish mark) — that this is mostly lifted from Paleo Mom’s post here: https://www.thepaleomom.com/adverse-reactions-to-ketogenic-diets-caution-advised/

      Shortly after this was posted and making some waves, Dr. Adam Nally did an extensive rebuttal on Jimmy Moore and the Doc here: http://ketotalk.com/2016/06/23-responding-to-the-paleo-mom-dr-sarah-ballantynes-claims-against-the-ketogenic-diet/

      But of more interest to me at the time was this break down by a prolific commenter at Reddit (gogge): https://www.reddit.com/r/keto/comments/35b5ra/the_paleo_mom_attacks_keto/cr3c031/

      Mostly, I think any critical review of a nutritional ketogenic diet should be with subjects who have had more nutrition completeness. And unfortunately for the epileptic kids of early last century, that wasn’t what they got in those shakes. 🙁

      – With regard to the last research paper you cited, there are a number of problems, these two being the biggest:

      —— Clearly, this is not a LCHF diet in macro composition: “The mice were divided into two groups and were fed a control diet (CD) (energy composition of 76% carbohydrates, 9% fat, 15% proteins; 3.8 Kcal/g) or a high-fat diet (HF) (energy composition of 26% carbohydrates, 59% fat, 15% proteins; 5.3 Kcal/g) for 8 weeks.”

      —— Moreover, there’s no breakout of the specific fats used. For example, rodents are often fed seed oils or transfats as the “fat” used, which is certainly not LCHF-encouraged — and now is getting less and less vegan encouraged as well!

      —————————————–

      All of this being said, I’m no party-liner. I don’t believe there is any diet that is one-size-fits-all. In fact, I regularly point out that I may ultimately find a keto diet isn’t right for me… who knows? I just go where the data takes me.

      1. Yoav

        Hi Dave,
        Thanks for the quick response.

        Despite agreeing with Raphi’s/Craig’s point 3 below, the thing that bugged me about this reseach’s results is the liver damage that the HF diet showed.

        Basically, as far as I have been able to understand our physiology, combining High-Carb and High-Fat is a recipe for disaster, as the research does show, although this usually produces the tastiest food 🙂

        During my first two months of Keto, I did not consider anything above 5% carbs as LCHF, but as I listened more, I’ve seen that many reasonable people supporting this lifestyle (including Ivor) cross the 5% considerably, even as far as 20%.
        Clearly determining a numerical value for LCHF is not easy if at all possible – since as you’ve said, this is not a once size fits all problem – but I did not expect to see liver damage compared to the control group in the mentioned composition (26/15/59).

        The two things that do raise my suspicion regarding these findings are:
        – Those are rats after all, with all due respect to the researcher’s will of creating a model of human obesity metabolism
        – As you’ve pointed out – the nutritional completeness of the HF diet provided is an unknown, not to mention the breakout of the fats they were fed.

        Yoav.

        p.s
        Thank you so much for all the information and experiments you are sharing – these are exciting times we’re living in !

        p.p.s
        Your heads up on the very important hyper-responders FAQ got me slightly concerned… I hope there aren’t any “bad” findings coming our way, as I’m trying to figure this one out as well. Any clue as to when you’ll posting the new page?

        1. Dave

          Hi Yoav

          – Yes, combining high carb with high fat. And FWIW, I’m not even sure if you can pull that off without refining the source of carbs or source of fats. Basically, the easier and faster you can get that energy absorbed into your system, the more problematic it can be. And yes, it’s no surprise that the tastiest of the tasty food happens to have BOTH refined carbs AND refined fat (typically oils).

          – And yes, I have a lot of problems with rodent studies which could be its own series of posts. But I’d rather put more of my efforts doing these experiments and reporting the data. Perhaps after this next phase, I may put more of my other, generalist thoughts in more posts.

          – Yeah, I need to update that freak’n FAQ. Maybe I’ll make some time in the next few days.

    2. Craig

      Yoav,

      I want to second the kudos on seeking out other perspectives.

      I’ll just steal a tweet from Raphi to make some points. https://twitter.com/raphaels7/status/938345114434523136

      1. From an evolutionary perspective, what kinds of diets were humans eating from say 1M-10K years ago? Our brains grew a lot in this time, what food made that possible? What adaptive strategies did we employ?
      2. From a nutritional perspective, where is the burden of proof? It should always on the innovator. Is a vit+min enhanced smoothie-a-day best for you? maybe, but we don’t know and its health claims should be looked at skeptically. Both seed oils and refined sugar are in the innovation category in this regard. Maybe even wheat and dairy for some populations.
      3. Good science tries to viciously tear down hypotheses with experiment. Research itself is having a bit of an internal crisis dealing with incentives to publish, get funded, show positive results, “one study showed X” or “4/5 studies showed Y” is isn’t good science and certainly not a way to inform life decisions.

      IMO, persistence hunting – made possible by our fat-powered brains – was a big part of what made us uniquely human. So I think the burden of proof would be on “it healthier to never be in regular ketosis”

      1. Yoav

        I totally agree.
        Thanks for the quick response!

  8. Steve

    I think I fall into the LMHR camp and have had my first ever NMR test at 44 years of age.

    Can anyone point me to a good place to learn how to read the test results as best I can? Specifically, I want to understand the LDL-P and particle size portion of the test.

    1. Dave

      I don’t have that video and/or guide up for that yet. You can post your numbers here and we’d be happy to let you know our thoughts.

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