Jan 20

START HERE (Pinned)

Please consider supporting our newly launched Citizen Science Foundation and its central endeavor, the LMHR Measurement Project. Your contributions are making citizen science a reality – thank you!

  • If you know little to nothing about cholesterol->
    • And you want to learn the basics->
      • You can check out my Simple Guide to Cholesterol series. It’s full of illustrations and is written for laypeople. Enjoy!
      • Likewise, I have this video that goes over the basic markers for cholesterol while on a low carb diet. (Pictured to the right)
    • You can enter your cholesterol numbers into our popular Report tool to check them against many risk calculations at the same time.
  • If you have seen your cholesterol rise considerably on a low-carb high-fat diet (like myself):
    • You may want to first visit the FAQ.
    • I would strongly encourage you to read through this blog and my own journey revealing the Inversion Pattern. Key moments were the Identical Diet experiment and the Extreme Cholesterol Drop experiment that I wrapped around the first presentation of my data for the Ketogains Seminar.

Nov 23

#CholesterolScience with Kevin Bass

Many of you who follow my work know I actively pursue challenge. Part of that process of engagement is in initiating contact with people who may not only disagree with me — but might be very polarizing for many in the low carb community. Certainly Kevin Bass fits this description.

I had booked Kevin for an appearance with #CholesterolScience a few months ago, but between then and the show we recorded yesterday, a controversy arose that involved Dr. Ken Berry. We address this briefly at the beginning of the interview.

All in all, there were many things I liked about this interview. It was a Friday night and we were both a bit loose and not always as articulate as our A Game might allow, but that also created a much more stream-of-consciousness kind of honesty that came through at multiple times.

Reference Links

We mentioned several things throughout the broadcast that I’ll link below.

Names mentioned:

NHANES Material

LDL Level Changes during Inflammation

Kevin provided this study — The Effect of Inflammation and Infection on Lipids and Lipoproteins

While I haven’t had a chance to read the study in full, I can say that it appears this had more to do with the serum levels of lipoproteins, not specifically the production. The blood levels don’t tell us much regarding production without knowing the other side of the ledger regarding how much is subtracted via endocytosis, scavenger receptor removal, etc.

Nov 15

Three weeks – $50,000 Funding Benchmark Reached and Counting

Click here to contribute to the project

I’m extremely proud to announce we met and surpassed the $50,000 benchmark I set as our starting point at Low Carb Houston exactly three weeks ago today.

Words cannot express the level of thanks I have for this community coming together and driving this science forward.

Please keep those donations coming. By our rough estimates, each $2,000 will cover us for one LMHR measured. And as I also mentioned in Houston, my dream would be for us to get to 50, or even 100 LMHRs tracked. To be sure, that may be a stretch goal… but as of right now, it’s not so far away.

As of this writing, we’re already at $56,232. Part of this new surge has been boosted by the new video I released a couple days ago, which has helped spread the message and reach new audiences.

Yet the most powerful MVPs are the people who actively spread the word far and wide — you might be one of them. Don’t just contribute, share!

Davoprotein

Lastly, I made a challenge with the community that if we actually reach all the matching funds for our Anonymous Donor ($25k for Nov), that I’d make a lipoprotein costume and run in it for the 10k I’m in this Sunday. As of right this moment, we’re just $3,423 from hitting that goal. Thus, I’ve already started making it, given the velocity of donations so far, I might very well be wearing it in two days!

The community has until midnight tomorrow to make this happen. And while it would be definitely be a much more difficult jog (I’m already woefully undertrained), it would definitely be worth it for me. Plus it would be pretty cool story, all in all.

Again, Thank You

One more time, let me just say thanks. I have more faith in citizen science today than ever before. The magnitude of progress to this benchmark has exceeded even my most optimistic assumptions.

You made it happen.

Nov 05

Travel Schedule and Signup for Documentary Filming

From January 7th to February 29th my wife and I will be traveling around the world (literally) and filming a series of interviews on the science of lipids and cholesterol along with the emerging research on its relation to low carb diets and metabolism (which is my central focus here at CC).

We actually have a sophisticated setup with several cameras, lights, mics, and tripods. We hope to gather quite a lot of footage over these eight weeks.

Who We’re Interviewing and How to Join

First and foremost, please check the schedule below to confirm we’re coming to your city and country when you would be available to be interviewed (details below). Please also be aware that we expect a lot of inquiries and will likely be unable to interview the majority of those applying. With that said, we hope to capture many interesting stories and opinions from medical and non-medical professionals alike.

We’re looking to interview three main groups of people.

  1. Lipidologists, Cardiologists, and researchers in the field of lipids and/or cardiovascular disease. It’s important to get perspectives from every side represented in the documentary. So whether you are pro-lipid hypothesis, a skeptic, or somewhere in between, we’d love to have you on.
    • If this category describes you and you’re interested in being interviewing for this documentary — please sign up here.
  2. Low carb “Hyper-responders” and “Lean Mass Hyper-responders” – those who have had a pronounced increase in their total and LDL cholesterol since adopting the diet. We’re interested in a variety of stories and opinions on what these means to the individual.
    • If this category describes you and you’re interested in being interviewing for this documentary — please sign up here.
  3. Doctors who have low carb patients and how they are treating the rising number of cases for hyper-responders.
    • If this category describes you and you’re interested in being interviewing for this documentary — please sign up here.

China and Japan

DateDayCityInterview Times
7-JanTuesShanghai, China5pm-onward
8-JanWedShanghai, Chinauntil 6pm
9-JanThursShanghai, Chinaall day
11-JanSatMacau, Chinaall day
12-JanSunMacau, Chinaall day
13-JanMonMacau, Chinaall day
14-JanTuesHong Kong, Chinauntil noon
16-JanThursOkinawa, Japan1pm-9pm
18-JanSatShanghai, China2pm-onward

Malasia, Tailand, and Singapore

DateDayCityInterview Times
21-JanTuesKuala Lumpur, Malasia7am-3pm
22-JanWedPhuket, Tailand10am-10pm
24-JanFriSingaporenoon-onward
25-JanSatSingaporeall day
26-JanSunSingaporeall day

Australia and New Zealand

DateDayCityInterview Times
28-JanTuesMelbourne, Australiaall day
29-JanWedMelbourne, Australiaall day
30-JanThursSydney, AustraliaTBD
31-JanFriSydney, Australiaall day
1-FebSatSydney, Australiaall day
2-FebSunSydney, Australiauntil noon
5-FebWedBay of Islands, New Zeland8am-6:30pm
6-FebThursTauranga, New Zeland7:45am-5pm
7-FebFriNapier, New Zeland10am-5pm
8-FebSatWellington, New Zeland7am-3pm
9-FebSunDunedin, New Zeland9am-5pm
13-FebThursPerth, AustraliaTBD

United Arab Emirates

DateDayCityInterview Times
15-FebSatDubai, UAEall day
16-FebSunDubai, UAEall day

Northern Europe

This visit will be a bit more variable. We may be visiting a number of northern European cities depending on the availability of certain key interviews. This may include Paris, Barcelona, Stockholm, and or Amsterdam to name a few.

DateDayCityInterview Times
17-FebMonLondon, United Kingdom2pm-onward
18-FebTuesLondon and Northern Europeall day / TBD
19-FebWedLondon and Northern Europeall day / TBD
20-FebThursLondon and Northern Europeall day / TBD
21-FebFriLondon and Northern Europeall day / TBD
22-FebSatLondon and Northern Europeall day / TBD
23-FebSunLondon and Northern Europeall day / TBD
24-FebMonLondon and Northern Europeall day / TBD
25-FebTuesLondon and Northern Europeall day / TBD
26-FebWedLondon and Northern Europeall day / TBD
27-FebThursLondon and Northern Europeall day / TBD
28-FebFriLondon and Northern Europeall day / TBD
29-FebSatLondon and Northern Europeall day / TBD

What the Documentary is and When it Will Be Released

While we know the subject matter of what we’re filming, the exact nature of its final format when it will be released is yet to be determined. We’re seeking to capture many, many hours of interviews that help tell the story of how we got this this point of understanding with cholesterol and risk, how hyper-responders from the low carb movement have opened new questions, and what the next steps are for the science in this field.

This may be a feature length documentary, or it may be a series of shorter segments tackling each topic in succession. Regardless, it won’t change our efforts to capture as much footage as we can for experts, doctors of low carb patients, and hyper-responders from around the world. This is a story that certainly needs to be explored.

Extraordinary Thanks to the Mrs

I have to take a moment to thank the Mrs for her tireless efforts in researching and capturing a huge cache of points and miles that are covering the vast majority of this trip. It was a year-long project and required a lot of sophisticated credit card swapping, targeted timing for purchases, and lots and lots of reward programs. That… plus we’re cashing in prior points and miles from before this year.

Update to the Film Project will be Posted Here

Lastly, be aware that this blog post will be where updates are posted — so bookmark it now. These updates will likely be added at the top of this page in reverse order of the timing so you only have to scan the top to know if there is something new to report.

And as always, I’ll be actively posting updates on Twitter as well @DaveKeto

Nov 04

#KetoAF Experiment Results – Trialing High Fat Carnivore

#KetoAF Talk of the Town on Twitter

Around March of this year I began to hear the term “#KetoAF” being used on Twitter. Not just from one person, but from several. The people using the hashtag weren’t using it to mean “very keto” or to exclaim that something was keto in a cool way. Instead, they were using it as a shorthand for “Keto Animal Foods”, or a carnivorous diet where fat was prioritized.

The people discussing KetoAF were also talking about how it helped kickstart weight loss after long stalls, or helped to resolve persisting issues that were lingering even with a more protein heavy carnivorous diet. I was intrigued, especially as I had heard the Paleolithic Ketogenic diet (PKD) discussed at CarnivoryCon earlier that same month.

By April, I was making plans and coordinating with Amber O’Hearn (who coined the term KetoAF) and Josh Blackburn (a fellow KetoAFer) to set up the experiment. This would turn out to be one of the longer experiments in my history, as I wanted to give it enough time to do something – if it did anything at all.

Testing Hiccups

Over the course of the experiment, I ran into a few problems with testing. You can read about the details below, but to summarize:

  • I needed to re-test my baseline, I did so by extending my baseline 1 day and re-testing the following morning.
  • The baseline microbiome results were lost
  • The post-intervention PEG400 data was lost
  • The two final tests were confounded by a cold and by a sunburn
Testing Issues In-Depth
The first was during my first baseline lab, on the 28th of May, the cholesterol reading I took after my blood draw (via a home monitor) indicated my triglycerides were unusually high. To ensure I collected accurate baseline data, I extended my baseline by one day, and re-tested everything the next morning. I suspect the confounder was the PEG400 testing, as the original labs did come back odd.

The data from the microbiome test I had done at the end of the baseline was lost as well – the company I was testing through (ubiome) discontinued support of the smartgut testing a day or so before I sent in my sample and cancelled my order as a consequence. I did however get a test at the end of the experiment via their explorer kit.

I was able to get a PEG400 at the end of the baseline, and got those results back fine. However the other kit I had for testing at the end of the intervention had apparently leaked in transit, and I wasn’t able to get a replacement fast enough due to an issue with the label on the replacement.

The final two blood tests were confounded due to 1) getting a cold and 2) getting a sunburn by falling asleep outside on accident. This definitely impacted the results, so unfortunately the blood data likely isn’t representative. I was working under some time constraints, and didn’t have time to extend the baseline further, but I did get another test when on unrestricted ketoAF a month or so later, so will provide that at the end, as it wasn’t part of the original experiment.

Prior Diet and Baseline

Prior to the experiment I had been following a predominantly carnivorous diet (barring experiments, etc) as of October 2017 (a little under a year and a half). I had lost an additional 25 pounds from switching to carnivore from omnivorous keto, bringing me down to 140 lbs. For around a year I had been at 143 lbs without additional weight loss. To note, this still left me “overweight” (and overfat, according to a DEXA). Throughout ad libitum carnivore I averaged around 30% protein, 70% fat and negligible carb from seafood and dairy.

Final baseline diet composition.

The baseline diet was originally intended to be 10 days, starting at May 17th, but was ultimately 7 days, starting at May 20th to May 26th. The first three days of the original baseline had unusually high glucose readings, and I also realized I was eating too fatty for my intended 1:1 target, so these three days were excluded.

Final baseline diet composition.

During the 7 day baseline I tracked morning glucose, ketones, and weight. I ate ad libitum, and logged all items consumed via pictures.

During this period I consumed:

  • Trimmed ribeye
  • Coffee
  • Water
  • Vitamin supplements (vitamin D, and methylated B vitamins)
  • Electrolytes as needed

After the baseline was completed I tested intestinal permeability with a PEG400 from ICMNI, as well as a slew of bloodwork which was repeated at the end of the intervention.

My baseline PEG400 returned the following result, with the comment “[It is] normal, even lower than the reference range which is characteristic of those not eating plant foods.”

I ended up having to re-test the bloodwork the next day, as discussed, thus on the 29th I did another set of blood tests which we will consider the official baseline bloodwork, here.

Intervention Design

The intervention diet was set up to be ad libitum, eating when hungry until full and avoiding fasting beyond 24 hours if possible (to ensure any weight loss was not due to the fasting/ensuring I didn’t confound any lab results). I wanted to make sure I gave it sufficient time to show positives or negatives so ultimately decided on 26 days. The goal was not protein restriction, but rather fat prioritization so meals generally followed this pattern:

  1. Eat raw beef trimming until no more was desired (satiety)
  2. Eat raw beef liver (75g) next – this was included as I had stopped B vitamin supplementation, raw liver was best tolerated compared to other preparation methods.
  3. Eat trimmed ribeye (main protein source) until satiated.

The “goal” would be 2:1 fat:protein by macronutrient gram, but if I got full before I reached this, it wouldn’t be forced, and if I ate above the ratio (more fat) this would also be fine. All food was weighed and logged via pictures. Supplements and coffee were discontinued during the intervention period. Weight was taken each day, along with glucose and ketones (BHB).

I had two check-in labs, mostly to verify my folate levels were remaining stable with the removal of supplementation and addition of liver. On June 24th, the end of the experiment I tested the following:

  • Microbiome test
  • Blood work
Blood Tests Done Over The Experiment

Late Game Change to Intervention Diet

Originally, the intervention diet was supposed to include 75g~ of raw beef liver per day. However, after a couple weeks, I began to feel averse to eating it. I continued eating it, as part of the experiment design, however this rapidly turned into nausea after consuming it at meals.

On 6/17 the reaction to eating the liver escalated into becoming physically ill after eating it. In order to make sure I could continue the experiment, I decided to discontinue liver consumption for the duration of the experiment.

I’m not sure why this happened, exactly, as the reaction was disimilar to food poisoning, especially as the reaction increased over time. Some I’ve spoken to have speculated the aversion may have been due to being “topped off” on a certain nutrient (or nutrients) found in liver, but I have no way of verifying this.

Results

Weight

During the baseline (5/22-5/28) I remained weight stable, fluctuating between my normal weight of 145-147 lbs. After the KetoAF intervention, I remained weight stable for four days, after which my weight began to decline. My weight continued to decline at a steady rate, with the exception of a period where I had a cold (6/9-6/14) during which I was weight stable. The week after the cold cleared (6/14-6/18) I was also stable at a slightly lower weight, but it is unclear if this is related.

The decline in weight continued until the end of the experiment (6/24). The total weight lost from the lowest weight of the baseline (145 lbs) compared to the lowest weight of the intervention (138 lbs) was 7 pounds. At 5’2″, and considering this is the lowest weight I’ve achieved during my adult life, I would consider this weight loss significant.

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Macronutrient and Energy Intake

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During the baseline, I averaged 1855 calories per day. During the first two weeks of the intervention, calories dropped to about 1750 calories per day – resulting in about a 100 calorie decrease from baseline. Average fat grams increased from 122g per day to 164g per day, and protein decreased from a daily average of 148g to an average of 51g per day.

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On the last day of my cold (6/13) I did not eat as I was not feeling well. This resulted in week 3 having a low average calorie intake. Unfortunately, week 3 is also missing data for one day (6/18). I know I didn’t fast that day, but can’t find picture logs of what I ate. In order to not artificially depress the average, this day has been excluded from all calculations of averages.

Finally, the average calories for week 3.5 was slightly lower than weeks 1 and 2 at an average of 1683 calories per day – on average, 67 calories less per day.

Over all it appears as though eating a carnivorous diet with a high fat content did not result in an increase in energy intake, and indeed seemed to result in a general decrease (100-200 kcal/d). Despite being very energy dense, appetite appeared to be properly regulated. It’s also interesting to note that although week 3 was the lowest calorie week, this did not correlate to more weight loss – in fact, I did not lose weight during this time period.

Calorie Data By Week

Ketones and Glucose

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Over the course of the experiment, a significant difference in average ketone level was recorded. During the baseline, average ketone level was 1.5~ mmol/L and over the course of the intervention average ketone level was 2.8~ mmol/L.

Glucose levels were not significantly different during the duration of the experiment, with an average of 89.8 mg/dL during baseline and 90.0 mg/dL during the intervention.

Labs

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At baseline, my Total Cholesterol and LDL Cholesterol were 312 mg/dL and 251 mg/dL respectively. By the end of the experiment these had decreased by 88 mg/dL and 83 mg/dL respectively, to 224 mg/dL and 168 mg/dL.

HDL remained within my normal range throughout the experiment at 45 mg/dL, while my triglycerides decreased by 26 mg/dL from 82 mg/dL to 56 mg/dL.

It’s possible that these results were confounded by the cold and sunburn at points 6/13 and 6/24, however a follow-up lab on 8/2 showed Total Cholesterol of 231 and LDL-C of 155 mg/dL, as well as triglycerides of 45 mg/dL so I find it likely these are representative. HDL at follow-up was 67 mg/dL but it is unclear if this is a one-off or a new normal. Further testing on all of these points will be beneficial.

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Vitamin B12 and folate both increased during supplement cessation and liver inclusion and dropped somewhat post liver exclusion. A longer time trial without liver would be needed to see where they settled longer term.

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Throughout the experiment Vitamin C levels remained steady with a small decrease in Vitamin A and a decrease in Iodine. It’s unclear if the decrease in Vitamin A was impacted by cessation of liver consumption.

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Glucagon increased from baseline and insulin generally decreased (excluding one datapoint on 6/13 from when I was sick; not shown). They appeared to mirror each other over the course of the experiment.

Free T3, and IGF-1 both decreased over the experiment. Longer term tracking of Free T3 would be needed to gauge relevance versus fluctuation. Low T3 is not entirely surprising due to a very high fat, low carb diet as mentioned in this post. No hypothyroid symptoms were noted during the course of the experiment, and energy levels remained stable.

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Uric acid, interestingly, increased over the course of the experiment. Further testing would be required to gauge whether the increase in Uric Acid was temporary due to a deeper level of ketosis (as evidenced by higher ketones) as noted by Westman Et Al that this can cause a temporary increase in Uric Acid during keto adaption. The follow-up test from 8/02 showed uric acid was back to 6.2 (data not shown), so this is suspected in this case. Further testing over a longer time period is warranted.

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Finally, although possibly confounded by the circumstances of the last two data points, lipoprotein(a) levels generally decreased during the experiment, just as LDL-C did. This is consistent with Lp(a) following LDL levels over the course of various experiments, with its role as an acute phase reactant in mind given the cold and sunburn of the last two tests (possibly elevating it above what it might have been otherwise). Longer term tracking would be interesting to see if this is sustained over a longer time period.

Final Comments

Ultimately I greatly enjoyed ketoAF as a way of eating over the course of the experiment, minus the liver incident. Since the experiment, I’ve been using ketoAF as my baseline diet including at conferences (e.g. at Low Carb Houston I ordered moist brisket with a side of butter). I find it easy to do even when away from home, and my food enjoyment has increased.

I’ve found it to be a helpful tool post-High Carb Experiment (post on this one coming soon), to help come back from the weight gain and adverse side effects that lasted long after the experiment. I find I will likely continue it longterm as long as I continue to enjoy it. Longterm data will certainly be interesting, especially if it allows me to come down to a normal/lean weight/bodytype given enough time.

Oct 29

Help Us Fund the Lean Mass Hyper-responder Measurement Project

Click here to support the project

Greetings everyone,

On Friday at Low Carb Houston, I announced the launch of the Citizen Science Foundation, a vehicle for helping us privately raise funds for its central endeavor, the Lean Mass Hyper-responder Measurement Project.

The Lean Mass Hyper-responder (LMHR) phenotype is a strong profile to test the lipid hypothesis, which posits levels of cholesterol in the blood are linked to the development of heart disease. The cut point for LDL cholesterol starts as 200 mg/dL (5.17 mmol/L) and higher, with many having levels well into the 400s and 500s:

  • LDL-C ≥ 200 mg/dL (5.17 mmolL)
  • Typically LDL-P ≥ 2,000 nmol/L

Yet they commonly have very low cardiovascular risk markers across the board:

  • High HDL cholesterol
  • Low Triglycerides
  • Low Insulin levels
  • Low waist-to-hip ratio
  • Low blood pressure
  • Low Inflammatory Markers
  • Low HOMA-IR

Moreover, most LMHRs who report having done their genetic testing have confirmed little to no connection with Familial Hypercholesterolemia. (For more on LMHRs, visit here)

Asking the Community to Help Us Advance Science

The Lean Mass Hyper-responder Measurement Project will help to match a portion of LMHRs with advanced testing they could otherwise get on their own through their doctor — but can be costly.

  • Such metrics may include wide spectrum blood panels and cardiovascular testing such as CT Angiogram, Carotid Intima Media Thickness (CIMT), and Coronary Artery Calcium (CAC) score.
  • For those who have little to no detectable atherosclerotic risk at baseline, we would seek to capture their data again in five years with the same tests for a comparison.
  • LMHRs who participate are not in any way asked to take any treatment action now or in the future. And any medical decisions made are between themselves and their doctor.
  • Note that participants will likely need to travel to the location where the initial baseline tests taken, and potentially again in five years. This ensures greater comparison between participants and negotiating a better price for the tests involved through bulk rates. The exact tests and host facilities are still being worked out and will depend on how much we raise.

Again, for emphasis — this wouldn’t be a study itself, it’s a project to help capture this data for LMHRs and provide the opportunity for them to share it for science. That said, it could set up future opportunities for retrospectives studies, and we are confident it would be of great interest to the general public, especially the low carb community.

Click here to support the project

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