- If you know little to nothing about cholesterol->
- If you’re wanting to learn more about why cholesterol could be higher, particularly on a low carb diet->
- You can watch Dave’s recent presentation for Stanford University on the Lipid Energy Model.
- You can also check out the Lipid Energy Model poster here
- You can also check out or Frequently Asked Questions (FAQ) here
- If you’re looking to better understand the risk associated with high cholesterol on a low carb diet->
- Watch Dave’s Deep Dive on Cholesterol and Risk presentation
- If you’d like to understand possible benefits of cholesterol and the immune system, you can read Siobhan’s overview article on the topic here or watch her presentation here
- If you’d like to learn more about lipoprotein(a), you can watch Siobhan’s presentation on it here
- Lastly — you can always just ask us anything our Questions Page. (Just be aware our site does not constitute medical advice and we always recommend consulting with your doctor.)
In the podcast dropped today by the prolific Joe Rogan, our work with the Lipid Energy Model, consideration of lipid risk in a metabolic context, and of course, the LMHR Study all got some decent airplay.
Mega thanks to Paul Saladino who brought all these concepts up about an hour and 49 minutes in. (The video link above is queued to that time)
Had a great conversation with Paul. Not surprisingly, lots of topics came up with regard to the risk, my current oxLDL vs oxPL experiment, my recent research regarding FH receptors, etc.
I did mention tendon xanthomas and why it is that I’m looking very closely for it with hyper-responders in general, and LMHRs especially (as you’ll note from my many posts requesting this information)
And of course, I mention the LMHR study at several points, including my pointing to how I feel those skeptical of LMHR having high LDL should be the most proactive in helping us make this happen.
As some of you may know, I got the opportunity to present on the topic of Lipoprotein(a) for Low Carb Houston 2019. Just this past week the video was released, and is now available to view!
This can basically be thought of as an improved, fleshed out update of my Big Deal About Lipoprotein(a) post, so if you’re curious about my thoughts on lipoprotein(a) I’d recommend giving it a watch!
I also provide some data from some of my own experiments, including my pork versus beef experiment, and experiments showing lipoprotein(a) following LDL-C e.g. during the protocol.
As always, discussion is welcome especially as this is a topic that’s far from closed – there’s still plenty to learn and I look forward to doing so as more work is done to understand – the still quite mysterious – lipoprotein(a).
Lately I’ve been experiencing an urge to fast for longer than the 36 hours per week I’ve been doing over the last month or so, thus I decided to fast for as long as I can (safely and comfortably). Of course, I couldn’t possibly do this without gathering at least a little data, so it will be a bit of a loose experiment as it stands.
The experiment will have multiple stages, that – except for the beginning and end phase – are not at a set length. They are as follows:
- Water fasting
- Fat fasting
During the baseline, from September 1st to September 7th I’ll be consuming an ad libitum diet of 73/27 burgers (pre-formed), butter, and commercial pemmican. Beverages will include tea, herbal tea, and flavored sparkling water (no sweeteners). Supplements will include my normal fare of a methylated B vitamin complex, and vitamin D. Electrolytes will be consumed as needed.
1 mile of walking will be done every morning as is my usual.
During water fasting, no calorie containing beverages or food will be consumed. Supplements, electrolytes, and beverages will be consumed as outlined in the baseline, and exercise will also continue as normal.
This phase will continue as long as I can comfortably maintain it, I suspect around one or two weeks.
If I reach a point where water fasting becomes uncomfortable I’ll be adding fat (via homemade broth made from marrow bones, and fat [e.g. cocoa butter and/or butter] added to hot beverages, according to hunger. I’ll continue this phase as long as I can comfortably do so.
Exercise, supplements, and beverages will continue as previously outlined.
After I can no longer comfortably fast, or fat fast, I’ll return to eating by slowly breaking my fast and then returning to the baseline diet. After a week of re-feeding I’ll conclude the experiment. Exercise, supplements, and beverages will all follow the baseline, as well.
I’ll be recording the following over all phases of the experiment:
- Glucose (daily, morning)
- Ketones/BHB (daily, morning)
- Acetone (daily, morning)
- Weight (daily, morning)
- Measurements (waist, hip, thigh, arm; after baseline, weekly during fasting phases, after one week re-feed)
- Blood testing (after baseline, weekly during fasting phases, after one week re-feed)
- Food/Beverages/Supplements consumed (picture logging; constant throughout all phases).
- Fasting time (via free fasting app, delineated between water and fat fasting)
I’ll be getting 12 tests total during each blood draw. This is pared down from what I’d usually get, but covers many metabolic markers.
- Comprehensive Metabolic Panel (14)
- Insulin and C-Peptide, Serum
- Ferritin, Serum
- Fatty Acids, Free (Nonester)
- Complete Blood Count (CBC) With Differential
- Glucagon, Plasma
- Uric Acid, Serum
- NMR LipoProfile
- Total Cholesterol
- Small LDL
- Oxidized Low-density Lipoprotein (OxLDL)
- Leptin, Serum
Over the course of the fasting portions I expect the bolded items to decrease and the italicized items to increase. Non-marked items are unknown, or contain multiple tests.
As a side note, I don’t expect GlycA to significantly change over the course of the fast. I expect triglycerides to initially increase and then fall back to normal over the course of the fast. I expect ketones to increase and glucose to decrease over the course of the fasting periods, and weight and measurements will decline. By one week post re-feed I expect blood markers to return closer to baseline levels, with some (although not total) regain in weight and inches.
I’ll be checking in frequently with Dave on how I feel throughout the fast, and in contact with my primary care doctor. If I ever feel unwell, especially any nausea or abdominal cramping, I’ll immediately abandon the experiment and eat. If I ever feel “off” or feel like I should call off the experiment due to any health/safety concerns I will do so without hesitation.
Overall I am very curious to see how things will change over a longer term fast. I’ve previously done a 7 day water fast, outlined here, but this will (hopefully!) extend even beyond that. Adaptions to longer term fasting is definitely something I’m interested in, especially given some studies I’ve been reading recently, and as I’m currently “overweight” I feel I can comfortably take it on. I’m also curious to see what changes may occur comparing water fasting to fat fasting especially in regards to weight, and blood markers.
Given the longer fasting time I’ll definitely be overly cautious about safety and being sure I call off the experiment if I feel it’s necessary for my own health. Other than that, I feel pretty confident overall, especially given I have access to a doctor who has other patients who fast regularly, and am looking forward to sharing back the data.
Starting tomorrow, August 30th, I’ll be executing a replication of the OxLDL experiment I performed last year.
As with the first, I’ll have three phases:
- Eat baseline diet for five days (maintenance calories)
- Eat 1/2 baseline diet for five days (hypocaloric)
- Eat high calorie keto for five days (hypercaloric)
- In the original experiment I sought to have 2x baseline diet but found it untenable and thus made an adjustment. This experiment will attempt to replicate that adjustment as well to keep all food the same.
- My current sleep schedule has me waking up a bit earlier in the morning than last year. Thus I’ll be adjusting both the eating and blood draw windows. (See below)
- As with the original, I’ll be eating at three time periods a day, each five hours apart. One difference is that my scheduled times will be about 1 hour earlier at 9am, 2pm, and 7pm.
- Given the earlier eating times, I’ll be likewise getting my blood drawn at approximately one hour earlier as well.
Blood tests for mornings of September 4th, 9th, and 14th
One exciting change is that I’ll be getting much, much more expansive blood tests than last time:
- Apolipoprotein A-1
- Apolipoprotein B
- C-Reactive Protein
- Complete Blood Count (CBC)
- Comprehensive Metabolic Panel (CMP)
- Fatty Acids, Free (NEFA)
- Ferritin, Serum
- Glucagon, Plasma
- Hemoglobin A1c
- Insulin and C-Peptide
- Lipid Panel
- Lp-PLA2 Activity
- Nuclear Magnetic Resonance (NMR)
- Oxidized Low-density Lipoprotein (OxLDL)
- Testosterone, Serum
- Thyroid Panel
- Uric Acid, Serum
- Vitamin B12 and Folate
- Vitamin D, 25-Hydroxy
- Cholesterol Balance
- Fatty Acid Balance
- HDL Map
- Leptin (Redundant, but of high interest)
- Oxidized Phospholipids on apoB (OxPL)
As with the first experiment, I predict my OxLDL levels will track with LDL particle count (LDL-P).
However — of much greater importance are the results of the Oxidized Phospholipid test (OxPL). If the assay is truly quantitative to this metric, it stands to reason OxPL will not quantitatively track with OxLDL, even if there were a correlation at a smaller magnitude. On the other hand, if it did track in magnitude, this would open up a lot more questions (that I won’t cover here), particularly if OxPL rises substantially in the hypocaloric phase and drops substantially in the hypercaloric phase.