Cholesterol Code

Note from Dave: Sean is a prolific member of the LMHR Facebook Group and I was keen to share this remarkable experiment with you all as a guest post here. Enjoy!

My name is Sean Brennan and I have been on a ketogenic diet for 14 months now, beginning on Thanksgiving of 2017.  It has been awesome – 35 pounds melted away in the first 6 months and I have a more stable mood, better digestion, resolved eczema, and have more control over my appetite. 

Unfortunately, I did not do a baseline blood test prior to the diet, however, I found a blood test from 2011, while I was eating a High Carb Low Fat/Standard American Diet. I was probably eating a vegan diet at that time: total cholesterol was at 191 mg/dL and HDL at 38 mg/dL.

Test #2 – Unexpected High Trigs  

I had read that if you are in the middle of losing weight you could skew your blood test, so I waited until my weight stabilized to get testing done. Back when I was eating a vegan diet several years ago, I became aware that saturated fat increased my cholesterol. I had tested around 240 mg/dL (the horror!) and I promptly decreased my coconut oil (high saturated fat) intake and saw my number drop to 165 mg/dL.  So, when my initial test came back after a keto way of eating with a total cholesterol of 313 mg/dL, I was not surprised.  However, I was very surprised at my triglyceride reading of 131 mg/dL. 

Typically, on a ketogenic diet it is expected that triglycerides drop like a stone due to the limited carbohydrate intake.  In fact, many people will have a triglyceride to HDL ratio approaching 1:1.  So, I was a little concerned that my ratio was 131:47 or 2.79:1.

Looking For Answers

Thankfully, I was aware of cholesterolcode.com and Dave and Siobhan’s work.  I promptly became a member of their Facebook group for Lean Mass Hyper-responders, and asked for advice regarding my numbers.  Siobhan directed me to a blog post for people who likewise had high triglycerides while on a Low Carb High Fat diet.

Of the suggestions listed, the only one that stood out to me as a possibility was a coffee sensitivity. Prior to test #3, I had 1-3 cups of coffee per day for several months.  So, I decided to cut it out and retest.

Test #3, #4, & #5 – No Coffee  

Somewhat painfully, I was able to cut out coffee for four days prior to test #3.  My triglyceride test result was 76 mg/dL, a dramatic decline from 131 mg/dL!  Better yet, my trig:HDL ratio was 76:51 or 1.49:1.  I was a happy camper!  I maintained my coffee abstinence and achieved similar, if not slightly improving triglyceride results, for test #4 & #5 of 71 & 70, respectively.

Test #6 & #7, Back on Coffee

To confirm the effect of coffee on my triglycerides, I drank a cup of black, French press prepared coffee on two consecutive days and re-tested.  My trigs effectively doubled back up to 140 mg/dL!  For test #7, I drank filtered coffee for a week and saw similar results of 147 mg/dL.

Test #8 & #9 – Decaf Result

I abstained for another week and predictably my triglycerides fell back to 63 mg/dL.  For one final test, I drank decaf for a week and interestingly saw my triglycerides climb back up to 125 mg/dL.

To Sum It All Up…

So, it is clear to me that unfiltered, filtered, and decaf coffee dramatically raise my triglycerides by a factor of 2.  This is quite the effect, although I really am not sure why this happens or if it is harmful (though it definitely makes me uncomfortable). 

Dave suggested that there is some evidence to support the hypothesis that coffee increases lipolysis, that is, it possibly super charges fat trafficking. Another interesting tidbit of information is that I have a gene (CYP1A2 – rs762551(A;C)) that indicates slow caffeine metabolism – although this may or may not be related.

Where to Go From Here?

What do I plan to do with this information?  Well, it has been theorized that while eating a low carbohydrate diet, high total and LDL cholesterol may not be harmful especially if one’s trig to HDL ratio is low.  I am comfortable living by this theory, and therefore, I think it is in my best interest to keep triglycerides low by greatly reducing coffee intake (and maintaining my low carb lifestyle).  I don’t think there will be a net loss to my well-being, since coffee tends to lower my energy after the initial bump, boost my stress hormones, negatively affect my digestion, and sometimes interferes with my sleep quality.  So, as the reasons stack up against coffee for me, I plan to only have it as an occasional treat or productivity boost.