Dropping My Cholesterol at Record Speeds – Part II

In Part I, we focused on the three day gap where I arranged a massive shift around the first public presentation of my data. There’s quite a bit more to the story, though, which we’ll dig into here…

Knowing I’d be presenting on October 9th made it immediately clear I needed to test on the Friday before (7th) and the Monday following (10th). This should reflect the shift in LDL-C and HDL-C, given they both follow that three day window immediately before a blood test.

But what about LDL-P, and for that matter, small LDL-P (smLDL-P)? Since these follow a three day window, but with a two day gap in between, I needed to be sure I captured all five days before Oct 7th and the five days following. So in short, I’d be on the “low calorie diet” on October 2nd, 3rd, 4th, 5th, 6th until the morning of the 7th (Sunday, Monday, Tuesday, Wednesday, Thursday). I’d then take the blood test and ramp up the food intake to a “high calorie diet” for the rest of the 7th, then the 8th, 9th, 10th, and 11th (Friday, Saturday, Sunday, Monday, Tuesday) up to the morning of the 12th.

Below, in each graph, I mark the blood test associated with these four tests over the ten days in red, which will always be at the right of the graph.

 

So let’s start by looking at our old friend, LDL-C.

3day_ldlc_positive

For those of you who regularly read my blog, this is a familiar graph. In this case the blue solid line represents the LDL cholesterol that resulted from the blood test. The dashed orange line represents the dietary fat I ate in the three days just before the blood test was taken.

At the far right end you’ll see a solid red line replacing the blue. Those four data points took place October 5th, 7th, 10th, and 12th. You can also see the dashed orange lines showing my extreme low, followed by the extreme high in dietary fat.

Let’s invert the axis on the left side of the graph (the Three Day Dietary Fat) so that we can compare these trends visually.

3day_ldlc_negative

Sure enough — I “broke” my own correlation given how quickly I shifted from one extreme to the other. Given our correlation on the left side of the graph, you’d expect my extreme low on dietary fat of 63g would theoretically push my LDL-C up to around 348.

However, I did manage to bring the LDL-C down to 155 which did match the expected position relative to the diet. Yet this completed on the 12th, not the 10th. Again, this was probably due to the degree of shift, but we’d need to do more testing to know.

How about LDL-P?

3day_ldlp_positive

Same thing. Purple is pre-conference, red on the right is during. Let’s invert again…

3day_ldlp_negative

Like LDL-C above, the massive shifts seem to surpass my metabolism’s attempt to catch up.

Now let’s look at HDL-C.

3day_hdlc

As you can see from the green line on the right side, we have a long established coupling in the positive between dietary fat and HDL-C. But this too is broken by the experiment as shown on the right.

Other Interesting Markers

I had a number of things change, but there are two specific ones I wanted to call attention to in this post.

Glucose vs Insulin

Now I don’t want to blow your mind too much, so prepare yourself… here comes fasting glucose vs insulin…

glucose_insulin

glucose_insulin_table

Whoa — really?!? As my fasting glucose went up, so too did my insulin? No way!

Okay, kidding aside, it’s difficult to tease out the impact of each macronutrient on my fasting glucose to see what the primary drivers of the increased insulin were. Since all of my macros went up, this could’ve been from higher carbs or protein — or possibly just overall caloric load.

What is interesting is that even after 5 days at 5000 calories, my peak insulin was still at the bottom third of the reference range, at 8.3. Incredible!

Calories vs Weight

Easily one of the most hotly debated subjects in low carb communities. I’m firmly in the camp that says Hormone Balance Matters Most, But Calories Are Still Energy. Is that a side? If so, should we start a website for hbmmbcase.com?

I’m 6’3″ (190.5 cm) and thus feel a bit underweight at my running average of around 176 lbs (79.8 kg). My typical average calories right now are around 3,100. So what happens when I drop it to 750-ish for five days, then ramp up to 5,000+ for five days?

calories_weight

calories_weight_tableI’m missing 10/2 and 10/3 due to not being around a scale (was on a camping trip), but presumably I had a similar trend as 10/4-7 given I hover around 176 lbs as mentioned above.

Clearly the massive drop, then rise, in calories had a very acute effect on my weight. Over this span of time, I was careful to keep my water intake roughly the same for both low and high periods, although my non-water beverages were a little higher on the last half.

Final Thoughts

I’m now at the point of being so sure about the dynamism of the lipid system that this is becoming almost comical. Getting to this point took a lot of money, time, and blood (literally). I was fortunate to have this experiment wrapped into my first presentation. Doing the demonstration was a no-brainer. Why only show the data if you can display its predictive power as well?

There’s actually a lot more data I couldn’t get to due to the balancing act I’m now performing between this, contract work, interviews, and helping others to gather N=1 data as well (upcoming).

Personally, I wish I could work on this research 100% of the time, but I do have to pay the bills…

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Richard B Arnesen
Richard B Arnesen
6 years ago

Dave,

Nice work! I suggest quitting your day job and staring a “go fund me” or “kickstarter” campaign! I will make the first contribution. 🙂

In all seriousness we apoe4/hyperresponders need answers – is high LDL -P and small LDL-p harmful in the context of LCHF/Keto with low inflammation and low FBG and low insulin??

Phoebe
Phoebe
6 years ago
Reply to  Dave

Dave, A quick suggestion is definitely start fasting… That has given me the best response of anything..

My first fast was four days and then followed on with 18/6. 2 meals a day 3 days a week, and 22/2 One meal a day for 4 days.. randomly depending on schedules and social activities.

Am now on day 6 of a 7 day fast with very low calories 2 days before and after. this has brought my fasting blood glucose down from 105 to 85 in twelve weeks. And dropped 45 pounds..,

However LPa has stayed stubbornly high as has ldl-P ….

I have read that APOE4 perform much better with regular fasts and as a group the handle that very well.. Which certainly aligns with my experience..

Andy Eccles
Andy Eccles
6 years ago

Dave,

Your presentation in LV was superb. I agree with Richard, the research is so interesting that there might be no harm in you opening a campaign to test out a market for community-funded research. I can think of a number of different approaches to monetise the research, testing, results, software, education materials….

Cheers
Andy

Rachael
Rachael
6 years ago

Hi Dave

I’ve just come across your blog and am finding it very exciting. I’m a 36 year old woman who has been on a ‘zero’ carb diet for 18 months, by which I mean I eat meat, eggs, a little cheese and lots of double cream. I drink coffee and (very occasionally) a little alcohol. I’ve seen extraordinary changes in body composition, mood, cognitive function, libido and energy levels – I seem to have gained muscle mass and dropped fat with very little effort. I’ve also completely lost any cravings for carbs. Previously I was overweight, pre-diabetic, depressed and had a long history of disordered eating. It’s been truly transformative. Obviously, though, everyone thinks I’m mad, including my GP. I had my cholesterol measured about six months ago. Unfortunately I’ve lost the results but they were high enough for my doctor to write requesting I made an urgent appointment. She tried to put me on a low fat diet and seemed not to be able to see the woman in front of her, only the numbers.

Some questions if I may:
– Am I welcome to contribute here as a ‘zero’ carber?
– Do you write about what you eat in detail anywhere?
– Any thoughts on where to test cholesterol privately in the U.K.?

Rachael
Rachael
6 years ago

Fantastic, I look forward to reading it. I hear what you’re saying about the evidence base regarding the protective effects of cholesterol in women, although I’d note that this has in no way seeped through into public consciousness. Add in the fact that I’ve made the choice no to eat fruit or vegetables of any sort at present and the pressure from family and health professionals intensifies. My GP is waiting for me to develop scurvy as well as heart disease, and no one believes that constipation isn’t an issue with no fibre.

I’ve looked through your food recording protocol and will certainly follow it if/when I have my levels tested again. How far in advance of a test should I start logging?

Thank you for your response.

Kevin
Kevin
6 years ago

Hi Dave,

I’d like to see if I can replicate your results on myself. In Jan. 2017, I intend to run pretty much the same set up as you did with two exceptions/questions.
1. I’m 5’11” tall, weigh 240 lbs and am around 31% BF. What would you recommend for low and high calorie targets?
2. I intend to plan out the amount of saturated fat, polyunsaturated and monounsaturated fat consumed. What were your protein, fat, carb ratios during your testing?

Thanks for doing all of this. I believe I also am a hyper-responder as I’ve clocked in as low as 1100 LDL-P and as high as 2,300 LDL-P. I’ve also gone from below 200 total to above 300 total before.

Thanks!

Kevin
Kevin
6 years ago
Reply to  Dave

Hi Dave,

Just got around to replying. I completed the tests and am just trying to figure out how best to put them together. Any suggestions on the best way to share?

Thanks!
Kevin

Ferro Silvio
Ferro Silvio
6 years ago

Hello,

I’m a MD in a Family practice in Belgium and for a long time reading into low-carb and on-off the diet. Still addicted to carbs…

But fascinated by the whole cholesterol story. I’m still instructing my patients to take statins and stay on a diet. BUT, I want to change that. I put more time in talking to my patients about low-carb and effect on CV risk. But I need “proof” to suddenly change my “old” story to a complete new one.

So I want to be your next N=1.

I want to do this to convince my colleague and my trainee that the whole cholesterol story is WRONG. I’m planning to do the experiment without telling them what I’m doing nor telling them what we are looking for in the blood samples. Just revealing everything when it’s done.

Can you help me with that? I would be happy to share all data with you. Please contact me.

Ferro Silvio
Ferro Silvio
6 years ago

I want to do the exact same experiment. But I want to be sure I do it right. I’m 68Kg 1m67. So not lean (yet). As an MD I have free blood-testing. So I can test anything the lab I work with can test. Even every day, because my trainee can draw the blood. So which test would be important. I’ll copy everything you are showing in your posts (if possible). But I need to know how to get the diet right in both fases of the test. Just low carb en low calorie en switch to low carb en a lot of calories (mostly fat). Is it that simple? Or are there things to watch out for?

Ferro Silvio
Ferro Silvio
6 years ago
Reply to  Dave

Perfect. I’ll wait until the guide is ready. And thank you for doing all the hard work.

Seth
Seth
6 years ago

Great info! Question: As someone that has some very good markers (HDL 90, Trigs 70) but very bad LDL-P #’s, I’m curious: did your LDL-P/particle size #’s return to their pre-experiment levels? i.e. how long does the drastic improvement in particle size and count last? It is acting in some way as a “Reset button” or do the numbers quickly return to their pre-5000 calorie LCHF diet levels?

Thanks for all you’re doing,
Seth

Ian A
Ian A
6 years ago

HI Dave
Thanks so much. Did you investigate triglycerides?
The longer I follow LCHF, the higher my LDL and TG.
Both are now off the charts high. My GP (LCHF advocate) is completely bamboozled.
Cheers
Ian A

Phoebe
Phoebe
6 years ago
Reply to  Ian A

Seth, I have had the same problem.. With disastrous health results… Dr William Davis says the first thing you need is a genetic test to establish which Gene type you are..Dr Steven Gundrey agrees.. If you are an APOE3/4 or 4/4 this approach daren’t work.

From both these Doctors comments found after much searching of the internet, snippets here and there.. I have embarked on a new strategy…. I will post a link to GUNDRYs utube with most concise information on APOE4 dietary needs for healthy Cholesterol Metabolism.

NO LECTIN FOODS, that’s an extensive list easy to google.. No beans Legumes Dairy and maybe nuts…

NO SAT and very little meat, chicken.

VEGIES, As much low carb Lectin free vegetable as you can eat… That means GREENS.

SEAFOOD, Oysters, clams, mussels, crab Pilchards Sardines ….Limited Fish Shrimp Squid Octopus.

OILS…Avocado, Oilive Oil, MACADAMIA OIL as much as you can drink….And then force some more down.. Over 70% of calories…

SUPPLEMENTS Fish Oil, Magnesium, Berberine, Vitamin C ,

DAIRY is banned , if you need to eat dairy make sure it’s Goats or Sheep fermented like cheese or Yoghurt.

Below is the link to APOE 4 interview with Dr GUNDRY

https://itunes.apple.com/au/podcast/ask-the-low-carb-experts/id495159994?mt=2&i=1000129575984

Michael
Michael
6 years ago

Dave,

Fascinating work. I am a bit confused however, what is your scientific reasoning for using the “2 day gap 3 day Look backr” as an accurate measure for LDL-P? Why not just last 5 days? Why is a diet, 2 days before the test not move the needle in LDL-P?

Michael
Michael
6 years ago
Reply to  Dave

Thanks Dave,

I have taken around a dozen NMR tests over the last 3 years. Here is how my Pearson correlation looks like for LDL-P using your 2 day gap 3 day look back. I am APOE4/3.

% Carbs: .01
% Fat : -.37
% Protein: .55

Sat Fat: .13
Pol Fat: -.11
Mono Fat: -.53

Total Carbs: .04
Total Fat: -.27
Total Protein: .47
Cholesterol: .53

It looks like Mono is good, Animal protein (cholesterol) bad. Pretty much on point of what Dr. Gundry has suggested would happen. Have you ever tried using the sdLDL tests?

Feel free to reach out if you have any questions.

Michael
Michael
6 years ago
Reply to  Dave

Correct.
% fat has a negative correlation to LDL-P. However if you break down the fat more granular, it’s the Mono Fat that really moves the needle.
The % for Fat, Carbs and Protein is simply a percentage taken over the 3 days. (All add up to 100% per day). It’s probably not the most accurate number to look at. Overall Protein, Cholesterol and Mono Fat seem to influence my LDL-P the most.

Jeff
Jeff
6 years ago

I absolutely love your blog, thank you! I realize your not a doctor but I wonder what you recommend for my situation. I have been treated for high TC since my 20s and I am now in by early 50s. I have been on at least four different medications and varying dosages. However, I am still having issues with the LDL-P values which are in the 2,000s. Way too high. I eat mostly vegan and low carb, nothing is really working to bring down the ldl-p value. The best I achieved was an ldl-p of 1,100 when I ate totally vegan and no added fat for 6 plus weeks. I often thought about increasing the good fats in my diet since I don;t get much but not sure I know how. Thanks!

Diane
Diane
6 years ago

Hi Dave – thank you so much for all you write, and for the experimenting you are doing. It’s all very exciting, and yet so worrying that tthat we seem to have been so wrong for so long too.

I’m a 60 year old female, weighing 52kg.I live in New Zealand. I have never been particularly over weight, although I have lost 4kg over two years, and can now easily maintain my current weight. I have chosen the LCHF life style because of the general health benefits I have read about, and also to stop that slow gradual weight increase that women can suffer at my age. I have experimented a lot with different amounts of various foods, from within the LCHF groups, over the last 4 years. I feel fit, well and healthy eating this way. I have retained muscle mass. It’s become just what I do – sugar and carbs are pretty much a thing of the past.

I have never had my cholesterol taken before so you can imagine the shock when it was 10.6 (August 2017)

I have thought that that reading may have been from my lack of exercise (which I have neglected for the last 12 months – I’m usually very active at the gym and with hiking). I have also had a very stressful job for the last 9 months (I have resigned that as of today 14/12/17). I had also had a bowel infection just prior to the 10.6 cholesterol result.

However, today 14/12/17, my next blood test came back at 9.9. While I have been fairly strict with my diet, I have not been completely carb free. I have worked out that I do not do so well on dairy products. I seem to put weight on with them.

My mother had always had cholesterol of about 8. She eats LCHF too (she’s 88 and has lost 5kg) but her doctor has scared her into taking statins.

My doctor is now really pushing for me to take statins. I will not do this.

I am supposed to have another cholesterol test on March 14. After reading your information about getting cholesterol down before testing, I’m going to follow your food protocol recording, and try the 3 day high calorie eating leading up to the test. Do you think that this is the best one to follow at this stage? Is there a food plan anywhere that can be followed for the 3 days, or do I just eat until the requirements are met?? I will be most happy to share my results with your community.

Below are the results and the website I used to calculate the numbers for the test taken 14 Dec 2016
Total Cholesterol 9.9 High risk
HDL 2.72 Optimal
LDL 6.49 Very high risk
Triglyceride 1.5 Normal
Total Cholesterol/HDL 3.64 Good
Triglyceride/HDL 1.262 Ideal

Thank you again for the time you take to write and share all you are discovering.

Kind regards
Diane

Diane
Diane
6 years ago
Reply to  Dave

Hi Dave
I really can’t thank you enough for this prompt reply to my message. I can only imagine how incredibly busy you are, and so I am doubly apprecaitive for your reply.

As you put it, I feel less concerned with what I’m doing, and more so after following some of these links you have shown me. I’m also interested in the ‘big break out’ of a carb binge. This could well describe me, on occasion, and I have to say, I do not feel well afterwards (and that’s not a downer from breaking out) – it’s hard to describe the physical feeling, but it doesn’t feel good at all.

I’ll certainly let you know how I get on with the 3 days before the next blood test – it’ll be very interesting.

It sounds to have been another wonderfull conference that you attended. I look forward to hearing more about it as the presentations become available. I also look forward to your next findings.

Thank you again
Diane

Phoebe
Phoebe
6 years ago

HI Dave , Great site and fantastic post.. What I find fascinating is that I had heard APOE4′ loved Marathon Sports, were absolutely meticulous about keeping numbers and statistics….. and they love CHEESE… are you a cheese lover.

I was involved in ocean paddling marathons which I stopped after my first heart attack, a few seasons after actually, that’s the extreme personality trait that also comes with being an APOE4.

After being on Low Carb, and high fat the Cardiac has worsened considerably..

So I am very much looking forward to reading your analysis of APOE4.. I have posted further down where I am heading next.. My VLDL is very low… the only high numbers left are LDL-P and LPa…

I will let you know if the new diet direction fixes either or both of those. High Omega 3 is built into the diet..

phoebe

Michele
Michele
3 years ago
Reply to  Dave

Hi Dave, Found you as I was looking into trying to lower my cholesterol. I am intermittent fasting now for almost 2 years. Have lost around 65# and will continue my current IF schedule to lose another 40ish #s. My labs are all greatly improved and normalized except my lipid panel.
I eat a healthy diet that is plant slant.
What do you suggest along with the IF to get my numbers back into the normal range. See the pic.

Siobhan Huggins
Admin
Siobhan Huggins(@siobhanh)
3 years ago
Reply to  Michele

Hi – were you water only fasted for 12-14 hours prior to the blood draw? Fasting longer than this, or not long enough, can sometimes impact the results. If you’re also following a low carb diet on top of IF, you’d be something called a hyper-responder. The answers to these two questions would impact how to address it if you are uncomfortable with it (although as always we can’t give medical advice, I can comment on what has worked for other people who have commented).

You may want to check out the cholesterolcode facebook group, as there’s plenty of discussion around tactics to take, as well as the latest science surrounding the phenomenon.

Chris H
Chris H
4 years ago

I can’t read Russian, my wife can. I posted the wrong portion of the blood test, here’s the first cholesterol test portion, attached. Can the moderator delete the Russian language photo from my previous post, or add this one in its place?

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