For more details on this graphic and the story behind it, see the post following.
Oct 31
Infographic of Prediction Experiment
Oct 31
For more details on this graphic and the story behind it, see the post following.
Hi David,
Remarkable, but in many ways not surprising. We need lots more biohacking experiments like yours — millions, actually! My start-up, Healthcoin, is seeking to document them on a blockchain. The idea is we can use that “certified proof” of prevention to channel recognition and rewards to those that are proving prevention right. We want to create a vast, “Living Chain” of proof, one that scales across the globe and over lifetimes, and can be accessed by medical researchers.
If interested, I’d like to include you in an early pilot of the technology. Please email me for more details.
Thanks,
Diego
I applaud your endeavor! Obviously I’m a big fan of advancing our data as much in the aggregate as possible.
At the moment, I’m a bit hammered between business and the current experiment I’m on. But if things loosen up more in the coming months, I’ll definitely reach out. 🙂
Reminds me of Dr. Atkins – when weight loss stalled, he’d advise a “fat fast.” Jackie Eberstein has commented on it.
Very true. You might be interested in what happened with my weight over this period, which will be outlined in coming Part II.
Hi Dave,
I just found your site. I am a hyper responder. I have been LCHF for 6 years. I hate to go to the doctor who wants to put me on a statin, which I will not do. But why does this happen? Can you point me to the link where I am sure you explained it. Also loved loved loved the illustrated Simple Guide to Cholesterol. Is part III up yet?
As to why some of us are and some aren’t hyper-responders, I don’t yet know. In my case I have an especially interesting situation where both my dad and sister are on the diet but I’m the only one of us who saw a dramatic increase in my lipids (they both saw a very marginal increase). This opens to the door to it being behavioral or circumstantial. But thus far I don’t have a lot more than that. There appears to be a slightly higher proportion with ApoE4 carriers and a slightly higher proportion with lean and/or athletic over heavier/sedentary — but each of these are still pretty loose.
Dave, I am 48 and have been on a ketogenic diet for about 5 years. I recently had a coronary CT scan that my doctor wanted me to do because of high cholesterol and because of my diet. My calcium score was in the 70th worst percentile for for calcium deposits. I am wanting to consult with someone in the keto community who can help me understand why I have high levels of calcium deposits and what to do about it. I don’t want to go back to my pre-keto life but this test result has scared me. Thanks for any guidance or referral.
Hi Patrick-
Sorry to hear about your CAC score. One of the unfortunate difficulties of getting it now is the inability to determine how much of the score attributes to the lifestyle before the diet vs the lifestyle during. I’ve talked with many in the low carb community who (like you and I) have very high cholesterol but have maintained low or 0 CAC scores in spite of this. But this is anecdotal and to my knowledge there isn’t a sizable study with regard to CAC sampling with a LCHF diet.
I myself have a 0 CAC (from Feb 2016, 1 year into keto) and just got another this last Tuesday of 0 as well. But I considered the first one a baseline and will likewise want to see it again five to seven years later.
Ivor Cummins of thefatemperor.com has many great articles and presentations on the CAC test and risk assessments. One key point you’ll be interested in is that your standing score doesn’t matter as much as its *progression*.
I’ll reach out to you offline with some doctor recommendations.
Hi Dave,
I am a software developer. I have been following your site recently to get more understanding about cholestrol. My Cac score came out to be 120 at age 35. A shock for me. Can you tell me what i can do to not let it go high that is not let it progress? You said in the post above about some doctor’s recommendation? can u please provide some my email is zeeshanjhirani@gmail.com. You know of any particular doctors in texas who have more info to figure out how i got here that i can do fix my issues. I did notice that u are signed up on low carb cruise in May in Galveston. Will u be going in Sep cruise too?
Hi Zeeshan,
– I recommend Ivor for much of the CAC score research, he has a lot of great info on his blog along with many presentations. http://www.thefatemperor.com/blog/
– In Texas, I definitely recommend cardiologist Nadir Ali https://twitter.com/eatmostlyfatali
– I won’t be on the cruise in Sep, only May. But I’ll be at many other conferences this year in case you manage to make it to a different one.
I did put my listing up on ketogenicforms.com maybe u can give me some feedback
https://www.ketogenicforums.com/t/rosuvastatin-caused-my-hdl-to-drop-despite-being-on-keto-and-intermittent-fasting/34907
What is your LDLp? My personal experience has been that high LDLp drives the process that eventually shows up as CAC score > 0. Keep in mind that CAC shows up late in the game so even with a score of zero you could still be subject to a long term ongoing disease process that may not manifest for yet many years. Check out Davis’ book “Track Your Plaque.” It was written some years ago but still has a wealth of useful information. At the time the book was written, Davis counseled low saturated fat along with his no wheat and low carb recommendations. I wonder what his take on saturated fat is today. Good luck. Keep us posted on your situation.
Hello Dave
Your data is interesting though scary. Your calories per day (high days) are too high. Your cholesterol numbers freak me out.
You appear to be a “youngish” man meaning that because your coronary arteries start with a wide diameter they are closing. You can’t tell because of starting diameter. I’m betting the smaller coronary arteries are closing. Penis and peripheral arteries.
If you continue to be low carb obsessed My suggestion is to Check degree of closure of coronary arteries by non invasive means like PET and so on. You might be one of the lucky folk who are not fat sensitive. Robert Atkins said about 1/3 of people (I think) have to be careful about fat intake.
A major problem with large fat intake i.e. High calories from fat is that you are not getting the phytonutrients necessary. Towards the end of Atkins life he was asked what he would do differently if any. He said he’d eat a lot more greens. Fat has a very low nutrient density.
With respect you seem to be missing the forest for the trees.
Hi Dwight-
– Yes, I’m tracking both blood indicators for atherosclerosis and having many ultrasounds (CIMT) and scans. In fact I just got back from NY where I completed one of the most advanced ct heart scans in the world, the 640 slice.
– Not sure about the “necessary” phytonutrients you’re speaking of. I do eat broccoli, salads, spinach, etc — but the most nutrient dense food I eat is liver, which I’m actually trying to eat more of as well.
– Not all fats are the same nutrient profile, many are nutrient poor. But this is likewise true for greens as well.
Interesting comments, Dwight. 🙂
Dwight
Interesting comments do you have any links to Atkins comments where he said he’d eat a lot more greens?
Thanks
Eric
Hello Dave,
What you are doing is amazing! Thank you for your work! I am interested in your food log for the higher calorie days. I see your macros percentages but what foods did you intake to achieve such a higher saturated fat and protein? I would like to follow your experiment myself and I currently use Cronometer to track my foods. Thanks!
I ate a lot of cheese, eggs, heavy cream, AdaptMeal, burgers, Nathan’s skinless hotdogs, peanut butter and my low carb pizza to name a few.
Try to fashion something you yourself would like to eat but still meets those macros. And try to do it with real food as much as possible. (i.e. don’t get the vast majority from, say, bulletproof coffee)
Thanks! And, avoid coconut and MCT oil but what about Brain Octane Oil, coconut milk or cream? Would these effect lipid results?
And is Extra Virgin Olive Oil ok?
Monosaturate fats and fish oil are known to increase HDL and decrease LDL. Have you tried to increase these instate of satured fat on your diet and watch the results?
I did an 11-day experiment where I upped my MUFAs and reduced my SFAs early last year, but didn’t see a substantial change. That said, I’d like to do another that would be much more tightly controlled and this time I’d have the benefit of the CardioChek for more frequent testing as well.
just got my first panel back after starting Keto in July. went from 305 to 404, and all my other indicators, except tri’s and HDL are red flagged to the extreme. not quite sure where i am going to go next.
fat is up/carbs down, fiber down from about 150/day to 20-25/day, sat fat up but not markedly.
now it’s all a process of elimination but the testing cycle is a pain, I don’t have a lab I can pound blood into easily.
Gary,
It sounds like you are comparing a pre-keto lab to a 2-months into keto lab. What all did you have tested? Could you post the TC/HDL/TG/LDL for those two tests? (We should have an article on recommendations for what labs to get, soon)
My LDL-C and TC are also “flagged to the extreme”, but after doing a bunch of research and some additional testing, I’m not too worried. If TG dropped and HDL went up, those are very positive developments.
Craig
Has anyone who is not routinely low-carb tried your experiment? I’m on more of a high protein, low fat body-builder type diet and wonder if this would still work for me. I just want my doctor off my back. I refuse to take statins.
Sorry for the late reply, Diane — I just saw this…
No — I don’t know that I’ve seen a lot of high protein, low fat and low carbers. But I am interested in your numbers if you’d like to post them. Of the few I’ve seen, there seems to be a slightly higher predominance of lower HDL relative to a typical LCHFer.
I have not tried your hack but my last test my numbers were:
TRIG: 78
Cholesterol: 312
HDL: 77
NON HDL CHOL. (LDL + VDL): 235
LDLCALC: 219
VLDL Cholesterol CAL: 16
CHOLHDL: 4.1
The numbers look pretty standard for a hyper-responder on low carb — which is interesting given the protein-centric aspect of your diet.
Thanks for the contribution, we’ll have Craig add to the data set.
Hi Dave, I just found out about you and your blog online and I’m already amazed.
i did the keto diet for 3 months and at the end I have high cholesterol. I also have polycystic ovary syndrome and my doctor asked me to stop this high fat diet.
Im on a regular diet, still low carb, but I definitely loved the keto diet…I was feeling amazing every single day, with a lot energy any time of the day.
I started to google today about it since I really would like to go back to the keto diet at least during the week (5 days a week).
what do you thing about this approach?
maybe I should stay way from Saturated fat for a month and test my cholesterol again?
you comments will be very important for me. thank you so much for sharing all this information.
Thank you, cibele
[DAVE NOTE: I removed your email as this site is crawled by spambots quite a bit!]
Hi Cibele,
If you don’t mind, I’ve “referred” you to a fellow low carber who has PCOS and had tremendous success with keto. She’s fantastic and very insightful/researched on this ! 🙂
I am interested in that too as I am Leto 8 months but pcos and hipo..thank you
Now that I have her permission, the one I’m referring to is Carolina Carier. You can reach her through her FB page here: https://www.facebook.com/CarolinaRevoWellness
Question:
Please forgive me if the answer is here on the site somewhere–I’ve crawled around and can’t find it.
For the cholesterol drop protocol, during the high calorie part, does the ratio of saturated to unsaturated fat seem to make a difference? Or is that something no one has looked at?
thanks!
– Amy
Generally not looked at too intently yet. I did do an 11 day experiment last year replacing SFA with M/PUFAs and didn’t have a high significant change, but I’ve heard of several (particularly ApoE4s) see a change.
With regard to how this fits into the protocol, I’d say try to stick with whatever fats you’re mostly using anyway. If your diet is 10% saturated fats, try to keep it at 10% saturated fats at the higher quantities. If it’s 25%, shoot for 25% and so on.
The idea is to be sure the composition is roughly the same to control for the variables. If you change the composition, that becomes one more thing that might have made a change in either direction that can’t be accounted for very easily.
From Healthcoin “Our mission is to allow employers, insurers and governments across the globe to incentivize and manage their population’s lifestyle change.”
Don’t we need less management from the government, our employers and insurers?
I’d prefer that, sure. But I’m much more about health (and health plan) ownership than most.
Dave – Please help!!!
I just want to make sure I understand this. I’ve been on a ketogenic diet for 3 months – with no cheats. I recently got my lipid panel and my Dr. and Fiance were extremely worried about my LDL and total cholesterol levels… (Total: 360 and LDL: 303). My Dr. asked me to eat less red meat and come back again in a month. He said I didn’t need the NMR Lipid profile ( I requested).
If I consume high fat/cals for 3 days leading up to the next test, I should notice a drop in LDL? I just don’t want them on my case about my LCHF diet, as it has been the best thing I’ve ever been on.
Please let me know…
Thanks,
Daniel
Hi Daniel-
Firstly, it’s worth posting your triglycerides (TG) and HDL as they also tell a lot more about your lipid pattern and standing than just LDL alone.
The protocol write up is here: http://cholesterolcode.com/extreme-cholesterol-drop-experiment/ — but as always, use at your own risk, it isn’t medical advice. It has about an 85% success rate, but that likewise means it has a 15% failure rate, so bear that in mind, of course.
Dave thanks for your prompt response… My doctor kind of freaked out, asked me to cut back on red meat ( I was eating 80/20 grass-fed beef daily) and wants me to come back in a month. I posted my numbers below and will check out that link you posted to the write up.
Here were my results:
Total: 360
Triglyceride: 39
HDL: 49
LDL: 303
Ah — a TG of 39 is great! It strongly suggests you’re not only metabolizing your energy properly, but I’d speculate it means your LDL is *necessarily* high because you need that many LDL particles to traffic that energy. Check out my easy guide that explains this here: http://cholesterolcode.com/a-simple-guide-to-cholesterol-on-low-carb-part-i/
I know this all seems out of left field, but this mechanistic understanding is how I’ve gotten to where I’m at with this research. It’s why I press (over and over again) that this is an energy distribution system above all else, and cholesterol is along for the ride. If you’re athletic and high energy demands, you require more “boats” to ship around that energy when fasted, which ultimately remodel to LDLp — but again, this makes mechanistic sense.
Your HDL is a *little* low for a low carber (not getting enough saturated fat?). I’d want to keep an eye on it and see if it rises over time.
Dave,
Wow – thank you for sharing that guide with the comic. It is extremely helpful in helping me understand what all of this means. As far as the HDL, I will take a closer look at my saturated fat intake and see where else I can add some in to my macros. I am so happy I stumbled upon this blog and I am super appreciative of you taking time out of your day to help me understand all of this.
Thank you!
Daniel
Thanks for the kind words, Daniel — glad the blog has helped you out! 🙂
Hello, interesting here! I just got my results from my blood analysis and was worried. I’m on the ketogenic diet for two months together with IF and am feeling great. But my blood analysis shows a high total cholesterol: 280 mg/dL and high LDL 194 mg/dL. Triglycerides are low: 58 mg/dL and HDL is ok (74 mg/dL), non-HDL-cholesterol is 206 mg/dL (too high!). So my doctor was very worried…
I’m lean, train 3 to 4 times with weights and with a bike, body fat (i guess) is about 14 %.
There’s one more thing i don’t understand: I read that when you are on ketosis, your glucoselevel is between 50-80, mine is 102, so i’m not on ketosis? (I did not eat for the blood analysis).
Many thx and love this blog!
Kristof
Edit: bough myself a glucometer and started testing my glucose. My first reading was 74 mg/dl, with is much lower than the lab test (102).
1. You’re markers are very close to a LMHR. If you haven’t already read this, be sure to: http://cholesterolcode.com/are-you-a-lean-mass-hyper-responder/
2. Higher fasting glucose levels are VERY common (even for those on keto) given your body is looking to meet your higher energy demands. For example, my BFG is notably 5-7 higher in the mornings when I’m training/running than when I’m out of season. This is very common for low carb athletes and you can look up more on it by searching “adaptive glucose sparing.” Worry when/if glucose rises and *sticks* either post-meal or in the morning.
I came to your site from Megan in the IDM program. I was/am doing low carb, high fat (but was still having sugar and carbs infrequently) and at my six month mark had the following numbers:
Total Cholesterol 288
Triglycerides 156 (in the past they have been in the 200s)
HDL 63
LDL 194
CRP 0.64
I won’t take statins which my doctor has been pushing on me for several years and just did my calcium scan, awaiting results. I don’t understand the fat grams-461 and saturated fat grams-274 listed in your protocol. Are the saturated fats part of the total fat gram or separate. I really want to try this for my next blood draw. Also, not sure I am APOE 4, but think I am 4/4 because of intrepreting my results through Prometheus. Thanks.
Hi Maryann–
– First, don’t feel you need to reach my numbers with regard to the protocol. I’m 6’3 and at the time was doing distance running, thus much higher appetite potential than most. The protocol basically has you go to as high as you reasonably can and that’s very individualized (and probably lower than mine).
– I myself am a 3/4. I do find ApoE4s do have a slightly higher propensity toward higher LDL, but on LCHF, I think the single highest correllation is lower body fat (lean) and energy demands (athletic). This has been so far confirmed with Lean Mass Hyper-responders http://cholesterolcode.com/are-you-a-lean-mass-hyper-responder/
– I’m happy to hear your lipid numbers are improving with TG going to 156 from the 200s. I hope the trend continues. 🙂
So the high calorie partmis not really a part of the protocol? Just high fat?
It can really be either one. The main thing is to increase overall fat consumption, but we like when it can be done with real food. When this is the case, you’d proportionally bring up carbs and protein too, even if fat remains at 75-80% of the total.
Gosh, Dave, thank you for getting right back to me. My Cardiac CT scan is 200. I am really excited to have this baseline and would like to do the higher slice test that you did in six months, after I go to 0. Can you tell me the facility you used. My current test was a 64 slice multi-detector. Thank you for your work. Whew – it such a relief to know that “I’ve Got This” after my doctor is trying to scare the hell out of me. Best!
Hi Maryann–
Well, as always, I qualify that I’m not a doctor or a medical professional, don’t take this as medical advice, etc.
You said your “Cardiac CT scan is 200” — by that you mean your *calcium score* from the CT scan is 200? (Typically referred to a CAC). If so, you should know it will almost certainly progress to a higher number perpetually, not regress. In fact, the progression is the key thing to focus on. For instance, I’d rather have a CAC of 500 with 3% progression year over year than a CAC of 50 with a 50% progression.
The advanced 640 slice CT scan I got was at Northshore University Hospital in New York. It is arguably the most advanced, non-invasive heart scan you can get. In fact, I literally flew there just to get that test.
Dear Dave, Please help me!
I would like to understand this. I’ve been on a ketogenic diet for 1,5 years. (Usually under 20 grams carbs, but sometimes with wine more than 50 grams carb)
I recently got my lipid panel and my Dr. were extremely worried about my lipid panel and would like to give medicine.
I posted my numbers below:
Here were my results:
Total: 377
Triglyceride: 34
HDL: 115
LDL: 226
I have 2 children, I am 39 woman. I love exercises and I was always underweightI feel fantastic, but I am worried about my results. If I consume high fat/cals for 3 days leading up to the next test, I should notice a drop in Total?
I love my diet! Please let me know…
Thanks,
Anita
Hi Anita-
Your numbers are well into that of a Lean Mass Hyper-responder. This makes perfect sense given you are BOTH lean and athletic. See here: http://cholesterolcode.com/are-you-a-lean-mass-hyper-responder/
In short — your numbers make mechanistic sense given your body is trafficking more triglycerides for energy.
Dear Dave! Thank you very much for your prompt response! I worried really much for my results. My doctor asked me to cut back or eliminate on red meat, creams, chicken, duck skins, eggs. I am gluten sensivite and have fructose malabsorption, so my diet not too easy and I would not like to change or eliminate these foods. I read your article you linked, so I try to understand. I am 175 cm tall and 49-50 kg with very low body fat. I do sports 60-90 minutes every day, so it means I am a Lean Mass Hyper-Responder and my result are okay. Should I change or eliminate anything in my diet?
Thank you very much for you advice in advance!
Anita
I’m more a researcher than a dietitian, to be sure. There are many great sites that talk through good choices with a lchf/keto diet like DietDoctor.com. 🙂
Hi David I am concerned about my ldl-p 3074, ldl-c 216, hdl-c 42, TC 285, HDL-p 27.6, small ldlp 1961, oxldl 70, CRP 0.42. I had a CAC in 2016 of zero. I am just starting a protocol for my gut as I have an overgrowth going on which I am hoping will lower all these no plus I think I am insulin resistant . I have also not be doing excercising since Nov trying to get back on that bandwagon. I think I eat pretty well done meat, veg, fruit, low carb some fat try to stay away from grains.
I am the same with every one don’t want to go on meds as I am 54 year old woman and is post menopause ( I think that is causing issues also) I have done the DUTCH test and 23 and me . I also I seeing a functional practioner and treating a leaky gut which I think is fueling my horrific results.
Your thoughts?
Hi Nat–
You listed a lot of metrics but not Triglycerides (often shortened to Trig or TG), that’s important for overall interpretation. Get that and run your numbers through our reporting tool ( http://cholesterolcode.com/report/ ) and copy/paste it back here. From there I can give a better opinion.
Hi Dave,
Been low carb/keto for long time. Lipids NOV 2016:total 261,trig 82,HDL 62, LDL 182. Doctor wants me on statins. My question is if I do the high fat diet 3 days before my lab work next week, how will it effect my other blood tests?
Been following you for a long time.
Dan
Your Remnant Cholesterol is just at 17 mg/dL, putting you just shy of the lowest risk quintile. (See my copy/paste below)
The protocol currently has about an 85% success rate with the 3-day high-fat phase. Please read the write up carefully: http://cholesterolcode.com/extreme-cholesterol-drop-experiment/
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 261 mg/dL 6.75 mmol/L
LDL Cholesterol: 182 mg/dL 4.71 mmol/L
HDL Cholesterol: 62 mg/dL 1.6 mmol/L
Triglycerides: 82 mg/dL 0.93 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 17 mg/dL 0.44 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.27 >>> Medium-Low Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.236 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 183 | Iranian LDL-C: 168
Total/HDL Ratio: 4.21
TG/HDL Ratio in mg/dL: 1.32 | in mmol/L: 0.58
I’ll share the results. I’ll try to eat 50000 calories for 3 days too!
I’m hoping you have an unintended extra zero there!
I hope it is 5000 calories in total for the three days right? Or 5000 per day? I am about doing the experiment myself and I very very much doubt I reach 5000 in one day
It’s usually around 2x normal daily calorie intake, which would be 5000 calories per day for Dave. But for me, it’s more around 3200. 🙂
So, it depends on the person.
Great information. I did keto a while and all cholesterol shot up (37 yo and was suggested statins). I think it was because of hypothyroidism. I’ve recently tried zero carb/carnivore. If you feel adventurous I’d love to know what your numbers might be eating meat drinking water. I’ve been zc for about 2 weeks and have a yearly blood test coming up. Im planning on lots of fat for a few days and hope the numbers are better than with keto.
That’s the plan. I should be doing a carnivore experiment at some point before the end of the year.
Hi David,
I found your site via Dr. Eades’ blog and have read a lot of what’s on it. I don’t quite understand everything, but I think I get the main points.
I’m pre-D and have been LCHF for about 8 years. (I can’t figure out the macros to do keto.) I’m 72, no longer work out, but I am lean, underweight actually. And I’m 3/3 for APOE. I’d been doing IF (simply skipping breakfast) every day for 2 weeks or so before my lab test last month, so I expected my numbers to be terrific. They’ve been trending upward for the past few years as I’ve been eating more fat, but this time they really jumped. My doc does the NMR.
What I think equates to your HDL-C is missing. It seems to no longer be included in my labs so I’ve listed my HDL-P.
Can you make sense of my numbers? I’m afraid to try your experiment before my next lab test but I want to lower my ldl and TG and up my hdl. Seven years ago I had a similar report, a total of 476 cholesterol. 314 LDL calc, and 146 HDL. So I eliminated whipping cream, cream cheese, chicken skin, animal fat, butter, coconut oil … and cut back to no more than an egg a day. That reduced my cholesterol nearly 200 points. So I’m confused as to what I should be doing. My doc knows I won’t take statins. Thanks.
Cholesterol 356
LDL-P 1826
TG 66–before I started LCHF, TG was usually in the low 40s
Direct LDL 189
HDL-P (total) 47.9
Your story and numbers appear very close to a LMHR, of course. http://cholesterolcode.com/are-you-a-lean-mass-hyper-responder/
With TG in the low 40s and a prior score of HDL 146, I’d guess your HDL is probably pretty high (likely above 100 mg/dL).
Overall, I think your numbers look pretty good, IMO.
Thanks for such a quick response. I’m buoyed that you think my numbers look pretty good, but I’m now even more confused. I’ve reviewed all my labs since Feb 2011 to try and find patterns and I can’t really find any–although I do know that cholesterol readings can change from day to day depending on what’s been eaten. Still, I think I’ll stick with reducing my fats and see what happens at my lab draw in August.
Since perhaps 2007 I’d been recording everything I ate. Then I moved to a much smaller place last year and threw out all those notebooks–boy, was that dumb. So, because I always want to know the “why” behind the “what,” I started recording again this morning. And I’ve emailed my doc to include HDL in my next test.
Sure, Jacque — as always, we want to be a resource for everyone, whatever they want to choose. The bigger question for cholesterol numbers is whether you’re powered by fat. Much of the central research here suggests if you are, it can be a big part of the explanation for higher LDL cholesterol and particle count. The key is to still maintain higher HDL and lower TG as these are closely linked to positive outcome whether you’re powered by fat or not.
Hi Dave, I figured I would chime in on this as your test results are not surprising. The body will produce more cholesterol whenever you take in less calories from fat/cholesterol. As you know the body makes up to 75% each day. Eat less food and your body will make up for it. Eat more food and your body will make less of it. Your body will try it’s best to maintain homeostasis based on demands. Repair, rebuild, etc..
If your body overcompensates whenever you take in less calories that tells me you have a sluggish liver, organs, cells, etc.. I normally put my clients on liver flushes and clean out their colons and add in a few other supplements for 14 days. Then do your experiment again and you will see your body won’t overcompensate on the cholesterol when eating low calories. I’ve done this experiment about two decades ago and learned the liver is the culprit in most cases considering your bowels are moving after every meal.
“Hi Dave, I figured I would chime in on this as your test results are not surprising. The body will produce more cholesterol whenever you take in less calories from fat/cholesterol. As you know the body makes up to 75% each day. Eat less food and your body will make up for it. Eat more food and your body will make less of it. Your body will try it’s best to maintain homeostasis based on demands. Repair, rebuild, etc..”
Yup, that’s common knowledge stuff and there’s nothing interesting about the cholesterol drop. Can Dave comment on this?
Hi David, how much does affect physical activity to the protocol?, I will do the 3 days protocol in the next days but I dont know if i should train or I need just to rest? Also, how long do I have to be on LCHF or Keto to do the protocol?
In general it’s recommended not to do intensive exercise during the protocol – e.g. a leisurely stroll is fine, but running or weight lifting is probably not a great idea. I’ve seen a few cases where they didn’t see a drop during the protocol, and when they re-did it sans exercise they got the expected drop.
As for the second question, generally about 6 months. And as an added note, we generally recommend getting a baseline lab as well to compare the results of the protocol as well, to see what your normal is before trying it.
Thanks Siobhan, I did weightlifting yesterday and have only been with LCHF for 2 months after a period of one month of bad eating habits so I will wait to do it.
Where do I send the results once I have them?
You can email them to cholesterolcode@gmail.com or siobhan.e.huggins@gmail.com 🙂
Hi Dave,
I am interested in trying this protocol. Any chance you can share exactly what you ate for the three days prior to blood testing to equate 5000 plus calories? I am having a difficult time figuring that out and still keepin in the right macronutrient profile.
I had a lot of fatty meats like burger patties and ribeyes, fatty cheeses like cheddar and Brie, some “fat shakes” (unsweetened cocoa powder+stevia+heavy whipping cream), and my “Dave’s Head Pizza” were some of the staples. (Pizza recipe: https://twitter.com/siobhan_huggins/status/997605476249595905 )
But again, that’s just a sample of what *I* ate — you should be comfortable using many of your own favorites that are keto.
Found this blog and info. Looking for some feedback on where to go from here and worried about my cholestorol.
38 year old male Type 1 insulin dependent Diabetic since 8 years old. A1C from 7-8 my entire adult life. Started Dr Bernstein/Keto last November. Went from 235lbs to 185 lbs since then. Weight stalled a while back and have been doing IF 22/2 or 20/4 successfully. A1C is now steady at 5.3. However my cholestorol numbers are looking bad especially this NMR.
My trigs were great back in July but I started adding heavy cream with my coffee instead of hemp milk in the morning and I started doing consistent 5 days IF mon-fri and now my trigs are high on my NMR. I am going to ditch the heavy cream but mostly I eat green leafy and cruciferous veggies and meat along with cheeses and eggs, figh, lots of nuts and seeds, etc.
SEPT 2018 PRE KETO (SAD DIET)
CHOL 244, Calculated LDL 155, HDL 44, TRIGS 223, Calculated non-HDL 200
JULY 2018 9 MONTHS KETO
CHOL 256, Calculated LDL 193, HDL 42, TRIGS 105, Calculated non-HDL 214, Chol/HDL 6.1
SEPT 2018 NMR
LDL Particle Number 2,379
LDL Cholesterol 172
HDL Cholesterol 33
Triglycerides 227
Total Cholesterol 250
Total HDL Particles 21.5
Small LDL-P 1,055
Large VLDL-P 4.5
Large HDL-P 2.7
VLDL Size 50.1
LDL Size 21.1
HDL Size 8.6
LP/IR Score 74
Any suggestions or thoughts I am lost on what to do or adjust and my doctor is telling me I should go vegan!!! My goes is to stay LC for my diabetes and maintaining A1C!
Drop all nuts and seeds just for kicks and see what happens:
https://freetheanimal.com/2016/05/what-been-truth.html
Hello to Dave and the community here. I plan to try the 3-day high cal cholesterol drop protocol. I have a question though that I haven’t seen brought up in the comments. I generally fast around 16 hours a day give or take – if I consume all of the higher calories during a defined eating window, is that sufficient, or would you recommend that I put intermittent fasting on hold while I do this? Thanks!
If you can comfortably do that, intermittent fasting should be fine (although we’ve never tested it specifically), so long as you push/move the window a little so that you only fast 12-14 hours before the blood draw.
Personally I have a difficult time getting calories high enough if I try to IF through the protocol.
Got it – thank you!
I just heard you on the 2KetoDudes podcast… from 2016. I’m still playing catch-up on all the old episodes. This is amazing. Do you have specific pictures of your meals throughout the day? Or anything written down? I got my blood test right before Keto and my readings were ok, not great. I then started keto and 4 months later we signed up for life insurance. We’ll surprise surprise my levels were elevated just passed the mark for Premium Level. (I wasn’t surprised)
It’s now 2 months later and I’d like to go Super High Calorie Keto to see if I can get my levels back to what the insurance company deems healthy.
My wife gave me a year to let my body adjust and see if my levels will come back down. Otherwise I’ll have to go back to eating like crap for a few months and probably feeling worse so my levels are satisfactory and I’m “healthy” again. This is to avoid paying the higher premiums for the next 30years.
I’m a thinner guy like you. 5’9” was 168lbs which was my heaviest and I lost 20lbs in the first 2months and another 5lbs of the last 4months. So 25 Total.
I didn’t start Keto for the weight loss. I had major low back pain that was just miserable. Within 2 weeks my low back pain went away. I still get nags in my back from time to time. But it’s not the constant everyday pain that I was dealing with before.
Anyway. I love keto and don’t plan to go back. But wanted to see if you had some specifics on how you got your calories to 5k per day.
Thanks. I really appreciate any help you can give.
Jeff
Hi Jeff,
I’ve likewise done the protocol (and have been on 2ketodudes, although a much later episode 😉 ) for what that’s worth.
Essentially, all you want is keto foods you know you love and can eat a lot of. The higher fat, the better. So if you’re already keto, take what you normally eat and increase it. It doesn’t necessarily have to be 5000 calories, I’ve gone up to 3000 (double normal caloric intake) and gotten results.
So just eat as much as you can of fatty keto foods you love, while keeping ketogenic ratios, as much as you feel comfortable doing and try to get above your normal caloric intake significantly.
Dave did fatty meat, fatty cheese, and stuff like that. I mostly did fatty cheese and processed fatty meat (pepperoni). But anything fatty you usually eat would probably work so long as it remains high fat very low carb and you can eat a lot of it.
Siobhan what happened to your weight those 3 days?
I’ve done the protocol twice where I’ve weighed.
The first time was a 12 1/2 day protocol where I fasted 7 days (went from 147 to 136.5) after which I went directly to high fat/high calorie (3000 calories a day) for 5 days where I went from 136.5 to 145.
So a net loss of 2 lbs (likely due to the fasting part).
The second one, I went from maintenance calories (1500/d) to high fat/high calorie (4000-6000 calories/d) for five days and gained 2 lbs (145 to 147).
So in one case a net loss of two pounds, and in the second a net gain of 2 lbs.
I have been following the Fung Protocol since 8/15/18. Doing Keto + IF, occasional EF for weightloss. I have lost 20#. Am schedule to see my primary care doc on 11/26 for a follow-up. Am concerned that due to the shift to keto my lipids will be spiking unless I do the Feldman Protocol. My test results, after 1 day keto, 16:8:
– Total Cholesterol 239
– Triglycerides. 143
– HDL. 42
– LDL (calc). 168
My total cholesterol on this latest test was the lowest I have had in 5 years (previous readings 262, 288, 258) Could a single day of keto have caused the improvement?
Woukd you expect 3 days of Feldman prtocol on upcoming test will at least orevent a “keto spike”?
Just realized that the drop to 239 was probably due to 6 months of Red Yeast Rice which I have since discontinued. This, and i troduction of Keto will likely further confound any upcoming test results.
Ah, yes, that would do it. Red Yeast Rice contains the same compound as many common statins, so a drop from taking it wouldn’t surprise me.
I’m not sure about the 1 day of keto, it would likely impact it somewhat but I’m not sure by how much.
I don’t really like the idea of using the protocol for your annual results – the point of those is to get the best data you can to see how well your health is doing, and the protocol can fudge with some other important results like insulin, HDL, and triglycerides among others.
Plus, your doctor’s job is to help you achieve your health goals and giving them “compromised” data makes that job harder. One option is to do it, but tell your doctor you’re doing it beforehand so they know it’s not your normal. Another option is to get normal testing, then ask for a re-test where you try the protocol to demonstrate how dynamic the numbers are.
Interesting meal plan huh
I am new (1yr) to the LCHF diet world but I am following it religiously. My doctor hates it, while I love it and won’t back down until I see concrete evidence that its not safe. My total chol. 340 LDL 266.8 HDL 59 Trig 71 RC 14.2 CAC score 0!!!!
That’s a lipid panel I wouldn’t mind having! Nice 🙂
Hello Dave/Siobhan,
I have been scouring the internet for help regarding my recent blood test results that has my GP & husband freaking out & pressuring me to stop doing keto which I have been on for 5 months. I have been reading & listening to everything cholesterol related though sadly it seems I have a mental block in truly understanding how it relates to my blood reading as what I usually I see online is American & I am UK based (if that makes sense).
A bit about me, diagnosed with Premature ovarian failure, went into premature menopause at 36, I’m 44 now & considered post-menopausal with a normal thyroid if that makes a difference. And I do HIIT 2 – 3 times a week & yoga every day.
Recent results (according to my GP an alarming leap from my pre-keto test results) are as follows
Cholesterol = 12.3 mmol/L – (normal considered 2.5 – 5.00 mmol/L)
* Trigs = 1mmol/L – (normal considered 0.4 – 2.30 mmol/L)
* HDL = 2.3 – ( (normal considered 1.2 – 1.70 mmol/L)
* LDL = 9.5 – (normal considered0.0 – 3.50 mmol/L)
* Cholesterol / HDL ratio 5.3
If anyone else on here is UK, possibly London based, knows of anyone to reach out to this side of the pond would be utterly amazing.
Many thanks in anticipation
Hi Shimmy! It looks like you’re a Lean Mass Hyper-responder! In other words, a lean mean fat burning machine (or someone who is lean and/or active and running on fat).
You may find this post regarding women and cholesterol interesting, as well as the Lean Mass Hyper-responder facebook group.
Would stopping exercise on the three days prior to the final blood test, during the high calorie days increase or decrease cholesterol numbers for the test? I other words, would it amplify the drop?
I’d suspect it would bring a higher drop overall, but my data on this is still very preliminary. See here: https://cholesterolcode.com/resistance-training-experiment-findings-part-1/
I completed the test and sent my numbers. My cholesterol dropped about 45 points.
Hi Dave,
Been doing keto for about 10 months and lost close to 70 pounds
My last lipid panel:
Chol: 221
Trig: 54
HDL: 71
LDL: 139
Doc wants to put me on a statin
Will try your method first. Need to show him your research
He thinks low carb and weight loss should have reduced
my numbers
You may want to pass this presentation along: https://www.youtube.com/watch?v=0LuKwsz9Woc
Hi Dave
How did your weight and blood pressure vary during the protocol? Did you do any exercise? If not, about how many calories do you think you burned/day?
Can’t remember the weight change right off hand, but I believe I gained about a pound a day. Blood pressure went up a little. My exercise was generally controlled at around 2.5 miles of planned walking a day + incidental walking.
I workout regularly and maintain less than 15% body fat. I was on a low fat diet most of my life, but I had to eat all the time. I went on a high fat diet in 2017 and my total cholesterol jumped 100 points (see attached file for data). My CAC is 0. Although my doctor wants me on statins, I have not agreed t take them. I recently tried the protocol for my blood test on 11/30/2018. My total cholesterol dropped 44 points and my LDL dropped 54. The data and my food log is attached. I did not consume enough fat, only 67%. When I do it again I will try to improve in that arena. I was 500 calories short of the 5000 on two of the days.
Hi David,
hopefully you can help me out. I’m still trying to figure out the cholesterol on LCHF. I’m eating LCHF now for two years and here are my blood test result (after fasting for 14 hours):
LDL-P: 1525 nmol/L
LDL-C: 144 mg/dL
HDL-C: 66 mg/dL
Triglycerides: 62 mg/dL
Cholesterol, Total: 222 mg/dL
HDL-P (total): 29.5 umol/L
Small LDL-P: 111 nmol/L
LDL Size 21.9 nm
LP-IR Score: <25
What do you think about this numbers? Are they OK or should I change something? My doctor said that my bad cholesterol, LDL, is a bit on the higher side but alltogether acceptable, particularly since I have very few of the small, more dangerous particles. My good cholesterol, HDL, looks great as do the triglycerides and the fasting blood sugar. I'm a little bit confused since I was reading that the LDL-P levels are ideal less than 1000 nmol/L.
I really appreciate your feedback on this. Much appreciated. Happy Holidays.
There’s a profile I wouldn’t mind having! 🙂
LDL-P is typically LDL-C x10 +/- 15% in metabolically healthy people from what I’ve seen so far, so it’s not surprising your LDL-P is around that range. Some people do consider high LDL-P in itself a risk, but there’s some debate on that. For what it’s worth I’ve yet to see a study showing that high LDL-C or LDL-P in isolation with high HDL and low triglycerides is, in itself, high risk. That doesn’t mean it doesn’t exist, just that I haven’t seen it yet. There are some studies which show the opposite, though.
For what it’s worth, it also looks like you might be heading towards Lean Mass Hyper-responder numbers, as well.
Hi Siobhan, thank you very much for your input and the additional sources of information. Very helpful. I appreciate it. Have a nice evening.
Hi David,
I want to try this, i have bump into your website because of my recent blood test result that my LDL reached 258 and my HDL is 50, Trig is 80. This happens 3 days after starting Keto Diet again. My Doctor asked me to go on Meds but I dont want to do it. So Im gonna stick to Keto diet and try this protocol.
Thank you.
Russel
–==== CholesterolCode.com/Report v0.9.3 ====–
…1 months on LCHF (20g to 120g carbs) ::: 10 hours water fasted…
WARNING: fasting for less than 12 hours can risk confounded lipid numbers. See https://www.youtube.com/watch?v=ZQHztlN1Yls
Total Cholesterol: 324 mg/dL 8.38 mmol/L
LDL Cholesterol: 258 mg/dL 6.67 mmol/L
HDL Cholesterol: 50 mg/dL 1.29 mmol/L
Triglycerides: 80 mg/dL 0.9 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 16 mg/dL 0.41 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.32 >>> Medium Risk Quintile
Go to https://tinyurl.com/y84u92wm for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.156 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 258 | Iranian LDL-C: 231
Total/HDL Ratio: 6.48
TG/HDL Ratio in mg/dL: 1.6 | in mmol/L: 0.7
By the way this is my numbers. I dont know if this is good or bad as what my doctor said.
It looks like a profile I’d expect from a low carber, but it’s worth noting that it’s recommended to wait for the 4-6 month mark to test after changing a diet as adaption can take a while.
Im trying to understand the mechanism. At the begining you were eating a low calorie, low carb diet. Taking into account that you had a decrease in LDL, It’s not clear to me why your TG’s levels have droped at the end, since you are eating more more calories from fat. Did’nt the decreased LDL levels resulted from increased TG’s so, they have became “FULL”, turned in VLDL?
With the greater food consumption, we also have increased levels of insulin which likely increases both uptake of TG (particularly with adipocytes) and reduced production of existing VLDL (thus reducing detected TG in a fasted test)
Dave, I recently did the 6.5 day 2 blood test protocol, how can I post my results?
You can post your results anywhere in the comments – if you have a spreadsheet you can attach it to the comment if that is convenient for you. Or you could upload the spreadsheet to e.g. google drive or similar and link that. Or just post the results as text – whichever you prefer!
Ok, i created a spreadsheet detailing all the lab results and the food intake on the days preceding. Let me know what you think.
Thanks! If I’m reading right it looks like there wasn’t a huge shift in LDL (although lowering still there it seems) Could you also describe yourself and the circumstances leading up to the test? E.g. activity level vs normal activity level, body type (if comfortable sharing)? Thanks!
Yah I wasn’t sure if that was because I was eating too much during the low calorie days or not enough during the high calorie days, I have seen my LDL under 3 mmol/l on previous tests on a low carb diet and eating consistently just over maintenance levels for a few months . I think if I were to continue with the high calorie days my LDL would have dropped under 3 mmol/L. I am 6’1″ 210 lbs lean around 12% bodyfat and workout with weights 5X a week, I did not workout during the week I tested and didn’t have coffee which I usually have 1 cup of a day. I did notice that HDL increased and Trigs decreased during high calorie which are both good trends.
Thanks for the extra information – when Dave is back from filming the CC documentary I’ll be sure to pass on your data and get his thoughts as well. Any “non-drop” protocol results are definitely worth specifically noting. 🙂
ok cool looking forward to his thoughts.
Hi Dave,
I was amazed by the research you have done, had left msg on twitter but long enough story to post.
I had an MI(STEM) this year on Jan 03,2019 and then had stent placed and pacemaker because of slower heart rate, since then im on medications and statins (Asprin,plavix,Inspira, Xarelto and Lipitor) after a month are so have do
done a lipid and the numbers are below.
CHOLESTEROL,TOTAL 84 mg/dL
Triglycerides 114 mg/dL
HDL CHOLESTEROL 30 mg/dL
LDL 31 mg/dl
CHOLES/HDL RATIO 2.8 Ratio
NON-HDL CHOLESTEROL 54 mg/dL
I stopped statins because of muscle pains and then done advanced Lipid panel , was quite amazed they sky rocketed, and doctors suggest back on statins, please suggest, according to the the theory if take my regular food, an indian bascially with high rice quantity and wheat (chapati) and weakly mutton or chicken and after MI not getting night sleep and im also software engineer so weekly 3 days of workouts on cardiac rehab – please advise should i stick on to the statins back.
LDL- p =1952
ldl-c =134
hdl-c -136
trig – 215
Cholesterol, Total 213
HDL-P (Total) 18.9
Small LDL-P 1290
LDL Size 20.3
LP-IR Score 61 H <=45
The high triglycerides are interesting considering the likewise high HDL. Have you seen this post? Do any apply here for you?
Hi Dave/Siohaun,
I’ve been keto/LCHF for about 10 months, here are my numbers (also showing what they were just before the switch to keto):
TC 449 (up from 391)
TG 35 (down from 62)
HDL 145 (up from 90)
LDL 298 (up from 286)
although I meet the numbers for a LMHR, I can see that I easily met those criteria even BEFORE keto – does this mean I’m NOT an Lean mass hyper responder? (I hoped I’d found something to ‘explain’ my extreme numbers!) If I’m not LMHR, do you have any thoughts on my numbers, eg do they look like FH? And do they look like anything to worry about? (they seem to be a lot more extreme than most people who have posted here!)
For info – I’m 51, female, lean, active, and E3/E4, with a CAC of zero.
thanks for your fantastic work!
Hi! That is certainly interesting. Can you describe your diet from before keto? What did a general day of eating look like?
Hi Everybody at Cholesterolcode,
I really appreciate all your fantastic work an passion for science.
Just want to add my experience, fwiw, with a rough try at the experiment.
After switching to full keto/AF from CKD I’ve witnessed an increase in TC so high as to lead to suspension of blood donor status (btw, I’m 50, 78Kg, 184cm – 30min HIIT/wk – I identify with a LMHR).
TC went from 337 to 402
HDL-C from 110 to 112
LDL-C from 217 (calculated) to 310 (measured)
TG from 52 to 36
Since I wanted to resume donations, without giving up the animal food diet or starting taking meds, then I tried to cheat the forthcoming lab for readmission.
So bad I had just a reminescence of Dave’s protocol and likely confounded with another experiment, I finished with a TC even higher at 413.
Basically I was eating mostly around 70/30 fat/pro, 2600Kcal/day before I emabarked in the week before the test where I added to the same regimen as before an average of 1000Kcal/day of CARB’s for the whole week (last meal 14hrs before draw).
Well, I’m now thinking whether to re-try the experiment (with tight adherence) or giving up blood donor membership – that’s a pity I could find (finally) a sympathetic doctor there, but policies are policies and must be obeyed.
Thanks for your attention and please keep up the wonderful work!
–Alex
Sorry to hear about your blood donating troubles! Am I understanding correctly that you added carbs on top of a high fat diet? I wouldn’t be surprised if this didn’t result in lower LDL – there are two protocol – one is high fat low carb high calorie (where you’d increase what you normally ate, no more than 3x normal baseline), and the other is a carb swap (where you swap fat out for carbs). But with the carb swap you don’t add carbs – you remove fat and proportionally replace it with carbs. Hope that helps!
Hi Siobhan, yes indeed, my fault I had taken it lightly, pretty convinced to recall it just requiring upping calories and eventually mixed up the two protocols; lesson learnt, hopefully.
For next time I believe the carbs-fats swap (same calories) could be my preferred way as it would appear to put less “eating stress”; maybe trickier in finding lean cuts and other very low fat protein sources – I could buy one shot of cheap whey protein supplement, though. I wonder however if there’s a way to predict which protocols could be yielding more effectively the temporary decrease of TC in the same or even less time span: should it be the high-calorie, so be it; in such a case do you think adding some resistance training or whatever exercise to try stimulate hunger is a viable option or maybe tamper with the methabolism somehow? Thanks again for you kind attention and continuous support–Alex
Hi again! That makes sense. We try to emphasize it’s swap and not add, but that can sometimes be misunderstood regardless. Generally from what I’ve seen exercising can result in no-drop – at least for the fat loading protocol. I would presume it’d be the same for carb-swap although I’m not sure.
As for lean meat – try chicken breast, chicken tenderloin, and top round beef. Turkey is another option. I did chicken breast during my recent carb swap.
As for what works best for which people – I don’t think we have enough information to know that yet.
Why are their no vegetables in this diet plan? You are going to become deficient in vitamins and minerals, it would seem.
Let me just add my THANK YOU for the great work you’re doing. (As more tangible thanks: I donated to your awesome Citizen Science Project.) The Feldman Protocol is genius. Several years ago I discovered that I’m a hyper-responder — in a very big way. (Email me if you’re curious about the number; it’s rather higher than most.) Obviously my Dr suggested statins, and I refused. After a fair bit of ad hoc research, I also concluded that although the jury is still out, there wasn’t enough evidence to change how I eat, so I didn’t bother with regular blood tests.
But: then I needed new life insurance, and sky high LDL would likely increase the cost. I didn’t take the time/money to get a ‘before’ test so there’s no way to know for certain that my LDL was still high. (It’s just very likely based on diet and previous results.) in any case, I piled on the LCHF calories with a bias towards NON-saturated fat: nuts & avocado oil (in addition to more meat). The result: total chol. under 200, so in the green.
Then: back to OMAD intermittent fasting to lose the weight I gained, and onward with my life.
Thanks for your support, and thanks for the donation as well! I’m glad you found an interesting way to use the protocol – you are definitely not the first to report using it in this way. Of course on principle we neither encourage nor discourage the use of the protocol in this way, but everyone must decide for themselves the way they’d like to use it.
A small note, that even if the jury is still out on the hyper-responder profile, I do find it very useful to get regular bloodwork anyway – not only to keep an eye on general health in regards to diet (as a self-check to make sure I’m not getting off track) but also to keep an eye out for non-diet related problems, too. I do know a couple people who were very glad to be getting regular bloodwork as they spotted problems early they might not have otherwise, even though their diet was what they would have considered ideal for their goals. Just thought I’d mention!
Did you have steatorrhea on the days where you ate 461 g of fat every day? That’s A LOT of fat!
I’ve done similar experiments at 540g+ of fat and didn’t experience any, I’ve also never heard Dave mention having any either and it’s something he’d likely bring up since it’s relevant. To note, ketochow does have emulsifiers in it which may help. I’ve also done it with solid food (cured meat and cheese mostly) at about 300g of fat and didn’t notice any either even coming straight from a long fast.
have you considered coming up with a standard diet to follow so that people who want to do this experiment can all eat the same thing (adjust for calorie requirements, of course).
Also – what I’m really wondering about is how does a different type of diet affect this?
For example – how does this change if someone is on a high carb low fat diet? (opposite of LCHF) standard american diet, paleo, keto, vegan, etc
So many questions…
Hi, while we do have a general guideline for how to complete the protocol it’s actually more valuable to us for people to replicate with their own versions of a ketogenic diet as it helps eliminate the possibility of one factor (other than fat loading) causing the drop in cholesterol. It also helps us catch issues that can happen (like from liquid fats, coffee, MCTs, etc) so we can help identify factors that can influence lipid metabolism.
There is another version called carb swapping, which Dave has done – described here.
my GP is worried about my cholesterol (recent test showed total choel at 302). I’m 37, I eat 99% carnivore and I feel great, so I don’t want to change a thing. I’d like to do this Feldman protocol the next round of bloodwork so my GP can be appeased and so he won’t want to push a statin on me (though I wouldn’t take it I’m just sick of talking to him about my choel). Wondering what people actually ate to accomplish their choel drop? Are you just soaking bacon in tallow to get fat waaaay up? Eating a high fat diet already I’m wondering how to get my fat way up, just eating sticks of butter? What are the “nuts and bolts” of going about this protocol and, also, do people generally see about a 65 point total choel drop? thanks y’all
Typically, if already eating a high fat diet, people just double their normal food intake. E.g. I’ve done it here with mostly high fat cured meat and cheese, I’ve also done it with keto shakes, etc. I’ve known people who’ve done it with high fat curries, casseroles, etc.
Personally, if I were to do it right now I’d take what I normally eat (high fat carnivore) and double it, or as close to doubling as I could do without causing nausea/discomfort, for three days, then water-only fast for 12-14 hours (no coffee, no tea, no caffeine – just water) and get the blood test.
As for what %/total drop – it seems to depend as you can see in the results of the ketofest cholesterol drop experiment.
As a side note, neither Dave nor I recommend using the protocol (or other methods to intentionally change lab results from their normal) in order to mislead a doctor. We’re not doctors and can’t give medical advice ourselves of course, but personally I consider it a doctor’s job to work as a health consultant and give advice that they think will help better their patients health based off of the information they’re provided – by manipulating that data, it makes it harder for them to do their job. I find it helpful to remind myself that, although it’s their job to give advice, it’s also my job to determine if their advice is a right fit for my goals and concerns and make it clear where I feel their suggestion isn’t something I’m comfortable with, or feel is right for me, and perhaps where we could compromise if needed so that we’re both comfortable.
One thing I have done is do the protocol, and be upfront with my doctor about it, and used that as an ice breaker to discuss my thoughts on cholesterol, and the lipid energy model, and my goals/concerns concerning it, though.
This is great! Thank you for your links and your detailed response. All so very helpful.
You’re welcome!
Hi David, thank you for the work you’ve done! I appreciate you! I have been eating a ketogenic diet for 6 plus years. I’m 50 years old. I’ve recently had my bloodwork done and my cholesterol came back higher than ever at 316 (I’m usually between 230-270) but I did just get over Covid. I’ve read that can tweak the numbers as cholesterol helps in fighting viruses? Not sure. Triglycerides were 83 (they’re usually below 60), HDL 91, VLDL 13, LDL 212. My LDL-P was about 2200 with my small LDL-P < 90. Overall LDL size was 21.6. LP-IR <25. A1C surprised me at 5.5% Fasting glucose was 93.
My PCP has already left a voice mail that she needs to see me, haha. The numbers fascinate me. I am going to do your three day study of high cal/fat and then test again. You suggested the NMR test. Where do I order that test if my PCP won’t order it? Any other lab tests you’d recommend? CAC? My Dad has had quadruple bypass as there is a history of familial cholesterolemia (Mine was always around 200 prior to Keto with low tryglicerides and high HDL). Thanks again! Great information! I love this stuff! Completely fascinates me and is so liberating knowing we are in control of our bodies and health! God bless!
Good morning folks,
I recently got my first NMR and am looking for some help properly interpreting the results. I am a 44 year old male with no history of high blood pressure, never smoked, and exercise 5 days a week for about an hour each session, no family history of familial hyperlipidemia. I have been following a low carb diet for the past year or so and my results are: total cholesterol 323, LDL 245, LDL P 2516, HDL C 68, HDL P 32.6, small ldl p of 815, ldl size of 21.5, large vldl p of <0.8, large HDL p 8.5, triglycerides 72, vldl size of 32.5, HDL size 9.3, LP-IR score of <25, glucose of 94 while fasting for 14 hours. My doctor has been trying to put me on a statin for a while, but I am not sure if that is actually needed or if anything is needed. I have been unable to get any doctor around me to order a CAC scan either. Any help would be greatly appreciated, thanks
Hi Ron,
We’re not doctors and can’t give medical advice, so we can only share our thoughts and resources in case they may be of interest.
Do you happen to have bloodwork prior to starting a low carb diet that could be compared? If you’ve seen your total and LDL-C go up from going on a low carb diet, then you would fit the profile of a standard hyper-responder. However, I can’t say whether this appears to be the case here from the information given, given there are other potential influences of lipid profile beyond diet, of course.
We can’t say whether this profile is of concern or not (as, again, we’re not doctors and can’t give medical advice), but we can offer some resources to explore different perspectives on the topic. For example there’s this presentation from Dave looking at high LDL in the context of high HDL and low triglycerides from a cautiously optimistic perspective, plus this post from Dr. Nadolsky looking at the same topic from a cautiously pessimistic perspective.
In terms of additional markers, from what we’ve seen in ourselves and others, generally LDL-P is LDL-C x10 +/- 15% or so in generally metabolically healthy people, so for an LDL-C of around 245 I’d expect LDL-P to be roughly between 2080 nmol/L and 2815 nmol/L which it seems yours falls into. Other things can impact this “concordance”, but this is the general pattern we’ve seen thus far. Along the same lines, small LDL-P tends to be 30% or less of total LDL-P in situations where HDL is normal/high, and triglycerides are below 100 mg/dL, which yours here is a touch above but pretty close to – as with LDL-P other things can impact this pattern (intense exercise prior to testing has popped up a couple times, for example).
Hola! Soy deportitsta , no fumo, no tomo alcohol y hago ayuno y keto. Mis analiticas fueron
CT 389 – LDL 299, HDL 74, TG 77. ApoA 210 (maximo 186) ApoB 193 ( maximo 173)
los parametros de inflamacion estan todos perfectos.. glucosa 85, homa 3. Tengo riesgo cardiovascular?
gracias