I was originally going to stream this presentation, but there were a series of technical issues with the wifi and setup at the conference.
For now, here is the rough cut before we later edit it in with the presentation slides directly. For now, you can follow along with the below link to the deck PDF:
Lean Mass Hyper-responder Presentation PDF
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Google Drive access denied.
This should be working now – thanks for letting us know! 🙂
When I click the PDFdeck link one is asked to request access, that’s correct?
Hi Silvio! You should be able to view it now 🙂
Great talk, thanks Dave! I’d like to ask about how the lipoprotein energy delivery model works for the majority non-hyper-responders. Assuming no disease or medical conditions confounding, would everyone that switch to LCHF experience a rise in LDL? (I understand it’s 1 of 4 pathways for fat metabolism, but surely it’ll have some effect?) Are hyper-responders necessarily lean mass? In other words, do you come across many lean mass non-hyper-responders? If so, do you roughly know what portion? Perhaps these questions may be related to your recent weight-gain experiment? Also, keep up all the GREAT work you, and now Siobhan, are doing towards getting to the bottom of the big ‘elephant in the room’ questions. I’ve been following CholesterolCode religiously, and always look forward to any new data you put out. (My most recent lipids on CardioChek: HDL-63, TG-57, LDL-215, Dexa-19% body fat)
Hello. My name is Emilio. I’m 57 years old. Sport 3 days a week. My diet es LFHC since October 2016. My weight was 76 kg and my analysis in november 2016 was Cholesterol 251. Hdl 67. Ldl 171.4. My analysis 07/03/17. Weight 66 kg. Cholesterol 353. HDL 93. Triglycerides 55. LDL 249. I’m worried about the rise in total cholesterol and LDL. I feel very good but I’m worried. Should I do a more thorough blood test?. Thank you.
As mentioned in the presentation, if you look at the study linked you can see that for the people they studied those with high HDL, and low triglycerides that their risk was low regardless of LDL levels. This isn’t a 100% guarantee of course, but the research we’ve seen so far seems to fall in line with this as well.
If you’re still worried, however, or just want to be cautious one option I’ve seen people go for is to see if you can get a CIMT at regular intervals (this measures the thickness of your arteries, one of the earlier signs of heart disease). This just uses an ultrasound, so can be done every 6 months if you want to make sure. You can also get a CAC (coronary artery calcium scan), which I’ve seen Ivor Cummins recommend. This measures the actual calcification of the arteries, e.g. the actual progression of the disease. I’m assuming you didn’t get one before you went low carb, but even so if there is a higher score you can get another in a year or so to make sure it isn’t worsening quickly/is stabilized.
Another thing to consider is to take a look at this list (#1), which looks at people with genetically high levels of LDL and separates them into two groups. Those who had heart attacks and those who didn’t and looked at the differences between the groups. The difference wasn’t who had higher LDL levels (they were about the same), instead it was their level of insulin resistance and fasting insulin. So, that’s another area to look – fasting insulin and IR (which HDL and TG levels tend to reflect).
Hope that helps, but if you have any more questions let us know 🙂
Thank you very much for the answer. I’ll have a look to my level of insulin.
Hi Siobhan, I asume Emilo did a simple mistake where he mention “My diet es LFHC” right?
Thanks for all the great work, in a month I will post the lab results mainly from my wife (71 years), we are not concerned at all, but her LDL and total cholesterol went up, but her
HDL are in the range of 96 to 135 mg/dl
and the Trigs from 26 to 44 mg/dl
We are going to do a CAC as well many other test like bone density to see how we are because of our age, we not only like to keep us without medication but as well our bones and muscles in good shape, with age we have to include other concerns.
i did the my CIMT and two electrocardiograms (ECG) over the last two years and are both perfect, but as a pensioner I was putting money aside for the CAC will be done ASAP or as $$$ money it is free.
Ah, yes, it might have been a typo but I’m sure he can clarify if not.
It sounds like your wife might be a lean mass hyper-responder for sure, but the interesting part is that for those over the age of 65 (and women in general) higher total/LDL cholesterol is inversely correlated to all-cause mortality. Glad to hear the CIMT and ECG’s came back clean, I would definitely be interested in the results of a CAC, too! Looking forward to the data 🙂
Ok, busy working as grandparents but will be done ASAP, regarding the CAC we are trying to find the best scanner in our city in Australia, I remember Dave in one of so many presentation spoke about one test he did in New York because of the 400 or 600 slices of the picture of the heart, not mentioned above my wife lost/drop 39/40 kilos (88 pounds) in the last 3 years and all the other test are OK.
I think we may be one of the very few born in the 1940’s doing a mix of LCHF and zero carb depending of the day, or at least none close to us most are from sick to very sick and with more medications than we can count, plus add pacemakers etc in the salad
Thanks Siobhan and sorry about your pork bad news, have beef instead 🙂
3 months keto total cholesterol 344 hdl97 .. 235ldl… 57trig ..5ft11 152lbs age 34 around 10 percent bodyfat lift 3 times a week .I’m only now starting to feel better on this diet after stopping intermittent fasting last week as believe it may have cause adrenal fatigue with doing both … one issue I seem to have constantly is every night is hot sweats in bed tossing and turning which I believe is insulin resistance very uncomfortable feeling .usually gets up and takes spoon of apple cider vinegar in glass of water helps …..Im thinking for now best to give up on this diet as feel I could be doing my self more harm with these night feelings and concern over elevated ldl. I mean might just up carbs to 100g per day…appreciate any advice are these night symptoms hyper glycemia come to think of it just had lunch now cheese and half an avocado and got very warm after it again
I first started Keto 14 months ago for cognition sharpening only. Within 6 to 8 weeks I dropped 25 pounds from 178lbs to 153lbs (I’m 5’10”). I’ve been in nutritional Ketosis since (.4-1.8 BHB). Many of the indicators Dave noted for LMHR, I felt like they applied so I was tested. Test results just came in: Overall Chl 277 / LDL 183 / HDL 69 / Tri 89. Glucose is consistently between 90-110 (the lowest I’ve ever seen it is 79 following a 24 hour fast). HbA1c = 5.3 but hs-CRP = .35. Wanted to get your thoughts on the numbers as they relate to the “typical” LMHR? Appreciate your work and your KetCon ’18 presentation. Thnx
thanks for sharing, this is fantastic!
@DaveKeto i tried the Cholestrol protocol Hack before my recent blood screen ie. High fat a week before ..no caffeine…14 hr fast prior.
My result were total cholestrol 314, HDL 70, LDL 233, tryglercides 58, wr crp 0.91mg/l. BMI is 21.7 and i’m super active 51 year old and lost 20kg in 12 months on keto.
To give you an idea my previous bloods before lifestyle change, which my doctor was happy with and i think now from what i’ve learn from you, were terrible results.Where total cholestrol 238, tryglercides 252, Hdl 44, ldl 124, crp 2.9mg/l. I was pre diabetic..insulin resistant, mildly fatty liver…borderline high bp..now bp totally normal..sometimes even low.
Can I be classified as. Lean mass hyperresponder? However my Hdl is lower than your 70 cut off. My GP is giving me so much grief about my total Cholesterol and “bad” Ldl C reading..ratio 4.5.
How should I modify/hack my protocol before the next test? One week of low-fat i stead?
As is i’m not too concern about my results..only things is the GP will me grief and want me to take statins..NO WAY.
What are you thoughts?
Holy cow! Your doc was happy with TG of 252 and an HDL of 44? Goodness!
Yes, your numbers are right on top of a LMHR, don’t overthink the HDL, it’s just an observed pattern. An HDL of 70 is very associated with positive outcomes (especially with CVD).
I don’t answer “should” questions, I just provide my data and research. 🙂 Myself, I don’t recommend leaving your current diet if you feel it is working for you. You may want to work on your doctor to explain how HDL and triglycerides have a much stronger association to CVD than LDL. Feel free to share these two studies in particular: http://cholesterolcode.com/cholesterol-endgame/
I came across your LMHR presentation this morning and it answered a lot of questions I had regarding my biomarkers. I am a healthy ketogenic athlete, and track my markers regularly. I fit the description of LMHR perfectly, including having a high blood glucose level of 90-102 (fasting or post prandial) and low blood ketones. I now understand adaptive glucose sparing explains the high BG, but can you explain why the low blood ketone levels? No matter what I do, I can’t seem to get passed the 0.7 (on a good day), and am often in the 0.3-0.5 range, which I’ve understood to be barely in nutritional ketosis. Thanks for shedding light on this topic for people like me! I now know that I’m not an anomaly.
It’s my current belief that both uptake is higher and there is more overall partitioning of fatty acid “direct delivery” (via NEFAs or VLDL-TG) in a fat-adapted athlete. I don’t think you’re any less in ketosis than someone who is a sedentary low carber with a BHB of 3.0 because you’re actually having much greater fatty acid turnover. (In fact, technically, you may actually be in more ketosis from a supply-and-signaling perspective)
You are not an anomaly the highest I’ve ever seen is a 1.1, typically 0.7 or less – recently 0.3 after 2 day egg fast ! I am also Fitting the LMHR category perfectly and would like to understand why the low levels despite hitting macros. Assuming it’s the activity level burning them but I could be way off base
When I click on PDF link it says ‘file in owners trash’
Thanks for the heads up – I’ll ping Dave on it.
Yes, I have the same result.
I see that Siobhan says that the PDF link has been fixed, but I get a message that the file does not exist. Can you please check it again?
I’ve verified he’s updated the link and put the slides in a folder that is marked not to move or delete so it won’t happen again. Thanks!
I’ve been on keto on and offfish for 15 years now. I think I understand my most recent lipid panel as relates to your discussions(cholesterol 259, HDL 73, LDL Direct 172, VLDL 36, Non-HDL Chol. 186 but am confused why my triglycerides are so high (181). I’m concerned that I may have what you describe as metabolic disorder. Can you give me some direction here? Thank you in advance.