It’s hard to believe it was just one year ago. It feels like much longer.
Here’s the tweet that started it all:
Hello! If you follow me, you know I keep pinging pro-LDL lowering experts on this key question, but still haven't gotten anything yet. So I'm making it a fun graphic for us all to use and hopefully get some great responses soon! (What would it mean if we didn't?) pic.twitter.com/hOCtUApyxH— Dave Feldman (@DaveKeto) February 13, 2018
When I wrote it, I genuinely had no idea how many studies would find their way through the door, which is why I was asking for the “best study” in particular. I imagined a flood of studies I hadn’t yet seen piling into my inbox… yet nothing came.
I already had two studies that showed the opposite — people with high LDL, high HDL, and low triglycerides having low heart disease. This included the Framingham Offspring study and the Jeppesen Study as well. So I wanted to ensure I wasn’t just skimming over other studies that would show high HDL and low TG as irrelevant to heart disease. The best way to eliminate your own confirmation bias is to reach out to those with a different opinion and data that substantiates it.
I then respectfully pinged a number of lipid-lowering experts on this as I was curious what evidence existed. I did get one attempt with Brian Edwards, but he didn’t meet the challenge criteria, though I really want to give him props for giving it a shot.
Then after six months, I decided to add some money to the mix with a new #LDLBounty. I offered $300 for any study that met the challenge.
Now the #LCCholesterolChallenge is a full year old today.
It’s really imperative that I double-check there is indeed no study that even shows above average CVD/CHD with high LDL when matched with high HDL and low triglycerides as there are so many low carbers who have this profile. So I’ve decided to up both my total budget to $3,000 and be prepared to give away $1,000 to any study that can meet the original criteria.
[…] UPDATE: The total budget has been increased at the one year anniversary to $3,000 at $1,000 per […]
ust got my blood results. I am 68yr old. Active man. LDL is 147 HDL is 52 Triglycerides are a low 82.(150 is normal) .I have also had a scan that shows my leg has Peripheral artery blockage of 50%. I get pain when I walk over a half mile or so. They want me to take cholesterol lowering med and a statin. I have refused. I have read how bad these drugs are. I take lots of CoQ10 and D and K2 and Vitamin D and have been doing better . The point I am making is that even though I have a great Triglyceride and HDL score, since I have a little high LDL count, they want to put me on killer drugs. Big Pharma tells these doctors what to do. BTW this is from a Cardiologist not my GP
You might have already seen this one, but I am going to try my best to find studies confirming or refuting your hypothesis. Here is a study showing low triglycerides, high HDL and low ischemic heart disease regardless of high LDL, hypertension, low physical activity, or smoking. BTW, I’m not doing this for the money, just for fun. https://www.ncbi.nlm.nih.gov/pubmed/11176761
Yup – that was mentioned in Dave’s Ketocon presentation iirc. 🙂
Hi Dave, Did your read already this publication?
LDL-C Does Not Cause Cardiovascular Disease: a comprehensive review of current literature
September 2018 Expert Review of Clinical Pharmacology 11(10)
This Lancet publication shows that a low carbohydrate (<40%) diet based on animal protein and fat resulted in roughy 20% higher all-cause mortality compared with a diet with 50-55% energy from carbs.
Dietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis, Lancet, August 2018, DOI: 10.1016/S2468-2667(18)30135-X
Low carbs results in high HDL, low TG, and high LDL, and CVD mortality is the number one cause of mortality (this is not shown in the publication, but can been seen as common knowledge).
Are we close to the study you are looking for?
Hi Dave and/or Siobhan, given the data you’ve accumulated, have you encountered any/many LMHR (or otherwise) that run consistently high-ish urea levels? All other readings are within normal levels, it’s just my urea that is always between 8-11 mmol/L . I s’pose there’s a chance I’m always a bit dehydrated, but I can’t think of anything else. Cheers.
Do you mean Blood Urea Nitrogen (BUN)? If so, yes. Megan Ramos said it’s something that pops up occasionally in low carb bloodwork in general. She has checked other renal markers (as high levels can sometimes be indicative of kidney issues) but it never turns up with anything.
It has popped up on mine occasionally as well.
Thanks Siobhan. Where I’m from, the UEC urea test is expressed as the whole molecule (not just the nitrogen part). At least that’s what the internet tells me. I believe 10mmol/L urea is equivalent to about 28 mg/dL BUN. Cheers, Adam.
Ah gotcha, that’s a tiny bit higher than where I saw mine but not sure how relevant it is. Is there a possibility you were dehydrated at the time of the test?
Hi Adam, just wanted to touch base on this as I got more information.
I reached out to someone who frequently sees low carb labs in a clinical settings, and they said that they’ll sometimes see 10-11 mmol/L for Blood Urea, but never over 11 so far – so it sounds like you fit into what they’ve been seeing in their own clients. If you are concerned you could always look into checking other renal function tests just to verify – likely what I’d do anyway. Hope that helps – cheers! 🙂
Thanks Siobhan, much appreciated. Yes, all other liver and kidney function tests are within normal. Cheers.
How about this review of observational studies
2018 April 1st – Stopped all the medication and Started LowCarb Diet – BMI 30 – Weight 75 kg.
2018 May 15th – HBA1C 49 – No medication only, low carb diet and stared Cycling.
Total Cholestrol 7.2 mmol/l, HDL 0.81, LDL 5.57, Triglycerides 1.8, Non HDL 6.39.
2018 July 23rd – HBA1C 46 – No medication only diet – BMI 25 – 63 kg .
Total Cholestrol 7.9 mmol/l, HDL 1.45, LDL 5.63, Triglycerides 1.8, Non HDL 6.45.
2018 Oct 1st – Total cholesterol 7.4, HDL 1.29, LDL 5.65,Triglycerides 1.0, Non HDL 6.11 Erythrocytes 6.0.
2019 Mar 5th – HBA1C 46 – No medication only diet – BMI 24 – 61 kg .
Total Cholestrol 7.3 mmol/l, HDL 1.33, LDL 5.5, Triglycerides 0.85, Non HDL 6.45.
Blood test is done with Fasting for 12 hours
My Current weight is 61kg – BMI 24.
Fasting sugars are around 7.
I’d be *much* happier to have your latest profile than the early ones, for sure. 🙂
Frontiers reports Inflammatory Links Between High Fat Diets and Diseases Immunology at https://www.frontiersin.org/articles/10.3389/fimmu.2018.02649/full . Can you advise if this is quality reporting or research and what if any implications it has for our diets?
Thank you, Doug Fager
Will add to the reading list. Thanks.
Total 345 LDL 265 HDL 64 TRI 64 LDL/HDL Ratio 4.14 TRI/HDL Ratio 1.00 CHOL/HDL Ratio 5.3 Remnant Cholesterol 16 Glucose 95 CRP 0.3 VITAMIN D- 47 ng/ml (Moderate Keto- 50G Carbs) CAC Score 979