Two Experiments in One
As soon as we started to discuss possibly attending #NLANashville Dave and I began to toy around with the idea of trying out a dual experiment, similar to the identical diet experiment, with a twist. Instead of doing the same experiment the two of us would be doing two different experiments – but both of us would be manipulating our cholesterol numbers intentionally. All while attending a lipid conference and trying to soak up all the knowledge there (because who doesn’t want to add more work on top of an already busy working weekend? Never doubt our masochistic nature).
Originally, two possibilities were floated for my experiment “track”: option 1) fasting for five days or option 2) high calorie ketogenic for five days. I ultimately decided on high calorie, as it would be more interesting to do, and I wanted to be able to concentrate on the presentations while at the conference (fasting longer term often makes me restless). As a result of this choice, I needed something I could easily prepare and eat 1) while traveling to Nashville and 2) while actually at the conference. Luckily, Chris Bair of Ketochow stepped in and offered to sponsor the experiment. This was helpful in a few ways as I would already have most of what I needed before I even left for the conference, it wouldn’t require any cooking, and I could prepare everything for the following day the night before and not have to think about it after that. With that out of the way, the experiment began!
Instead of starting out with fasting, as I did with my Feldman Protocol experiment I instead decided to start with Ketochow intake with baseline calories in the 4 days prior, with some added whey protein powder after day 1 as I had been craving lean meat after a full day of Ketochow only. Calorie intake ended up being around 1500 calories with the added whey. The fat source used was heavy whipping cream – 99 ml per shake, 3 shakes a day. The flavors used were banana and orange cream for baseline, and pumpkin spice caramel and strawberry for intervention (noted here, as some of them have slightly different nutrient info – all Ketochow used was version 2.1).
Since I was aiming to drop my cholesterol over the course of the following five days, the intervention was to increase the amount of fat while keeping all else the same. Unfortunately, I forgot to bring my whey protein powder with me, so I just went without it after day 1 of intervention. I also found that trying to cram 550~ ml of cream into a bottle for the shake ended up making the texture very…. unfortunate. In order to avoid this problem, I kept the amount of powder the same, but split it up into 6 shakes per day for a goal of 6000 calories (with 4000~ calories achieved on days 1-3, and 6000~ calories achieved on days 4 and 5). For those curious this involved 297 ml of cream for baseline, and 1.6 liters of heavy cream for the highest calorie portion of the experiment. The liquid nature of the fat this time definitely made this possible!
All results include data from my 12 1/2 day Feldman Protocol attempt in the shaded area for comparison – new results are highlighted. The correlations listed are for all data points between 8/20 and 9/24.
As expected, Total Cholesterol dropped from the baseline of 313 mg/dL to a new low of 171 mg/dL after 5 days of high fat feeding. This leaves me with a total drop of 142 mg/dL and a correlation of -0.967684 with the 3 day average of dietary fat before the blood draw.
Baseline LDL-C on the 4 days of Ketochow came out to 252 mg/dL and after 5 days of the high calorie protocol it dropped to 105 mg/dL for a total drop of 147 mg/dL. The correlation between 3 day average dietary fat remained high at -0.97497754. To note, this is the lowest LDL-C I have on record, regardless of diet (Standard American Diet, keto, or carnivore). It’s also worth noting that during the highest calorie days I was consuming 554g of total fat, 387g of which were saturated fat.
LDL-P did exactly as expected and dropped during the high fat/high calorie phase – from 3068 nmol/L to 929 nmol/L for a total drop of 2139 nmol/L. This is pretty much what I would expect from the drop in LDL-C but I was still pretty surprised it had dropped so low. I suppose I won’t complain! The correlation for this one was between LDL-P and the 3 day average of dietary fat plus a two day gap and resulted in -0.919329629.
HDL-C surprised me by starting out higher than is typical for me when at baseline calorie/fat intake – especially as fat was a bit lower than my norm during baseline. I have had a few cases of HDL around the upper 40s on record with a baseline diet, but it’s not the usual case for me. Even more surprising was that upon high fat feeding I got the highest level I have on record – suggesting that my baseline HDL-C may have shifted up during the protocol. I suspect this may be due to something that’s in the Ketochow, and I have my suspicions as to what, but I’ll save investigation into that for another time.
Regardless of the slightly higher baseline at 48 mg/dL HDL-C still did as expected and went higher during the high calorie ketogenic phase all the way up to 57 mg/dL. This is a total increase of 9 mg/dL which is about what I would expect. The correlation with the 3 day average of dietary fat was positive, at 0.815920699.
HDL-P, like HDL-C, went up during the protocol from 21.6 umol/L to 35.7 umol/L for a total increase of 14.1 umol/L and a positive correlation between the 3 day average of dietary fat (plus a two day gap) of 0.922353315.
Triglycerides were around normal baseline levels at 63 mg/dL which dropped further upon the high fat/high calorie feeding all the way down to 45 mg/dL – the lowest I have on record. Apparently, despite the high fat intake, I was able to use or store the fat-based energy quite efficiently! This was a total drop of 18 mg/dL and a correlation of -0.857910104.
Out of all the markers I had been looking at, I was most curious about what lipoprotein(a) would do. During my Feldman Protocol attempt in August, I was surprised to find that it seemed to be following the inversion pattern. As dietary fat intake went higher, lipoprotein(a) dropped lower. But, there were some questions as to why this could be – was it perhaps that having the high calorie phase immediately after a 7 day fast influenced it? Was it something else? Obviously, testing with Ketochow helped isolate out most other possible influences and once again lipoprotein(a) dropped like a rock upon the high calorie ketogenic phase. It also started off a bit higher than my typical 130-140 nmol/L range, but this could be due to the macro composition I was consuming due to using Ketochow + whey protein isolate (resulting in slightly higher protein via whey, and slightly lower fat than usual).
Regardless – despite starting out at 171 nmol/L lipoprotein(a) quickly dropped to an astounding 58 nmol/L after the high fat/high calorie phase of the experiment. Not only was this 7 nmol/L lower than the previous low from August, but it resulted in a 113 nmol/L drop in 5 days of high fat/high calorie feeding (a 66% decrease). Wow! Lipoprotein(a) can move!
Not only that, but the correlation between dietary fat stayed strong here, at -0.93368339.
It will definitely be worth exploring how energy status impacts lipoprotein(a) in the future, along with other possible influences on its levels day-to-day. This experiment (especially back to back with the other protocol) confirms that just like other lipid markers lipoprotein(a) appears to be slightly more dynamic than anticipated.
On the Locals
Although I didn’t get to do much (any) sightseeing while in Nashville, except to walk to the conference area from where I was staying, I did get to interact with some of the locals. I had several long conversations with my AirBnB hostess, Meredith, for example, who was surprisingly delighted to hear about what I did for work and what I was in town for. Within about five minutes of me arriving at the AirBnB we were discussing lipidology, and she even pulled up a recent lipid panel she’d had so I could discuss what the markers were referring to. Funnily enough, she’d also had a CAC (a test I’m fairly interested in) recently, citing that she wanted to see any signs of actual disease (I brought up Ivor Cummins after this, of course!). She’d often ask how the conference was going, and said she could discuss lipidology with me for hours as it was all so fascinating (something I would have, of course, been happy to accommodate if I’d had more free time!) and over all was one of the highlights of my time in Nashville.
On the Conference
There were many interesting presentations throughout the weekend, ranging from lipoprotein(a), to lipid disorders (I find that understanding how things look when they’re going wrong can help me figure out how they should work when they’re going right), and intermittent fasting was even mentioned during a presentation regarding dietary habits! There was also a section of vendors at the conference, including ones that offered genetic testing, and more in-depth lipid testing which I found intriguing. I’ll definitely have to do a little more research into those sometime in the future.
It was honestly a bit surreal to walk past people having a conversation and hear them discussing LDL, particle counts, and other lipid-y things in passing – it’s not often I get to experience that in person! I also got the opportunity to meet some interesting people, from clinicians, to nurses, and dietitians. I was also delighted to see that one of the complimentary goodies the conference was offering its attendees was the most recent volume of The Journal of Clinical Lipidology. I got to have a bit of a study session with Dave before the conference day started in earnest as we both read through the studies it contained. It ended up being pretty productive and (dare I say it) fun.
Over all, it was a great learning experience, and I’m glad I decided to go.
On the Experiment
I’d say, in this case, the inconvenience of having to drink 6 shakes a day was far outweighed by the data I got in the process. Lipoprotein(a) coming from a baseline diet to a high calorie/high fat phase provided some useful information that – of course – leaves me with even more questions, and possible future experiments in mind, for sure. Plus, it wasn’t too bad, as the very kind staff at the hotel where the conference was taking place offered to store my shakes in the front office fridge so they could stay refrigerated until I needed them. I’m extremely grateful, as this made the whole process much less of a hassle, and allowed it to go as smoothly as it did. The food served at the conference actually did look quite appetizing, but in this case the sacrifices of citizen science won out over the freshly carved meat they were serving.
Even with that said, I must say that my diet over the conference weekend was definitely more appetizing than what Dave was eating – as he expressed multiple times! I’m sure he’ll be mentioning that himself, however, in part 2….