My health markers after eight years on LCHF

Scary stuff - or?

Scary stuff – or?

In the summer of 2006, I started eating an LCHF diet and since then I have continued to do so. It has now been eight years and I decided it was time for a thorough checkup.

According to certain fat and meat phobics, I should have been dead a long time ago. Personally, I’m planning to hang in there for about 50 more years. So who’s going to be right?

Here’s the result from my recent blood work:

Background

I’m basically healthy. But as a 42-year old dad to a small child, with some sleep deprivation, and who regularly works 60-hour weeks, this is probably the time when health should start to fail.

If LCFH doesn’t save me.

I’ve eaten an LCHF diet for eight years, at times very strict, at other times less strict. Plenty of butter, eggs, meat and heavy cream – and vegetables. For the last six months I’ve also done intermittent fasting, 16:8, on most weekdays ( I skip breakfast).

Results

Here’s a summary of my results 2007-2014.

Numbers

Click on image to enlarge.

The recent test results are in the colored columns. Numbers converted to US units to the right.

Comment

The wild rumors about how dangerous LCHF is long term, don’t get validated in my blood work. After eight years on LCHF they are excellent, just as when I started. There simply aren’t any big changes during these years.

Many things are typical and the trends are also confirmed in studies on low-carb diets:

  • Low triglycerides (good)
  • Excellent HDL cholesterol levels
  • Nice ApoB/AI ratio
  • A low fasting blood sugar and a low HbA1c (good)
  • Low, but normal, insulin levels, measured as C-peptide (probably excellent)
  • A normal weight and a normal waist circumference
  • A low and good blood pressure

To summarize, all problems associated with the metabolic syndrome and type 2 diabetes usually improve on LCHF. Obesity, high blood pressure, high blood sugar, high insulin levels and dangerously disturbed cholesterol numbers (high triglycerides and low HDL).

My test results also show that the inflammatory level in the body – as measured CRP – is non-detectible on all test occasions.

With these results in mind the fantasy talk about long-term risks with LCHF doesn’t seem to be valid,  at least not in my case. Perhaps you’ll have to put up with me for about 50 more years.

Weight

I’ve kept my weight at a normal weight level effortlessly and without any calorie counting during these years. I’ve gone up and down a few pounds within the normal range.

During my experiment with a strict LCHF diet and ketone measuring, I lost 12 lbs/5 kg. They came back when I returned to liberal LCHF, but disappeared again when I added 16:8.

My experience is that the latter is clearly the easier alternative. At least if you’re like me, and not that sensitive to carbohydrates. So I will continue with liberal LCHF with the addition of 16:8 on weekdays.

What Do You Think?

What has happened to your health markers on LCHF?

Previously

Great Cholesterol Numbers After 4 Years on an Ultra-Strict LCHF Diet

More

LCHF for Beginners

Diabetes – How to Normalize Your Blood Sugar

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159 comments

  1. Andrew
    Krabby patties without the bun are LCHF!!!! ;)
  2. Max EV
    Congratulations. Keep up the good work and positive example how people can regain their lives.
  3. Mitch
    Me (male) 2 years natural foods lchf:

    Total cholesterol went up to beyond 'recommended max' of 5.5 or 200
    HDL doubled
    LDL doubled
    Trigs halved
    Ratios very good

    Glucose same normal/good numbers

    Waist circumference smaller
    Chest/arm/leg circumference larger

    Strength/energy/health/performance very good.

    Is it healthy to look/feel healthier and younger, perform better but exceed recommended fat intake and have 'high cholesterol"?

    Reply: #4
  4. Victor
    Around my area, more docs are ignoring total cholesterol because it just isnt that good a measure. HDL numbers and trig/chol ratios are better indicators.
    Reply: #7
  5. Bill
    I'm curious if you perceive a meaning in fasting triglycerides much lower than yours. Mine have been ~20 since adopting a moderate LCHF diet probably not vastly different than yours, also with 16:8 IF. I also do Body By Science-style high intensity strength training, which I suspect contributes. Though with HDL of 160 I may just be an alien. (An alien recommended for statins due to "concerning" LDL despite the other numbers, plus super BP, lean, etc.; the alien demurred). Love your work, thanks.
  6. tz
    What is 16:8? The link seems to have something to do with intermittent fasting. But I don't see the term "16:8" there.
    Reply: #8
  7. Mitch
    OK good to see more docs doing this - not that I was really concerned about 'high cholesterol' as my ratios are good:

    TC/HDL : 3.2
    Trig/HDL : 0.32 (U.S. = 0.73)

  8. Mitch
    16:8 is :

    16 hours fasting (including sleeping time)
    8 hour eating 'window' - eg can be 1, 2, 3 meals/snacks during this 8 hours

    If you skip either breakfast (most common), or dinner you usually go about 16 hours of not eating including sleep time.

    Simple way for most people is skip breakfast - just have a coffee/tea (with or without milk/cream) and maybe a piece of dark chocolate - not really a fast, but close enough :)

  9. Lari
    Tested 6 months after I started a LCHF regimen and again after 2.5 years and everything got better except the fasting blood glucose, but I keep my vegetable carb grams down below 50 grams/day and was told by many other keto people as well as the pharmacist and nurse that if I carbo-load for a few days (equal to adding a 6 oz sweet potato per day) and retest, my fasting numbers will go down to what they are supposed to be.
  10. Chad Musgrove
    My cholesterol is extremely high by societies definition. After 6 months of lchf, the total and the LDL went up a bit more (approximately 11%), but my triglycerides dropped 45% and my HDL jumped 67%! I consider that extremely good because my TG to HDL plummeted from over 4 to 1.3.....

    All the results are here:http://www.ironmanorbust.com/low-carb-high-fat-6-month-results/

    Controversial, but I'm not sold on cholesterol needing to be around 200... My belief is that the body will make what it needs. Since I also have inflammation and calcium buildup, I suspect my body is cranking out the cholesterol as a response. If my inflammation reduces, u would expect to see the cholesterol drop a bit, but I'm not sure. I am going in to have a particle size test done. Will also do a follow up heart scan. We'll see, but controversial or not, I feel great on lchf.

  11. Garry Lee
    I've done no testing yet. Cut out sugary things in 2012. Lost 20lb but always hungry. Started creeping back on. LCHF from Jan 1st this year, down 28lb. No hunger. BMI 23 now. Feel fine. Started and maintain 50g carbs/day. I cycle a lot. Am retired doctor. Will do following tests soon..
    LDL, HDL, Trigs, HbA1c, Blood Pressure by my GP. Haven't done a lipid workup for about 10 years but even when I was fat, my HDL was always very good and my BP low. I get my BP measured (independently) once a year.
  12. Ula
    What do you eat when you're not strict LCHF? Potatoes, some pasta?
  13. Bill UK
    A comment on LDL, I belive it is calculated not measured and the formula which is used to calculate LDL is reliant on triglycerides being within a certain range otherwise the formula produces rather inacaccurate results. Typically most people have a substantial drop in triglycerides when following LCHF.

    I will dig out the formula and post up, Friedwald (spelling) bloke who created it.

  14. Mat
    You're 6'7"!!!! - Vikings eh!?
  15. sten
    A little off topic: Studies recently showed that a high HbA1c is more correlated to Heart disease than high cholesterol, something that doctors seemingly ignores.
    This may come down to that when hemoglobin is glycated in the blood stream increasing the HbA1C, the very same thing happens to other unmeasured proteins and fat carriers, like HDL and LDL.

    Question to Doc, Is glycated LDL easily measured ? It has been described as a "new dangerous type of LDL", although it is directly related to high blood sugar racting with and "coating" LDL particles with glucose, summed up over time.
    Obviously glycated LDL is dangerous as it the sugarapparently makes it sticky, the necessary property to stick in the blood vessel walls.
    Think caramel and Maillard.
    In my opinion this should be the last nail in the sugar coffins we soon have been prescribed for the last 50 years as safe by now.
    A high HbA1C is formed by poor blood sugar regulation, including millions of prediabetics heading for Diabetics or Heart Disease in unknown order.
    According to William Davis' research references, plaque regression requires blood sugar below normal or 100 (5.5); to wipe out the stickiness completely?
    Hence three standard carb meals a day is causing 3 blood sugar spikes that directly injures arterial walls, AND at the same time makes our LDL sticky and probably useless

    The reason we can stick such meals for very long is that we seemingly are given good blood sugar regulation and insulin sensitivity in younger years, before these abilities slowly cannot take any more.

    So, is it easy to measure Glycated LDL , or is it enough to look at the HbaA1c to know?

    Here one link to subject matter that means live or die to too many right now.
    But with very good and effective heart stenting today many deaths are thankfully postponed today, giving more of us another change to think and act.

    http://phlauntdiabetesupdates.blogspot.ie/2011/05/glycated-ldl-may-ex...

    Reply: #22
  16. Liezel
    Watch Cereal Killers, in it Prof Noakes evaluate the final cholesterol. Everybody else was extremely worried about the man had a high cholesterol of 7.2, but the fact that basically all the LDL particles was large it showed that he in fact had an extremely good cholesterol profile.
  17. Tyrannocaster
    Wow, great results, Dr. Eenfeldt. Thanks for posting them. I don't know what my current stats are; I haven't had them measured in a while because I hate my doctor, LOL. All I know is that the triglycerides went down 170 in 30 days when I dropped wheat from my diet, putting them in a normal range, and I lost 35 pounds in the next six months. And then we changed health insurance companies when my wife got a new job; I wish I had a doctor I trusted but my current health insurance only offers a big corporate style plan which doesn't even have any physicians who seem to have heard of the word "paleo". :-(
  18. Kathy
    Your results demonstrate that you are definitely on the best diet for your ancestral heritage. I live in the USA and fear that I have some "mutt" characteristics, meaning that I am not able to trace my heritage to ancestors that have lived here for thousands of years. For that reason, I might not be able to be as low in carbs and as high in fat as you. Still, I'm happy for what you have achieved, and I hope to be able to do the same. (Am still in the process of detoxing from heavy metal poisoning -- I think we can safely assume you have excellent dentition and haven't needed dental work, possibly EVER!)
  19. Kat
    Well, it's anecdotal evidence, but since nobody will pony up the funds for studies, that's all we have to go on. Nice going, Doctor, and thank you for sharing with us.

    There's not a trace of heart disease in my family and I come from a country where eating pork lard on a piece of black bread is a meal. The last test of CRP was zero, but I do have a bit of diabetes in my family and I decided to start testing my glucose (as long as I'm testing ketones and my finger is already pricked, why not?). I'm happy to say my fasting glucose is between 70 and 80 (U.S. metrics) and that provides even more motivation to keep LCHF and most of all avoid sugar.

  20. David
    I wonder have you done a NMR test to see what, if any, changes in LDL-p? I would be curious what has happened to the particle count in total. Thanks
    Replies: #21, #23
  21. erdoke
    That's more or less Apo AI (HDL-p containing chylomicrons) and Apo B (LDL-p).
    Reply: #24
  22. Francois
    Sten, though it is what I would call a "confirmatory finding" glycated LDL does not need to be measured. A simple measure of your glycated hemoglobin (HbA1C) is sufficient: it is a proxy of glycation of ALL proteins in the body. If it is elevated, the LDL-C will also be glycated (and be of the small, dense atherogenic kind).

    Speaking of A1C, less than 5,5% is considered normal, 5,6% to 6% considered high normal, 6,1% to 6,4% is in the pre-diabetic range and you<ll see 6,5% and more in diabetics.

    You have to realize these are arbitrary values. I do not think there is a great deal of difference between 6% and 6,1% in terms of cardiac risk, or between 6,4% and 6,5%. See it as a continuum: the higher, the worse it is.

    These HbA1C are a much better proxy for heart disease risk than blood glucose: for a long time, blood glucose can be within the "normal range" at the expense of extremely high - and dangerous because of the fact it creates enormous inflammation in the vascular system - insulin levels. I have seen many patients with extremely elevated HbA1C and normal blood glucose. They are very much at risk of heart disease.

    Because hemoglobin lives about 60 days, at any given point in time, the HbA1C reflects the average control of your blood sugar (and insulin levels) in the previous 60 days. If you want to follow-up that risk more frequently than every 60 days, go for glycated albumin, much shorter-lived. A change in diet will be reflected within one week.

    The beauty of it all, triglycerides and HbA1C, both coronary and cardiovascular risk factors, respond to an easy diet modification: cut the carbs. Cutting calories and being hungry all the time do not work! There has been some very interesting Japanese studies on that and they demonstrated that point quite elegantly.

    Sure, as pointed up by some people in this chain of comments, eating a higher fat diet will increase your total cholesterol, sometimes significantly. So what? it means nothing! As a higher fat (I'm speaking of good NATURAL saturated fats, omega-3 fats (fish) and omega-9 fats (olive oil) diet will also naturally increase dramatically the HDL-C and change the LDL-C from a small dense atherogenic particle to a big fluffy harmless particle.

    Treatment is not the same as prevention. If you are diabetic (or prediabetic) you should cut dramaticallly carbs. not so much if you are healthy. But the healthiest diet for the average human being is a low(er) carb diet. You can go high(er) carb if you are not prediabetic and diabetic, IF your carbs are from real food (ie with fiber) AND if you exercise (walk, run, do something) - think Kitivans or Japanese.

    Hope this helps.

  23. sten
    Isn't that apo b (LDL) and apo a (HDL). Quotient is excellent, 0.5.
    As I wrote before maybe we should be more interested in glycated LDL. Or looking at known glycation products like HbA1c, which is really good!
  24. Murray
    Apo-B includes the B-48 protein that is part of chylomicrons, which are benign. Chylomicrons ferry fat from the gut and they have a relatively short half life (something in the order of 20-30 minutes). Because of the short half-life they are thought to not contribute to apo-B in a fasting cholesterol test; however, if one is on a high fat diet, there could be chylomicrons long after the previous meal as the rate of fat absorption is regulated by the liver signalling secretion of bile in response to signals from cells low in energy. When, as part of an experiment, I ate over 5000 calories of fat per day (and did not gain weight) fat simply passed through in stools. However, this meant a constant stream of chylomicrons and a higher Apo-B from the B-48. Going back to normal calories lowered the Apo-B. So one should not be fat-loading before an Apo-B test, otherwise it might give a misleading result.
    Reply: #25
  25. erdoke
    I'm wondering how difficult it is to distinguish between ApoB100 and ApoB48 in clinical tests. If I recall it correctly the latter got its name after being exactly 48 % of the sequence of ApoB100, due to a stop codon inserted into the intestinal version of the mRNA. Otherwise both are coded by the APOB gene.
  26. Ed Terry
    Before moving to a LCHF diet in 2008, my HDL was 32. My latest fasting blood test showed an HDL of 72.

    Now, if I could only get my total cholesterol over 185 ;-)

  27. Karen
    Do you truly fast during that 16 hours, or do you have a bpc?
  28. Maxine
    I am a 71 year old woman and have been eating lower carb primal for years. My blood values are normal, but my doctor wanted to put me on a statin, because the "experts" recommend it just based on my age. I told him "No thanks".
  29. Bob M
    I've been on and off LCHF for a while. LCHF has not changed my total cholesterol or HDL much. When I was 26, my values were 180/39 (on low fat), and today my values are about the same. Nothing seems to change them -- not exercise or what I eat. However, my hemoglobin AIC has gone down a bit, to 5.4, my triglycerides are much lower (now 113) and my LDL density pattern is close to being "large, fluffy". Hopefully with a little longer on low card and further reduction in insulin resistance, I'll be able to get solidly in the "large, fluffy" range.

    Also, my general doctor refused to take my hemoglobin A1C or LDL density pattern, so I had to pay for these myself. She said we take too many tests in the US (then proceeded to try to put me on a statin; I think paying for a statin for the rest of my life is much more expensive than a few tests, personally).

    Reply: #57
  30. LCC
    I just received my latest fasting results:

    HsCRP: 0.320 mg/L
    Glucose: 63 mg/dL
    Potassium: 4.3 mmol/L
    CO2: 28.0 mmol/L
    Calcium: 2.8 g/dL
    Uric Acid: 6.1 mg/dL

    Cholesterol: 195 mg/dL
    Triglyceride: 50 mg/dL
    HDL: 69 mg/dL
    LDL (Calc): 116 mg/dL

    I typically eat anywhere from 10-20g carbohydrate a day, and around 60-65% daily caloric intake as fat. 3+ years in ketosis.

  31. Nigel Kinbrum
    Would anybody like to comment on https://twitter.com/MacSmiley/status/488863668038148096 ?

    CHD rates in Sweden & Finland have been increasing recently, possibly due to increasing uptake of the LCHF diet.

    Replies: #33, #34
  32. Nigel Kinbrum
    "My test results also show that the inflammatory level in the body – as measured CRP – is non-detectible on all test occasions."
    Unfortunately, CHD is probably *not* an inflammatory disease. See http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3492120/ Emphasis, mine.
    "Hypothesis

    Neovascularization of the normally avascular coronary DIT by permeable vasculature from the adventitial vasa vasorum is the cause of LDL deposition and CA. DIT enlargement, seen in early CA and aging, causes hypoxia of the outer DIT and induces neovascularization.

    According to this alternative proposal, *coronary* *atherosclerosis* *is* *not* *related* *to* *inflammation* *and* *can* *occur* *in* *individuals* *with* *normal* *circulating* *levels* *of* *LDL*, *consistent* *with* *research* *findings*."

    Replies: #35, #50
  33. Bill UK
    Interesting although I would like to see figures on what other food stuffs are being eaten.

    On a person note and aside from the all the politics and point scoring that goes in these forums my own personal experience of LCHF has been extremely positive. Considerably more energy and mental energy, controlled weight, all blood markers are great (including LDL).

    I gave it a go and it would appear to working well for me although I have an open mind, if bloods change I will stop.

    I think sometimes looking at the whole population and attempting to draw conclusions is possibly not the best way to go. Think we are all different and we need to find what is best for us.

    My father who is 88 has been LCHF for the past 18 months and he is looking and feeling superb. I never see him anymore, he has gone from being chair bound to gardening for many hours everyday. All circumstantial I admit but..

    Also, and I am doing my best to be completely neutral in all these discussion, there would appear to be a lot of new science coming out pointing to changes/type of LDL and not just the level, plus a myriad of other factors, blood sugar levels, inflammation etc.

    I have come to the conclusion that you can pick any number of studies to support any view point on nutrition, throw in huge multi-billion financial interests and it becomes very confused.

    Its interesting,more so if we all remain open to the science, which you appear to be.

    Bill.

  34. Bill UK
    Wow, Nigel would it be possible to trsnslate

    "Neovascularization of the normally avascular coronary DIT by permeable vasculature from the adventitial vasa vasorum is the cause of LDL deposition and CA. DIT enlargement, seen in early CA and aging, causes hypoxia of the outer DIT and induces neovascularization."

    into something which could be deciphered by "non-medical" people"

    Thanks,

    Bill.

  35. Nigel Kinbrum
    Bill UK said...
    "Think we are all different and we need to find what is best for us."
    I totally agree. However...

    Looking at the LDL cholesterol results:-
    2007: 2.0mmol/L.
    2014: 3.2mmol/L.
    That's not what I'd call an "improvement".

    Looking at the Vitamin D results:-
    2012: 64nmol/L.
    2014: 167nmol/L.
    Now, *that's* what I call an improvement! :-D

  36. Nigel Kinbrum
    Zepp said...
    "Its bogus!

    http://www.kostdoktorn.se/wp-content/2013/06/hj%C3%A4rtsjd-stroke.jpg "
    Your results are bogus!
    Actually, I have *no* idea if your results are bogus, as you haven't given a source for the information.

    Reply: #49
  37. Signe Gad
    I have been on GAPS-diet for 2 years, a very low-carb diet, and I don´t know any of my numbers exept my weight. I lost 6 kilo and landed on 57 during the first 3 weeks. The big change for me has been no virusinfections at all. That´s new and a clear indication, that my immune system has improved.. Don´t need any numbers to prove anything here, though it would be interesting to have them!
    According to this never ending focus on cholesterol, I would worry, if the numbers were low. I recommend Uffe Ravnskov´s articles and books on this topic.
  38. Nigel Kinbrum
    Bill UK said...
    "Wow, Nigel would it be possible to translate

    "Neovascularization of the normally avascular coronary DIT by permeable vasculature from the adventitial vasa vasorum is the cause of LDL deposition and CA. DIT enlargement, seen in early CA and aging, causes hypoxia of the outer DIT and induces neovascularization.""

    neovascularization = growth of new blood vessels within
    avascular = blood vessel-free
    coronary DIT = diffuse intimal thickening of coronary arteries = thickening of the intima (the innermost layer of arteries) of coronary arteries
    permeable = allowing substances to pass through
    vasculature = blood vessels
    adventitial vasa vasorum = the outermost layer of arteries
    CA = coronary atherosclerosis
    hypoxia = lack of oxygen

    In conclusion:-
    "Growth of new blood vessels within the normally blood vessel-free thickening of the innermost layer of coronary arteries by permeable blood vessels from the outermost layer of coronary arteries is the cause of LDL deposition and coronary atherosclerosis. Thickening of the innermost layer of coronary arteries, seen in early coronary atherosclerosis and ageing, causes a lack of oxygen in the outer thickening of the innermost layer of coronary arteries and induces growth of new blood vessels within it."
    Phew! Note that LDL deposition contributes to coronary atherosclerosis. LDL went up from 2007 to 2014. :-(

    Reply: #42
  39. Bill UK
    So Nigel, do you think its correct that we put a lot of importance behind LDL? I personally think, IMHO and non-medical opinion, that it is just one thing in the puzzle to consider? Perhaps more the nature of the LDL and not just the levels of it.

    And also given the fact that LDL is calculated and not measured makes me somewhat uneasy that it receives so much attention. Correct me if I am wrong but the formula used for LDL can become inaccurate if triglycerides are too high or too low; the formula has a few magic numbers in it.

    I am fascinated by this topic which seems to grow and evolve day by day and I have difficulty finding someone with whom I can discuss it with without running up against the usual aggressive or one sided approach/mind set.

    Thanks for you time,

    Bill.

  40. Nigel Kinbrum
    Signe Gad said...
    "According to this never ending focus on cholesterol, I would worry, if the numbers were low. I recommend Uffe Ravnskov´s articles and books on this topic."
    That's an appeal to authority fallacy. Even experts get things wrong. Do you have any quality evidence to support your argument?
  41. Bill UK
    Thanks for that, a bit clearer, messages overlapped.
  42. Nigel Kinbrum
    Bill UK said...
    "So Nigel, do you think its correct that we put a lot of importance behind LDL?"
    Yes.

    "I am fascinated by this topic which seems to grow and evolve day by day and I have difficulty finding someone with whom I can discuss it with without running up against the usual aggressive or one sided approach/mind set."
    I try to remain unbiased (I actually have a bias in favour of low-carb diets, but I keep it well-hidden! :-D ) in my discussions. I prefer logic to emotion, when it comes to discussing things.

    "Thanks for you time,

    Bill."
    You're welcome!

    Nige

    P.S. If you want to discuss anything in the comments sections of my blog posts, see my blog (Google my username) Anonymous comments are allowed, but read the Moderation Policy first!

    Reply: #45
  43. Nigel Kinbrum
    Bill UK said...
    "Thanks for that, a bit clearer, messages overlapped."
    It *was* a bit of a mouthful!
  44. Bill UK
    Thanks, I did a quick google on your name and found your blog. I will post up some interesting data published by the BHF and WHO on levels of cholesterol and all cause mortality (think I got that term correct!?!)

    Very interesting stuff.

  45. Nigel Kinbrum
    Bill UK said...
    "Thanks, I did a quick google on your name and found your blog."
    I noticed. My visitor tracker sees everything.

    "Very interesting stuff."
    Thanks. I've just increased the number of posts per page. It makes page loading a little slower, but it makes going back through older posts quicker.

    There are ~800 labels down the right-hand side, to make navigation to specific topics quicker.

  46. Regina Richards
    Thanks for sharing this. All my blood work has improved amazingly on LCHF over the last couple of years. One example: going from a usual glucose reading in the 130s to usual readings in the 80s and 90s.
  47. Tank
    Honestly? You find those GOOD cholesterol levels??
    I am diabetic, take NO medicine, eat a plant based diet and my glucose levels are just as good, my cholesterol levels are much healthier. Your cholesterol levels in 2012 were dangerously high. You should know better, doc..!
  48. murray
    It is an interesting hypothesis, but just that, and a very incomplete one at that. (I was going to say it is a very badly written paper, but I see the author's first language is not English.)

    The hypothesis that LDL concentration is a driving factor is contradicted by data such as from the Framington study that showed no increase in CVD once HDL-C was at 2.2 mmol/L, even when LDL-C when up over 7.0 mmol/L. Other data shows apoB/apoA ratio has strong correlation and the author's hypothesis gives no account of HDL relationship.

    There is also no accounting of Dr. Kummerow's findings concerning sphingomyelin and plaque formation.

    There is no accounting of the effect of vitamin K2, nor of the success of programs such as Track your plaque which have had success zeroing out CAC scores with LCHF diets that do not have low LDL-C.

    Even on the author's hypothesis, there does not appear to be any accounting of the cause of the neovascularization. (Perhaps I missed it while struggling through the clumsy writing.)

    So the paper is an interesting hypothesis that might be a step (but just a step) along a path to a plausible mechanism for arterial plaque formation. However, it hardly establishes that higher LDL-C per se is an aggravating factor, independent of HDL-C, apoB/apoA, LDL-P particle size and LDL-P count.

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