No More Than Seven Months?

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I just learned from a health care professional about a new silly LCHF myth. Someone had said that you shouldn’t be on an LCHF diet for more than seven months because of cholesterol issues.

Old ideas about LCHF being harmful and generally bad for cholesterol are common, but why the number seven month? Any guesses?

The truth is that LCHF usually produces great cholesterol numbers, or simply normal ones. Significant elevations are less common, and it’s not seen at all in averages in large studies (for example) on years of eating LCHF.

My Health Markers After Eight Years on LCHF

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

35 Comments

Top Comments

  1. François
    Why seven months? This is the first time I hear that number.Probably pulled out of thin air. Sounds so scientific and generous... "I'll let you do something so very dangerous for your health for a while, but I won't tolerate that you put your health in jeopardy for any length of time." Part of the problem with the cholesterol issue is that unfortunately, most physicians have a very superficial concept of cholesterol: in their mind, it is something bad and useless (sight) and all forms except for HDL promote myocardial infarction. So they are genuinely concerned and, as a rule, since most hate with passion being contradicted in their supposed wisdom (Who are you to question me, trust me, I am a doctor...), the more you question their authority, the more rigid they'll become.

    Reality is quite different: HDL, LDL and VLDL are not cholesterol, they are lipoproteins. Cholesterol is essential for life and makes a significant portion of our cell membranes and of our brain (it's so important that most of our cholesterol is made "in situ", directly in the cells. It is also necessary for bile, fat and fat soluble vitamin absorption sex hormones and a few other things.

    Cholesterol may go up with a ketogenic diet, including the LDL fraction. But then, this LDL fraction is of the big, fluffy and harmless kind, with no effect on cardiovascular disease. And usually, HDL also dramatically increases. But most docs ignore this.

    An argument I hear also is that ketogenic diets do work for weight loss, but "so do other diets". Which is true. At the expense of being hungry all the time. Which does not happen with LCHF...

    Then I regularly hear that "studies have proven that LCHF diets work no better than any other calorie-restricted diet". Which is false and based on very poor studies where "low carb" is anything less than 45% of total calories. Which in my book is NOT LCHF. Certainly not ketogenic. All well done studies (Andreas has linked to many good studies that demonstrate the superiority of the LCHF lifestyle- I hate the word diet) on obtaining a healthy body weight and fantastic health markers.

    Another preconceived idea is that while it works (some docs can see the evidence), it is "too restrictive" and people quit after a while, bored by the unpalatability of the food. For example, here is what I read on the otherwise remarquable and interesting blog of my colleague Yoni Friedhoff: " low-carb dieting, for many, is far more of a restrictive diet than it is a livable, long-term lifestyle. Meaning that even if low-carb were the holy grail of diets on paper, that fact would be worthless in practice unless you happened to enjoy low-carb enough to stick with it, and judging from the folks I see regularly in my office, that's far from a given. In fact it's a very rare person that I meet who hasn't tried a low-carb diet at least once. And all of those folks? No doubt when they undertook their low-carb diets they were true believers. As far as they were concerned low-carb was to be their salvation, and many report to me having had real success losing but that they just as rapidly regained everything when they couldn't stomach living low-carb anymore."

    At least, it is clear that people obtain a healthy body with LCHF but regain the fat weight when they go back to high carbs. It is not a diet, it is a lifestyle!

    Actually, I feel there is an ounce of truth in his statement. Many people (a majority?) have no imagination when it comes to food and they are OK to eat low carb as long as they can eat anything, including carbs. Go figure!

    Yet, when I invite friends at home for a meal, we only serve LCHF and everyone loves the meal. I never had any complaint about the food being "bland" or "boring". Which brings me to the following point: in order to ease the way to a low carb lifestyle, since this blog is quite popular - it is even visited regularly by trolls, and of course by people who are looking for answers. Why not get a recipes sections? Or at least a link to websites that do provide these recipes. If Andreas decides to go with the recipes sections, those of us who have lived a LCHF lifestyle for a while and enjoy it could send in recipes... Food for thought.

    Reply: #11
    Read more →
  2. Brett Graham
    After six months on LCHF I had my blood tested and found that my LDL went up, HDL went up, Triglycerides went down, blood pressure down and fasting blood glucose down to 4.6.

    The doctors at my heath screening were very happy with my improvement in health but also said I should stop the diet as it was killing me as my total cholesterol had risen considerably. They said they would recommend statins.

    This was all based on Total Cholesterol. What a load of crap. Leading edge scientists in lipidology moved away from Total Cholesterol as a risk factor years ago.

    LDL/HDL ratio is better but, even still, it has to be interpreted correctly. i.e. the higher your HDL the higher the ratio you can have. However doctors just look at it as > 5 is bad. However, if your HDL is 2 then your ratio could be as high as 6 and probably still be OK. If you whatch the video that Zepp linked, by Ivor Cummins (which is brilliant), it shows a graph that suggests LDL is probably insignificant when HDL is over 1.68.

    We should really be concentrating on the quality of our LDL, not the quantity. If it's all big and fluffy then it's fine. Small, dense, glycated, oxidised LDL is bad. What causes the bad stuff? High blood glucose.

    So, how can you tell if your LDL is bad without a test? Divide your Triglycerides by your HDL. A ratio of 2 is ideal, 4 is high, 6 is bad. Mine is 0.46, which is one of the reasons I'm not concerned.

    Of course there are other factors, too. Blood pressure and blood glucose. If these are low, you generally have a low chance of glycated/oxidised LDL and low chance of atherosclerosis.

    I'm no doctor, so don't take my word for it. Research it yourself, like I did. A good place to start is the Ivor Cummins video, mentioned by Zepp. When you speak to your GP, if their mindset is in the past, ask to have your bloods referred to a specialist lipidologist who's aware of modern research.

    Reply: #24
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All Comments

  1. erdoke
    Instead of proving that any issues are caused by LCHF, scientific evidence grows again that high carb is linked to cancer, this time to colorectal cancer:
    Gut Microbial Metabolism Drives Transformation of Msh2-Deficient Colon Epithelial Cells
    http://dx.doi.org/10.1016/j.cell.2014.04.051

    Highlights

    • Gut microbiota induce colon cancer in genetically sensitized MSH2-deficient mice
    • Reduced dietary carbohydrates decreased polyp frequency in APCMin/+MSH2−/− mice
    • The carbohydrate metabolite butyrate induces colon cancer in APCMin/+MSH2−/− mice
    • MSH2 regulates β-catenin activity and/or transit-amplifying cell differentiation
    Carbohydrate metabolites, produced by gut microbes, can directly induce hyperproliferation and transformation of genetically susceptible colon epithelial cells. This process is independent of inflammation or production of DNA mutagens and provides a mechanism for interaction of microbiota, diet, and mismatch repair deficiency in colorectal cancer induction.

    Replies: #3, #29
  2. FrankG
    Maybe it is because many experience an initial increase in the calculated LDL-C that resolves after about 6 or 7 months... they don't want you to find this out! :-P
  3. Murray
    erdoke, I saw this paper earlier and scanned it quickly. What struck me is the so-called butyrate paradox and that the proposed mechanism of why a high carb diet increases colon cancer is the butyrate produced by bacteria fermenting carbs in the large intestine.

    This calls into question the wisdom of eating resistant starch. The whole point of the fascination with resistant starch lately is the production of butyrate in the large intestine, which is claimed to be good for gut lining and anti-inflammatory.

    On the other hand, I have never seen any suggestion that leafy greens promote colon cancer and they get fermented into butyrate in the large intestine.

    So what gives here? Is the paper's result an artefact of the specially bred cancer prone mice? Is there a dose threshold that creates a paradoxical shift in the desirability of large intestine butyrate?

    Plus it seems odd that butyrate would proliferate cancer cells, as cancer cells generally have impaired mitochondria and rely principally on glucose (aerobic glycolysis) and glutamine for fuel. Perhaps the butyrate effect works on precancerous cells that can still use fatty acids for energy, increasing the number of candidate cells for emergence of cancer.

    Anyway, this paper raised a lot more questions than answers for me, so I have been reluctant to cite it as evidence that high carb promotes colon cancer until I can make some sense of these apparent paradoxes. Any help in that respect would be appreciated.

    Replies: #6, #10
  4. François
    Why seven months? This is the first time I hear that number.Probably pulled out of thin air. Sounds so scientific and generous... "I'll let you do something so very dangerous for your health for a while, but I won't tolerate that you put your health in jeopardy for any length of time." Part of the problem with the cholesterol issue is that unfortunately, most physicians have a very superficial concept of cholesterol: in their mind, it is something bad and useless (sight) and all forms except for HDL promote myocardial infarction. So they are genuinely concerned and, as a rule, since most hate with passion being contradicted in their supposed wisdom (Who are you to question me, trust me, I am a doctor...), the more you question their authority, the more rigid they'll become.

    Reality is quite different: HDL, LDL and VLDL are not cholesterol, they are lipoproteins. Cholesterol is essential for life and makes a significant portion of our cell membranes and of our brain (it's so important that most of our cholesterol is made "in situ", directly in the cells. It is also necessary for bile, fat and fat soluble vitamin absorption sex hormones and a few other things.

    Cholesterol may go up with a ketogenic diet, including the LDL fraction. But then, this LDL fraction is of the big, fluffy and harmless kind, with no effect on cardiovascular disease. And usually, HDL also dramatically increases. But most docs ignore this.

    An argument I hear also is that ketogenic diets do work for weight loss, but "so do other diets". Which is true. At the expense of being hungry all the time. Which does not happen with LCHF...

    Then I regularly hear that "studies have proven that LCHF diets work no better than any other calorie-restricted diet". Which is false and based on very poor studies where "low carb" is anything less than 45% of total calories. Which in my book is NOT LCHF. Certainly not ketogenic. All well done studies (Andreas has linked to many good studies that demonstrate the superiority of the LCHF lifestyle- I hate the word diet) on obtaining a healthy body weight and fantastic health markers.

    Another preconceived idea is that while it works (some docs can see the evidence), it is "too restrictive" and people quit after a while, bored by the unpalatability of the food. For example, here is what I read on the otherwise remarquable and interesting blog of my colleague Yoni Friedhoff: " low-carb dieting, for many, is far more of a restrictive diet than it is a livable, long-term lifestyle. Meaning that even if low-carb were the holy grail of diets on paper, that fact would be worthless in practice unless you happened to enjoy low-carb enough to stick with it, and judging from the folks I see regularly in my office, that's far from a given. In fact it's a very rare person that I meet who hasn't tried a low-carb diet at least once. And all of those folks? No doubt when they undertook their low-carb diets they were true believers. As far as they were concerned low-carb was to be their salvation, and many report to me having had real success losing but that they just as rapidly regained everything when they couldn't stomach living low-carb anymore."

    At least, it is clear that people obtain a healthy body with LCHF but regain the fat weight when they go back to high carbs. It is not a diet, it is a lifestyle!

    Actually, I feel there is an ounce of truth in his statement. Many people (a majority?) have no imagination when it comes to food and they are OK to eat low carb as long as they can eat anything, including carbs. Go figure!

    Yet, when I invite friends at home for a meal, we only serve LCHF and everyone loves the meal. I never had any complaint about the food being "bland" or "boring". Which brings me to the following point: in order to ease the way to a low carb lifestyle, since this blog is quite popular - it is even visited regularly by trolls, and of course by people who are looking for answers. Why not get a recipes sections? Or at least a link to websites that do provide these recipes. If Andreas decides to go with the recipes sections, those of us who have lived a LCHF lifestyle for a while and enjoy it could send in recipes... Food for thought.

    Reply: #11
  5. Carol
    I'll add my 2 cents regarding medium-term LCHF and cholesterol markers. I have been LCHF for 15 months. My HDL jumped shortly after starting this diet, and has continued to trend upwards every since--every HDL measurement is greater than the last. My TG plummeted shortly after starting. This measure has jumped around, but has hovered around 85. My LDL increased initially, but after 1 year it began to fall and is currently about what it was before I went LCHF. That's my experience. Regardless of the LDL, the other 2 biomarkers definitely improved short- and medium-term for me, and I figure that 2 out of 3 aren't bad, and it's looking as though long-term the 3rd marker will be no worse. I'll stick with LCHF for a while longer, if not indefinitely.
  6. erdoke
    I did not draw conclusions and in fact also found the results surprising. Butyrate has been believed to be the magic compound so far to decrease the prevalence of colorectal cancer by dropping pH by up to half a percentage point in the large intestine.
    They do mention this butyrate paradox in the article, noting that higher concentrations seem to have adverse effects. Also, ruminants do not drop dead left and right from high butyrate levels...
    On the other hand I found both the methods and the explanation proposed in the paper reasonable.
    Reply: #7
  7. Murray
    Thanks, erdoke. I'll give the paper a very close read and ruminate on it. A well done paper with surprising results is always worthy of careful consideration as it may be a paradigm changer. Paradoxes often indicate that the current manner of thinking has reversed cause and effect in some manner.

    For example, we are not getting fatter because we eat too much; we are eating too much because we are getting fatter. How so? Because maladaptive hormone signals (from eating excess refined carbs) cause inappropriate fat storage and the resulting unavailability of internal energy drives appetite ("gluttony") and conservation of energy ("sloth"). Saying it is simply a matter of calories in calories out inappropriately suggests that eat less and exercise more is the solution and that failure to do so is lack of willpower and, therefore, weight gain is the result of moral failure (gluttony and sloth), which therefore warrants condemnation and ridicule. So CICO is really the hangman's dogma, rationalizing cruel behaviour. I always read carefully proponents of CICO for this streak of schadenfreude, as cruelty provides people with a feeling of power. People love their auto de fe. (Nietzsche makes similar points in Twilight of the Idols, The Four Great Errors.)

  8. Eddie Mitchell
    "For example, we are not getting fatter because we eat too much; we are eating too much because we are getting fatter." I agree, don't forget we are getting fatter because we are too lazy and sedentary. A post I wrote a few days ago, somewhat tongue in cheek but........

    Is your cat spending too much time computer gaming or surfing the internet ? does he always drive rather than walk ?

    The rise in obesity rates and it's often linked type two diabetes, is often put down to a lack of exercise and slothfulness, we are all too lazy. So many manual jobs have gone, too much TV and computer time, too much time playing video games etc. etc. But does any of this apply to your cat ? Obesity and diabetes rates are going through the roof in the cat world. I subscribe to Dr. Malcolm Kendrick's blog. When someone comments on his blog, I get an email sent over. This came in today.

    "My local vets’ sell Virbac dog and cat food. (The ingredients are atrocious!) Virbac also supplies them with drugs and vaccines too. Does that tell you anything? Personally, I feed my dogs a raw diet and believe domestic pets are over vaccinated. It is the same in the pet “health” industry as ours. A big, fat, lying money racket!

    I began my lchf diet nearly a month ago for various reasons, really, just to see what happened and I must say, I feel great! When one reaches their mid fifties, one (do I sound like the Queen?) accepts the aches and pains as part of getting older, but that’s not the case in my experiment, sorry, experience. They’ve all gone! As for my HDL’s and big, fluffy LDL’s, I love em!"

    This interested me, so I had a Google around, and found the information below on Wiki.

    "High-carbohydrate cat food: Many commercial foods (especially "light" foods) are extremely high in cereals and therefore carbohydrates. The extra carbohydrates will keep the cat's blood sugar high, and if you're free-feeding may also make the blood sugar curve over the course of the day volatile and unpredictable. In general, canned foods are lower in carbohydrates than dry ones, and canned "kitten" foods lower still. Recent studies show that cats' diabetes can be better regulated and even sometimes cured with a low carbohydrate diet." More here.

    You can see where this is leading. Your cat hasn't changed habits and drives everywhere rather than walk, your cat doesn't spend too much time hooked on surfing the net, my neighbours cat seems to sleep most of the time, get my drift ? It's rubbish food that brought about the epidemic in cat diabetes !

    Cats are carnivores they evolved eating meat and fat, not cereals, biscuits and other high carb food. We are the same, hence we have canine teeth. And just as in cats, diabetes can be reversed, (type two only) but not until a drastic change in diet is put in place. MEAT and FAT is the answer not more drugs.

    Kind regards Eddie

    Reply: #9
  9. Francois
    Interesting comment! Indeed cats and dogs are getting as obese and sick as their masters. Nevertheless, a nuance here: cats are obligatory carnivores, dogs are opportunistic ones (a dog will eat carrion, a cat will never) and we are omnivores, which does not mean we can eat anything! One who eats anything behaves like a garbage can, not like an omnivore. An omnivore can eat food from both plant and animal source. We do not have the genetic make up to digest grains ~ try eating it raw, you'll understand... And yes, we do have canines and can rip raw meat. A vegetarian cannot. On the other hand, we do have amylase, which means we can (I did not say we should) eat starchy food... (A chimp cannot). In a period of food scarcity, this is a massive advantage and will keep us alive. Which does not mean we should do it on a regular basis... Ancient Hawaiians cultivated certain plants they never ate except in periods of food scarcity. This is, I think, how we should eat starches. Otherwise, let us respect our genetic makeup and behave like omnivores, not garbage cans.
  10. Lari
    http://www.ncbi.nlm.nih.gov/pubmed/16460475

    "Butyrate has diverse and apparently paradoxical effects on cellular proliferation, apoptosis and differentiation that may be either pro-neoplastic or anti-neoplastic."

    Reply: #13
  11. tony
    "Why not get a recipes sections? Or at least a link to websites that do provide these recipes."

    I'd be happy if someone would be kind enough to provide the name of some good LCHF cooking books.

    Reply: #14
  12. Anne
    Going on month three of a ketogenic diet. Cholesterol is up 30 points, and I have only lost three pounds. I was hoping for better results. Good fats, 70%, protein, 25%, vegetable carbs 5%. Calories about 1500 a day. Any thoughts?
    Replies: #16, #30
  13. murray
    Thanks, Lari. More good background reading for me. I hadn't realized before that there was ambiguity concerning butyrate.
  14. Galina L
    It is just one example of a blog with LC recipes http://lowcarbdietsandrecipes.blogspot.ru
  15. Eddie Mitchell
    Thank you Galina for linking to our very basic and humble low carb recipe blog. It was set up as basic guide for people starting out on a low carb lifestyle. No skills or special tools or equipment needed. Here are a couple of stunning sites, one low carb and one with many great recipes and food ideas, some are low carb and many others can be adapted.

    http://alldayidreamaboutfood.com/

    http://www.simplyrecipes.com/

    Kind regards Eddie

  16. Zepp
    HDL often rises and triglycerids often get lower.. both are very good healt markers.

    And LDL goes different ways for different people.

    Here you can learn all about blood lipids!

    http://www.youtube.com/watch?v=fuj6nxCDBZ0

  17. Zepp
    101 Healthy Low-Carb Recipes That Taste Incredible

    http://authoritynutrition.com/101-healthy-low-carb-recipes/

  18. Linda Nedderman-Eaton
    Intriguing to read some comments by posters that this blog is visited regularly by trolls. I have commented once or twice and was treated as a troll. I sub to a vegan blog by Dr. Gregor and get treated as a troll there too.

    Differing opinions should be treated as such on both blogs. I should say I eat Lower carb because I do eat some quinoa and buckwheat but can no longer eat any true grains. But I certainly do not and cannot eat vegetarian or vegan. I feel vegan diets are quite dangerous in fact. I eat plenty of grass-fed meat, organic poultry, turkey, eggs etc. and tons and tons of veggies. But even when I was eating whole grains (gluten-free only and no corn) my triglycerides were always ridiculously low. (38-48...Yep you read that right)

    I am someone, however, for whom, higher saturated fat intake translates into higher Total LDL, as well as higher HDL, and even holistic docs have a fit at this. Can't seem to convince them of the fluffy vs dense concept. And I am a nutritionist. I am so food sensitive that all dairy, nuts, and underground veggies are out. So all of my massive veggie amounts are low glycemic. I also cannot eat any fruit. ! Eat a lot of salads with added eggs or chicken etc. with homemade mayo made with lemon.

    I'm in my early 60's and weigh the same as I did in high school and exercise regularly. BP is 110/75-80 Recently had a stress test and I was even sick at the time and I passed with flying colors with the Cardiologist stating that for my age the level I was able to reach was excellent. (The stress test was given because of racing heart due to mold allergies if anyone is interested, and the allergic urinating at the time caused a drop in potassium levels which when corrected went away.)

    But I do eat more carbs than more Low carb adherents, and of course the vegan doc hates my posts over there because I talk about the danger of B12 deficiencies and the extreme danger of low fat diets for children.

    I do have to say that most of the studies that bash high carb always seem to be referring to the standard type of diet that includes little veggies and tons of refined carbs, desserts and high sugar and processed food intake...which is horrific for anyone!

    I eat some quinoa for breakfast but it is always with a ton of veggies, moderate protein, and yes added fat! I could never sit down and eat a bowl of say oatmeal (if I tolerated grains) with blueberries without any fat on it and expect my blood sugar to stay stable! I cannot eat any fruit at all.

    My diet is one that works for ME, after all my studies. Some people do in fact do better with a higher amount of carbs and others don't. But the other parameters of the diet also have a lot to do with it as well.

    I am going to quote from a newsletter I get from Dr. Alan Christianson ND (who graduated from the Southwest College of Naturopathic Medicine in Tempe, Arizona.) at this point because it is kind of where I have also arrived. Not everyone has to go low carb to regain maintain health. Many do, but many don't

    (QUOTE)

    "In the late 1980’s, nutritional authorities decided that dietary fat was to blame for obesity, heart disease, and many other common maladies. It seemed so obvious that if fat on the body and fat in the blood vessels was the problem, that fat in the diet had to be the cause. Although reductions in poor quality fats were helpful, people thought that if reducing fat was producing good results, it would be even better to reduce all fat. Eventually low fat was not enough and fat-free became the new goal.

    The next belief that emerged was that all carbs must be good. At the peak of this thinking, foods that would not normally be thought of as healthy were eaten without restraint: jellybeans and pretzels were prime examples. I remember one evening in the late 1980’s; a group of co-workers and I visited a mutual friend at her home. She was an athlete and always up on the latest diets. She served us bowls of pretzels, jellybeans, and Swedish fish candies. She exclaimed how much she loved fat-free diets because of all the fun foods they allowed her to eat. I also remember, from around this time, completing a 5K race (and winning!) and having breakfast with the other runners after the event. Typical fare was fruit and bagels but someone brought a spread, which was an equal blend of cream cheese and brown sugar. One of the top women’s runner put maybe half of a teaspoon of this mixture on a bagel and said: “there goes my fat grams for the day.”

    Nutritional beliefs shift partly because of new information but in no small part because of the very nature of trends, much like trends in fashion. If we decide fat is to blame, eventually we will binge on jellybeans. It seems our minds can only focus on the smallest number of concepts at once.

    Thankfully we moved out of the fat-free craze and came to realize that there was such a thing as good fat. Fish, nuts, avocados, and olive oil became okay foods to eat again. If you follow current books and some popular blogs and podcasts, you will see that we have now swung 180° from the low-fat days. Many have gone far beyond saying that some fats are good and are saying that most of our calories should come from saturated fat.

    Let’s shorten the learning curve this time. Just as it was such a revolution to learn that some fats could be good for us, it is time we realize that carbs are also not the villain and some carbs are good for us. Just as Crisco and margarine are clearly unhealthy fats, high fructose corn syrup and white flower are clearly unhealthy carbs.

    Yet good carbs, rich in fiber, are a critical part of our diet. As important as fiber is, there are different types that we need. We need soluble fiber from fruits and vegetables, and we also need insoluble fiber from grains and beans. High fiber carbs are the body’s best source of energy, they feed protective intestinal flora, and allow our immune system to work.

    As omnivores we can subsist on many different types of diets. Beyond subsisting, we have the greatest chance of thriving when our diets contain nutrients from a variety of healthy unprocessed foods. The global obesity crisis started in the 1980s, even though we consumed carbohydrates for decades and centuries before then.

    My favorite good carbs include pinto beans, black beans, buckwheat groats, lentils, quinoa, and brown rice. Stay tuned for future tips on how much of these foods to have and how to time them for optimal health." (UNQUOTE)

    My input again, AndI am sure to get a backlash as usual.

    Replies: #19, #20, #21, #25
  19. Zepp
    I think I was one of them that bashed you that time!

    And I can tell you why.. you write like a troll that dont know anything!

    It can be that you dont let your old dogmas go enough!

    First.. you dont make a differens betwen macronutrients and food composed of them.. there are no healty carbs.. non unhealty either.. its macronutrients!

    But there is a lot of unhealty carb containing foods.. other foods to that are unhealty!

    You try to make a message thats sounds quite in line whit the old dogma.. let it go.. its stone dead!

    Heres one that explain it better then you (and me).. becuse I think you are trying to say somthing similar?

    http://chriskresser.com/9-steps-to-perfect-health-2-nourish-your-body

  20. erdoke
    Linda,
    I fully agree with you on that there are differences between people with regard to optimal diet. However, there is not much chance anymore to leave food decisions to the average people, mainly due to the distorted options available for them in the supermarkets they tend to purchase food. If we roll back time by a few centuries and examine food options in populations where natural and whole food, including meat was close to abundant, we find that nobody was gorging on veggies. In fact they preferred red meat and that applies to current and ancient Greeks as well for example.
    I recommend Nina Teicholz's recent book, especially chapter 8 in this regard. It is very well researched and sheds a very different light on how the now mainstream recommendation of the Mediterranean Diet emerged and how shallow the scientific evidence is behind it. Even I was surprised that olive oil had not been a big part of traditional Mediterranean diets and its higher consumption only originates from the late 1800's.
    There is also an interesting discussion going on about the need for and usefulness of fibers on different forums.
    I myself have been experimenting with low carb food options for the past few months and the surprising result is that I seem to feel the best when I'm gorging on fatty dairy and nuts. Fatty red and organ meats also satisfy to a great extent. I do add vegetables to almost every meal and some of them I really like (hot green peppers, tomatoes or a broccoli-cauliflower soup for example), but still have a kind of unnatural feeling when eating big portions of leafy veggies even with several types and plenty of "healthy" oils and seeds added on top. I would expect that after fixing my sugar intolerance and getting out of metabolic syndrome, my body should be able to clearly signal what whole foods I need. And I seem to end up with high fat dairy, nuts and fatty meats over and over again, some types of veggies craved on top. Remembering my childhood these were my favorites back then as well. Of course excluding candies...
  21. tony
    Zzzzzzzzzzzzzzzzzzz!!!
  22. Brett Graham
    After six months on LCHF I had my blood tested and found that my LDL went up, HDL went up, Triglycerides went down, blood pressure down and fasting blood glucose down to 4.6.

    The doctors at my heath screening were very happy with my improvement in health but also said I should stop the diet as it was killing me as my total cholesterol had risen considerably. They said they would recommend statins.

    This was all based on Total Cholesterol. What a load of crap. Leading edge scientists in lipidology moved away from Total Cholesterol as a risk factor years ago.

    LDL/HDL ratio is better but, even still, it has to be interpreted correctly. i.e. the higher your HDL the higher the ratio you can have. However doctors just look at it as > 5 is bad. However, if your HDL is 2 then your ratio could be as high as 6 and probably still be OK. If you whatch the video that Zepp linked, by Ivor Cummins (which is brilliant), it shows a graph that suggests LDL is probably insignificant when HDL is over 1.68.

    We should really be concentrating on the quality of our LDL, not the quantity. If it's all big and fluffy then it's fine. Small, dense, glycated, oxidised LDL is bad. What causes the bad stuff? High blood glucose.

    So, how can you tell if your LDL is bad without a test? Divide your Triglycerides by your HDL. A ratio of 2 is ideal, 4 is high, 6 is bad. Mine is 0.46, which is one of the reasons I'm not concerned.

    Of course there are other factors, too. Blood pressure and blood glucose. If these are low, you generally have a low chance of glycated/oxidised LDL and low chance of atherosclerosis.

    I'm no doctor, so don't take my word for it. Research it yourself, like I did. A good place to start is the Ivor Cummins video, mentioned by Zepp. When you speak to your GP, if their mindset is in the past, ask to have your bloods referred to a specialist lipidologist who's aware of modern research.

    Reply: #24
  23. Bill UK
    Brett,

    I would agree, also remember that LDL is calculated not measured and is dependent on triglycerides being within a particular range. The formula for LDL is in effect an estimate. I think glycated LDL would appear to be the real devil.

    IMHO as you said, Its the quality of the LDL not the quantity (unless perhaps it is sky high). The formula ( i think there are others);

    LDL Cholesterol = Total Cholesterol - HDL - (TG / 5)

  24. FrankG
    Focus on Total-C makes no sense... HDL-C (the so-called "good" cholesterol) is included in the total... so higher HDL-C is both "good" and "bad" at the same time?!?
  25. Francois
    Linda,

    Any reasonable and nuanced post is not "trollish". Any statement to the effect that LCHF is "dangerous" and cholesterol "evil" is trollish, especially since these comments are done without any backing good articles.

    You are absolutely right, LCHF lifestyle is not and should not be a religion. There are principles, and ideally people should adapt these principles. The overarching one being that the more sick you are, the more strict you should be.

    Then, I'll side with Erdoke when he states: "However, there is not much chance anymore to leave food decisions to the average people, mainly due to the distorted options available for them in the supermarkets they tend to purchase food.".

    Let's give the facts here. As clearly as possible. As for nuances, I guess they can be somewhat addressed in this forum. And as for basic recipes, see above: there are a few excellent references higher up in the discussion.

  26. Eddie Mitchell
    Linda said "You are absolutely right, LCHF lifestyle is not and should not be a religion"

    The path of the righteous man is beset on all sides by the inequities of the selfish and the tyranny of big pharma and junk food companies. Blessed is he, who in the name of charity and goodwill, shepherds the unknowing through the valley of greed and lying propaganda. For he is truly his brother's keeper and the finder of lost souls. And I will strike down upon thee with great vengeance and furious anger, those who attempt to poison and destroy my brothers and sisters with their high carb junk and poisonous medication. And you will know I am the Low Carb Diabetic when I lay my hot buttered lettuce upon you.

    Macadamias Chapter two verse six.

    Reply: #27
  27. Francois
    Amen.
  28. Gin
    "...when I lay my hot buttered lettuce upon you."

    Mmmmm, yum. Have you tried butter-stir-fried romaine yet? SO GOOD!!

  29. Murray
    Wow. I read the full paper carefully and this is superb science.
    http://www.cell.com/cell/pdf/S0092-8674(14)00736-3.pdf

    Previous research has shown the incidence of colon cancer goes up with higher percentage carbs in the diet. This paper shows that (in mice) the colon cancer rate is higher for higher carb eaters because gut bacteria in the large intestine ferment slow-to-digest carbs into butyrate. So that means carbs such as resistant starches, fibres, beans, etc. are cancer promoting. The mice who got 58% carbs in their diet had lots of colon cancer and the 7% carb mice (keto mice!) did as well as the mice who had antibiotics to kill the carb-eating bacteria. So both the antibiotic treated mice and the low carb mice had much less incidence of colon cancer. So this might explain why higher carb eaters get more colon cancer. Of course, the current Myplate guidelines tell you to eat about 58% carbs.

    In other studies butyrate has been shown to be beneficial for the colon. Eating fibre is thought by dieticians to be good for colon health, based on epidemiological association studies.

    My hypothesis to resolve the paradox is as follows. The mice used were bred to have DNA maintenance deficiency genetically so as to be prone to colon cancer. Based on other research , higher butyrate levels are beneficial to the gut unless the gut lining is already compromised by impaired DNA repair mechanisms or the gut lining already has precancerous polyps or such that disturb the villi pockets and mucous flow to drastically affect the butyrate gradient and other bacteria byproducts.

    It appears that a higher carb diet means more glucose burning by gut cells which means more likely weakened mitochondria and so more likely impaired DNA repair. (I take this from Dr. Thomas Seyfried's Cancer as a Metabolic Disease.) But eating unprocessed food in its original fibre and not milled , juiced or whatever , slows absorption of sugar and reduces the early stage damage to the colon cells and increases butyrate when it is beneficial to have plenty of butyrate. This also fits with why simply adding pure, extracted fibre, such as a spoonful of bran, has no effect on rates of colon cancer. Apparently the beneficial effect of real food fibre is that the carbs remain inside the fibre shell and are slow to digest and get partially used by bacteria, which thus reduces the carb load and produces saturated fats as a byproduct. So the real-food fibre that is beneficial decreases the carbs absorbed and increases the fat absorbed. Real food fibre magically transform a higher carb lower fat in-your-mouth diet into a lower carb higher fat in-your-gut diet.

    So if you already have polyps or other colon cell abnormalities , it looks like starch and fibre increase risk of cancer . Lower carb reduces risk of cancer at every stage.

    Reply: #31
  30. erdoke
    Based on your hypothesis we, as shifters to a low carb diet relatively late in age, should limit fiber intake as well, but leave the kids gorge on veggies if they want to.
    Do you know if gut bacteria ferment SCFAs from inulin/fructo-oligosaccharides as well? I have never looked into this, but already found some interesting papers:
    http://jn.nutrition.org/content/137/11/2568S.full
    http://jn.nutrition.org/content/129/7/1438S.full
    From a quick look it seems that fructans rather promote bifidobacteria which sounds like a good idea for my dairy heavy diet.
    Reply: #32
  31. Murray
    Good observation but I would be slow to give up on fibrous vegetables. There is also meat connective tissue and casein "fibre" that gut bacteria convert into butyrate and other short chain fatty acids. I don't eat much with soluble fibre but quite a bit with insoluble fibre.

    Unless I get indications of gut distress, I'll continue to eat plenty of real-food vegetable fibre, if only to keep speedy transit time. With signs of gut distress, the GAPS approach by Dr. Natasha Campbell-McBride (or any of several comparable elimination-reintroduction approaches) seems to be a sensible strategy, to eliminate fibre and fructans (FODMAPS) and eat foods less challenging to gut lining until there is sufficient healing and then progressively reintroduce more challenging real foods.

  32. Mac
    I have an answer to the question. Anyone who studies the work of Dr. Richard Bernstein can find in it a lot of clinical evidence for what I will explain.
    Dr. Bernstein has found that 70% of diabetics also have some form of "hypothyroidism". An appreciable percentage of these will have the characteristic of low free T3 and high reverse T3 in serum concentrations, while sometimes also having normal central and secondary thyroid function (I am an example). Switching to a low-carb diet will exacerbate this problem (again, I am an example). A very high LDL-c is a very common associated characteristic (again, I am an example).
    Experienced clinicians such as Dr. Bernstein know that the latency of lipids response to thyroid hormone replacement therapy is large -- typically on the order of six months.
    I have maintained a ketogenic diet for close to five years. My LDL-c (not TC; that is higher of course) went from high (usually between 160mg/dL and 190mg/dL) to very high (250mg/dL to 350mg/dL) after adopting the ketogenic diet. This occurs in a minority of individuals, but I estimate it to be more than 10% of those on a truly ketogenic diet -- it is not rare at all.
    Possibly the most common cause is my form of hypometabolism due to what might be called "tissue thyroid hormone resistance". This was actually well understood in the mid-twentieth century within clinical practice. Dr. Bernstein always treats with T3 supplementation and he has published that this always normalizes cholesterol serum concentrations.
    Individuals on ketogenic diets are often in good general health -- many or most are unconcerned about high serum cholesterol concentrations. Hence, these individuals do not generally provide much further evidence for what causes the high cholesterol and what might reduce it.
    I myself ordered a coronary calcium test (primarily to get my GP off my back) and scored zero -- I am 55 years old. I do not know if most or all of those individuals whose serum cholesterols go up to very high concentrations on a VLCD are hypometabolic or hypothyroid, but I suspect so.
    Dr. Bernstein prescribes a ketogenic diet and has treated thousands of patients. His patients walk in the door with the hypothyroid or hypometabolic conditions, typically before they begin the VLCD.
    So I strongly suggest that the "7-mo." notion relates to real-life common anecdotal evidence. But the fallacy is in the causality assumption, as Dr. Bernstein's more thorough and extensive observations illustrate. Those like me will exhibit the phenomenon, and it is treatable with various forms of active thyroid hormone (T3) replacement therapy.
    Thyroid hormone is the primary regulator of hepatic LDL receptor activity, which in turn is the dominant clearance mechanism for chylomicron and VLDL remnants. Those with my characteristics will respond well to both statins (which I strongly recommend against) or other experimental devices such as a high fiber diet (also not recommended in the long term), in terms of LDL-c reduction. This is consistent with the primary regulatory abnormality of hepatic resistance to thyroid hormone -- i.e. a down-regulated basal metabolism.
    Many, many older medical studies and literature references identify hypometabolism/hypothyroidism as a cause of high serum cholesterol (e.g. Broda Barnes' book "Hypo-thyroidism"). In fact before the modern lipid panels came into general use a high TC was primarily noted as an indicator for thyroid hormone replacement therapy.
    The prevailing ignorance of well-known physiology within the modern medical profession must be well appreciated.
  33. Mac
    P. S. Dr. Eenfeldt, I might guess that you are familiar with some of the low-carb bloggers who share my hypercholesterolemia and diet. There are a lot of them. But studies of epileptics on ketogenic diets and other more formal (i.e. non-anecdotal) data tend to support the notion that a hypercholesterolemic response is not very unusual.
    Long ago I formed the opinion that the rarity is study of those on truly ketogenic diets rather than high-carb diets -- not the hypercholesterolemic response. Various forms of hypothyroidism are very common in the modern population, as any GP will be aware.
    Dr. Eric Westman is another clinician (and researcher) who has had the experience of thousands of patients on a true ketogenic diet. And lo and behold, he has observed that the hypercholesterolemic response is not unusual. I believe he also probably treats with thyroid supplementation sometimes, but he has not been as explicit about this as Dr. Bernstein.
    But very few doctors today really have much experience with patients practicing a VLCD.
    For those who believe that a true risk factor for CVD is oxidized and glysylated lipoproteins (whereas measures such as LDL concentrations are thoroughly discredited by the research data), hypercholesterolemia due to an abnormally low clearance rate is probably a secondary (i.e. weak) independent factor worth avoiding. But there are other important reasons to treat hypothyroidism as well.
    Another thought that I have had is that the balance between the two primary sources of lipoprotein and cholesterol SYNTHESIS amongst the organs -- that is, the liver and the small intestine -- is likely heavily modified by a VLCD vs. a HCD. All of the studies are of cohorts on HCDs. But one of the critical parameters of the homeostasis model for serum cholesterol concentrations is SYNTHESIS -- this is just as important as clearance to the equilibrium, no? The small intestine is a very different organ than the liver, and it is responsible for producing the very large chylomicron particles that are generated in proportion to dietary fat. Conversely, not many VLDL particles (and hence not much hepatic lipoprotein and cholesterol synthesis) are produced with a LCHF diet.
    I very much suspect that many false assumptions are made based upon the serum cholesterol model that has been worked out based entirely upon a high-carb diet, where the liver dominates the synthesis role and the small intestine is insignificant. I do not know for sure, but it seems that the roles MUST be reversed on a LCHF diet -- otherwise, where do all the chylomicrons come from to service all that dietary fat? Probably a significant portion of the cholesterol can come from the diet itself if it is heavily based upon non-plant food. But I doubt that all of it does, and what about plant sources of dietary fat that supply no dietary cholesterol? The literature seems to identify the small intestine as the second-largest synthesizer of cholesterol even with a standard high-carb diet (which still includes some dietary fat of course), but I have been unable to find anything on organ synthesis rates with a VLCD or LCHF diet.
    So thyroid hormonal effects may not be the only factor behind the hypercholesterolemic response to a ketogenic diet.
    Any thoughts?
  34. Dee
    I started the low carb lifestyle over two years ago. I suffered an injury this past Nov. and unfortunately began eating carbs again. I am back on track and feeling great and working on tweaking my daily intake of fat/protein since I have hit a plateau and still have 15 lbs to lose. I wanted to share that my total cholesterol is only 133 . My doctor stated that it was over 130 and his office considered that "high". I thought that this number was excellent since my parents fight to keep theirs below 170-200. I'm wondering if the est. medical community is wanting more people on medication. I think my doctor would flip out if he knew I ate butter right from the stick as part of my snack or cooking routine :). Thank you for all of the helpful info in this site. I came her due to the plateau and think you put me on the right track with fat increase and vit. D.

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