5 ms·

So much keto talk here yet no one mentions blood markers or LDL (bad cholesterol). What ever happened to good'ol'data approach? It's pretty obvious that alteri

So much keto talk here yet no one mentions blood markers or LDL (bad cholesterol). What ever happened to good'ol'data approach? It's pretty obvious that altering ones diet can have profound effects. But a scientific approach to diet is a far safer approach. Ever tried to lower your bad cholesterol? So a group of friends who are data obsessed tried keto after another group of friends raved on about it like it was a sign from above. The group that took a scientific approach getting blood work before and after noticed their LDLs shoot through the roof. Before keto: LDL 70. After 4 months on keto LDL 190. That's well above the Sutter health recommended LDL 120. Even 120 is well above what heart surgeons recommend to avoid cholesterol in your arteries: LDL below 70. The other group that raved on about keto claimed to have done blood work but never shared the numbers. They said they felt great etc.. no st, the brain craves fats. You will feel better. You can triple your fish oil intake and experience some of that natural high for those daring. Anyways some food for thought.

_up 8y ago
The theory I heard is that sugar hardens the LDL and makes it dangerous. Source: https://www.youtube.com/watch?v=k-P2McPkgfg https://www.youtube.com/watch?v=k-P2McPkgfg
JanSt 8y ago
If you want to lower your LDL I'll advice you to eat nothing but white bread with slices of highly processed meat for a week. Will lower your HDL and increase Trigs too, but if LDL is your primary concern: Go for it. Here is the thing: it's not as easy as LDL = BAD. For older people higher LDL is actually protective, for women there seems to be nearly no effect whatsoever. Don't be fooled by simple answers.
- spraak 8y ago
  > If you want to lower your LDL I'll advice you to eat nothing but white bread with slices of highly processed meat for a week. That sounds like dubious advice. On what basis would you recommend that? There are healthier ways to have low LDL, namely just eating whole plant foods. A variety of fruits, vegetables, beans, grains, nuts and seeds, and spices is my recommendation.
  - JanSt 8y ago
    I'm not recommending it at all. It's to show, that LDL is not a good measure of cv health.
- spraak 8y ago
  > For older people higher LDL is actually protective, for women there seems to be nearly no effect whatsoever. Don't be fooled by simple answers. Your last statement is in direct contradiction with all of your previous simple answers. Where is there evidence of the protective effect of LDL?
  - JanSt 8y ago
    How so? LDL can be a marker of bad health, but is not so by any means in all cases. Relevant study: https://bmjopen.bmj.com/content/6/6/e010401 https://bmjopen.bmj.com/content/6/6/e010401
    - spraak 8y ago
      That study is problematic: https://www.cebm.net/2016/06/cebm-response-lack-association-inverse-association-low-density-lipoprotein-cholesterol-mortality-elderly-systematic-review-post-publication-pee/ https://www.cebm.net/2016/06/cebm-response-lack-association-... And just one? Lots of studies showing the opposite.
      - JanSt 8y ago
        I'm not here to dig up all studies showing those results. Here is (probably the best) one. The MCE was orignally designed to show the opposite: https://www.bmj.com/content/353/bmj.i1246 https://www.bmj.com/content/353/bmj.i1246
      - JanSt 8y ago
        Btw, it's not "just one" study, but a meta study. I guess you understand the difference? Please link the studies showing the opposite results.
  - rhinoceraptor 8y ago
    Like pretty much everything, there's a U shaped curve. Low cholesterol can be bad, just as high cholesterol can be bad. Plus, it could just be a side effect of something else and we don't actually know what the underlying cause is.
- fredsir 8y ago
  > For older people higher LDL is actually protective Their bodies are decaying, and/or (mostly and) is in a state of sickness, and can't saturate its needs properly because of this, so a higher level of LDL can be indicative of them eating enough to counter their bodies increasing inabilities, or not being as sick, and so forth. It's a correlation, not a causation.
  - JanSt 8y ago
    The MCE was a very controlled study that would disagree with your assesement. Here is another review of the literature: https://www.tandfonline.com/doi/full/10.1080/17512433.2018.1519391 https://www.tandfonline.com/doi/full/10.1080/17512433.2018.1...
  - copperx 8y ago
    Making such outlandish claims requires hard evidence.
- vbtemp 8y ago
  Wow, this comment is prime material for https://twitter.com/shit_hn_says https://twitter.com/shit_hn_says !
  - JanSt 8y ago
    Why?
deleted 8y ago
[deleted]
glastra 8y ago
The "good'ol'data" approach is useless when the data themselves are useless from the get go. LDL cholesterol is not a predictor, indicator or otherwise relevant measure with regards to disease, at all. If anything, HDL/trig ratio might be.
- vbtemp 8y ago
  [Citation Needed] And if you are just an armchair cardiologist and you cherry pick one or two publications that suit this conclusion, well...
  - glastra 8y ago
    That goes both ways. To be honest, you can bear the burden of proof yourself. If you want to show me I'm wrong, I'm more than willing to review the evidence. Unless of course you're just projecting the whole armchair thing onto others. Lastly, if you think of it, asking others to prove the irrelevance of LDL with regards to CVD is straight non-sense. Do I also have to prove to you that wearing grey socks doesn't cause disease?
    - vbtemp 8y ago
      I normally wouldn't belabor the point, but you peddle at best dubious information and cloak your argument in pseudo-logical sophistry. You, without any clear credentials in the field, make a bold claim that flies in the face of the standard medical understanding of cardiovascular health. And - when challenged - you twist the argument around and ask your interloper to defend the scientifically standard model. Elevated LDL is associated with CVD, and is - in itself - an independent risk factor for developing CVD. The _extent_ to which this is true seems to be an open and unresolved question. The scientific understanding of this interplay between LDL and CVD may shift over time, and there may well be breakthroughs in the years to come, but that is the medical consensus and one should need significantly clear evidence that to the contrary. Not that you are on this level right now, per se, but this is how anti-vaxxers operate too. This is pick-your-facts pseudo science. This is spreading misinformation that less-informed people might make decisions on.
vbtemp 8y ago
I cannot upvote your comment enough. Keto is all well and good... until you get your lipid panel checked. We all understand that lab values are not everything, but I don't think _anyone_ who is informed about cardiovascular health would say that over the long term such elevated LDL values are anywhere near healthy... I say this as someone who felt great on a very low carb diet and preached the keto diet for a while.
- acuozzo 8y ago
  > Keto is all well and good... until you get your lipid panel checked. Yeah, I did. Every value was significantly improved across the board after losing the amount of weight I managed to lose on a Ketogenic diet.
rhinoceraptor 8y ago
If you can do keto and feel amazing and lose weight, but your numbers "look" bad, who cares? I doubt you'll die sooner, but even if you did, you don't want to spend your life tired and hungry.
semerda 8y ago
Worth a listen to 2 experts debate LDL, plant based diets etc.. and throw around a ton of data points. Joe Rogan Experience #1175 - Chris Kresser & Dr. Joel Kahn https://www.youtube.com/watch?v=ULtqCBimr6U https://www.youtube.com/watch?v=ULtqCBimr6U

_up 8y ago

The theory I heard is that sugar hardens the LDL and makes it dangerous. Source: https://www.youtube.com/watch?v=k-P2McPkgfg https://www.youtube.com/watch?v=k-P2McPkgfg

JanSt 8y ago

If you want to lower your LDL I'll advice you to eat nothing but white bread with slices of highly processed meat for a week. Will lower your HDL and increase Trigs too, but if LDL is your primary concern: Go for it. Here is the thing: it's not as easy as LDL = BAD. For older people higher LDL is actually protective, for women there seems to be nearly no effect whatsoever. Don't be fooled by simple answers.

spraak 8y ago
> If you want to lower your LDL I'll advice you to eat nothing but white bread with slices of highly processed meat for a week. That sounds like dubious advice. On what basis would you recommend that? There are healthier ways to have low LDL, namely just eating whole plant foods. A variety of fruits, vegetables, beans, grains, nuts and seeds, and spices is my recommendation.
- JanSt 8y ago
  I'm not recommending it at all. It's to show, that LDL is not a good measure of cv health.
spraak 8y ago
> For older people higher LDL is actually protective, for women there seems to be nearly no effect whatsoever. Don't be fooled by simple answers. Your last statement is in direct contradiction with all of your previous simple answers. Where is there evidence of the protective effect of LDL?
- JanSt 8y ago
  How so? LDL can be a marker of bad health, but is not so by any means in all cases. Relevant study: https://bmjopen.bmj.com/content/6/6/e010401 https://bmjopen.bmj.com/content/6/6/e010401
  - spraak 8y ago
    That study is problematic: https://www.cebm.net/2016/06/cebm-response-lack-association-inverse-association-low-density-lipoprotein-cholesterol-mortality-elderly-systematic-review-post-publication-pee/ https://www.cebm.net/2016/06/cebm-response-lack-association-... And just one? Lots of studies showing the opposite.
    - JanSt 8y ago
      I'm not here to dig up all studies showing those results. Here is (probably the best) one. The MCE was orignally designed to show the opposite: https://www.bmj.com/content/353/bmj.i1246 https://www.bmj.com/content/353/bmj.i1246
    - JanSt 8y ago
      Btw, it's not "just one" study, but a meta study. I guess you understand the difference? Please link the studies showing the opposite results.
- rhinoceraptor 8y ago
  Like pretty much everything, there's a U shaped curve. Low cholesterol can be bad, just as high cholesterol can be bad. Plus, it could just be a side effect of something else and we don't actually know what the underlying cause is.
fredsir 8y ago
> For older people higher LDL is actually protective Their bodies are decaying, and/or (mostly and) is in a state of sickness, and can't saturate its needs properly because of this, so a higher level of LDL can be indicative of them eating enough to counter their bodies increasing inabilities, or not being as sick, and so forth. It's a correlation, not a causation.
- JanSt 8y ago
  The MCE was a very controlled study that would disagree with your assesement. Here is another review of the literature: https://www.tandfonline.com/doi/full/10.1080/17512433.2018.1519391 https://www.tandfonline.com/doi/full/10.1080/17512433.2018.1...
- copperx 8y ago
  Making such outlandish claims requires hard evidence.
vbtemp 8y ago
Wow, this comment is prime material for https://twitter.com/shit_hn_says https://twitter.com/shit_hn_says !
- JanSt 8y ago
  Why?

deleted 8y ago

[deleted]

glastra 8y ago

The "good'ol'data" approach is useless when the data themselves are useless from the get go. LDL cholesterol is not a predictor, indicator or otherwise relevant measure with regards to disease, at all. If anything, HDL/trig ratio might be.

vbtemp 8y ago
[Citation Needed] And if you are just an armchair cardiologist and you cherry pick one or two publications that suit this conclusion, well...
- glastra 8y ago
  That goes both ways. To be honest, you can bear the burden of proof yourself. If you want to show me I'm wrong, I'm more than willing to review the evidence. Unless of course you're just projecting the whole armchair thing onto others. Lastly, if you think of it, asking others to prove the irrelevance of LDL with regards to CVD is straight non-sense. Do I also have to prove to you that wearing grey socks doesn't cause disease?
  - vbtemp 8y ago
    I normally wouldn't belabor the point, but you peddle at best dubious information and cloak your argument in pseudo-logical sophistry. You, without any clear credentials in the field, make a bold claim that flies in the face of the standard medical understanding of cardiovascular health. And - when challenged - you twist the argument around and ask your interloper to defend the scientifically standard model. Elevated LDL is associated with CVD, and is - in itself - an independent risk factor for developing CVD. The _extent_ to which this is true seems to be an open and unresolved question. The scientific understanding of this interplay between LDL and CVD may shift over time, and there may well be breakthroughs in the years to come, but that is the medical consensus and one should need significantly clear evidence that to the contrary. Not that you are on this level right now, per se, but this is how anti-vaxxers operate too. This is pick-your-facts pseudo science. This is spreading misinformation that less-informed people might make decisions on.

vbtemp 8y ago

I cannot upvote your comment enough. Keto is all well and good... until you get your lipid panel checked. We all understand that lab values are not everything, but I don't think _anyone_ who is informed about cardiovascular health would say that over the long term such elevated LDL values are anywhere near healthy... I say this as someone who felt great on a very low carb diet and preached the keto diet for a while.

acuozzo 8y ago
> Keto is all well and good... until you get your lipid panel checked. Yeah, I did. Every value was significantly improved across the board after losing the amount of weight I managed to lose on a Ketogenic diet.

rhinoceraptor 8y ago

If you can do keto and feel amazing and lose weight, but your numbers "look" bad, who cares? I doubt you'll die sooner, but even if you did, you don't want to spend your life tired and hungry.

semerda 8y ago

Worth a listen to 2 experts debate LDL, plant based diets etc.. and throw around a ton of data points. Joe Rogan Experience #1175 - Chris Kresser & Dr. Joel Kahn https://www.youtube.com/watch?v=ULtqCBimr6U https://www.youtube.com/watch?v=ULtqCBimr6U