[frederickson]

I posted this over on imminst, but given the amount of low-carb discussion on this forum I thought some of you may find this interesting.

I follow a very-low carbohydrate, raw-veggie heavy, mostly paleo approach and have posted my lipid profile below. In addition to the blood lipids, I should also note that by eliminating peri-workout carbs and all fruits/starchy vegetables I have dropped to about 10% bf from 14% while performing considerably less exercise due to demands of finishing my dissertation. To put the macronutrient intake in perspective, I am 6'3 and weigh about 215 lbs.

Macronutrient breakdown: approx 300 grams of fat (150 saturated, 125 mufa, 25 pufa [fish oil, etc.]), 200 grams of protein, 30 grams of carbohydrates a day (from non-starchy veggies).

Main foods: eggs, coconut oil, local organic leafy green/cruciferous veggies, grass-fed beef/bison, wild-caught salmon, organic chicken, organic olive oil, fish oil, tomato sauces/paste, coconut flakes, raw cacao, raw milk yogurt, whey protein isolate, sesame seeds. I eat NO grains, starchy carbs, fruits, extremely limited sugars, and very limited dairy (other than whey and raw milk yogurt once or twice a week).

Lipid panel: I have ranked these in order of health importance, imo

HDL: 68 mg/dL
VLDL: 8 mg/dL
Triglycerides: 38 mg/dL
LDL: 126 mg/dL
Total Cholesterol: 202 mg/dL

Iron: 16.4 mg/dL

Personally, I was very happy with these results. HDL was very high, VLDL and triglycerides were extremely low. After dropping all peri-workout carbs/fruit and increasing saturated fats by about 50 grams a day from my last blood test, triglycerides had dropped (44 to 38), LDL decreased (136 to 126), and HDL increased (54 to 68). As if we needed any more evidence that most physicians are clueless, my doctor's only commentary was "total cholesterol borderline high - monitor dietary fat". No mention made of the fact that I have always had high LDL (especially when on a low-fat diet in the early/mid 90's) and that my high HDL was a major contributor to the total score! Also no mention that triglycerides and vldl were exemplary.

[Benson]

Nice. Thanks for posting that. Had the same reaction from my doc with very similar lipids...I got a new doc.

[dashforce]

How long have you been on this diet? After my last keto stint, my LDL and HDL were both about 30 points more "favorable."

According to "standard of care," your LDL is almost high enough to begin recommending a statin (unless you're considered an "at-risk" individual, in which case you've passed that quite a bit). I assume your physician is likely just trying to do his job in a way that leaves him under solid protection in terms of licensure and litigation.

I'm very curious to see how longer-term prospective studies work out. The reasoning behind following a Paleolithic diet while "in your prime" seems quite logical to me. However, once we have passed our reproductive peak, I'm not convinced that evolutionary pressures play such a heavy hand, and I'm concerned that we might find some (evolutionarily) counterintuitive interactions between diet and health.

http://en.wikipedia.org/wiki/Pleiotropy#An...stic_pleiotropy

[djremix]

how does this diet impact your cognitive ability? sleep habits, energy levels etc?

[Benson]

According to "standard of care," your LDL is almost high enough to begin recommending a statin (unless you're considered an "at-risk" individual, in which case you've passed that quite a bit).

Don't forget, the standard calculation for LDL doesn't work with excessively low or high TAG levels. With TAG levels <100, calculated LDL will be significantly higher than actual measured LDL. source

There is a thread someplace here which has the corrected calculation in it.

[frederickson]

That's a really interesting paper, benson. I did not realize that LDL was generally not calculated directly, but rather using the Friedewald equation.

For those interested, the authors' LDL regression equation that was most closely correlated with directly measured serum lipids was as follows:

LDL = (Total Cholesterol/1.19) + (Triglycerides/0.81) – (HDL/1.1) – 0.98

Using this equation, my LDL was about 115 as opposed to 126 from what I presume was the Freidewald equation.

As for how I feel on this diet, I'm sure most here already realize this, but don't believe the hype about the side effects of very low-carb dieting. Most are BS propagated by nitwit nutritionists. Any side-effects that occur are transient (maybe a few days) and are probably more an effect of not getting enough fat and calories. I have never felt and performed better, both cognitively (especially) and physically. Energy levels are sustained, and appetite is greatly reduced. Sleep hasn't changed much one way or another. I have been eating low-carb for about 10 years, but after eliminating all sugars/starchy carbs and eating more raw veggies the last 6 months, body composition and skin are noticeably improved.

[dashforce]

Don't forget, the standard calculation for LDL doesn't work with excessively low or high TAG levels.

I'm not sure if that paper's "estimation" has been validated or replicated, and I likely would not use it "on the record" as a health professional until I had a better defense for using it. *Err on the side of safety,* and throwing a statin at somebody is almost always the safe move, despite any personal concerns I might have with their use. According to a recent discussion with a cardiologist, he "doesn't know a single physician that isn't on a statin, regardless of their cholesterol levels." Was an interesting comment.

[PhDstudent]

I posted this over on imminst, but given the amount of low-carb discussion on this forum I thought some of you may find this interesting.

I follow a very-low carbohydrate, raw-veggie heavy, mostly paleo approach and have posted my lipid profile below. In addition to the blood lipids, I should also note that by eliminating peri-workout carbs and all fruits/starchy vegetables I have dropped to about 10% bf from 14% while performing considerably less exercise due to demands of finishing my dissertation. To put the macronutrient intake in perspective, I am 6'3 and weigh about 215 lbs.

Macronutrient breakdown: approx 300 grams of fat (150 saturated, 125 mufa, 25 pufa [fish oil, etc.]), 200 grams of protein, 30 grams of carbohydrates a day (from non-starchy veggies).

Main foods: eggs, coconut oil, local organic leafy green/cruciferous veggies, grass-fed beef/bison, wild-caught salmon, organic chicken, organic olive oil, fish oil, tomato sauces/paste, coconut flakes, raw cacao, raw milk yogurt, whey protein isolate, sesame seeds. I eat NO grains, starchy carbs, fruits, extremely limited sugars, and very limited dairy (other than whey and raw milk yogurt once or twice a week).

Lipid panel: I have ranked these in order of health importance, imo

HDL: 68 mg/dL
VLDL: 8 mg/dL
Triglycerides: 38 mg/dL
LDL: 126 mg/dL
Total Cholesterol: 202 mg/dL

Iron: 16.4 mg/dL

Personally, I was very happy with these results. HDL was very high, VLDL and triglycerides were extremely low. After dropping all peri-workout carbs/fruit and increasing saturated fats by about 50 grams a day from my last blood test, triglycerides had dropped (44 to 38), LDL decreased (136 to 126), and HDL increased (54 to 68). As if we needed any more evidence that most physicians are clueless, my doctor's only commentary was "total cholesterol borderline high - monitor dietary fat". No mention made of the fact that I have always had high LDL (especially when on a low-fat diet in the early/mid 90's) and that my high HDL was a major contributor to the total score! Also no mention that triglycerides and vldl were exemplary.

very good numbers indeed. Drs being clueless? no way! hahah

Cholesterol is produced when HMG-CoA reductase is active, which is when blood glucose is high. so I'm not surprised that your numbers got better (among other reasons).

I really have to do something about my lipid profile. Last time i checked HDL was 41, LDL 220, triglycerides 113 and total cholesterol 284. That was before going paleo. In fact that was after 3 months of following all their advices, ie very low-fat, nearly no dietary cholesterol, some olive oil, cacao, etc.

How did you get the 25g of pufa? I mean is this mostly from supplements or did you include an average from food as well? If so how much fish oil do you take daily? I'm trying to decide how much I should take, as can be seen in http://www.mindandmuscle.net/forum/index.php?showtopic=41498

You get your grass-fed beef/bison and raw milk yogurt in a farmer's market or online? What brand of whey protein isolate? The main food you listed is very similar to what I eat now, except i take nutiva organic hemp protein instead of whey and i eat nuts like almonds. Your saturated fat intake, would that correspond to taking very lean meat or is that with 10% ground meat and not too much fat trimming? I suppose coconut oil is another big chunck of that number?

Have you ever tested your urine for ketones? I'm curious on how cognitive abilities are affected during ketosis. So many people say the brain needs lots of glucose to work optimally..

[Benson]

I'm not sure if that paper's "estimation" has been validated or replicated

I'm not sure if their substitute equation has been validated but its pretty well established that very low or very high TAG levels will result in a Friedewald-calculated LDL that is inconsistent with measured LDL (higher or lower depending on TAG levels). I would think the prudent thing to do before putting someone with very low TAG on a statin for "elevated" LDL would be to have the LDL actually measured.

[blarger]

I need to get back on this. The desire to eat carbs in winter was too strong to resist... lots of healthy bean soups, but definitely made me look and think soft.

[distinct]

Stuff, etc.

I had similar results, except my V/LDL was lower IIRC. I was 24 at the time, and the doctor wrote me a script for Lipitor because my cholesterol "was high". I think the total was 205 or some such. This boggled my mind, and I found a new doc. I should have seen it coming when he was as much if not more concerned with my 6-8 egg/day consumption than he was WRT my smoking habit.

I'd love to get re-testing a year after having quit cigarette smoking.

[nightop]

I'd love to be able to try this, but have so much trouble gaining muscle/size without a ton of carbs, even if the total cals are the same...

Which brings up another question, what is the best source of carbs that are not "grain-based"?

[rippedforce63]

white potatoes, yams

[Benson]

white potatoes, yams

This is where I have been trying to limit my carb intake to...on the theory that tubers would have been one of the only significant sources of starch to pre-agriculutral man.

[dashforce]

I'd love to be able to try this, but have so much trouble gaining muscle/size without a ton of carbs, even if the total cals are the same...

Which brings up another question, what is the best source of carbs that are not "grain-based"?

Berries.

[eclypz]

This is where I have been trying to limit my carb intake to...on the theory that tubers would have been one of the only significant sources of starch to pre-agriculutral man.

so 'tatoes are cool on a paleo diet?

[Mr.Kite]

so 'tatoes are cool on a paleo diet?

Only if you are part Incan.

[PhDstudent]

I should also note that by eliminating pre-workout carbs and all fruits/starchy vegetables I have dropped to about 10% bf from 14% while performing considerably less exercise due to demands of finishing my dissertation.

probably nothing new for some but a paper showing the benefits of cutting the pre-workout carbs
http://ajpendo.physiology.org/cgi/reprint/273/4/E768

[startingserious]

incredible how different people's physiology's can be...

i go near low carb/high protein and i start to feel dead, wired all the time, poor sleep and unable to maintain any sort of cardio exercise. i get love handles even if my ribs are showing

with high carbs and low-moderate protein, i can pretty much eat whatever i want and stay lean, no love handles, capable of impressive endurance exercise, lots of energy, sleep better etc

for what it's worth i'm lean/thin, narrow face of mid-eastern descent

i can't wait for someone to come out and convincingly explain these 'genotypes' or whatever they may be

[frederickson]

very good numbers indeed. Drs being clueless? no way! hahah

Cholesterol is produced when HMG-CoA reductase is active, which is when blood glucose is high. so I'm not surprised that your numbers got better (among other reasons).

I really have to do something about my lipid profile. Last time i checked HDL was 41, LDL 220, triglycerides 113 and total cholesterol 284. That was before going paleo. In fact that was after 3 months of following all their advices, ie very low-fat, nearly no dietary cholesterol, some olive oil, cacao, etc.

How did you get the 25g of pufa? I mean is this mostly from supplements or did you include an average from food as well? If so how much fish oil do you take daily? I'm trying to decide how much I should take, as can be seen in http://www.mindandmuscle.net/forum/index.php?showtopic=41498

You get your grass-fed beef/bison and raw milk yogurt in a farmer's market or online? What brand of whey protein isolate? The main food you listed is very similar to what I eat now, except i take nutiva organic hemp protein instead of whey and i eat nuts like almonds. Your saturated fat intake, would that correspond to taking very lean meat or is that with 10% ground meat and not too much fat trimming? I suppose coconut oil is another big chunck of that number?

Have you ever tested your urine for ketones? I'm curious on how cognitive abilities are affected during ketosis. So many people say the brain needs lots of glucose to work optimally..

if you are trying to lower your triglycerides, there is no better way than to reduce your carbohydrate intake. other lipids are more difficult to predict with such blanket statements due to genetics, etc., but reducing triglycerides by cutting down carbs is basic science and accepted by essentially everyone.

the single biggest source of my omega-3 is fish oil supplements. i take about 10 grams of carlson's liquid fish oil daily. i also eat 2-3 pounds of salmon a week, 3-4 tins of sardines, and several pounds of grass-fed beef and bison. this comes to about 15-25 grams omega-3 a day.

the raw milk yogurt comes from an amish market in my area, and i get the bison from a local farm. i get my whey protein isolate from trueprotein.com, which has the best product and prices in the business imo.

as for the saturated fat, coconut oil and other coconut products (coconut flakes, thai green curry from trader joe's, etc.) accounts for most of my saturated fat intake. the rest is from raw cacao, beef/bison, and olive oil.

i have ketostix to measure the ketones in my urine, but have never measured anything more than trace ketone bodies after testing probably 50 times over the past several years. i am a pretty muscular guy, and i have been told that this can reduce ketone presentation in the urine. of course, it is also possible that i never quite dip into ketosis since the amount of vegetables i consume puts me at about 30 carbs per day. still, i have had many days over the years with next to zero carbs and still couldn't get the ketostix to register anything more than beige/pink.

[PhDstudent]

Thx for the added infos

the single biggest source of my omega-3 is fish oil supplements. i take about 10 grams of carlson's liquid fish oil daily. i also eat 2-3 pounds of salmon a week, 3-4 tins of sardines, and several pounds of grass-fed beef and bison. this comes to about 15-25 grams omega-3 a day.

I'm surprised you include that much fish oil. I think there is an increasing number of MD/PhD bloggers who are going against any extra PUFA, basically claiming that w-3 are only beneficial to people consuming large amounts of w-6 (typically from vegetable oils). Cordain claims a typical paleo diet would have been about AA 1.81, docosapentaenoic acid 0.42, EPA 0.39, DHA 0.27 g/day.

as for the saturated fat, coconut oil and other coconut products (coconut flakes, thai green curry from trader joe's, etc.) accounts for most of my saturated fat intake. the rest is from raw cacao, beef/bison, and olive oil.

I read on imminst that you increased the sat fats to increase HDL.. sounds good to me. But I take it you are not eating ground meat and much lard? I'm wondering because I have read that lauric, myristic and palmitic acids reduce the level of hepatic LDL receptors activity. I dont know if it also reduces other LDL receptors, but still I wonder if more coconut fat really beats more animal fat.

i have ketostix to measure the ketones in my urine, but have never measured anything more than trace ketone bodies after testing probably 50 times over the past several years. i am a pretty muscular guy, and i have been told that this can reduce ketone presentation in the urine. of course, it is also possible that i never quite dip into ketosis since the amount of vegetables i consume puts me at about 30 carbs per day. still, i have had many days over the years with next to zero carbs and still couldn't get the ketostix to register anything more than beige/pink.

I'm not here to tell you what to do, but do you think you could potentially use fats better if you went ketogenic for a while, and then came back to your current diet?

[Fecal McAngry]

incredible how different people's physiology's can be...

i go near low carb/high protein and i start to feel dead, wired all the time, poor sleep and unable to maintain any sort of cardio exercise. i get love handles even if my ribs are showing

What is your macronutrient breakdown on this diet?

While I don't doubt that some people are poorly suited to VLC diets, many people who fail to thrive on such diets eat far too little fat (esp. saturated fat)...

http://en.wikipedia.org/wiki/Rabbit_starvation

http://www.biblelife.org/stefansson1.htm

http://www.biblelife.org/stefansson2.htm

http://www.biblelife.org/stefansson3.htm

[frederickson]

Thx for the added infos



I'm surprised you include that much fish oil. I think there is an increasing number of MD/PhD bloggers who are going against any extra PUFA, basically claiming that w-3 are only beneficial to people consuming large amounts of w-6 (typically from vegetable oils). Cordain claims a typical paleo diet would have been about AA 1.81, docosapentaenoic acid 0.42, EPA 0.39, DHA 0.27 g/day.



I read on imminst that you increased the sat fats to increase HDL.. sounds good to me. But I take it you are not eating ground meat and much lard? I'm wondering because I have read that lauric, myristic and palmitic acids reduce the level of hepatic LDL receptors activity. I dont know if it also reduces other LDL receptors, but still I wonder if more coconut fat really beats more animal fat.



I'm not here to tell you what to do, but do you think you could potentially use fats better if you went ketogenic for a while, and then came back to your current diet?

i realize my initial fat breakdown may not be entirely accurate, because i get a decent amount of omega-6 (eat 4-6 eggs a day... probably 30 grams w-6) and try to maintain about a 2:1 w-6 to w-3. i have considered dropping my fish oil intake to 5 grams again (did this for a few years), but my lipid profile has been better with the higher dosage. for the record, i used to have pretty awful lipids. LDL about 200, triglycerides 200, hdl in the 30's. taken a while to get my numbers where they are now, though they could still improve.

i've tried going keto, with basically zero carbs for several days at a time. i just can't get the ketostix to measure more than trace. at only 30 carbs per day from non-starchy veggies, i wonder whether i am usually in ketosis, but the ketones are being consumed and thus not excreted in the urine?

as for the low energy on low carb idea, i definitely concur that increasing fat intake helps most people avoid that feeling. since it is possible to feel sated much easier on low carb, sometimes caloric intake is too low and you get that tired feeling. increasing fat usually prevents too much of a caloric deficit and energy levels are maintained or even increased.

[Benson]

i've tried going keto, with basically zero carbs for several days at a time. i just can't get the ketostix to measure more than trace. at only 30 carbs per day from non-starchy veggies, i wonder whether i am usually in ketosis, but the ketones are being consumed and thus not excreted in the urine?

Consuming any "sugar-free" stuff with sugar alcohols?

[frederickson]

Consuming any "sugar-free" stuff with sugar alcohols?

no sugar alcohols. i do use moderate amounts of stevia at times, but i wouldn't think that would have a huge effect. though maybe it does?

ironically, i checked ketone levels this afternoon and the ketostix were more pink than usual. i have never had anything darker than pink, but today's reading registered beyond trace, probably closer to "small".

i know you eat a low-carb diet benson, have you ever measured moderate or greater?

[dashforce]

i've tried going keto, with basically zero carbs for several days at a time. i just can't get the ketostix to measure more than trace. at only 30 carbs per day from non-starchy veggies, i wonder whether i am usually in ketosis, but the ketones are being consumed and thus not excreted in the urine?

What's your ht/weight and approximate % bodyfat?

"A few days" really isn't very long if you're not doing a moderate amount of high-intensity exercise.

[PhDstudent]

i realize my initial fat breakdown may not be entirely accurate, because i get a decent amount of omega-6 (eat 4-6 eggs a day... probably 30 grams w-6) and try to maintain about a 2:1 w-6 to w-3. i have considered dropping my fish oil intake to 5 grams again (did this for a few years), but my lipid profile has been better with the higher dosage. for the record, i used to have pretty awful lipids. LDL about 200, triglycerides 200, hdl in the 30's. taken a while to get my numbers where they are now, though they could still improve.

i've tried going keto, with basically zero carbs for several days at a time. i just can't get the ketostix to measure more than trace. at only 30 carbs per day from non-starchy veggies, i wonder whether i am usually in ketosis, but the ketones are being consumed and thus not excreted in the urine?

as for the low energy on low carb idea, i definitely concur that increasing fat intake helps most people avoid that feeling. since it is possible to feel sated much easier on low carb, sometimes caloric intake is too low and you get that tired feeling. increasing fat usually prevents too much of a caloric deficit and energy levels are maintained or even increased.

ok i get you on the w-6 balancing. Btw if you can find pastured eggs, from chicken that eat bugs and grass instead of grains, the omegas 6:3 ratio will already be much nicer to start with. So how did you process to rebalance your blood lipids? I mean you cut down the carbs, weat, etc but then to fix your protein/fats ratio and your optimal fat (MUFA, PUFA, Sat) ratios did you just go trial and error, blood testing every 2-3 months, or did you follow general guidelines from somewhere? This is a process that I'm starting so I would of course appreciate any inputs. I read that Dr William Davis has pretty good techniques in the track your plaque program, but he tends to go a little too much against saturated fat. Now he might be right and it might depends of genes. The so called optimal diet is protein:fat:carbs of 2:5-7:1 (as energy) , and i think they further break fat as sat:mufa:pufa like 50:40:10 not counting trans.

anyway if you can get an nmr test i think thats more meaningful. like really low percentage of small LDL, and low Lp(a), is likely more important than just low LDL. Not surprisingly I read of many people decreasing their small LDL % by increasing sat fats, even if sometimes that incease their total LDL.

As far the ketosis, I feel the same way. I dont know what it will take to make me have ketones in my urine. As you, I can never go above the pink 15mg/dL. Right now, I have only taken water and vitamin C for the last 4 days and 14 hours (no kidding). I had a high intensity weight lifting session and 20-25 min cardio (treadmills, 6-9 mph) every day, plus studied a lot. I have more energy now than ever, my brain is on fire. I seem to have enough glycogen stored to feed Africa for a day. My theory is that there are humans, like horses, who are genetically "easy keepers" ie they are extremely efficient at storing energy from carbs. Evolutionary this is a very good characterictic, especially for harsh climate. The downside when changing the diet is what you expect http://en.wikipedia.org/wiki/Equine_metabolic_syndrome

edited a typo with omegas 6:3

[raptor2003]

do u guys supplement with vitE, sesamin or other anti-ox while supplementing with this much amount of fat?

[Benson]

no sugar alcohols. i do use moderate amounts of stevia at times, but i wouldn't think that would have a huge effect. though maybe it does?

Shouldn't have any effect really.

i know you eat a low-carb diet benson, have you ever measured moderate or greater?

Because, for reasons I cannot understand, the local pharmacies don't carry ketosticks, I've not used them in a number of years...but I can tell by how my urine smells and how my mouth tastes if I am generating significant ketones or not and it usually only takes me a day or two of carb depletion combined with exercise to get there.

[frederickson]

Shouldn't have any effect really.

Because, for reasons I cannot understand, the local pharmacies don't carry ketosticks, I've not used them in a number of years...but I can tell by how my urine smells and how my mouth tastes if I am generating significant ketones or not and it usually only takes me a day or two of carb depletion combined with exercise to get there.

not sure where you live (hopefully not times beach, mo ), but i've actually purchased them at walmarts in three different states over the years. may be worth a try if you haven't, though it sounds like you have a pretty strong handle on when you are in ketosis without them.