High ldl calcium plaque artries

annabell1 said:

I've been seeing data that some people on keto diets have CAC high calcium plaque and high cholesterol, so I'm wondering how does one do keto diet without causing more plaque buildup and cholesterol etc. If one already has this. Any suggestions

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Hi - this has been a stick that certain people have tried to beat keto with for some time. I don't doubt that some people on a keto diet have high plaque and high cholesterol, but so also do people who are not on keto diets.

My cholesterol hasn't shifted in the more than five years I've been in ketosis. Most of our cholesterol, which is essential for life, is produced by our own bodies anyway (around 80% is the usually quoted figure) and cholesterol from food is therefore a relatively minor source.

Is this something you are currently experiencing, or is it something you've read about?

The recent hyper-responders studies have shown that high LDL is not usually associated with artery calcium plaque (at least not in those on a keto or near keto diet).
I've never had a CAC test done, but I certainly had artery plaque when eating the high carb low fat diet as advised by my GP, the angiogram and subsequent 3x bypass showed that!
Unfortunately, I am/was a slim T2 (TOFI) slim all my life only slowly gaining weight slowly when put on a low fat diet, after which I first got plaque in my arteries , then a T2 Diabetes diagnosis. So I'm the typical body shape to get raised LDL on a LCHF way of eating. The experience of others on this forum (and the patients of Dr David Unwin) show that the vast majority of more typical T2D's who eat HCHF or Keto reduce their LDL as well as raising HDL and lowering Triglycerides. Fortunately even though my LDL is raised on LLCHF, both my HDl is almost doubled and my triglycerides are almost halved so many Cardiologists would consider that my Cardio risk has dropped despite my higher LDL.

HDL used to be called 'good cholesterol' because those with higher HDL had fewer heart attacks, but once it was found that all studies on drugs which raised HDL showed no benefit, the medical profession started to say that high HDL had no benefit despite the earlier studies which did show a benefit in those whose HDL was 'naturally' higher.

I was on statins while on a low fat diet (Simvastatin) I got muscle pain and skin rashes, so came off them. I tried again after my 3x CAB (Atorvastatin) got brain fog and higher Blood Glucose, so came off those too.
Statins may be beneficial for those who can tolerate them - but not for the 20% or so who can't. I know this latter number is disputed, but Prof. Rory Collins (a leading statins advocate) patented a test as to who could not tolerate statins and sold it for several million dollars and the 20% number comes from that company.

Here are the best threads on this subject:

shelley262 said:

We are all different and I'm sure all have different reactions to what we eat. Speaking for myself I had high LDL before I started Keto as always had had it as did my mum but I didn't continue with prescribed statins as I had side effects which meant I couldn't continue with them. Keto definitely raised my ldl more and my figures have remained high over last 8 years while I have stayed in remission by mainly eating keto/low carb.
I was concerned about what high ldl meant for my heart health and took part in a heart health study for diabetics in remission a few years ago and the tests included a CAC score and full heart imaging etc. I luckily had a full set of good heart health results including a zero CAC score so no obvious calcification despite my longstanding high LDL score. At my review early this year my LDL had become a little higher (I think 5.8, as part of a 9.2 total cholesterol) so I was persuaded to try a small dose of lipid lowering therapy - Ezetimibe - I take half of standard dose as couldn't tolerate whole dose but it has brought my ldl down to 2.9 as part of a total 5.8 cholesterol score. So my LDl has now lowered but I'm still not convinced 're the LDL leads to heart disease theory but was eventually worn down by the persistent medical pressure to lower it despite no heart disease family history or other risk factors that I'm aware of.
Not sure this answers your question but is my experience.
Edit to correct spelling

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Interesting post @shelley262 . As a matter of interest were your Triglycerides low? I had high LDL's , normal HDL's but very low Triglycerides. I'm a lean and fit 64 year old . My liver stats were and are normal. The Dr's convinced me to go on statins. Unlike you I have suffered no ill effects from statins, they have not even increased my blood sugars. I must admit I feel more at ease having lower LDL's. Despite what I have read about LDL's not being the bad guys. I was not comfortable having high LDL's. Maybe that's because for years we were told LDL's were bad. I would fret every time I had a blood panel done seeing those out of range blood sugars and total cholesterol figures. I feel better physiologically for being on them when I see my normal lipid panel results. As an aside, my Grandmother on my dad's side had angina, and one of my aunts on my mom's side died of a heart attack. That aunt ate a healthy diet and weight wise she was thin.

shelley262 said:

I have always had high HDL around 2.5 and up to 3.5 on one test and always had low triglycerides of between 0.5 to 0.7. I have no family history of heart disease and so with me it was more the pressure to lower the LDL and I was made to feel anxious about it with gloom and doom predictions about my heart health risk. Interestingly they are still not happy with my much lower figure and want more meds but the half a tablet is as far as I'm going! As an aside too 20ish years ago I spoke to my then gp about my concerns - as my cholesterol total was 6.2 and he said then that it was a really healthy figure especially as my HDL was 2.5 and trigs below one! Funny how advice on healthy cholesterol has changed....

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I agree. My LDL's have always been raised even though my Triglycerides hover between 0.5 - 0.6. I can understand everyones concerns, particularly those who feel pressured to go on statins, even though their LDL figures are normal! I can also understand why people think it's to do with money and kickbacks because of this pressure. I personally don't think that is the case at all. It's doing an injustice to HCPs implying that they are all in it for the pennies they get for statin uptake.

I do think there is an element of biased research by pharma, but then cardiologists are split on the matter. The jury is still out for me. Both sides can cite arguments for and against. Confirmation bias when looking for information plays a role. I honestly don't know. It's a polarizing topic. I would say that some people absolutely need statins and these drugs do save lives. I wouldn't like to be complicit in persuading someone to stop using statins when that drug could be , in part, saving their life.

For me, going on statins was a phycological decision. There is too much debate going on right now with no clear winner, so I aired on the side of caution.