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.
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.
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....
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.
My agreement to taking the lipid lowering half a pill which lowers LDL and works in a different way to a statin- was me erring on side of caution too. I was also really heartened when I came across a study of Ezetimibe which showed half a dose had a similar effect to a full dose was a good compromise for me. It has no effect on my bgs and I can tolerate and accept the half dose. It's also a relief to have the number come down.
You might find these interesting reading. The Journal of the American College of Cardiology and the British Medical Journal are probably everyone's idea of mainstream reputable science.
I am 74 years old - I have seen money bend science, I have been told of research being abandoned when it was not showing the desired results at the first evaluation, also large numbers of prospective test subjects being carefully sifted for the right ones to test - well established seems to mean accepted due to constant repetition, with no one actually doing any checking.
What about your own annual lipid tests?
This rather over the top generalisation is not borne out by the research. Take the American College of Cardiology paper. Below are their "highlights", which would be downright perverse if what you assert were indeed to be true. If saturated fats raise LDL and if LDL causes heart disease, why would these be their recommendations?
t.co
I'm going to respond to some of the posts in this thread with questions.
ianf0ster wrote above:
"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"
I was curious about this claim, so tried to find some supporting papers from Dr Unwin.
This one
Low-carbohydrate diets in the management of obesity and type 2 diabetes: a review from clinicians using the approach in practice
appears to be the main relevant publication from him.
Here's what it has to say about LDL:
"Clinical trials lasting up to two years have shown that low-carbohydrate diets (in which total and saturated fats have replaced carbohydrates) have had beneficial effects on excess body weight, lipids (including high-density lipoprotein (HDL) cholesterol and triglycerides, but not low-density lipoprotein LDL cholesterol)" (emphasis added)
The other mention:
"A second consideration is the increase in LDL-cholesterol that is described with some [27] but not all [108] low-carbohydrate interventions"
is a link to 2 studies.
The first (https://pubmed.ncbi.nlm.nih.gov/26768850/) finds a significant increase in LDL on an Atkins type keto diet.
The second (https://pubmed.ncbi.nlm.nih.gov/26224300/) finds a small decrease in LDL, when following a low carb diet which was also low saturated fat.
Therefore it seems the claim is quite incorrect.
He also links a post by BulkBiker, which links as evidence a paper which claims that 'LDL Does Not Cause Cardiovascular Disease'. That paper has been found to fail many basic scientific standards:
There is also a link to the work of David Feldman, who as far as I can tell is a software developer and a sort of 'social media personality amateur lipidologist'. He has been a co-author on some papers pushing these ideas about LDL, which have been reviewed and found severely lacking in scientific rigour https://cdn.nutrition.org/article/S2475-2991(22)00065-8/fulltext
As for KennyA's reply, the first paper he links goes into the topic of LDL particle size. While I think it is quite well accepted that the smaller particles are more harmful, that is not to say that the large ones aren't. Here's a very clear video on the topic, well referenced with links to the studies in the description
I responded to the other papers he also linked in this thread:
(in summary, if you actually read the papers they are not really supportive at all of a claim that high saturated fat intake does not cause elevated LDL, or that elevated LDL does not cause heart disease)
I have no affiliation with any of the authors or video creators I linked above. I'm just another diabetic trying to be healthy, and wanting to to avoid getting led astray.
I post these questions and criticisms not as any sort of 'gotcha', and they are not personal.
I'd dearly love to believe I can eat copious amounts of butter and ribeye and stay healthy, so if some genuinely high quality science comes along supporting that I'll be thrilled.
I can certainly say that this was the case with me - about 15 yrs of Law Fat, whole grain (Eatwell Plate) food immediately before my clogged arteries and 3x Cardio Artery Bypass grafts. For the 49 yrs before that I didn't follow any particular way of eating, having always been on the slim side of normal weight.
