Keto and high cholesterol

[Loken]

I have mostly been following a ketogenic diet sense I was diagnosed with type 2 diabetes. Started on 4 metformin a day, I managed to get my sugars under control and only 1 metformin with my bloods being a 44-47.

Until about a 6 months ago when I stopped eating the keto way due to the cost of it, had the tighten the belt for a bit an ate what we the rest of the family did. So my sugars when back up to 64. So back on the keto wagon and they are coming back down, but my cholesterol has gone up to 7.1 and the doctor wants me to go on statins what I don’t want to do.

Been reading about removing the obvious fats and fried food what has been my omelets for breakfast. Planning, on changing my breakfast to a keto friendly nut seed granola. Plus maybe start taking omega 3 supplements?

Anyone got experience bringing the cholesterol down and staying on keto?

 

[KennyA]

Hi and welcome

I have been on keto for about five years now and my cholesterol is what it was five years ago - and what it was 25 years ago for that matter. I don't bother with it as a concept. You might find these pieces of research, all within the last 10-12 years or so, interesting reading.

Cholesterol and all-cause mortality – Korean research on 12.8m adults

Total cholesterol and all-cause mortality by sex and age: a prospective cohort study among 12.8 million adults - Scientific Reports

It is unclear whether associations between total cholesterol (TC) levels and all-cause mortality and the optimal TC ranges for lowest mortality vary by sex and age. 12,815,006 Korean adults underwent routine health examinations during 2001–2004, and were followed until 2013. During follow-up...

www.nature.com

UK research showing lower cholesterol increases mortality

https://www.bmj.com/content/353/bmj.i1246

HUNT2 – Norwegian research

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3303886/

Journal of the American College of Cardiology 2019:

"There is no robust evidence that current population-wide arbitrary upper limits on saturated fat consumption in the United States will prevent CVD or reduce mortality".

https://www.sciencedirect.com/science/article/pii/S0735109720356874?via%3Dihub=&utm_source=arrow.proteinpower.com&utm_medium=referral&utm_campaign=the-arrow-188

[edited to remove dead link]

 

[Loken]

Hi and welcome

I have been on keto for about five years now and my cholesterol is what it was five years ago - and what it was 25 years ago for that matter. I don't bother with it as a concept. You might find these pieces of research, all within the last 10-12 years or so, interesting reading.

Cholesterol and all-cause mortality – Korean research on 12.8m adults

Total cholesterol and all-cause mortality by sex and age: a prospective cohort study among 12.8 million adults - Scientific Reports

It is unclear whether associations between total cholesterol (TC) levels and all-cause mortality and the optimal TC ranges for lowest mortality vary by sex and age. 12,815,006 Korean adults underwent routine health examinations during 2001–2004, and were followed until 2013. During follow-up...

www.nature.com

UK research showing lower cholesterol increases mortality

https://www.bmj.com/content/353/bmj.i1246

HUNT2 – Norwegian research

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3303886/

Journal of the American College of Cardiology 2019:

"There is no robust evidence that current population-wide arbitrary upper limits on saturated fat consumption in the United States will prevent CVD or reduce mortality".

https://www.sciencedirect.com/science/article/pii/S0735109720356874?via%3Dihub=&utm_source=arrow.proteinpower.com&utm_medium=referral&utm_campaign=the-arrow-188

[edited to remove dead link]

Thanks for all that information. My doctor is insisting that I start taking statins, even when I said I would like the chance to reduce it with adjusting my diet, they prescribed me it.

 

[Outlier]

If you are in UK, there is a lot of pressure on GPs to prescribe statins.

 

[KennyA]

Thanks for all that information. My doctor is insisting that I start taking statins, even when I said I would like the chance to reduce it with adjusting my diet, they prescribed me it.

That's what I had too. My cholesterol level has gone from being described as "good" in the 1990s to "OK" to "too high" although it hasn't itself changed at all. I have no interest in reducing my cholesterol level. The evidence from the papers attached above is that mortality rises at cholesterol levels below 5, although that's where the current system thinks we should be. Statins will certainly reduce cholesterol, as will switching to a non-saturated fat diet, but to quote the Journal of the American College of Cardiology in 2019: There is no robust evidence that current population-wide arbitrary upper limits on saturated fat consumption in the United States will prevent CVD or reduce mortality.

There is a financial incentive for practices in the UK to prescribe statins to certain defined groups (T2 is one) through the Quality and Outcomes Framework, which is part of the way general practices are funded. Basically it rewards activity - practices doing something - rather than patient outcomes. So you get a payment eg for putting X % of your appropriate practice population on statins, and a bigger payment if it's X+10%. Whether the patients actually take the statins or see any benefit isn't part of the consideration.

The BMA, which agreed to the system when it was introduced just over 20 years ago, believes that this affects the relationship between patient and doctor, and has called for the entire system to be scrapped.

 

[Le Duan]

That's what I had too. My cholesterol level has gone from being described as "good" in the 1990s to "OK" to "too high" although it hasn't itself changed at all. I have no interest in reducing my cholesterol level. The evidence from the papers attached above is that mortality rises at cholesterol levels below 5, although that's where the current system thinks we should be. Statins will certainly reduce cholesterol, as will switching to a non-saturated fat diet, but to quote the Journal of the American College of Cardiology in 2019: There is no robust evidence that current population-wide arbitrary upper limits on saturated fat consumption in the United States will prevent CVD or reduce mortality.

There is a financial incentive for practices in the UK to prescribe statins to certain defined groups (T2 is one) through the Quality and Outcomes Framework, which is part of the way general practices are funded. Basically it rewards activity - practices doing something - rather than patient outcomes. So you get a payment eg for putting X % of your appropriate practice population on statins, and a bigger payment if it's X+10%. Whether the patients actually take the statins or see any benefit isn't part of the consideration.

The BMA, which agreed to the system when it was introduced just over 20 years ago, believes that this affects the relationship between patient and doctor, and has called for the entire system to be scrapped.

Interesting [and worrying] that GPs are being incentivised on inputs rather than outputs, outcomes and results! Typical, box-checking bureaucracy...

 

[KennyA]

Interesting [and worrying] that GPs are being incentivised on inputs rather than outputs, outcomes and results! Typical, box-checking bureaucracy...

It's been that way for quite a while now, and unfortunately the objections voiced back in 2002/3 all appear to have been well-founded. Here's a link to the current guidance for England 2024/25:

NHS England » Quality and outcomes framework guidance for 2024/25

NHS England » Quality and outcomes framework guidance for 2024/25

www.england.nhs.uk

 

[jeano999]

For me every GP follow up Statins are suggested - I just say no thanks! I too have read the research that calls into question the efficacy of taking statins and the (almost nil) effect on mortality. Plus there are also reports that it can cause Type 2 diabetes for some people as well as other adverse side effects. Still the NHS are pushing to prescribe. Strangely enough only today I bought a book by Dr Malcolm Kendrick on this very issue "A Statin Nation--Damaging Millions in a Brave New Post-Health World" which I am looking forward to reading. There have also been studies that concluded that dietary fats are not directly connected to cholesterol in the blood - so you should still be able to eat your omelettes and stay on the keto journey.