Lean-Mass Hyper-Responder paper discussion video

[ianf0ster]

Only a minority of Type 2 diabetics (TOFI's like me) will encounter this situation when they try a Low Carb or Keto 'way of eating'.
At first I thought you had to be really lean (not just not overweight) and really fit in order to fall into this category, but apparently the cut off is a BMI of under 25 (at your fattest). So I almost sneak in OK so my HDL and LDL don't quite make it up there either, but you get the drift!

Incidentally this doesn't take the view that such an elevated LDL is OK in the context of high HDL, low triglycerides and a Low Carb way of eating. Just that there are other people like this and so you're not a walking 'dead person'.

It's also reassuring for anybody with Type 2 who is overweight/obese and concerned that a Low Carb Higher Fat diet would raise their LDL - the evidence shows it's unlikely to do so!

 

[cynetique]

The article is available here: https://academic.oup.com/cdn/advance-article/doi/10.1093/cdn/nzab144/6446805

 

[Widgets]

I am very glad that Ken Berry talks sense (aka I agree with him) because I could listen to that accent forever.

Thank you for the link, not that I'm ever going to be in the TOFI category, but more information is always good to have.

 

[DEBBIESCOTT]

Just checked my lipids, looks like I’m one too, bmi 18.1 time to up carbs a little?

 

[ianf0ster]

Just checked my lipids, looks like I’m one too, bmi 18.1 time to up carbs a little?

perhaps up the carbs a little, but be careful.
I tested raising carbs (only by about 10gms per day for 4 days (to around 50gms per day) before my blood tests for my annual diabetic review. The lipid results show it apparently worked, but although LDL r(calculated) reduced and Triglycerides stayed constant, my HDL also dropped (which isn't what I wanted),
So I had lower LDL and a lower Total serum Cholesterol number, all the ratios I care about got worse due to my lower HDL.

 

[Lainie71]

I am very glad that Ken Berry talks sense (aka I agree with him) because I could listen to that accent forever.

Thank you for the link, not that I'm ever going to be in the TOFI category, but more information is always good to have.

Glad its not just me that likes the guilty pleasure of his voice. Him and Neil Oliver GBnews

 

[ultradad]

I been wondering the same about myself, my BMI is about 24.9 now i think maybe a bit lower. Not sure the machine in boots was doing my body fat correctly but i should be about 25% now ?. Hoping its ok when i do a proper blood fasting test in 3 months but if i go by my bloodsugars every morning then everything should be working correctly.
I think the GP is going to try and put me on Cholestrol tabs but i wont be having any of that as this is the best i felt in years

 

[saky]

Just checked my lipids, looks like I’m one too, bmi 18.1 time to up carbs a little?

Even my ldl is high....I have low body weight...trigylcerides dropped, hdl increased due to low carbs ...
If I cut out chicken, butter, cheese my ldl reduced to 124 from 147....

 

[AloeSvea]

Hi @saky. My understanding of the youtube and study is that these cholesterol hyper-responders were not high cholesterol folks before they go Keto/LCHF. Tryglycerides lowering, and HDL raising is good, in lipid health terms, on low-carbing.

I have that pattern, I had no idea it was rare - but I had high LDL before going T2D, going low carb, and going leaner. I don't think this pattern refers to folks like me. Unless I am missing something. Everytime my lab results come back there is a little note about checking out if I have inherited high cholesterol. No medical professional has talked about it with me, so.

 

[saky]

Hi @saky. My understanding of the youtube and study is that these cholesterol hyper-responders were not high cholesterol folks before they go Keto/LCHF. Tryglycerides lowering, and HDL raising is good, in lipid health terms, on low-carbing.

I have that pattern, I had no idea it was rare - but I had high LDL before going T2D, going low carb, and going leaner. I don't think this pattern refers to folks like me. Unless I am missing something. Everytime my lab results come back there is a little note about checking out if I have inherited high cholesterol. No medical professional has talked about it with me, so.

Same with me. I too had high cholesterol (high ldl, high trigylcerides, low HDL) before low carb.
I also have SIRD(severely insulin resistant diabetes). Pcos, belly fat but low body weight.
Currently am on low carb diet and exercise daily. It seems to be working atleast for now.
I may need medications(insulin, metformin) later.

 

[AloeSvea]

Hi @saky! Ah! There you are. Or - there we are.

Not me re low body weight at diagnosis - far from it. But it did not take much belly weight and a bit of plumping padding in my 20s for me to have PCOS and subfertility. (That subfertility didn't really hit me till I was in my 30s and trying for a second child, so I guess it can take a while, but, I certainly had multiple cysts on my ovaries when only a bit plumper than lean in my 20s. Darn it.)

Anyway - the lipids. Yeah, so, we aren't the hyper-responders they are referring to, as we didn't have normal LDL prior to low carbing/high fatting, which then massively elevates on eating more fats. We are, according to my understanding, 'merely' lipid dysregulated, or with 'dyslipidemia. So our signaling is up the wonk, to use a good expression, due to the T2D. Is my understanding at least.

But yes, presenting with that pattern (high LDL, healthy high HDL. healthy low trigycerides on a low-carb diet and having physical fitness) apparently is rare as well, according to Ken Berry and co on that youtube. I was surprised by that. I did have a doc, since retired, who did talk about my dyslipidemia with me, but that my blood lipid results are rarely seen was never discussed, has never been discussed.

But because my lipid ratios are good, and my blood pressure is good, even with high total cholesterol, I don't have statins pushed on me. That was only at diagnosis, and I got fit and lost the weight pretty quickly. I am what is called an exercise super responder, which you might be too? Another way of saying - we respond quickly and well to physical activity and exercise, in terms of muscle growth and strength, and can get fit pretty efficiently. Sporty/athletic body types and families is another very basic way of talking about it!

I focus then on heart health via fitness too, which I take you are doing (love your photo! Jogging/running there).

I do a really easy fitness test, btw, from my favourite health tracking website - health-calc.com. It involves finding a straight forward 'mile' measurement via google maps, or 1.6 or 7km stretch. Walk it briskly, Timing yourself. Taking your BPM (I think is the right acronym? correct me if I am wrong) - once heart beat/pulse per minute at the end of it, and putting it into a calculator on the website, and finding out your VO2max, ie how oxygenated your blood gets with physical activity, and your gender and age, and up pops an age group and gender comparison and fitness level. Very easy to do. Also provides you with a simple 'pick up the pace' via testing too, which is apparently very good for our heart health and continuing fitness levels.

Just to remind - this is about keeping your arteries nice and clear and the well oxygenated blood flowing! And to keep a track of it. This isn't about weight management. Which is the important stuff behind blood lipid testing after all - how well our cardio vascular system is functioning. And staving off vascular dementia and strokes and heart attacks - all big risks for us with T2D, at least the insulin resistance based kind.

 

[saky]

Yes. Since ldl was high before low carbing, I think it can't be put under LMHR.
I was stout too with high body fat percentage. Lost it after restricting carbs and eventually going low carb(80g per day).
I have lost too much weight, trying to gain muscle muscle mass by doing dumb bell exercises and eating more protein.
Thanks for liking my avatar.
BPM is beats per minute so you are correct.
Am also scared of vascular dementia, heart attacks, strokes! My mother has them.
SIRD folks have high trigylcerides and take longer to achieve glycemic control... but with low carbing I got my trigycerides down and hba1c is OKish.(5.4%, 5.3%, 5.7%) In remission for about a year.
Then there is this fear of kidney disease also! I am trying desperately to keep hba1c between 5.1 %- 5.4% which also helps in preventing kidney disease.
I have read Bernstein's 'diabetes solution' and watched all his youtube videos. He advocates low hba1c (4.4%-4.9%) to prevent kidney damage.

 

[Melgar]

I'm just jumping on this discussion about LMHRs, from a couple of years back. I'm well behind the 8 ball on this. I had never heard of LMHR phenotypes before. So I have now come from under my rock after being nudged by a couple of members. I fit this type. I went on a keto diet with high expectations. I lasted 9 months. I didn't enjoy my meals, and fats do make me feel a bit icky. The other reason, I didn't want to lose anymore weight.

Ignoring the fact that my blood sugars didn't really come down, I was taken aback, to say the least, when I had my lipid panel results. My LDL cholesterol had actually gone up and out of range, it was high. In point of fact I had resumed carbs prior to getting the lipid test done. My LDLs have in the past been in range, but not this time. I couldn't understand why. I put it down to the increase in dairy which I used to replace the carbs: 35% cream; aged cheddar; and many other high fat cheeses; full fat Greek yoghurt; and butter on everything, but very low carbs, sufficiently low to put me into nutritional ketosis. First thing I did on getting these result was to cut back on my dairy. Then asked my Dr if I needed to go on Statins! A swift no was his reply.

So, keto diet, increased LDL. That sums it up.

I am very fit
BMI of 19
Low Triglycerides - 0.61 mmol/ls - the lab range states less than 2.21 mmol/ls is optimal.
Out of range LDL's and HDL's.
Total Cholesterol 6.54 mmol/ls lab range 2.00 - 5.19 mmol/ls
LDL Cholesterol 4.41 mmol/ls lab range 1.50 - 3.40 mmol/ls
This was after I reintroduced carbs, my mind boggles as to how high my LDL's actually went. I will never know.

 

[saky]

My ldl drops if I cut out dairy and meat. It went down by 38 points which is good. Am on a statin now as I couldn't get it down further. I do eat nuts like almonds, pistas, flax seeds, peanuts, cashews...
ldl - 164mg/dl(dairy, meat)
ldl- 126mg/dl(eliminated meat and dairy including milk)
ldl - 90mg/dl( with 5mg statin)

 

[Melgar]

My ldl drops if I cut out dairy and meat. It went down by 38 points which is good. Am on a statin now as I couldn't get it down further. I do eat nuts like almonds, pistas, flax seeds, peanuts, cashews...
ldl - 164mg/dl(dairy, meat)
ldl- 126mg/dl(eliminated meat and dairy including milk)
ldl - 90mg/dl( with 5mg statin)

By hook or by crook you got your LDL's down, well done! A whole different story, but are LDL's really the bad guys? Check out some of the discussions around LDL's here on this site.

 

[saky]

Since I have family history of CAD, I want to do all that I can. Planning to get a non invasive CT angiogram done...

 

[Melgar]

After a new Lipid panel it appears I’m not a LMHR . I increased my carbs a while back, but it has made no difference to my LDL‘s , they are still out of range , my Triglycerides, have fallen to 0.54 mmol/ls . My Dr keeps testing me for hyperthyroidism. Apparently I have the symptoms for it. Each time I get tested I am found to be producing enough TSH at 1.12 mU/L. The lab range being 0.32 - 5.04. So I have no idea why my lipids are out of balance.