There is pretty compelling evidence though that greater intake of saturated fat leads to greater risk of atherosclerosis. If your ldl hasn't increased (was it already elevated though?) that is unusual, it almost always increases with a higher fat diet.I've been on ~20g carb/day for five years, plenty of animal and dairy saturated fat and my cholesterol hasn't altered. Around 80% of the body's cholesterol is made in the body, not derived from diet. Statins work by interfering with the liver making cholesterol - they have no impact on dietary cholesterol.
Yes GPS love their ranges. As if you are a few points above or below the cutoff for normal or abnormal that makes any actual difference in symptoms etc. How long does it take with daily iron supplements to replenish the iron from a deficient level? Or how long to notice improvements in symptoms?Ferretin under 30 is considered absolute iron deficiency even by the nhs. Your dr needs more education along with many others. They have no answer for those in the gap between bottom lab number and 30! It’s taken me years to get to haematology and someone who pulls his hair out at his colleagues ignorance and lack of training. Sending the GP these got the ball rolling for me
Your D is adequate but not great. I’d continue to work on that personally if it were me. If your b12 is in the high hundreds that’s unlikely your cause. People do get symptomatic even in the 3 and 400’s though.
There isn't. I am guided by the American College of Cardiology who say there is no robust evidence. They produced this paper in 2019:There is pretty compelling evidence though that greater intake of saturated fat leads to greater risk of atherosclerosis. If your ldl hasn't increased (was it already elevated though?) that is unusual, it almost always increases with a higher fat diet.
It's one theory which does have credible science behind it, but not the only one. Nobody as far as I know has definitely proven the root cause of IR, if there even is one cause. The triglycerides thing is a question I had about that, as triglycerides go down on a LCHF diet yet they have been shown to correlate well with IR in various formulas.Is this true though - see this post and the posts leading up to it:
Food combining?
afaiu having high triglyceride levels in the blood stream does increase insulin resistance - Going down a bit of a rabbit hole, but wanted just to pick at this - It's one of the things that is ... used as evidence ... but isn't quite correct. In a lab (and this is all Ben Bikman, he did the...www.diabetes.co.uk
One paper from 6 years ago does not represent the totality of evidence! I have seen this cited before, it doesn't actually say that saturated fat doesn't contribute to heart disease, it just says there shouldn't be an arbitrary limit imposed because some saturated fat is healthier than others, the part you quoted, and a set limit does not take that into account.There isn't. I am guided by the American College of Cardiology who say there is no robust evidence. They produced this paper in 2019:
This is what they describe as the "Highlights"
The U.S. Dietary Guidelines recommend the restriction of SFA intake to <10% of calories to reduce CVD.
Different SFAs have different biologic effects, which are further modified by the food matrix and the carbohydrate content of the diet.
Several foods relatively rich in SFAs, such as whole-fat dairy, dark chocolate, and unprocessed meat, are not associated with increased CVD or diabetes risk.
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.
Yes I have read it. Nowhere there does it say that saturated fat is not correlated to increased risk of heart disease. It is a review of guidelines, again saying that some saturated fat is more problematic than others so saying that any level of and type of saturated fat should be avoided is misleading and not accurate. We need some level of saturated fat, just like we need blood glucose, the issue is excess which this paper does not specify or talk about. Nowhere does it say high levels of saturated fat are not harmful. Quote where is says that, or where it says excess saturated fat consumption is not correlated to heart disease? It doesn't.I'm not sure you can have read it. It is not "one paper", it's a review of all the available evidence by the American College of Cardiology. As you'll be aware the ACC was previously a strong advocate for lowering saturated fat in diet. So the review marks a significant change in direction. I also think that the College might just have a greater standing and reputation than individual MDs on YouTube.
here's the conclusions:
The long-standing bias against foods rich in saturated fats should be replaced with a view toward recommending diets consisting of healthy foods. What steps could shift the bias? We suggest the following measures: 1) enhance the public’s understanding that many foods (e.g., whole-fat dairy) that play an important role in meeting dietary and nutritional recommendations may also be rich in saturated fats; 2) make the public aware that low-carbohydrate diets high in saturated fat, which are popular for managing body weight, may also improve metabolic disease endpoints in some individuals, but emphasize that health effects of dietary carbohydrate—just like those of saturated fat—depend on the amount, type and quality of carbohydrate, food sources, degree of processing, etc.; 3) shift focus from the current paradigm that emphasizes the saturated fat content of foods as key for health to one that centers on specific traditional foods, so that nutritionists, dietitians, and the public can easily identify healthful sources of saturated fats; and 4) encourage committees in charge of making macronutrient-based recommendations to translate those recommendations into appropriate, culturally sensitive dietary patterns tailored to different populations.
Yes I have, although there is also evidence that HDL has limited use as a predictor (they did trials of a drug that increases HDL and it made no difference at all to incidence of heart disease etc) and some leading cardiologists don't see much value in any figure that includes HDL as part of the calculation. Note that the NHS uses Qrisk, which uses HDL/LDL ratio, more recent and supposedly accurate calculators use non HDL cholesterol which is the best predictor on a lipid panel.
None of that is anti low carb in any way, I don't know where that came from. It was purely that HDL is not a good predictor of heart disease risk, and therefore any ratios or calculations using HDL are likely to be inaccurate, nothing to do with any specific diet. That is what many leading cardiologists seem to be saying now, one even called it "highly disappointing lipoprotein"I look at the fact that drugs which raised HDL were not shown to reduce heart disease in this way:
Are those drugs also shown to improve health in other ways?
- No they are not, so why should they be used as evidence against Low Carb when the whole reason those drugs were developed was that there was a correlation between low rates of heart disease and people who had a higher HDL than average. There was plenty of evidence for this 'in nature' - just that it didn't hold true for those whose HDL was 'artificially' raised by drugs.
I consider a Low Carb way of eating to be at least as natural as a High Carb way of eating. High Carb WOE = plant sourced is food of the grain farmers or lower classes, while Low Carb WOE = high animal content is more the food of the better off or at least Hunter/Gatherer food. Note that the introduction of agriculture coincided with a population expansion but poorer health, smaller stature and smaller brain sizes.
No, I am saying the leading European cardiologists say that LDL causes atherosclerosis, and nobody is denying that excess intake of saturated fat raises LDL. It doesn't have to mention saturated fat specifically, that is the reason that it has harmful effects in excess, because it raises LDL. I never said it was a "single piece of research" it is more powerful than that because it draws on a large number of trials which total over 2 million people, as it states clearly in the paper. It is 2 years before the one you mentioned.Yes - the single-page paper you linked doesn't mention saturated fat at all. It's about LDL and ASCVD which is not really the same thing.
And it is also a review of evidence, not a single piece of research on "2 million" participants. Of course that paper, being published in 2017, a few years earlier than the one I linked, would have been available to the authors of the ACC paper.
So - if I have this right - the Journal of the American College of Cardiology says "Most recent meta-analyses of randomized trials and observational studies found no beneficial effects of reducing SFA intake on cardiovascular disease (CVD) and total mortality, and instead found protective effects against stroke" . You say they're wrong.
Between your statement and the quote there appears to be no benefit to reducing sat fat/LDL. Even if one accepts saturated fat raises LDL (not sure that I do because it didn’t mine and may others when I increased it hugely on keto) then does it matter in the least, if reducing sat fat (and therefore LDL) doesn’t gain me anything in terms of cvd or mortality gains?Note again the harmful mechanism of saturated fat being that it raises LDL as said before.
"no beneficial effects of reducing SFA intake on cardiovascular disease (CVD) and total mortality"
For what it's worth (I'm only N=1), this is what happened to my lipid levels from the point of diagnosis and during the past 8+ years. No statins except for a month or two after diagnosis (the initial sharp decline). https://www.diabetes.co.uk/forum/th...tion-book-recommendations.201616/post-2674018There is pretty compelling evidence though that greater intake of saturated fat leads to greater risk of atherosclerosis. If your ldl hasn't increased (was it already elevated though?) that is unusual, it almost always increases with a higher fat diet.
N=2. My lipids have also improved since adopting a higher fat diet. I once told my DN I was following LCHF and she said ' but your cholesterol level...oh it's gone down'. She sounded very disappointed that the figures hadn't responded as she expected them to.For what it's worth (I'm only N=1), this is what happened to my lipid levels from the point of diagnosis and during the past 8+ years. No statins except for a month or two after diagnosis (the initial sharp decline). https://www.diabetes.co.uk/forum/th...tion-book-recommendations.201616/post-2674018
For me, having a higher fat diet (to compensate for the carbs I don't eat) has only improved my lipids.
No way to tell what it will do for you though.
I've been happily eating pork scratchings, mayo, fatty cuts of meat, and frying my food in butter, and I've reduced he carbs.
I'm an overweight T1 and I've been on relatively high doses of insulin for the past 8 years, which keeps my bg mostly in range.
Well your same ACC concluded not long before that "The attenuated associations of lipoprotein particle measures with CHD after the adjustment for lipids indicate that their measurement does not detect risk that is unaccounted for by the standard lipid panel" - particle size is largely seen as less important now, all LDL particles are atherogenic.If you look at the ACC's paper, on the first page, in the fifth line of the abstract you will read "Although SFAs increase low-density lipoprotein (LDL) cholesterol, in most individuals, this is not due to increasing levels of small, dense LDL particles, but rather larger LDL particles, which are much less strongly related to CVD risk. " So a clear recognition of an increase in certain LDL.
I found this in Hooper, the first of the papers you linked in support:
We found little or no effect of reducing saturated fat on all‐cause mortality (RR 0.96; 95% CI 0.90 to 1.03; 11 trials, 55,858 participants) or cardiovascular mortality (RR 0.95; 95% CI 0.80 to 1.12, 10 trials, 53,421 participants), both with GRADE moderate‐quality evidence.
I think that agrees with what the ACC paper says "...no beneficial effects of reducing SFA intake on cardiovascular disease (CVD) and total mortality"
I guess we'll just have to differ.
Yes there are confounding factors, but well designed trials account for those as much as possible and mention them. A big one is weight loss - that will usually result in better lipid results regardless of the diet. Yes there certainly is strong evidence that LDL causes atherosclerosis, here it is:Between your statement and the quote there appears to be no benefit to reducing sat fat/LDL. Even if one accepts saturated fat raises LDL (not sure that I do because it didn’t mine and may others when I increased it hugely on keto) then does it matter in the least, if reducing sat fat (and therefore LDL) doesn’t gain me anything in terms of cvd or mortality gains?
A huge confounding factor may well be those that have ignored the standard advice (of low fat) may also more widely be those who ignore all other health advice (Even if those low carbers dont fall into this category). They may have eaten the butter and may well have also eaten the bread, potatoes, sausage rolls and doughnuts too. And sat on the sofa all day, smoking and drinking.
Without checking all those studies are they really considered all those factors effectively? Have they studied those that only ignore the low fat advice but otherwise look after themselves and reduce the junk, and carbs (a small but growing minority)? Is it the combination of fat and carbs together and fat alone is ok?
There are many mitigating factors - had you lost weight? Weight loss usually causes improvement in lipids regardless, at least in the short term. Was cholesterol raised already? Were you doing more exercise? Eating more fibre? This is why we have to look at large populations to see trends to average out for some of these factors.N=2. My lipids have also improved since adopting a higher fat diet. I once told my DN I was following LCHF and she said ' but your cholesterol level...oh it's gone down'. She sounded very disappointed that the figures hadn't responded as she expected them to.
Well yes, the DN asked how I had at last managed to lose a little weight. That's when I said it was by following LCHF. So win, win for me. Lower cholesterol, lower weight.There are many mitigating factors - had you lost weight? Weight loss usually causes improvement in lipids regardless, at least in the short term. Was cholesterol raised already? Were you doing more exercise? Eating more fibre? This is why we have to look at large populations to see trends to average out for some of
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