Vegan Keto vs Carby Carnivore: Cholesterol Conundrum
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- เผยแพร่เมื่อ 16 มิ.ย. 2024
- OreoVsStatin: pubmed.ncbi.nlm.nih.gov/38276...
Meta of 41 RCT: ajcn.nutrition.org/article/S0...
Cooper et al.: www.frontiersin.org/journals/...
Case series (Table 4): cdn.nutrition.org/article/S24...
Low-Sat Fat Keto Case Report: pubmed.ncbi.nlm.nih.gov/35498...
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0:00 - Something weird (Intro)
0:46 - HOW is this possible? (LEM)
3:46 - LDL 545 mg/dl!
4:37 - "Remove the driving factor"
5:12 - Why not "healthy" carbs?
5:58 - Returning to thought puzzle
6:35 - Why YOU should care
7:48 - Productive Provocation - วิทยาศาสตร์และเทคโนโลยี
![[TH] VCT Pacific Stage 2 - Week 1 Day 1 // DRX vs ZETA | BLD vs TS](http://i.ytimg.com/vi/AWaOqaxN6Y0/mqdefault.jpg)
"Well, aren't you curious?"
You speak my language.
😄🤔
Nick, great video. Your explanation is easy to follow. And I agree, it's cool to ask these questions and understand how the body works.
Glad you liked the thought puzzle!
I’m not particularly lean but have extremely high LDL high HDL and pretty low TG
I eat ketovore but my dr is truly freaking out. My husband with low normal cholesterol and high trigs had a Heart attack last week The stress on me is scary
Never Worried about my high LDL for35 years until recently because of his many illnesses
Yeah some people say it doesnt matter, some people say LDL is the bad guy, im neither side, im unsure, but my HDL is 170, LDL is 170 and my TG are 38, so metabolically healthy, CRP low.
It’s the low triglycerides that are the key!
The context is inflammation. If your body is chronically inflamed, low cholesterol means nothing b/c sinister things are happening. Cholesterol is a building block and always at a place of injury. High LDL in a metabolically fit person is for energy delivery. LDL in a metabolically unfit person is running around trying to patch injuries and soothe inflammation.
@@karend.9218 Yeah so if my HDL is 170 and Trigs. are 38 (much higher HDL than trigs.=good insulin sensitivity and metabolic health), and LDL is 170, then high LDL shouldnt matter in terms of CV risk because my CRP is very low and my insulin sensitivity is very good.
"My husband with low normal cholesterol and high trigs had a Heart attack last week "
It's because eating sugar and having high insulin is what in reality cause a heart attack...
Outstanding. Brilliantly explained. As a humble virologist what struck me with all the -omics work looking at host responses to the recent dreaded lurgy was that blood glucose best predicted patient outcomes after hospital or ICU admission. Superficially to me it appears our bodily systems don’t work well when sugar coated. More power to your elbow Dr. Norwitz. Science goes farther when it’s fun and for the sh**s and giggles as they say even when deathly serious.
"Science goes farther when it’s fun and for the sh**s and giggles as they say even when deathly serious." ... I like this. Thanks
I feel like I am a Keto/Carnivore test rat, and Dr. Nick is my leader! Thank you for explaining this so well! I plan on telling my Dr. to check out your channel, and the LMHR studies. I am close to my ideal BMI, and know my LDL/HDL will stay high..triglyceride are 49!
I wish you all the best from a fellow LMHR. My docs were not receptive to this new model and insisted I be on a statin with my LDL at 160 regardless of HDL 94 and triglycerides of 46. Most docs tend to stick with the old lipid model I've found.
@@efsmiley1995Yeah maybe if you are very metabolically healthy then maybe LDL doesnt matter that much, because it makes sense ,you have it higher because body needs to compensate to have more energy, i have HDL 170, LDL 170 and Triglycerides 38.
Great explanation. I’m a 68 year old female. I’m very lean, lift weights, walk 10000 plus step daily. I was eating mostly carnivore. In November, my numbers were Total cholesterol - 487, LDL 370, HDL 102, TG 50. Started watching you and added more carbs. My numbers now are Total 390, LdL 277, HDL 99, TH 43. My doctor wants to see it go down more, but it indeed works by adding back some carbs. Love your videos.
My LDL is 170, HDL is 170 and my Triglycerides are 38, i eat mainly same things everyday 1pound organic grass fed finished beef, pound of carrots, 5 eggs, can of sardines, 1tbsp organic nonalkalized cacao, some flax, bakers yeast, raw milk kefir, some raw cheese and fruit
@@lukasholly5517 a pound of carrots is very interesting. Not sure I could do that.
I eat many similar things daily. Raw milk was recently added.
First mistake is listening to your doctor, a 70,000 person study revealed low ldl had a higher mortality rate than high ldl
HIGH CHOLESTEROL IS NOT DANGEROUS!!!!
I recommend both professor Bartholomew Kay and Dr. Christy kesslering for this.
This doctor has points, but all in all he doesn't seem to understand the lack of connection between cholesterol and heart disease, cardiovascular disease, etc. It's a massive, massive lie. The irony in his shirt that says science that can't be changed or questioned is religion, when it's that science around cholesterol in general that has lead us to be dummies on what the hell cholesterol is.
The answer is CLEAR, the diet heart hypothesis is an absolute lie in order to make humans believe cholesterol is some big bad guy, when true science repeatedly proves that this connection is a lie and CANNOT be proven, your body makes cholesterol, and it's shown the United States is refusing to adapt to this new information, which MEANS our hospitals and nutritional experts in the U.S. still don't have this updated information, so PLEASE understand these are scary boogie man lies, and in order for many doctors to truly come to their senses it means they would have to figure what the lie is, and how to undo it. I myself had to source in my own brain what I thought I knew and what I felt were lies, when thinking something was a lie I dug deep until I found truth and ability to apply.
Whats for certain here, is carnivore with 0 carbohydrates is the best thing that has ever happened to me, and after transitioning it was so painfully obvious how much other foods did damage to me.
Foods I ate my entire LIFE, had blindly unaware how all the little nitpicky feelings I had in my head came directly from the food, and going carnivore full on makes you come to realize how toxic everything around our diets is. Then when you see and learn the system built on destructive information blatantly, hence all the WHEAT in every grocery store, sugar, etc. and at that point you see the destruction that has been forged, and also, yes elite class people who want to rule the world, evil and proven liars, absolutely spend billions to make sure systems like this get built, a very expensive system built on a mountain of lies, and if you don't think that's possible then you need to figure out and understand what communism, Marxism, etc. Is., because these ideals very much leak into medical consensus and this is what is looks like, big cholesterol bad, Causes heart disease, blah blah, and the hospitals and media, and everyday establishments, again THEY OWN, reflect this, not because they want you to know the truth, but because they want you sick. The reality with it is people are everyday Alarmed by these words and get told to make the wrong decisions and that's the real problem here, we need to realize again doctors like this don't understand the lies at hand. They are drawn out, complex, and billions of dollars were spent on them, highly sophisticated and people will study something their whole lives and not see the root cause here.
Don't you get that hospitals want you to come back not stay away?
It's not that the doctors and nurses are evil, maybe some are, but it's more they don't understand that the sophisticated information they all learn and go through in training has been manipulated and forged on lies. The methodology and understanding is a false and they don't realize it, hardly ever, because it's almost too complicated to think out of it, compared to buying into it. It takes a doctor to see both sides to realize one is built on a mountain of lies, and the other is truth and the actual ability to heal isn't all that scary, when it's quite simple instead, and we are just simply lead astray our whole lives when all the food, advertising, doctors, nutritional experts, people around the block, all know and understand the same lie, it gets hard to see around it, and instead it becomes simply just normal. It's normal to go drink a soda right? Have yourself a burger or two? We don't realize how easy it is to attack us on levels we can't see, and this is the point. Those who are good, with gifted brains, who have looked under the scope further have come to conclude meat is the most appropriate diet, and we don't need much anything else really, aside from that and water.
We aren't supposed to be a sick society, obese, with cancer on medications, and when you go back to the food that nature perseveres for the most, MEAT, you know like a lion chasing a gazelle?... Then health really starts to return and also when you can break away from these systems that aren't true, like the needs for fiber, sugar, carbs, veggies, fruits, etc. You come to realize NONE of those things are necessary. I spent 15 years fooled thinking they were, and literally almost overnight, carnivore changed my mind.
I get that's hard to see but Come on people, what a quicker way to attack the inside of you? IN YOUR FOOD. How many people around us are fat and sick? What foods are we surrounded by?? CARBS AND SUGARS. Open your eyes as much as possible, and think for a second why???
I for one, appreciate your delivery on what is a fascinating subject to me. You make the hypothesise much easier to understand. Thank you Nick.
Make that hypothesis, duh?
Appreciate this! Thanks!
Your channel it's addictive men! Well done!
Men? Man? Either way... thanks :).
Absolutely fascinating! Love what you're doing.
Cheers thanks!
Absolutely fascinating! Thanks for sharing.
Glad you enjoyed it!
I’m fascinated by your research. Watching also with an eye to how this might apply to me, now or later. I’m not an LMHR, but I went on the specific carbohydrate diet, which is lower carb, to alleviate serious gut issues. Issues resolved, and I ended up loosing 50 pounds, I’m now “normal” weight, but my cholesterol went through the roof. I don’t fit the LMHR phenotype, and am currently trying very hard to modulate lifestyle to lower my risk of CD. Your research and curiosity is inspiring my own what ifs and testing ideas out on how to use food / lifestyle to improve my numbers. Meds may very well be in my future but I’ll feel better about it if I know I tried the alternatives first.
Keep up the good work!
Love the T-shirt, BTW
Thanks for sharing. These are hard choices we all have to make for ourselves. Only you can know what's right for you.
Great channel with deep dives that make sense and are easy to understand.
thank you :) welcome!
I love the enthusiasm around the science. It's kind of contagious!
YAYYY!
this was a highly needed video explainer! 👏👏
Glad you think so!
So curious, yes! thanks for explaining all these variations.
You're welcome!
Awesome! I am curious and love this!
Yippee!
Love your content, thanks for explaining so clearly. I am a LMHR 57 yr fem. Trig 46, HDL 143 and Ldl 262. Carnivore for 1 year before ketovore. Feeling great. Oh I weigh 52 kilos 165cm. ❤
Par for the LMHR course...
Great video Nick keep ‘em coming.
I will... !!!
Fabulous Video!!! Thank you for your curious mind.
Thanks for joining, listening, and for your liberal use of "!"
Your summary hits the nail on the head. It’s fascinating how this super-complex biochemical “world within” is steadily being revealed.
It seems like such as sad state of affairs when people want to oversimplify to set their mind at ease, rather than standing in awe and appreciation of the complexities
@@nicknorwitzPhD Exactly
Excellent video. Thanks for sharing.
you're very welcome!
Just ordered your shirt!
LOVE!
I guess the real question is "Which metabolic state is the more healthy?" Based on the boxed in definition of modern lipid research the consensus would lean in the direction of the Low LDL patient being the more healthy. The real discovery here is not about lipid hypothesis, rather about evolution and the body's ability to metabolically respond to its environment, and not just respond but respond in a relatively short timeline.
Is the term LMHR (Lean Mass Hyper Responder) truly an anomaly? Evolutionarily speaking every human on the globe would have been a LMHR thousands of years ago based on environment, food source, chemical exposure and so on. Which state of being "metabolically" is the more healthy?
Joe
Love the questions: "Which metabolic state is the more healthy?" and "Is the term LMHR (Lean Mass Hyper Responder) truly an anomaly?". I believe that LMHR may not be such an anomaly and unhealthy (being in ketosis) as one might think. But I also believe the type of ketogenic lifestyle (foods, exercise,etc) may be one of the variables making it healthy vs less healthy. I was LMHR on medicinal keto, but wasn't LMHR on carnivore (zero carbs). My LDL dropped especially after water fasting. Food for thought.
" Evolutionarily speaking every human on the globe would have been a LMHR thousands of years ago "
That sounds like pure fantasy.
From my understanding LMHR is a phenotype therefore it would only be seen in people with that phenotype and people don't go in and out of it, but it's expression is triggered. What it kind of reminds me of is the bodybtypes of sprinters who have more fast twitch muscle fibers which run on glucose as opposed to long distance runners who have more slow twitch and would be fine with either type of "fuel." Thus when the sprinter type goes low carb, there muscles preferring the faster burning glucose don't utilize the fatty acids for fuel and they build up in the blood. I could be wrong in my understanding though. There are some differences in people depending on where there ancestors originated that favor ripped sprinter type bodies vs more distance/endurance types.
Keep up the great work
Will do!
Great video! I want to hear a lot more about plant vs animal fats/sterols/etc, beyond PUFAs.
Awesome shirt bruv
Get one bruv ;) metabolismshirts.myspreadshop.com
Great video Nick. I’m somewhat the opposite of you. When I was on a vegan diet, my LDL was lower but still outside the reference range. My triglycerides were also well outside the reference range. On a carnivorish diet with some honey and fruit occasionally, my LDL increased significantly, but triglycerides fell within the reference range. I guess everyone is uniquely created and responds differently.
Context always, and the value of an n = 1. The great thing about metabolic health is the proof is in the results... there is no one way... we are all unique... but the challenge is to discover what makes us unique
This is so, so interesting! Prompts the question in my mind as a LMHR. Should I be taking that repatha my cardiologist insists I need to keep from dropping dead? Seems to me the body knows what it's doing and adding the drug may just be throwing a wrench into it's operational plan! I'm still waiting for more information to make this medication decision. I know you can't give medical advice so please keep providing any relevant data as it comes available. Thanks for your information, I eagerly await more.
"Carby Carnivore". 🤣 I love it. Thanks for the succinct rundown!
Welcome!
Brilliant!
So insightful - thanks Nick
Love this research
I wonder though - why would you want to lower your LDL if metabolically healthy?
Brilliant Nick. All my students got their cholesterol dawn 30 to 50% with carb cycling on keto carnivore.
Yep... just need to understand the physiology... then (under some circumstances) a banana or two can perform like high-dose Rx meds on LDL/ApoB levels.
Omg Nick!!! I must have one of those T-shirts!
Do iT!!! metabolismshirts.myspreadshop.com
I love your videos!!!
Thank you!
Well done!
I prefer rare ;)
Great explanation. Thanks.
I am not “hyper” but it definitely happens. I am low carb and I fast. Weight and triglycerides way down. HDL and LDL up.
That's the "triad"
This is a good example of a spectrum / continuum. The hyper responders will presumably be at the tail end of the distribution, but this phenotype doesn't just "end" it's more of a phase out/phase in of sorts so just by logic (know nothing about medicine) I'd guess that it can happen to every one, it will just happen to different extents with the exact same food/diets...
Thx! I'm a lean mass hyper responder as well and trying to navigate through it all. Doctors are saying take a statin but it just doesn't make sense given my metabolic are good and inflammation low in pretty good health except for some long covid issues. Thx for the info as I enjoy hearing it to help me on my journey. I'm definitely staying curious
I can endorse curiosity... ;)
boost vit D for Covid and do some long covid alt. research
Nick I have been carnivore for 16 months, I really enjoy your videos and your approach. I wanted to share my recent labs, I know your channel, along with many others are not meant for diagnosis but I find my results quite curious.
March 2024 lab results total cholesterol 905, LDL 800, HDL 89, Triglycerides 80. Not quite LMHR criteria, body fat 12.8%.
I had the unique opportunity to go to the same facility where you, Dave Feldman, Adrian Soto Mota and Matthew Budoff had your patients get their scans. Same principle investigator read my results as well.
April 2024
Left Main 0
LAD 0
Circumflex 40
Right 21
I’m 56 and this is my first scan, using this as my baseline, just something I thought you might find provocative and thought provoking.
Thanks for all you do.
905 total? Did your doctor lose his mind?
@@dontrend5956 Yes 905 total, he called me at 8:30pm and asked if I was sitting down, he was very concerned that if he provoked me with this news that I might stroke out right then and there, then he said I broke the office record! 😂
@@dontrend5956this is a numbers game baby. The higher it goes, the better you feel lol
Where did you go for the testing? What dr? Thanks
The Farima Czyzyk Center for Cardiac Research and Wellness, part of Harbor-UCLA Medical Foundation in Torrance, California in conjunction with Dr. Budoff
I did the oreo trial myself , and yes my HDL went up and triglyceride down but my LDL went UP !
You did it wrong. (Ha, ha, ha just kidding!).
A well-articulated explanation of this intriguing phenomenon, Nicholas! As one with a penchant for unravelling metabolic curiosities, I must commend you on encapsulating the lipid energy model so eloquently. The proposed mechanism underpinning the LDL-HDL-triglyceride triad in lean individuals adhering to carbohydrate-restricted diets is both compelling and thought-provoking.
However, as is often the case in the intricate tapestry of human biology, several additional factors merit consideration. Might the specific composition of dietary fats, particularly the ratio of saturated to unsaturated fatty acids, modulate the observed lipid profile? Furthermore, could the intricate interplay between the gut microbiota and host metabolism influence this metabolic response? Certain bacterial species are known to produce metabolites that can impact lipid homeostasis.
Another avenue worth exploring is the potential influence of gender dimorphism. Do men and women exhibit differential susceptibilities to this phenomenon, perhaps attributable to hormonal differences or variations in body composition? Moreover, one cannot dismiss the potential role of physical activity and energy expenditure in modulating this metabolic adaptation.
I happen to be a LMHR, with the triad numbers you talk about. The Why and How is fascinating! I finally found a young female doctor who is willing to open her mind to these questions as well, and come on board with me as my health partner, instead of condemning me ,like the 2 before her,whom I fired. Finding a metabolic doctor remains elusive since I must work within the system, but at least she's curious about this also. The last reading was LDL of 275, calcium artery score 0,so she said, You don't seem worried about it? I said no, I'm not! She asked to see me in 6 months and sent me home!
Nick, please keep up your mission of bringing science to us, the people! I feel like I'm in class with you.
" finally found a young female doctor who is willing to open her mind to these questions as well, and come on board with me as my health partner, instead of condemning me ,like the 2 before her,whom I fired. Finding a metabolic doctor remains elusive since I must work within the system, but at least she's curious about this also" I love this! Glad you found someone who works with you :) Thanks for listening in!
So are you concerned about elevated LDL levels in LMHRs? I thought that was the point of the LMHR study - that the LDL did not seem to be a concern for them. No?
Being a LMHR, I did find this really interesting.
As you should!
Thanks for the interesting video and makes a lot of sense. I'm a 59 LMHR in Australia. I've been on carnivore for jsut over a year. My total cholesterol is almost 15 (I'm in Australia, so am only familiar with their numbers), my HDL is normal and my Triglycerides are very low. My carnivore doctor wants me to introduce a few carbs to lower my LDL, which I'm doing now, as he said that though there is no evidence super high LDL is bad, it doesn't mean it isn't. My concern isn;t so much the extremely high LDL, but my lipid subfraction test comes back as pattern B, with elevated small LDL particles (not the super tiny ones though). The question is that a cause for concern? Would adding a few carbs necessarily lower the smaller LDL particles? My most recent calcium score test came back as zero. However, my Ferritin levels are higher than normal (my doctor likes to see about 100, but mine is over 400). Could the higher ferritin cause a rise in LDL, especially oxidised LDL? Thank you.
I love the shirt.
enjoy: metabolismshirts.myspreadshop.com/
I have LMHR numbers on vlcd, I’ve done several (6) n=1 experiments, each with a different % of macros/calories. I’m fascinated by how I can manipulate my labs in only 5 days. I have a question, My BMI is 23.3 but I am not athletic/muscular and I have wondered if this phenotype is more relative to visceral leanness instead, or is that the same? Last week I gave my PCP copies of your Lipid energy model and your meta analyses. She said she was interested and will read them. Thanks for all your work. It has made a big difference in my life.
Thanks for sharing the work. You could be right about the VAT, or it could alternatively be SubQ. Unfortunately, we don't have refined enough data yet to say... but I suspect we will be able to do better than BMI in future.
love the shirt!
Thanks! metabolismshirts.myspreadshop.com
Great video... I also am a lmhr. I am wondering if the fact adding more carbs in order to lower a bit of the LDL would also affect my glucose level.... Have you tried to find a way to lower your LDL without affecting your blood sugar levels? Please keep up with the great videos. I'm a subscriber and I'm glad that you guys are doing such good research.
I'm the same, I have added carbs back in- 60 grams seems to be my sweet spot- and through trial and error monitoring my blood glucose I have found I do well adding things like veggies and some fruits (berries, clementines, and cantaloupe don't trigger blood glucose spikes for me). I also do okay with homemade sourdough bread- but only 1/2 slice with a meal, eaten after the protein and fat. This dropped my LDL from 616 down to 180. My HDL is still 80 and my triglycerides are still 48. Just play around to see what works best for you personally. My CAC is zero. Helped my doc calm down- but he loves the LDL being 180 instead of over 600.
First thought is LDL a relevant marker or risk factor for heart disease and/or ill health.
Nope, risk implies cause and effect and there is no valid mechanism which can show ldl causes anything bad.
Fascinating video as always Nick! What are your thoughts on hyperabsorbers of cholesterol (Not plant sterols) from exogenous sources? Do you find any LMHR are hyperabsorbers?
Also what are your thoughts on exogenous cholesterol absorption. Do we know how much (% wise) exogenous cholesterol can be absorbed. And do we know the conversion rate of esterified exogenous cholesterol to free cholesterol in the gut?
Thank you!
Great video by the way.
However, still confused on a couple of things trigs:
Background:
1. Im 68 yr old male who is fit with 23 BMI (lean T2)
2. I struggle to put on and keep muscle mass.
3. Im on low carb (for 3 yrs) but not your typical LMR.
4. T2 reversed, after 30+ yrs of glucose intolerance and eventual T2 diagnosis in 2006.
Note these are International units:
After my low carb intervention av HDL raised from 1.0-1.5 to 2.5-3.0 and LDL raised from 8.5 to10 unmedicated.
Both became raised after low carb.
However, trigs stubbornly stay above 1?
Note my unmedicated trigs were often very high when on carb diet - sometimes 5+!
However, my trig/hdl ratio is still optimal, other than those pesky trigs?
Question:
Are there reasons for trigs to stubornly stay above1.0 when low carbing?
What can cause trigs to stay higher than optimal (IR)?
Maybe trig receptor disfunction?
Thanks
John
Love your tee shirt.
Nick, another great presentation. But I'm still not sure I understand how the lipid energy model applies to (and explains) ketovores who are not LMHRs. For example, my LDLs were high before I started keto (consistently in the 250-400 range over the past 20 years). When I switched to a strict keto/carnivore lifestyle my TGs went down and my HDLs went up, but LDLs have remained stubbornly in the same range, neither rising nor falling significantly. What does the lipid energy model say about this?
Hey Nic, I remember you mentioned you use keto to manage IBD, could you make a video on managing inflammation with keto? My inflammation markers are still high (CRP 4.9, ferritin 339) on pretty much carnivore, I am curious what else I can do.
So what's better? Do we stay low carb and walk around with high LDL, or do we add carbs back to our diet, thereby creating a glucose and insulin spike (or spikes), as well as likely raising our triglycerides and lowering our HDL? Also, how will our LDL particle numbers look? I suspect the low carb approach will minimize the number of small (dense) LDL particles (which is supposedly a good thing), while the addition of carbs will yield an increase in small (dense) LDL particles (which some would say is not good).
@@stellasternchenYour approach sounds more like the Cyrus Khambatta "Mastering Diabetes" method. It's more vegetarian and certainly not high fat. Doesn't appeal to me, however.
@@stellasternchen I think carbs are the major cause of metabolic disease. But I'm referring especially to modern day carbs, which are processed foods mixed with industrial seed oils and excess sugar. But even a simple baked potato cooked at home in your oven will (for most people) spike blood sugar. So will a so-called "healthy" bowl of oatmeal. Carbohydrates provoke fat accumulation in people much more readily than protein and/or dietary fat. Dr. Ben Bikman (among others) demonstrates that very well: th-cam.com/video/gfikT_O4v9A/w-d-xo.html
@@stellasternchenplease give the reference on the study you mentioned
There is a lack of compelling evidence to support the addition of exogenous carbohydrates, particularly in the form of sugars, given their potential impact on blood glucose levels. Even fructose, upon entering the bloodstream, can pose metabolic concerns. However, the ingestion of a significant quantity of protein in a single daily meal could theoretically attenuate this issue by modulating the postprandial glycemic response to carbohydrates.
Question: I'm at the beginning of my journey to good health, and I've been low carb (trending towards mostly carnivore) since last summer and have lost about 20 pounds, but still need to lose about 50 or 60. At my last lab a couple of weeks ago, my LDL zoomed up, my HDL made a moderate increase, and my triglycerides dropped drastically. Obviously I'm not a LMHR because I'm still obese, but does this explanation for the numbers fit someone of my body type, too, generally speaking?
There is no actual BMI cutoff for LMHR. The "lean" feature is an association, albeit a strong one. I don't know you exact numbers and body shape, but the LMHR triad is a set of cutoffs that are set to classify a phenotype. However, physiology doesn't care about the cutoffs we set. The Lipid Energy Model thus CAN certainly apply to people who are not lean and who not mean LMHR lipid criteria. There can also be transient changes with rapid weight loss. All that said, if someone were - say - going from class II obesity to class I/overweight on a low-carb diet, I'd expect LDL-C to probably go down in the long-term. May not apply to all, but this is what the meta-analyses of human RCT would predict.
Thanks for the interesting discussion. So is the LMHR solely defined by high levels of LDL, HDL and low triglycerides? As in someone with 15 lbs to lose who is not lean - but has those markers - can still be a LMHR?
Anyone looked at the Cell Danger Response (CDR) and high LDL levels in Lean Mass Hyper-Responders (LMHRs)?
So, here's the deal - when the body encounters stressors like toxins or infections, it kicks into CDR mode. This triggers a cascade of biochemical responses aimed at defending the body and restoring balance. Part of this response involves ramping up LDL production, as lipoproteins play crucial roles in immune function and tissue repair during times of stress. But here's where it gets even more interesting - the interplay between diet and the CDR. Research suggests that adopting a high-fat, low-carb diet can influence the body's adaptation to stressors. When you restrict carbohydrates and increase fat intake, your body undergoes a metabolic shift (ketosis). In ketosis, the liver produces ketone bodies from fatty acids, which become the primary fuel source for cells, including immune cells.
Now, let's talk pathways. One key player here is the nuclear factor kappa B (NF-kB) pathway, which is central to the inflammatory response triggered by the CDR. NF-kB regulates the expression of genes involved in inflammation, immune function, and lipid metabolism. When activated, NF-kB can upregulate LDL receptor expression, leading to increased uptake of LDL cholesterol by cells. Additionally, the peroxisome proliferator-activated receptors (PPARs) pathway may also come into play. PPARs are transcription factors that regulate lipid metabolism and inflammation. Activation of PPARs by fatty acids can modulate LDL receptor expression and lipid metabolism in response to dietary changes.
The introduction of carbohydrates into an LMHR's diet likely influences the CDR and LDL levels in several ways. Firstly, readily available glucose from carbohydrates alleviates the metabolic stress associated with the initial LCHF adaptation. This reduced stress could lead to a dampening of the CDR response, potentially downregulating the activity of NF-kB and SREBP, transcription factors known to drive cholesterol synthesis. Secondly, carbohydrates might influence lipoprotein metabolism by stimulating insulin secretion. Insulin promotes LDL receptor expression in the liver and peripheral tissues, facilitating the clearance of LDL particles from the bloodstream and lowering circulating LDL levels. Finally, dietary carbohydrates might impact VLDL production or conversion to LDL, further contributing to a decrease in overall LDL.
please can you tell us your overall opinion on adding some carbs to an carnivore diet? for example some fruits or sweet potato after a workout
Where were you when I had to find out about this phenomenon by trial and error....countless blood tests to figure out what was going on. And it goes harder to figure out with the weight fluctuating. I seem to need 60-70gr of carbs to keep my numbers in the perfect range and just a tiny bit lower on the saturated fats. Fasting for 2-3 days doubles my cholesterol numbers at the other side of the spectrum. Hope I can help someone get things right faster than I did...
Living the n = 1 life I see...
Thank you for sharing your experience ! I’m a LMHR & started keto for pre diabetes. Unfortunately recent cac was 62 with some carotid intimal thickening (im a 48 yo female) so I’m keen to reduce LDL & apoB.. i have increased fibre & I will trial adding back in carbs to a similar amount & see what happens. Your story is valuable ☺️
@@Melbketoshrink - 3 yrs ago I bought a cholesterol meter. With this device I can detect and follow up changes in my diet.
@@acke26 I’m going to do the same! 🙏🏼
@@acke26 which one do you recommend? Do they also measure LDL?
How did your glucose/insulin levels respond to the Oreos?
super cool!!!
Thanks! Glad you think so!
What are your thoughts on coffee consumption Nicholas?
Hey nick, I am almost as lean as you are, but I am getting different effect on keto/carnivore, my Cholesterol is high, but my triglycerides gone up a lot, my HDL have plummeted in half, and yes I was 12 hours fasted going for my test, at the end of April I will be a month without coffee, I will be testing again to see if that was coffee giving me false readings, all I eat is beef butter eggs coffee and double cream. Thanks
The elevated serum LDL of LMHRs is on account of the large and fluffy LDL particles, the ApoLipoA, not the ApoLipoB. Hence there is no increase in any kind of risk, running around with an elevated LDL as long as HDL is high and TYG are low. Having said that, insulin is an important hormone with other functions apart from fat storage. It seems reasonable to trigger it a little from time to time so that it can do what it needs to do in the body. Once a day or once a week, that's the question.
Thank you! I’m still waiting for any info on how high is to high LDL for LMHR or when/if should I worry
You and thousands of others...
@@nicknorwitzPhD at least I know you’ll tell me as soon as something is known😁, again much appreciated for what you do
@@Svalsorim trust me... I will!
Great video, still waiting on the safety of actually having a higher LDL as LMHR i.e. is that fat usage mechanism a plan B of sorts that should be used sparingly or does it not have any downsides like organ overwork and consequently premature aging.
I've definitely also seen my LDL drop substantially reintroducing some carbs after having been mostly carnivore with very low/no carb.
You and many others are waiting on those data... you have no bad how I want those data...
@@nicknorwitzPhD I can imagine!
My N=1 is that higher LDL will be understood to be generally the same in meaning regardless of the person is LMHR or not.
I have a vein insufficiency in my legs as well as some bulging muscular tissue which I've been told can happen... and can't really do anything about it and it's limiting in anything physically active like running a lot or playing soccer. Anyways, when I do push it it just feels like my legs are sorting of swollen and I can't keep the exercise up. But that's about it, thing is, last summer (had started carnivore some months before) I actually started to feel this feeling even if in a lighter version, whilst totally resting!
So the heat of course impacts that, but I get heat every summer so something's new..... What was new, an overall high cholesterol and a high LDL.
Might have been something completely different but if it was this does the reasoning have any chance at even being a theory worth considering i.e. could the vein issue "represent" more aging than I've actually undergone (40 years old), serving as a proxy for what id eventually feel maybe at 60/70 years of age anyway even if I didn't have the vein issue but did have the higher levels of cholesterol present.
@nicknorwitzPhD - Hi Nick, thanks for a very interesting video. I'm a LMHR myself. What's your take on cholesterol, should I strive to keep my LDL as low as possible?
And do you have any thesis on why the carb/carniore/saturated fat diet is better than the vegan keto diet regarding LDL ?
Re "LDL as lower as possible... I won't tell you what to do but I certainly don't strive to keep mine "as lower as possible" to the exclusion of other considerations. As for the carb+carn vs vegan keto, this video is the explainer.
I have two young competitive athletes aged 15 and 16. They place highly on their respective sports on State level. In fact, they have full student athlete scholarships already. They have ungodly rigorous workout schedules starting at 5am strength training daily, and an average 2 to 4 hrs practice after school. And regardless of what we do, they have had high ldl colesterol for years...we have a "balanced" diet, mostly home-cooked meals, no veg oils, no junk food at home. The intersting think is, they have both tested high for ldl when they have lost the "baby fat" and became lean...my son in middle school and my daughter this year. I initially was looking into carnivore or other eating regimes that could help with their higher ldl. We have already visited countless nutritionists per the pediatrician request. I am at my wits end. I am not sure if they could fall into the Lean Mass Hyper Respond hypothesis (although it could somewhat explain the lbl) since they do have also have a hefty portion of carbohydrate in their diets. They are very lean. Any suggestion?
What would you eat approximately to achieve 300g fat to 115g protein for example?
How many carbs and how often did you consume them to lower your cholesterol ?
Outstanding. And it’s interesting the crowd that’s chuffed by the notion we are all scientists.
I believe being a scientist is intrinsic to us as human beings. The tools to efficiently manifest and optimize our scientist natures can be taught, but the drive to be curious exists within us by virtue of being human. If we lose curiosity, we lose our humanity.
Hi Nick.
Curious if you believe if the Thrombogenic Hypothisis of heart disease has any merit.
Also someone told me you had your blood tested for plant sterols, if so, what was that all about? Maybe a video on that and your concerns.
Thanks for being so curious!❤️😎❤️👍
Went carnivore and blood markers went nuts. LDL 648 total cholesterol 728 123 tri 53 hdl high hs CRP, apoB etc. happy to participate in your studies
I have lost over 70lbs and as I am becoming lean my cholesterol and triglycerides are getting into the LMHR range. I did a dna test recently and found I have the muscle red fibers of an elite athlete. Have you tested other LMHRs to see if they also have the muscle fibers of an elite athlete? Retired nurse just curious.
Do you have a video covering your typical "vegan keto" foods/meals? Would love content like that.
I used a decent amount of pea protein and tempeh for protein sources (try to maintain 1g/lb protein). Fats primarily EVOO, tahini, sesame, macadamia. Some well-cooked greens like bok choy...
@@nicknorwitzPhD awesome thanks!
@@nicknorwitzPhD Sounds delicious (NOT!).
I just discovered I am a LMHR phenotype. In determining the lowest effective carb intake to lower my LDL, would considering glycemic index, etc. be overthinking it?
I think it has more to do with hepatic glycogen levels, not GI.
Do all people below a certain BMI threshold (lean) who are in ketosis become LMHR? If not, why?
The generalizability of the phenotype hasn't been formally assessed. I REALLY want to... just given me 20 really lean people and let me control their diet for 6-8 weeks...
I'd be into this .@@nicknorwitzPhD
My curiosity wants to know how long the lmhr carby carnivore can maintain a CAC score of zero (or unchanged)? Or do they risk becoming skinny fat over time with an increased chance of atherosclerosis? And how many carbs constitutes 'carby' when eating carnivore? Hmmm....thoughts, many thoughts
Yes but do I NEED to lower My LDL ? Is high LDL bad ?
Isn't adding carbs will get me out of ketosis? Isn't going in an out of ketosis unhealthy?
Going into and out of ketosis is not unhealthy, but natural and perfectly healthy, unless you need ketosis therapeutically.
Well said. I purposely go on ketosis for extended periods of time, but allow myself to get out of it a few days a month when I consume a larger amount of carbs and then fast and finally back to a low carb diet. Repeat and rinse.
On ketosis watch mark sisson on Keto camp. He thinks it's not good to always be in deeper ketosis, so he hovers around 0.3/4 if I remember. It's sort of like overdoing fasting/or exercising,,, it's still a stressor, there is a point of dimishing returns and a point further down where bad things can crop up..
Unfortunately it's not a pleasant experience for me, feels like having to go through keto fat adaptation again
maybe try smaller amts of carbs, and track what carbs trigger you worse- I discovered that most grains are HORRIBLE for me, but things like root veggies and berries don't' bother me at all, I have no problem going into ketosis again, it only takes me 24 hours to get there@@lt8833
So it's the dash of carbs that makes the difference. Now you don't have to mobilize so much fat left and right.
Love your new format! But before we talk so much about lowering LDL, shouldn't we talk about whether high LDL is bad to begin with?
There is a gap in the literature with respect to LDL-C and risk in LMHR. We are trying to fill that gap. This platform isn't for medical advice.
have you seen what (dr) paul mason says about what plants do to ldl?
For a LMHR, which diet would produce lowerer LDL-c, a non-keto whole foods plant based diet, or the Carby carnivore?
former most likely
So it's purely the absence of carbs in the diet that raises LDL cholesterol, nothing to do with saturated fats at all because the unsaturated fats eaten on vegan keto also raise LDL cholesterol... We still don't have an answer to whether having high LDL is really a problem (a risk for disease) if some people are managing to resolve certain other health issues on these very low carb diets. But we can say confidently that saturated fats are not the cause of high cholesterol at all and unsaturated fats in absence of carbs will do the same thing.
Saturated fat can have an impact, but it's minimal compared to carb restriction in LMHR
and have you uncovered whether the LMHRs who also sometimes end up with elevated triglycerides are actually overdoing it on the proteins and fats? Does overeating on fatty meats and dairy products, even though they are not eating many or any carbs, raise triglycerides too? I just saw a video of a man who went carnivore for a year and lost a lot of the weight he had from years of carb addiction, but then went back to those bad carbs for about week, really indulging though, but forget to pull back on the fats that he'd become accustomed to eating on carnivore, and he ended up having a stroke. Do you think those who do the carnivore diet are in danger of something similar to the refeeding syndrome the WWII prisoners experienced when they were given chocolate and biscuits after having been starving and many of them died shortly after? @@nicknorwitzPhD
Nick, do you see a decrease in HDL proportional to your decrease in LDL when you reduce the amount of exercise you do? The LEM would predict that, wouldn't it? I understand we are talking n=1 here.
It would, but the timeframe may be different and the HDL physiology is far more complex... harder to predict. But you're right in theory
To me intuitively (I realize sometimes intuitions are incorrect) this (and the lipid energy model altogether) suggests that having high cholesterol in and of itself isn't bad for health. Maybe it's only bad for people who have high cholesterol for reasons OTHER than the lipid energy model ie people who aren't using it to transport fat.
By the way I totally respect your consternation at the lack of curiosity that so many people demonstrate when confronted with this information (or something else that challenges their long held beliefs).
Hi Nick, would you mind analyzing the associative scientific studies involving a considerable number of people regarding all-cause mortality when it comes to HIGH and very low HDL levels with a J-shaped relationship?
What I'd point out is that there isn't good reason to believe these associations would translate to LMHR, which is a metabolic response. These studies are from large cohort on mixed diets. Therein, very high HDL is often associated with decreased HDL-C function, whereas HDL-C increases in LMHR as a functional response, as per the LEM. Etiology and physiology informs consequences.
@@nicknorwitzPhD Yeah, I know that associative scientific studies are very weak with a lot of unknown factors, but they tend to scare people. Yesterday, I watched "Surprising Bloodwork After 1 Year Carnivore + Fruit Diet! - Lillie Kane channel," and there was grandpa in comments who was shocked by his labs and scared with his high HDL...
It was a good video. Such curiosities cause me to read books like 'Ketones, The Fourth Fuel: Warburg to Krebs to Veech, the 250 Year Journey to Find the Fountain of Youth' by Travis Christofferson,
Hope you enjoyed it
What happened to your triglyceride level in your oreo experiment?
See the paper ... it's in the tables ...
Do you think high LDL cholesterol is bad or not?
This phenomenon is very interesting but still the question remains, what are the long term outcomes?
TBD... those are data we all want!
Everything you said in the LEM section starting at 0:46 is also valid if you are not lean. In fact, one would think that this effect should be stronger if you have lots of fat to packaged as VLDL. So, why only lean people?
What is the music , just at the end ? Is it boards of canada ?
Dunno. Editor chose it. LMK if you find out. Wasn't thinking about it... now I'm curious...
@@nicknorwitzPhD
Regardless of the author, the piece is clearly inspired by Boards of Canada, an electronic music duo from a decade ago, who became famous for their strange, distorted sounds, and their eerie and melancholic atmospheres. This little piece clearly reminded me of them. Try them if you're into experimental stuff. th-cam.com/video/lMKhq8l_9mI/w-d-xo.html&ab_channel=Anon1696
Can you make a video about what you eat on.sn.average day on your ketogenic diet p!ease?
I like the T-shirt. Can I buy one?
Ok typed the message then found your store
Those cookies look good.
What if you're NOT a LMHR does putting carbs back in lower LDL? I'm not overweight on keto but Im not super lean I dont think either.
Then carbs probably wouldn't do much to your cholesterol...
I always experiment on myself, because I'm not allowed to experiment on anyone else. ;) On a serious note, several years ago my doctor put me on a statin, like they are inclined to do, I felt terrible so stopped taking them after a week. I took some Niacin and the numbers went down, which confused the doctor.
Stay curious!
YES!
I hope people don’t get a new excuse to keep their cholesterol high by saying they are LMHR. My personal experience is with saturated fats my TC was 175, without saturated fats my TC was 130 same for LDL went from 113 to 80. Triglycerides went from 60 on low carb to 40 on very high carb with no saturated fats. I’m seeing some comments with LDL at 300+, I never thought it could be that high
Edit: very high carb = 200-400g per day
I find it funny how when he includes carbohydrates his numbers improve. Of course they will improve, all those numbers should be low and eating a high carb low fat diet would be far superior.
@@airrunkle and isn't it funny that the people who have these high LDL (LMHR) are all on low carb diet ? Like don't we know that high saturated fats tend to increase LDL ? Don't we know that ? This is such a pointless study to me I don't understand the interest people have in it.