What Is Hdl And Ldl
LDL and HDL are simply shuttles that carry cholesterol.
HDL is a protein that carries cholesterol from the blood vessels and cells back to the liver for recycling.
LDL is a protein that carries cholesterol from the liver to the cells and blood vessels.
But not all LDL is bad! It is vital in repairing cells and blood vessels and can act as a band-aid to help heal damaged areas in the body.
It can be compared to firemen at the scene of a fire. While they are at the crime scene, they aren’t the cause. They are there to help.
LDL can be one of two things: Type-A Pattern or Type-B Pattern.
Type-A Pattern is large, fluffy, and is non-plaquing.
Type-B Pattern is small, dense, sticky, creates plaquing, and is what really does damage.
So how do you know what kind you have?
If your triglycerides are low with high LDL and high HDL, this means you have type-A. So you’re good, regardless of how high your cholesterol is!
You get more Type-A LDL by consuming healthy fats without carbs.
If your LDL is high, triglycerides are high, and HDL is low, then chances are you have type B.
You get more Type-B LDL by consuming sugar, vegetable oils, GMO, grains, having high cortisol , and having high blood sugar.
Sugar is also what causes high triglycerides. If you’re eating more carbs than are needed for energy – regardless if they come from healthy carbs or junk food carbs they are stored in the body as glycogen, and eventually, as triglycerides.
Can Apoe4s Follow A Ketogenic Diet
Indeed they can. In fact, I strongly encourage all fatigue patients to follow a ketogenic diet regardless of your genetic status. But the ApoE4 group needs to be mindful of the type of fat and protein they consume on a day-to-day basis. Below I lay out the dos and dont for those of you with ApoE4 genes.
- Eat as much olive oil as possible
- Remember, 1 liter per person of extra virgin olive oil every week.
DONT:
- Follow a traditional paleo or ketogenic diet.
- Both diets are too high in animal fats and proteins for your genes.
- Adherence to either will create negative health outcomes!
Practical Application: How To Interpret The Cholesterol Levels On Your Blood Test Results
The beneficial effects that the ketogenic diet has on cholesterol levels are not guaranteed for everyone. This is why it is important to consult your doctor and get your blood tested to track the results of your dietary changes.
Most of your blood test results, however, may only cause more confusion. Your LDL-C, HDL-C, Total cholesterol, and triglycerides numbers are valuable, but they only provide small pieces to the puzzle of your cardiovascular health. Does this mean that you have to get an advanced cholesterol panel?
Although some doctors may suggest it if you have genetic factors that are actively contributing to your cardiovascular health, an advanced cholesterol panel isnt necessary for everyone. Instead, most people should look for a different blood marker that can be found from the results of a standard blood lipid panel the total-to-HDL cholesterol ratio. Why?
Dr. Chris Masterjohn postulates that this ratio is an accurate marker for the amount of time that LDL particles spend in the blood . This is an important thing to take note of because the LDL particles are more likely to become oxidized and cause atherosclerosis when they are in the blood for longer periods of time. This gives us a deeper explanation of why the authors of the 2003 meta-analysis looked at the total-to-HDL cholesterol ratio rather than total cholesterol levels.
Key Takeaway: Total-to-HDL cholesterol ratio is the best predictor of cardiovascular disease risk on the basic blood lipid panel.
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Replace Some Saturated Fats With Monounsaturated Fats
In the largest and highest quality studies, saturated fat is not linked to increased heart attacks or death from heart disease .
However if you have problems with cholesterol, then it is a good idea to try to replace some of the saturated fats you are eating with monounsaturated fats.
This simple modification may help to bring your levels down.
Cook with olive oil instead of butter and coconut oil. Eat more nuts and avocados. These foods are all loaded with monounsaturated fats.
If this alone doesnt work, then you may even want to start replacing some of the fatty meat you are eating with leaner meat.
I cant emphasize olive oil enough quality extra virgin olive oil has many other benefits for heart health that go way beyond cholesterol levels.
It protects the LDL particles from oxidation, reduces inflammation, improves the function of the endothelium and may even lower blood pressure .
It is definitely a superfood for the heart and I think anyone at risk of heart disease should be using olive oil, no matter whether their cholesterol is high or not.
It is also important to eat fatty fish that is high in Omega-3 fatty acids, at least once per week. If you cant or wont eat fish, supplement with fish oil instead.
Bottom Line:
Monounsaturated fats, like those found in olive oil, avocados and nuts, may have cholesterol lowering effects compared to saturated fats.
Inflammation Causes Heart Disease Not Cholesterol
A common misconception is that cholesterol builds up and clogs your arteries, like grease blocking a pipe. The process is more nuanced than that.
As you read about in the last section, cholesterol is a repair molecule that shows up to heal damaged cells. When your arterial walls get damaged, cholesterol arrives to fix the problem. The issue is that LDL particles carrying cholesterol are large, and they can get stuck in the tear in your arterial wall. Thats when plaques begin to form.
The solution, then, shouldnt be to decrease your LDL and deprive your body of repair. It should be to get rid of whatevers tearing holes in the walls of your arteries. LDL is a symptom of an underlying problem, not a cause. The question is, what causes arterial damage in the first place?
The answer seems to be inflammation.
One of my favorite examples is smoking, Feldman says. Smoking causes oxidative stress that damages endothelial cellsthe damaged cells then become problematic, to the extent that it makes sense that the body would take action to repair them. Would you rather have a hole in the endothelial wall of your blood vessel, or would you rather have some spackle there to try to plug the leak?
Cholesterol seems to be a symptom of a larger problem. So why the confusion all these years about cholesterol causing heart disease?
The Framingham Study and related studies have found that the main risk factors for heart attack are:
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Reasons For High Cholesterol On A Ketogenic Diet
Now that you understand a little more about how these cholesterol numbers relate, there a few other scenarios you should become familiar with. Abnormally high or low cholesterol levels are typically an indication of metabolic adaptations or deeper issues going on.
There are several reasons for this such as pre existing insulin resistance, rapid weight loss, an increase in HDL, thyroid conversion and chronic inflammation. Hopefully this information will allow you to discern what it is going on in your body a little better.
Effect Of Saturated Fat
A review of low-fat diets versus low-carb, high-fat diets greater than 12 months long looked at the effects on cholesterol levels in overweight or obese people.
Researchers found that decreases in total cholesterol and LDL cholesterol levels were significantly more noticeable in those following low-fat diets. In contrast, an increase in HDL cholesterol and a reduction in triglyceride levels were more apparent in high-fat-diet participants.
Whether cholesterol increases or decreases largely depends on how the very-low-carbohydrate ketogenic diet is followedparticularly with the types of fats consumed.
The study authors further found that in high-fat diets, decreased total cholesterol levels were associated with lower intake of saturated fat and higher polyunsaturated fat intake. In comparison, increased HDL cholesterol was related to a higher intake of monounsaturated fat.
Lower saturated fat intake was marginally related to lower LDL cholesterol levels. Additionally, increased triglyceride levels were associated with higher intakes of carbohydrates.
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A Quick Primer On Your Genome
A genotype is a set of genes in your body. Everyone has a unique genotype . A phenotype is how those genes are expressed in other words what makes you, you.
The other two factors influencing the characteristics expressed by your genes or your phenotype are:
This means that two people with the exact same genotype could end up looking completely different due to the way their environment affected the expression of their genes.
Of particular interest to ketogenic dieters are the apolipoprotein A and apolipoprotein E genotypes. These genotypes influence the way your body processes fats and cholesterol. Some of you will have the perfect genes for a keto diet: if this is you, you will be able to eat all the fat you want and it wont affect your cholesterol.
However, others may be negatively affected by high levels of saturated fat intake.
The key takeaway here is that a keto diet consisting primarily of saturated fat is not for everyone! Lets dive into the keto genes and how they affect your cholesterol levels!
Cutting Through The Fat: What Are Lipids And Cholesterol
Before we can examine the research, we need to understand the roles fat, cholesterol, and carrier molecules called lipoproteins play in the body.
Fats, also known as lipids, are a diverse group of molecules with a non-polar characteristic that repels water. This means that you if you put a fat in water, they will not mix.
In the human body, fats are most commonly found in the bloodstream in one of two forms. The first is triglycerides, a fatty acid that stores energy for later use.
These long molecules can be broken down into other fatty acids and glycerol to create fuel for the body. Glycerol can further be broken down and converted into glucose. Elevated levels of triglycerides in your blood can increase your risk of developing diabetes, cardiovascular illnesses, and other life-threatening diseases.
The other important class of lipids in the body is a waxy substance called cholesterol. These molecules have a variety of functions in your body such as building hormones including estrogen and testosterone, maintaining the integrity of cell membranes, and aiding in the absorption of vitamins.
Your body produces all the cholesterol you need in the liver and other cells throughout the body. Cholesterol is also obtained by consuming animal-based foods such as poultry, dairy, and red meat. Typically, 75% of the bodys cholesterol is produced endogenously while the other 25% is ingested from external sources.
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Testing Your Cholesterol Levels
With a simple blood test, your doctor or health care practitioner can check your cholesterol levels, such as your important triglyceride levels. Cholesterol is used to build certain hormones and regenerate your cells, whereas triglycerides help store unused calories and give your body energy. Triglycerides are stored in your fat cells.
High cholesterol doesnt present any symptoms, so you might not be aware of your cholesterol levels without a blood test.
The Bottom Line On Trying The Keto Diet To Lower Cholesterol
If you have high cholesterol or triglycerides, speak with your medical team first before embarking on a keto diet. If you get the green light, continue to seek their help. There are a lot of popular books out on how to follow a keto diet, but I think patients need additional support and guidance and ongoing conversations about if its working for you, says Ryskamp. Its a tool that someone can use to improve their health, but it may not be the right tool for them, or the right tool the way theyre doing it, she says.
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What Are The Different Types Of Cholesterol
It helps to understand the three main types of cholesterol or more specifically, lipoproteins that carry the lipids through your blood. The three types are HDL, LDL, and VLDL.
Since cholesterol doesnt dissolve in water, it cant travel through your blood on its own and needs to be transported through these lipoproteins particles derived from fat and protein.
The Original Keto Studies
When keto diets were first studied, they did in fact report an increase in cholesterol. This is probably where the keto raises cholesterol mantra originated.
Study #1
In this study, one of the original studies that monitored the impact of a ketogenic diet on cholesterol levels. It is often cited as proof of the increase in cholesterol associated with keto diets.
The effect of a high energy, low carbohydrate diet on serum levels of lipids and lipoproteins was studied in two normal individuals.
Results
- There was a marked rise of total cholesterol
- HDL Cholesterol levels remained the same
- LDL Cholesterol levels returned to normal once the diet ended
Study #2
The second study which is regularly referenced is this one from 1974 which looked at the change in cholesterol levels during a diet called the Stillman diet which is similar to a keto diet it is protein and fat dominant.
The cholesterol levels of 12 healthy volunteers were monitored which they followed the diet. They followed the diet for between 3 and 17 days
Results
- Total cholesterol levels increased in every case
- The high levels of cholesterol in the blood presents potential risks, particularly in people with existing heart problems
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What Are Normal Cholesterol Levels
The recommended targets for cholesterol vary slightly among different countries and health agencies. The US National Institutes of Health website lists the following optimal cholesterol and triglyceride values for people at low risk for heart disease, measured after a fast of 9-12 hours:
- Total cholesterol:< 200 mg/dL
- LDL cholesterol:< 100 mg/dL
- HDL cholesterol:> 40 mg/dL for men, > 50 mg/dL for women
- Triglycerides:< 150 mg/dL
LDL levels > 160 mg/dL are considered high, and levels 190 mg/dL and above are considered very high.
Many factors can affect your blood cholesterol, including genetics, hormonal changes, injury, and certain health conditions. For instance, people with untreated hypothyroidism often have elevated cholesterol.
A persons diet can also influence cholesterol levels sometimes significantly.9
Some would argue that since these cut-off points are based on epidemiologic studies, they likely do not apply the same to all individuals regardless of their baseline metabolic health and overall health. For instance, there are data that show people with low LDL levels can have heart attacks and people with high LDL can live long lives.10
The point is that LDL levels should be regarded as one of many variables for evaluating cardiovascular risk, using an individuals metabolic status and other risk factors to adjust that risk assessment up or down.
How Does Keto Or Low
In some people who follow keto or low-carb diets, blood total cholesterol goes up little, if at all. Some even experience a drop in LDL cholesterol after starting low carb. However, others experience an increase in both LDL and HDL cholesterol levels.11 Or, there is an increase only in HDL cholesterol resulting in an improved LDL/HDL ratio.12
One meta-analysis of randomized trials reported that people eating a low-carb diet, on average, experience a reduction in both total LDL and small LDL particles, as well as an increase in the peak LDL size.13
A rise in cholesterol during keto or low-carb eating may be related to losing weight. Although cholesterol levels often drop during the first 2-3 months of losing large amounts of weight, there can be a later rise in cholesterol that persists until weight stabilizes. Once weight loss ceases, cholesterol levels tend to come back down.14
Therefore, it could make sense to wait until someones weight has been stable for a few months before assessing cholesterol levels.
For an estimated 5 to 25% of people whether weight loss occurs or not LDL cholesterol goes up significantly in response to very-low-carb diets, sometimes by 200% or more. Many of these folks seem to belong to a group that Dave Feldman at Cholesterol Code refers to as lean mass hyper-responders .15 These often healthy people are sometimes shocked to discover that their LDL cholesterol has soared above 200 mg/dL after going keto.
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How Is Cholesterol Transported In Your Body
Cholesterol is absorbed from your digestive tract or produced by your liver and circulated throughout your bloodstream, where it can be used by cells as needed. The remaining cholesterol then returns to the liver to be converted into bile acids or used for other purposes.
Importantly, cholesterol doesnt travel around your bloodstream on its own. As a hydrophobic substance, it must be packaged within lipoproteins to move around the bloodstream.
Think of lipoproteins as boats needed to safely carry cholesterol through the bloodstream. When we talk about blood cholesterol levels, were referring to the amount of cholesterol contained in different lipoprotein particles .
In addition to cholesterol, these lipoprotein particles also contain special proteins called apolipoproteins, triglycerides, and other compounds.
- Cholesterol packaged in lipoproteins that contain apolipoprotein B100 is referred to as LDL cholesterol, or LDL-C .5
- Cholesterol packaged in lipoproteins that contain apolipoprotein A is referred to as HDL cholesterol, or HDL-C .
Despite what weve all heard, theres actually no such thing as good or bad cholesterol there is only one type of cholesterol. Your LDL and HDL values refer to how much cholesterol is carried in your HDL and LDL lipoprotein particles. In fact, the same cholesterol is continuously transferred among these and other types of lipoproteins as they make their way through the bloodstream.