The Lipid Energy Model in a Nutshell

[@fivebluelakes8948]

I’m a bit overwhelmed and still trying to process. I had a heart attack 17 months ago-90%-blockage in the widow maker and told to go on statins but I won’t. Doc feels high lDL is the best all and end all and just what is “high” anyway? Great info I’ll be following.

[@ezgoolsen]

Same. Just had CABG3 four months ago. Have always had high Cholesterol/LDL & refused to use statins all my life. Pretty fit & slightly overweight. I’m now on statins because I’m confused on what to do & why.

[@intenzityd3181]

@@ezgoolsen Go carnivore, lose the weight, don't worry about anything else.

[@Jrodmcn]

Thank you. This was great for someone that needs to visualize this process. I can listen to you, Saladino et al, talk about this but your graphics really clarify things. Can't wait for the full presentation.

[@cbyao3564]

Hoping LowCarbUSA posts the full presentation soon. Thanks Dave!

[@TopgunB]

Dave it all makes sense. There is a group of people like me on a Carnivore (keto ++) diet whose LDL does not go up. However our morning glucose goes up on strict keto. Also our ketone body levels never go really high even on total water fasts. I postulate that this group of people use more glucose from gluconeogenesis and when fat adapted are able to use the ffas really well so ketones do not go up significantly. Both groups are metabolically healthy. interestingly what I have found is that glucose stays at say 108mg/dl all morning and when I break my fast at lunch time glucose immediately goes down to 85 mg/dl. It seems to me that there are two groups of people on a keto diet, the hyper-responders who predominantly use fat either dietary or adipose as energy and the other group who convert a lot of the glycerol to glucose and use more glucose as energy (even on a carb free diet) via gluconeogenesis. also those people who do not produce a lot of ketone bodies may direct more of the ffas directly to the tissue that needs it and less so to the liver. I struggle to get my ketones above 1 even on a 5 day water fast and that was not the case before I became fat adapted when I could easily get to 2.5 or 3. Obviously there are a whole Bell curve of people between the two extremes.

[@DrTomMD]

Some glucose could be also coming from deaminated protein from muscle, converted to carbohydrate. Considered?

[@DrTomMD]

Did you consider the down regulation of LDL receptors on hepatocytes under the influence of high saturated fat to also contribute to the significant rise in LDL particle concentration in many on keto? Would be interesting to see a low saturated fat, high polyunsaturated fat form of keto and the resultant effect on LDL concentrations. There’s a lot to tease out here.

[@spin564]

Very interesting and makes sense to me. As body activity goes up and down, there has to be some recycling/rebabsorption mechanism for released adipose energy, else releasing that energy for use in tissues would be massively wasteful in such a variable environment. Looking forward to seeing the full presentation. Thanks Dave.

[@paull6547]

Love your work and your open attitude.

[@TyronPiteau]

Excellent video. Thanks.

[@bumbles3304]

Great info, thank you. My cholesterol has gone up to 8.9, triglycerides 1 and albumin on the slightly high side. Just had a CT Calcium score done waiting on the results but I’m feeling very confident.

[@bumbles3304]

CT Scan result; Zero. So thrilled.

[@RaviPatel-eb8wt]

@@bumbles3304 what is your before-after weight and how fast you lost that weight?

[@bumbles3304]

@@RaviPatel-eb8wt I’m not over weight. Always had high cholesterol but never this high. (53kgs 5ft 3inches). I have just started to eliminate all sugars and starting intermitting fasting. I’m thinking this will help lower my cholesterol if not it may just be hereditary.

[@vandpiben]

@@bumbles3304 the problem has always been inflammation, as cholesterol is used in the anti-inflammatory process. So, just getting rid of inflammation you dont need to think of cholesterol.

[@bumbles3304]

@@vandpiben thank you, that must be it ! It’s hard to get rid of inflammation as I have always had it. I have a damaged knee and tummy problems so I will work on that. Thank you for your advice much appreciated.

[@JohnnyRocketone]

WOW!! So exciting!!

[@georgeelgin3903]

power (*) time -= energy; i am not saying it's missing, but the way fatty acids are used to make ATP (then ADP) involves ION transport. It is not clear that de-Esterification is `complete` upon passing the cholesterol out through cell membrane, and oxidized (partially) LDL is returned to the liver. This return transport appears to not be entirely HDL

[@sharonillenye8036]

what happens to LDL and triglycerides levels when a person only eats carbs and sugar? (in a person with no fat and a person with a lot of fat)

[@robertos4172]

What do you guys on the hot dogs and American cheese diet do for vitamin C for example? Do you supplement?

[@realDaveFeldman]

When I'm doing these experiments, I supplement on a multivitamin. I definitely don't think of it as a legitimate nutrient replacement, but I'd prefer that over having none at all.

[@robertos4172]

@@realDaveFeldman Thanks for the reply.

[@guilhermecosta7938]

Great video! No one won you challenge yet, am I right?

[@realDaveFeldman]

It hasn't been met yet, no. twitter.com/DaveKeto/status/963437664199352322

[@joetart9905]

But the big issue is, are these LDL's atherogenic? If so, why? Is it because of vascular inflammation only, or is it just having a high number? Or is it due to oxidized LDL'S that can't be reabsorbed by the liver and get stuck in damaged arteries?

[@georgeelgin3903]

it would appear to be an issue of time ... if the particle hangs around more than a week it can no longer return to the liver so ends up as food for mAcropahAge and desposited into an artery wall (foam cell conversion). The size thing might be correlation NOT causation (None too small neither too large a sizes but just right for RCT).

[@_FightForYourFreedom_]

Hi Dave - Your experiments & Lipid Energy theory are probably saving thousands from statin prescriptions (my doctor just made that suggestion to me this week - no way!) - thank you!! I would like to run something by you and your Subscribers that has baffled me over the 2+ yrs that I've been on keto, at less than 20g/day Net Carbs (and maybe 40g/day Total). In that time, I've only rarely been shown to be in keto (using urine keto sticks), and then only up to Moderate at most, and that includes on tests after having fasted around 16 hrs (drinking black coffee with salt) and done exercise. Your LMHR phenotype is the first possible explanation for that - I think I'm there or close to that - my stats: male, 54 yrs old, 6 feet,175 lbs, around 17-18% bodyfat, regular weight training and muscular, most recent bloodwork (last week): HDL: 2.81 (Cda)/108.7 (US); Triglyceride: 0.92 (Cda)/81.5 (US); LDL: 8.06 (Cda)/311.7 (US). Now my question (to all): The majority of the time, my keto sticks turn a very pale whitish-yellowish colour, which is not in the range at all for the brand I use (Nurse Hatty - various shades of pink to purple; ...confirmed keto sticks NOT defective.). Any ideas as to what that means? >> Could the keto sticks be reacting to something in my urine that correlates to the super-high LDL, or perhaps free-fatty acids, in my blood? Thanks all for any input - I'm so keen to understand what is going on! (..Dave, as you would expect from a fellow engineer :-) - Elec Eng class of 1990)

[@Boss_Scaggz]

Keto sticks are useless after a few weeks in ketosis. The body stops secreting them in the urine and starts using them more readily as energy instead. This is called "fat adaptation". Look into it. Also look into getting a blood ketone meter if you're really interested in knowing what your ketone levels are. This is a well known issue.

[@_FightForYourFreedom_]

@@Boss_Scaggz I'm a huge Boz Scaggs fan! That said this is completely wrong - I continued to have keto sticks show me in ketosis once in a while even after two years in keto. Nevertheless I am sure there is a better reason that explains why I'm rarely in keto despite being very low carb.

[@ScienceUnbiased]

@ 6' & 175 lbs I gather you aren't trying to lose weight? Some studies on keto have shown after a certain amount of time urine ketones (acetoacetic acid aka AcAc) are typically non-detected & they jump to the conclusion that subjects are no longer compliant. I believe they're wrong & would know this if they'd bothered to measure BHB in the serum/blood. Context matters, seems like most start keto to lose excess body fat, but can also be used for certain medical conditions where weight loss isn't the goal or even desired. If you look at homeostasis as a type of reverse entropy perhaps that would help? Presuming you're looking to maintain, you wouldn't necessarily want urine ketones to test positive - as they're an indication of excess energy being excreted. (those looking to lose fat on keto WOULD want excess energy to be excreted) If fasting or post exercise you could see a rise in urine AcAc as a result of the "overshoot phenomenon". (well documented that your body will release more energy than needed in certain circumstances - better to have it available & not need it than need it & not have it... which leads to re-esterification of fatty acids that weren't required at the time) Most I've worked with over the years started around 300 lbs (136kg) & following my program they've pretty consistently "buried the needle" on urine tests from a few days in onward. They tend to have higher levels of NEFA (non-esterified or "free" fatty acids) than clients with less excess fat to lose, which indicates FFAs don't interfere with the nitroprusside pad on the urine sticks. Those with ~50 lbs ( 23kg) excess weight trend in trace-mid range & less that 20 lbs (9kg) it's not uncommon for them to only rarely have measurable AcAc in their urine... even though on average they lost ~10% starting mass in 60 days. What I find interesting is that (to date) the body comp tests (DEXA, BodPod, Hydrostatic) have shown over 85% of the loss was from fat mass, not muscle. So while I do find the urine ketone shifts between excess weight classes a curiosity, I don't dwell on it. As a side, thanks for providing the conversions. A huge peave of mine is Uni studies taking millions of taxpayer funds in the form of grants, pocketing over half & rarely having the common sense/courtesy to have a TA spend at most an hour providing conversions of lb to kg & mmol to mg/dL.

[@andrewdean7917]

I use a meter once a month with no problems. check to see that you have active strips.. use by date ok , or stored correctly.

[@_FightForYourFreedom_]

@@ScienceUnbiased thanks so much for the detailed answer! I started keto at around 188 lbs and definitely was in it for the weight loss in addition to the health benefits. My goal is to get "ripped" which for my frame means around 170 lbs. Even with the "pedal to the metal" these last two years those 13 lbs is all I have managed to keep consistently off, occasionally dipping down to around 172 lbs for a week or so at a time. so net is I would like to lose another 5 lbs if I can. Do I understand correctly that in your experience even if the urine strips do not show ketosis, that the blood meters may show ketosis? If so, are the meters detecting a much lower ketosis-level (i.e less deeply into ketosis) or is the ketosis-level still reasonably high, but somehow not detectable via urine and still detectable in the blood? Thanks so much for sharing your wealth of experience! 😊. P.S. after your kindly acknowledging my providing the blood levels in both common units I could have divided my weight in pounds by 2.2 to give kilograms but most have that one memorized!

[@robyn3349]

Cool!

[@arosalesmusic]

Makes sense, but in the end LDL has nothing to do with CAD

[@fantasticallyfit6030]

Makes sense

[@Antonio-ew9pv]

low carb does not imply that the person is in deficit, and you say that later.1. fact - a person does not have to be on low carb to be in deficit 2. fact - if a person is on low carb then it is most likely also on high fat which completely changes this model because more chylomicrons are introduced and LDL generation is reduced

[@shadrsabirov6412]

fact - you if you say something is a fact it does not become a fact, you usually just sound like a moron

[@joeamrine7450]

Can I ask, what is controversial about this model? If fat goes to the liver, wouldn’t that liver release some of that fat as VLDL and eventually ldl and wouldn’t that go back to other tissues? I’m not a lipidologist I’m genuinely Asking out of ignorance like what other possible model is there that is inconsistent with what was explained?

[@realDaveFeldman]

Yes -- I agree (but of course, I'm biased). For me, this is the occam's razor explanation for higher LDL-C/-P/ApoB explanation for those on a low carb diet.

[@georgeelgin3903]

@@realDaveFeldman there is probably a cross correlation since the 3#s move On regression tandem tricycles .. in multi-variate calculus the eigenvalues of the covariant matrix provide weight(s). Roughly this is PCA as opposed to Factor Analysis which you are probably more conversant with (pearson and all that)

[@urielwong]

👍👍🙏

[@Eraera1]

You don't hypothesize, others do. This is not your idea

[@datura4785]

This is great. BUT WHAT DO WE ANSWER WHEN ASKED: Why does LDL go up on a SAD diet when one eats more fat than usual? Kind of HIGH CARB HIGH FAT diet. The usual unhealthy diet across the globe... I do not know how to answer it to support you in a more all inclusive way if you know what I mean.... Please make a video to explain it.... 💐🌷🌺🤯 Because if I do not have the full answer the usual reaction is that I am a flat earther(plus the mocking)... You cannot persuade the average guy in five minutes so as to pay attention to what you are saying... We need the "full package" answer so as to leave no doubt... Because the average guy (esp. with high LDL) does not know what keto is. They all know "you are not a doctor, you are not right blah blah blah" end of story...

[@realDaveFeldman]

This is why I emphasize "healthy" for the context. You can have high LDL-C in an unhealthy metabolism -- which typically goes along with high VLDL secretion and a lack of successful triglyceride delivery, hence the "Atherogenic Dyslipidemia" profile (low HDL-C, high triglycerides). That's the issue with making any "in a nutshell" video, of course, we can't cover it all in five minutes.

[@JohnnyRocketone]

LDL doesn't go up on the SAD diet. It goes up on a keto diet.

[@Boss_Scaggz]

@@JohnnyRocketone Not always.

[@realDaveFeldman]

@@JohnnyRocketone LDL can definitely drift higher with atherogenic dyslipidemia -- which often can associate with a SAD diet and someone with metabolic syndrome.

[@sweetlife1765]

The story ends (blah, blah ) and begins here. The experts in this field are not always physicians but scientists who make a lifetime of studying the lipid system. Persuade your "average guy" that he should find a physician that looks at more than just LDL to decide on care of a patient. That same guy will take Statin (drug) prescribed to lower LDL without further study. Lifestyle: The Keto Diet has so many overall positives such as improved HDL, blood sugar, blood pressure and at the same time reduces weight and lowers Triglycerides. Ask your docs for other tests like APOB that perhaps are better indicators of atherosclerosis. LDL is not always the enemy!!

[@deckchaironthetitanic]

Interesting how easily pornographic terms fall from the mouths of little dudes. Thanks, I needed to be reminded of how sick y'all really are.

[@Boss_Scaggz]

What the hell are you on about?

[@lq4657]

@@Boss_Scaggz lol! Who knows. I didn't see any unsavory comments above. Maybe someone deleted a comment?