so. this is so general that it’s not helpful. what ranges are we talking about?

also, when people talk about cholesterol they usually don’t mean cholesterol they mean lipi-proteins that carry the cholesterol through the blood (cholesterol needs this as it’s hydrophobic). LDL from those lipo-proteins is definitely correlated with heart disease.

Here, read about it in more detail than you probably need to know: https://peterattiamd.com/the-straight-dope-on-cholesterol-pa...

>this is so general that it’s not helpful

I think digging into the minutiae of specific numbers is silly, when the better frame is to construct the right diet the comports w/ human evolution and lifestyle, energy, activity and go from there.

Generally low carb (particularly avoiding high glycemic index carb, and sugars) preferring lower starch vegetables, while prioritizing animal fats, meat, fish.

Keto / keto carnivore, low carb etc have been around and well studied for a while now. People should do their own research (I like all of Gary Taubes' books and presentations, there are many others as well and podcasts) but ultimately I summarize the point as our bodies have evolved to follow this diet and observations of societies or time periods when one or the other was more prevalent show stark differentials in health, obesity, diabetes, metabolic syndrome...

I have no idea what my cholesterol numbers are (I'm sure they are "high"), but I certainly would never take a statin which would destroy my brain.. and as the OP mentioned, I know what makes me feel rested, energetic, what provides energy and muscle mass along with workouts in the weight room, what does or does not result in brain fog (sugar), better sleep, lower body fat, etc. All low carb / high fat. The more intense the exercise one does, the more carbs they can consume.

Keto diets have most definitely not been around long enough for anyone's bodies to evolve to follow them. That takes many thousands of years.

Why would our bodies need to evolve to follow them when the mechanisms are already built-in?

Our body already contains the necessary pathways, enzymes and processes to switchover to utilizing fat as fuel. We quite literally evolved to do this...

That being said, I think this adaption was more of an energy conservation mode for when food was scarce rather than our ancestors intentionally eating in a ketogenic compatible manner.

> That being said, I think this adaption was more of an energy conservation mode for when food was scarce rather than our ancestors intentionally eating in a ketogenic compatible manner.

Yeah, that's the point I was trying to make. I am aware that humans have the capability of surviving on a ketogenic diet, but that doesn't support the argument I was replying to that following such a diet is what we evolved to do.

The diet of primitive humans was more similar to keto than to current developed country diets and it was in place for hundreds of thousands of years. The first big change was from agricultural civilizations in neolithic, less than ten thousands year ago. Current diet is at most a hundred years old. And specifically the diet that is causing so many problems is only fifty years old.

primitive humans also lived 20-30 years tops. today at 20 you can eat whatever you want and you’ll mostly be fine short term.

i’m tired of people justifying their life choices by what primitive humans were doing. we’re not primitive humans.

Life expectancy may have been that low, but overwhelmingly due to infant mortality. It's not like primitive humans were dying of old age in their 20s.

not in their 20s but definitely not in their 80s like today. if you reached 50s you were a boss. a lot of things that we consider routine to fix today would have ended your life (broken leg/hand, infections, severe diarrhea, etc). We really under-appreciate how many things we have as tools to expand our lifespan today.

From what I remember, it was more like if you made it past adolescence, making it to 50 was about normal. All kind of beside the point; you seemingly rejected the relevance of the primitive human diet based on their life expectancy. I don't think that follows.

Considering that soldiers in Ancient Greece could only retire after 30 years of service, I think it's fair to say there were plenty of 80 year old "primitive" humans.

I think we're talking prehistory, pre-agriculture here.

that what i also though. at least 10000 years ago if not more

Typical diets these days are pretty bad. But few, if any, societies of anatomically modern humans have lived under conditions where they would almost always be in ketosis, so evolutionary history doesn't provide a reason to think that we are best adapted to that being our normal state.

i don’t like this line of thinking. digging in can help you tailor your diet and lifestyle on the genetics you have. also, decades of medical research cannot just be swept away based on a gut feeling. do know everything? no. do we have some good indicators? definitely.

LDL is correlated but not causative and it's been discovered that HDL is a much better indicator.

Take a look at this book: https://www.amazon.com/Big-Fat-Surprise-Butter-Healthy/dp/14...

It goes into it quite a bit more -- cholesterol is a _terrible_ indicator of overall health. This is well known in the Keto community.

when you use LDL, HDL and cholesterol interchangeably this tells me that you don’t know what you’re talking about. Cholesterol itself is part of the lipid membrane of every cell. It’s essential. When people say “high cholesterol” they usually talk about high cholesterol carrying lipo-proteins in the bloodstream. high ldl is definitely a risk factor for CHD

How do you explain what Dave Feldman refers to as the lipid triad which is common in people that are on a low carbohydrate diet?

In this case, there is not sufficient evidence that those who have elevated HDL, LDL and low triglycerides have higher rates of cardiovascular disease...

https://cholesterolcode.com/a-dialog-on-the-lipid-triad-with...

not familiar with this fellow but if I had to guess I would say that in some cases ldl-c (volume) is high while ldl-p (count) is low leading the ldl not to cause as much damage as it a high number of particles

I didn't use them interchangeably...? Did you mean to refer to someone else?

And the opposite is well known in the Whole Foods Plant-Based community.

I don’t have a horse in this race but appeals to authority when it comes to the science of diet are highly suspect.

Nah, I used to be on a plant-based diet -- have done quite a bit of research. This is _not_ well known in the community, but sure, a few under-researched people in the group might say that has to do with it.

Just an addendum to people who aren't familiar with medical research. This is way outside of mainstream medical practice, and 95% of researchers in the field believe cholesterol matters, statins have saved more lives than any other drug, and they improve cognition in most cases.

You must not know too many people that have taken statins...

Sure, on paper, the LDL number goes down and according to the numbers you have a lower risk of heart attack, but the one common thing I've notice is that everyone complains that they feel terrible. Things like dizziness, nausea, low energy/libido, etc...

Let's not forget that it takes mainstream science time to catch up to new research. There is a lag in existing beliefs while more research is being done and evidence solidified.

That being said, lipidology is extremely complex but in the case of low carbohydrate diets the issue of having high LDL and HDL may not be as bad as mainstream medicine would make it out to be.

For some interesting insights on research being conducted in this field, Thomas Dayspring and Dave Feldman are extremely knowledgable and explain things quite well.

https://twitter.com/Drlipid

https://cholesterolcode.com/

They both have appeared on a number of health/fitness related podcasts but a quality one they both have been on is "The Drive" by Peter Attia:

https://peterattiamd.com/tomdayspring1/

https://peterattiamd.com/davefeldman/

edit: I would also argue that his subjective feelings of good health are a much better indicator than the population-averaged cholesterol numbers...

edit2: to say that this type of research is outside of mainstream medical advice is misleading. Lipodology is a prominent topic and a quick pubmed search for the "lipid" keyword since 2018 shows over 60k results. In medicine there is rarely a such thing as "settled" science. Things are continuously researched with new questions and information is used to update our original hypothesis. To refer to current advice as set in stone is very naive...

> That being said, lipidology is extremely complex but in the case of low carbohydrate diets the issue of having high LDL and HDL may not be as bad as mainstream medicine would make it out to be.

I'd 100% agree with this. But "your cholesterol sky rocketing a good sign" is not something the evidence currently shows.

> that everyone complains that they feel terrible. Things like dizziness, nausea, low energy/libido, etc...

Statins definitely have side effects, just on balance it leads to better cognitive outcomes instead of worse ones.

It's true that it takes time for mainstream science to catch up. But new preliminary research is new and preliminary and when it goes wrong it goes wrong more catastrophically than solid mainstream science.

> I'd 100% agree with this. But "your cholesterol sky rocketing a good sign" is not something the evidence currently shows.

"sky-rocketing" is a definite over-exaggeration here.

I would be curious to see what your response is to the link I posted in another comment here.

I am wondering how people that still reference these dated outlooks on cholesterol can explain why there is insufficient evidence of higher cardiovascular disease rates in those with high LDL in the presence of high HDL and low triglycerides, commonly called the "lipid triad"?

https://cholesterolcode.com/a-dialog-on-the-lipid-triad-with...

What the parent comment initially stated would lead me to believe that he falls into this lipid triad group and if I was in his shoes I would tell any doctor that recommended a statin to f* off if I had just started feeling the best I'd ever had in my life.

Also, can you send me some research for your points about statins having an increase in cognitive function? My understanding was that many were arguing the opposite and some meta-reviews I read on the topic suggested that more evidence was needed to make any clear observations.

Masai all have atherosclerotic plaque build up and it is also present in their children. Childhood with plaque forces various adaptations to blood vessels. They get wider and more elastic to counter the reduced blood flow and rigidity.

Anyone who isn't a child won't be able to make these adaptations and anyone who isn't on a starvation mimicking diet but is trying to gain or maintain weight on diets filled with dietary cholesterol will almost certainly start building up plaque.

Yes, dietary cholesterol has a low effect on blood serum cholesterol after some amount. So yes, increasing the consumption of eggs from 5 to 10 a day won't linearly effect the blood serum cholesterol.

Problem with fasting mimicking diets is that they are not a cure and are not long-term.

Also, consuming only things that are easy to digest makes you digestion more fragile to varying stimuli in the future. Which is why people who are on these "rejuvinating" diets for a longer period of time tend to experience their disease symptoms much quicker when they go back to eating vegetables rich in antinutrients.

Here's a very nice study where all Masai participants had atherosclerosis. Some even died from heart disease being less than 20 years of age: https://academic.oup.com/aje/article-abstract/95/1/26/167903

"These pastoral people are exceptionally active and fit and they consume diets of milk and meat. The intake of animal fat exceeds that of American men. Measurements of the aorta showed extensive atherosclerosis with lipid infiltration and fibrous changes but very few complicated lesions. The coronary arteries showed intimal thickening by atherosclerosis which equaled that of old U.S. men. The Masai vessels enlarge with age to more than compensate for this disease. It is speculated that the Masai are protected from their atherosclerosis by physical fitness which causes their coronary vessels to be capacious."