Carb Back-Loading and Cholesterol
After I reached the 8 week mark of my Carb Back-Loading experiment, I planned to draw a series of blood tests to see where things stood compared to my most recent set of labs which were drawn after doing Carb Nite for 10 weeks.
If you’ve been following my cholesterol adventures at all, you’ll know that I’ve been dealing with high cholesterol these past few years when I switched to various forms of high fat low carb diets. More specifically my LDL-C and LDL-P have risen with my dietary changes and I’ve been trying to see what, if anything, I can do to get those numbers under control.
While it’s generally agreed upon that having a high LDL-P is correlated with increased cardiovascular risk, this data was obtained from a general population consuming a high carb standard American diet. Since we don’t have any data from the low carb / ketogenic population, no one can say whether a high LDL-P reflects the same elevated cardiovascular risk for people eating this way.
In any case, here are the results of my latest NMR lipid profile:
Just like I did with my most recent post on the effect of Carb Back-Loading and my thyroid, I’ll take a few moments to review my entire journey with cholesterol thus far.
In 2010 my numbers actually looked ideal (the HDL could’ve been higher). During this time in my life I was actually following a standard American diet, trying to count calories while running almost 3 miles a day. I was also 20 lbs heavier than I am currently and wearing pants that were a couple sizes larger… and I definitely wasn’t as strong as I am currently… the state of my body definitely did not reflect the near perfect cholesterol test.
As I started playing around with Tim Ferriss’ Slow Carb Diet which he introduced in his book, The Four Hour Body, my weight started coming down and my pants started falling so much that I had to go down a couple waist sizes. While all this great stuff was happening, my LDL-C and total cholesterol started creeping up from 8/30/2011 to 11/16/2012.
On 2/21/2013, after 72 days of being in nutritional ketosis I decided to check my first NMR lipid profile, especially since I had read how useless the LDL-C number is. I was also expecting my LDL number to come down especially since I had lost even more weight while doing nutritional ketosis. Needless to say, I was surprised to see that not only did my LDL-C rise to 213, but that my LDL-P was a sky high 2800!
I knew that Jimmy Moore had the same thing happen to him and the more I looked around, the more cases I found of people experimenting with ketosis and then finding themselves with alarmingly high LDL-Ps.
When I dove into the research, I saw that:
It seems almost universal that following a ketogenic diet leads to an increase in HDL and a decrease in triglycerides. What happens to total cholesterol and especially LDL is unpredictable since both can either go up, go down, or stay the same with no clear explanation as to why this happens.
I came across a few theories as to why ketosis could induce a high LDL-P and decided to test them out.
My first test was to cut back on my saturated fat intake while continuing to remain in ketosis. I cut out all the coconut oil and butter I was consuming and on 3/11/2013, only a few weeks after my initial NRM lipid profile, this really didn’t lead to any change in my LDL-C or total cholesterol (I decided to cheap out since the standard cholesterol test is only $29 while the NMR lipid profile is around $100 with my initial NMR test I could see that I wasn’t one of those people who had discordant LDL-C vs LDL-P).
Almost 2 months after terminating my nutritional ketosis experiment I checked my cholesterol again on 5/9/2013 and found that despite putting on a little bit more weight, my LDL-C had come down. This occurred at the same time that my thyroid numbers improved really making me think that one theory made the most sense, at least in my case:
Chronic low carb -> Hypothyroidism (low T3) -> Decreased expression of LDL receptors in the liver -> Higher serum cholesterol
Then things in my life got a bit crazy with quite a bit of travel, a wedding, followed by a honeymoon, and it wasn’t until another 5 months on 10/4/2013 when I re-checked my cholesterol just to get sense of where I stood. The small bit of weight that I had put on was still there, and my carb intake was in the 50-150 gm range regularly. My LDL-C and total cholesterol were pretty much unchanged while there was a slight improvement in my TSH.
It was around this point that I started experimenting with Carb Nite which is a cyclic ketogenic diet (carbs once a week). After 10 weeks of being on Carb Nite, I checked an NMR lipid profile again on 12/16/2013. This showed a bump in my LDL-C, LDL-P, AND total cholesterol. Despite losing a bit more weight and abdominal circumference, my cholesterol numbers took a hit! Looking at my thyroid hormone levels at this time showed a concurrent trend in the direction of hypothyroidism, further supporting the link between low carb, thyroid, and serum cholesterol.
Currently, I’m in the midst of following Kiefer’s Carb Back-Loading, a targeted ketogenic diet (carbs only after you work out). After 8 weeks of this protocol, I drew my latest set of labs and surprise surprise, my LDL-P has come down to it’s lowest point at 2694. It looks as if the increased amount of carbs inherent to this diet helped to improve my thyroid AND to lower my LDL-P. It’s also interesting to note that there wasn’t a significant difference between my total cholesterol and LDL-C when compared to my Carb Nite and nutritional ketosis days.
C-Reactive Protein (CRP)
This was the first time my CRP went higher than 1.0. I hypothesize that my lack of sleep while doing the graveyard shift as well as my increased volume and intensity of exercise had something to do with this. In any case, I’ll need to keep an eye on this in the future.
Triglyceride to HDL Ratio
An ideal ratio is less than 2, so you can see that I’m doing pretty well in this regard with a ratio of 1.47. It’s interesting for me to see that my triglycerides went down despite eating more carbs! You would expect it to go in the opposite direction, but this would tend to support Kiefer’s idea of carbs later in the day having a more beneficial metabolic effect as opposed to carbs earlier in the day.
While my fasting insulin went up to 4.6 uIU/mL compared to 2.8 uIU/mL on 12/16/2013, it’s still in the ideal range of being less than 5 uIU/mL. I wasn’t surprised with this slight elevation because of the increased carb intake on Carb Back-Loading. Since I was essentially doubling or tripling the amount of carbs I ate as compared to Carb Nite, a bump in my insulin of 1.8 is actually pretty good!
Image credit http://en.wikipedia.org/wiki/Cholesterol