Great Article on Ketogenic Diet and Increased Cholesterol

Great Article on Ketogenic Diet and Increased Cholesterol

Just read a great post written by Franziska Spritzler, RD, a registered dietician who went on a ketogenic diet and also experienced a meteoric rise of her LDL-P.  

From June 2013 to November 2013 she was eating around 50 gm carbs per day and these were her numbers:

• 6/11/2013 – LDL-P: 1174, LDL-C: 124, Small LDL-P: 103
• 11/2013 – LDL-C: 160

Then in January 2014 she experimented with further decreasing her carb intake to around 20 gm per day.

• 4/28/2014 – LDL-P: 1851, LDL-C: 221, Small LDL-P: 137

Here’s a great quote from her and is inline with what I’ve read:

I want to make it clear that this type of dramatic elevation in LDL-C and LDL-P doesn’t occur in most people who adopt a very-low-carb, high-fat diet. I’ve seen estimates that somewhere between one quarter and one third of low-carbers experience this. I’ve met and read about several who have. Most people who eat VLCKDs see their cholesterol rise only slightly, not at all, or even decrease, remaining within or near the normal range. I’ve met plenty of folks like this as well. I’ve also spoken with people who tell me their LDL cholesterol has always been over 200 and didn’t really change after switching to a VLCKD. This is in sharp contrast to what happened to me: going from relatively stable LDL-C between 120s-150s to 221 within a very short period of time.

She then goes through the current thoughs of many experts and does a fantastic job of summing things up.  One statement that jumped out at me, that I had never heard before, was from Dr. Thomas Dayspring:

He also states that when ketone bodies are present in excess, they can enter the cholesterol synthesis pathway, thereby increasing serum cholesterol levels.  

[otw_is sidebar=otw-sidebar-1]

She decided to make the following changes:

1. She reduced saturated fat intake (including dairy fat and coconut oil)
2. Increased her protein intake to 100 gm per day
3. Increased carb intake from 20 gm to 35-45 gm per day
4. Added Chia seeds
5. Added sardines 4-5 times a week.

And then she retested:

• 6/17/2014 – LDL-P: 1700, LDL-C: 177, Small LDL-P: 120

(Before going nuts with the chia seeds, keep in mind that this just happened, so be aware of where they’re coming from)

There’s also a lot of interesting stuff going on in the discussion section, with some comments from Dr. Dayspring that again caught my attention:

I have that found most folks with your response have evidence of induced cholesterol synthesis which is evident if one measures desmosterol or lathosterol in serum. If so the therapeutic approach has to be reducing the synthesis by dietary alteration (reducing or changing type of fat or for those unwilling to do that or do not have a response at moderate to high lifetime risk for CAD, a cholesterol synthesis inhibitor (statin)

This is all new to me… so gives me yet another thing to start looking into.

Now I’ve documented my journey with cholesterol these past couple years, and I guess here’s a good place to aggregate them all:

• The Effects of a Ketogenic Diet on Cholesterol Part 1
• The Effects of a Ketogenic Diet on Cholesterol Part 2
• The Effects of a Ketogenic Diet on Cholesterol Part 3
• The Effects of a Ketogenic Diet on Cholesterol Part 4
• The Effects of a Ketogenic Diet on Cholesterol Part 5
• Carb Nite (Cyclic Ketogenic Diet) and Cholesterol
• Carb Back-Loading and Cholesterol
• Carb Back-Loading, Resistant Starch, and Cholesterol

One big difference between Franziska Spritzler and me is that her Small LDL-P (associated with higher cardiac risk) was never elevated while mine was.  Now I’ve played around with cutting back my saturated fats, adding in a carb up day (via Carb Nite), or multiple carb up days (via Carb Back-Loading), or by adding in resistant starch, without any real effect.

One interesting finding in my labs were that my LDL-P and Small LDL-P while sky high during nutritional ketosis, went even higher after Carb Nite, and then came down a bit with Carb Back-Loading.  Not quite sure what the correlation with carbs are with this pattern…

In any case, if you have time, please give Franziska Spritzler‘s article a read.  She did a great job and put together a very well researched and well written post.