Is a LCHF Diet safe for a person who has high LDL-C/LDL-P and advanced athrosclorosis?
LCHF Diet & Heart Disease: Is a LCHF... - Low-Carb High-Fat...
LCHF Diet & Heart Disease
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pcspetpro
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Baldly - undoubtedly.
ALL blood paramaters improve on a well formulated LCHF lifestyle.
Your current diet has got you where you are today.
youtube.com/watch?v=qXtdp4B...
Diet is only one of many potential factors for athrosclorosis. People respond differently to a LCHF diet depending on their genetics. It is still unknown whether the increase in LDL-C/LDL-P on a LCHF Diet is harmful to a person with advanced athrosclorosis. I'm still looking for evidence to prove that LCHF benefits everyone.
nutritionandmetabolism.biom...
sciencedirect.com/science/a...
This is not 'evidence' that LCHF Diet is safe for someone with advanced athrosclorosis.
So you aren't looking for evidence that it halts/slows progression, more that nothing bad can happen whilst following the regime?
The article is an argument/hypothesis not evidence.
Sorry not to be more use 
I have access to all the medical journals though if you need a hand with your research.
I certainly appreciate any help I can get to find evidence, although I'm starting to realize how hard that task is going to be. The process of Athrosclorosis is such a complex issue. I'm hoping that in the near future it will be proven that a LCHF Diet is beneficial for those suffering from Athrosclorosis. Until that time it's possible that a Keto/LCHF Diet may be detrimental to some people.
If you are sceptical, then I'm guessing you have one foot in the high carbohydrate camp as opposed embracing the science behind the high fat camp. Remember that the controversy only started in the mid '70's and was firmly established in the early '80's - and that's when the obesity/diabetes etc epidemic took off and is still rising exponentially.
You think it's complicated, but from my point of view it isn't. Just dump all refined carbohydrates/seed oils and eat like our recent ancestors, and yes, that could include some potatoes and a little bread.
That's not an answer to my question: Is a LCHF Diet safe for a person who has high LDL-C/LDL-P and advanced athrosclorosis?
in reply to pcspetpro
I’m not at all up on the science. But my late mum died from severe atherosclerosis and her diet was very much along the LCHF lines - very little refined food, healthy weight, high cholesterol, rather too much roughage I suspect (she had hypermobile connective tissue which caused a knot to form in her bowel). She never had her heart or lungs checked as far as I’m aware so she ignored her classic symptoms in terms of seeing a GP - until it was too late.
A point I would like to concur with is that no one rule fits all - so much of this is about our genetic make up. It is wrong to pronounce that if someone had followed LCHF earlier then they wouldn’t have atherosclerosis. There are autoimmune diseases that can cause high inflammation levels which can in turn affect our arteries, heart and lungs and cause conditions such as pulmonary arterial hypertension.
It isn’t ALL about lifestyle - although poor lifestyle choices will undoubtedly account for many people’s common conditions of course.
But nonetheless a lot of rare conditions exist and so it’s wrong to tar everyone with the same brush.
pcspetpro in reply to
Absolutely! Diets have become like religions, people tend to want follow rather than find out what is right for their unique genetic predisposition. Damage can be done to the Glycocalyx/Endothelium at a very young age. This damage can have many causes.
I have to admit to not looking to see if this answers your specific question, but maybe it will be of some use to you? dietdoctor.com/low-carb/sci...
Many Keto/LCHF sources will actually note that medium and long chain fatty acids may be detrimental to individuals with familial hypercholesterolemia.
Have you read Vitamin K2 and the Calcium paradox by Kate Rheaume Bleue? I’ve probably misunderstood your query but think it’s worth the read
Finding out why there is inflammation is a good direction to go. Processed Carbs and excessive Carbs definitely contribute to any problem and are probably a major cause. It's very obvious to me that the 'way things are' need to be changed. Your right there is too much money going into drug research and not enough into diet and nutritional research.
I agree! Personally I am moving from Keto/LCHF (Carbs 20 - 50mg) to a more Mediterranean style of eating (Non-Processed Carbs 200mg), while maintaining weight through exercise. I think that anyone going long term Keto/LCHF and has high LDL-C/LDL-P may be wise to get a CT Calcium Score.
Yes .…… there does seem to be a link between Osteoporosis and Heart Disease. There are still many things to be discover about the relationship between K2 and heart disease.
We all have different genetics, finding out what is right for the individual, is the way forward for health care in the future. There are many causes of Athrosclorosis. It does seem that many people can have high LDL-C/LDL-P for a long time and have a zero CAC Score.
Here is a baffling statistic ………… in a study over 50% of the people admitted to hospital for a heart attack had LDL levels <100 mg/dL
LDL is probably not the cause, but once the endothelium has been damaged high LDL levels may be contributing to progression of athrosclorosis.
Inflammation can be caused by many different things. Experimental evidence indicates that insulin-like growth factor-1 (IGF-1) exerts anti-oxidant, anti-inflammatory and pro-survival effects on the vasculature, reducing atherosclerotic plaque burden and promoting features of atherosclerotic plaque stability.
Age 64 5' 11" 150lbs Total 282 LDL 212 HDL 60 TRI 51 VLDL 10
Glucose 95 CRP 0.3 HA1c 5.5% CAC 979 (No Drugs)
No ............ after looking at the clinical trials and understanding the difference between Relative and Absolute risk/benefits I decided not to take medication.
TheAwfulToadAmbassador
He's technically telling the truth. It's not a statin. It works in a completely different way. And it does reliably drop your LDL-C.
What it doesn't do is change your prognosis. People taking Ezetimibe have an all-cause mortality rate which is essentially the same as people who don't take Ezetimibe ... although they do suffer unpleasant side-effects associated with having their cholesterol messed up.
Scientists would conclude that a) Ezetimibe is clinically useless and b) heart disease probably doesn't have anything to do with LDL-C. Fortunately for the drug companies, modern medicine runs mostly on superstition, not science. Ezetimibe is normally sold in a combination pill (with a statin) precisely to mask the fact that it doesn't do anything useful by itself.
It made the drug companies a lot of money. From 1996 to 2012, under the trade name Lipitor, atorvastatin became the world's best-selling medication of all time, with more than $125 billion in sales over approximately 14.5 years.
TheAwfulToadAmbassador
pcspetpro : a few thoughts ...
1) Asking "is LCHF generally safe for people with advanced CVD?" and "is LCHF safe for me?" are two different questions. The first can be answered with statistics and clinical observations on the population-at-large. There is such antipathy to LCHF among the medical community that you can be sure of one thing: if people eating an LCHF diet were turning up at the ER with strokes and whatnot, every vested interest would be shouting it from the rooftops. You'd never hear the end of it. But since they're not - and since there is no indication of problems in the literature - it's reasonable to assert that LCHF is generally safe.
Nobody can answer the second question. It is impossible to predict the precise effects of any given intervention on any given individual. But you might want to ask yourself ...
2) "Is a high-carbohydrate low-fat diet safe for me"? Again, you can look at statistics, clinical experience .. and you own experience. You have, I assume, spent most of your 64 years eating a "healthy diet". And yet here you are. And you're in good company, because many people eating a "healthy diet" end up exactly where you are. Dieticians like to call this a "paradox". I like to call it "being wrong".
3) The upshot of all that is that LCHF appears to be safer than the alternatives.
4) Nobody knows what causes atherosclerosis or CVD (and as I'm sure you know, they're not the same thing). However, cholesterol appears to have been vindicated precisely because we now have a whole range of cholesterol-lowering drugs on the market. None of them have any useful effect on all-cause mortality. Statins seem to have some tiny effect on middle-aged men who are already basket-cases, but no discernible positive effect on others.
5) There is no known method of reversing atherosclerosis once you have it, especially calcified plaques. OTOH, LCHF reliably stops it getting worse. You might want to look at some of the stuff that Ivor Cummins ("The Fat Emperor") writes about.
Ivor does great work and I agree it's about finding and fixing the root cause. But that is not always an easy thing to do. The fact is that I now realize I have not always had a great diet (mostly the wrong high fats). One must be clear about what type of Carbs and Fats they are eating and that they are not eating them in excess (gaining weight). My recent genetic testing (two different sources) points to a lower fat diet. It must be remembered that there are many causes of Athrosclorosis, it's not just about the food one eats or has eaten. I'm not looking to reverse Athrosclorosis, at this point I would be happy to slow it down. There's not enough evidence at this point that even a quality high fat diet, will help me in that pursuit. I think for most people LCHF is a great way to go, but I would advise anyone with genetically high LDL to be cautious and get a CT Calcium Score...…….. as Ivor would say "know your score".
I think it's easy to lose sight of the wood for the trees here.
Once you start thinking that, "OMG, maybe I have something wrong with my [insert random recently-discovered protein]" the question arises ... what can I do about it? And the answer is often "nothing" or "who knows?"
Out of the many factors that contribute to heart disease, stress is one of the top five factors. Some would argue it's up at the top. Those life-hours spent worrying about whether you're eating the "correct" fats are eroding into the life-hours your spend enjoying life.
Let me give you an example of how the rabbithole tends to have lots of dead ends. Take FH. Now, the fact that FH even exists suggests that it must have conveyed some sort of evolutionary advantage. If it were a fatal genetic disorder, it would have disappeared completely, eons ago. It's true that some people with FH develop heart disease at a young age, but those who make it past their 30s go on to live as long as anybody else. The reason, it turns out, is that high cholesterol protects against a range of other diseases, including infections - that effect has been corroborated in the general population (ie., people without FH). My suspicion is that those who die early are just extraordinarily susceptible to junk food.
This is an important reminder that there are other ways to die besides heart disease, and quite frankly, when I kick the bucket, I'll go for a heart attack, thanks very much. The other options (eg., cancer) look a whole lot worse.
As for heart disease itself, you'll find that many papers that purport to show a link between X and Y are quoting tiny relative risks. 0.7, 0.8, 0.9. These numbers mean nothing. They are almost certainly artifacts, or pure random noise. Want a guaranteed decrease in risk in the RR>2.0 ballpark? Avoid junk food, and do some exercise. Those give you the biggest bang for your buck, by a long stretch.
It's only my opinion, but considering how many people on the NHS weight loss site get results simply by dumping "white carbs" and going for a walk, I reckon diet follows the 80/20 rule: get at least 20% of it right, and you'll get 80% of the results.
I agree..……. worry about anything doesn't help and I don't. I'm actually enjoying the challenge of trying to figure it out. It has made me more disciplined, and I like the idea that I have a certain amount of control over my health. There are probably over 1000 sub- types of FH and all are some form of genetic disorder. Unfortunately one doesn't always die instantly of a heart attack. Yeah I'm aware of the 'deception' of Relative vs Absolute Risk/Benefit. I have accepted my challenges and continue to enjoy my life for as long as it lasts. If I can help some other people along the way, that would be great.
TheAwfulToadAmbassador
"On the other hand"
You can have atherosclerosis without having heart disease. In fact most people do have atherosclerosis without any clinical symptoms. "Cardiovascular disease" covers a whole bunch of stuff, but what people usually mean is the acute, life-threatening result of a clot forming and floating around, as a result of turbulent flow or a ruptured plaque.
Ezetimibe: you specifically asked the doctor for something other than a statin, but he was keen to prescribe something, and it doesn't generally matter whether the drug is useful or not. The doctor must merely be seen to have followed Best Practice, in case he gets sued.
Fat: you're starting from the assumption that (a) "saturated fats" are inherently problematic and that (b) there is such a thing as a "safer option". There is absolutely no evidence that this is true, for anybody. In fact it cannot logically be true - see my rant on the subject.
There is mounting evidence that medium and long chain fatty acids may be problematic for some people. Some LCHF sources point out that some people with FH may be vulnerable.
TheAwfulToadAmbassador
Yes, I understand. I think we're just talking at cross purposes. My point was merely that, since you had rejected statins, he couldn't offer you the combination pill. He could only offer you Ezetimibe alone. Which doesn't do anything. But at least he would have covered his back, legally speaking, by offering it to you, because Ezetimibe lowers LDL-C, and the powers-that-be consider that a primary outcome. The fact that you then rejected it doesn't reflect badly on him.
TheAwfulToadAmbassador
And what mechanism do you think is involved, whereby animal fats are harmful but your own bodyfat (which has the same chemical makeup) is not?
I understand you've had a life-threatening condition, which tends to leave one scared of living. But try not to think in terms of everything being bad for you. Most things just ... aren't.
TheAwfulToadAmbassador
I'll do that - I do like Ivor Cummins's work. But I know what ApoE is, and I'm not sure how it relates to this question. If you want to assert causality, then it's a pretty important point.
A genetic test will provide your ApoE Status, it's also a strong indicator of Alzheimer's. Glucose Metabolism is a player in both Alzheimer's and Heart Disease.
In Alzheimer Research, Glucose Metabolism Moves to Center Stage
The Health Care System is not really about Health! It's a Sick Care System, it's geared to acting after one is sick, very little energy/time is put into prevention. There is a growing field of functional medical practioners, but at this time one has to pay to play.
Through genetic testing, I discovered that I am E3/E3, but then I am also genetically at higher risk of having FH, Heart Disease and Cardiomyopathy. It seems that those with ApoE4 issue's and Athrosclorosis may benefit from reducing saturated fat.
I am in California.
It's critical that one avoids all processed high glycemic index Carbs, is not overweight and exercises to maintain a consistent weight.
Your fine in the U.S...……. 'IF' you have the money to pay for 'Quality' (functional medicine) 'Care'.
I moved to California from England in 1979 ……….. I don't regret it.
Like everything the 'good' has to be balanced with the 'bad' from an individual standpoint. Personally I still enjoy living in San Diego and would never consider returning to England.
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