When faced with emotionally-charged opposing views of a scientific topic that has no place for opinions, I like to dig into each angry arguer's motive. Often a profile click is enough to reveal they work in oil & gas (climate sceptics), or are vegan (pro-carb gang) etc...

Hint hint

This seems like a lot of debate for one crappy "study" in which nobody actually ate a low carb diet. It also shows that those that had the best health and died the least ate the most saturated fat, to a statistically significant degree. Too much fat is the implicit danger in limiting carbs right? Wonder what the reaction would have been had the authors led with that instead.

FWIW...
Trigs ~90
HDL ~55
LDL - whatever I want it to be when i get it measured, between about 90 and 200. LDL is hyper-agile in a healthy person
A1C - 5.1
CRP - 0.2
lp(a) - 7

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Me: https://carnivoreendurance.blogspot.com/...ever-comes-next.html

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Can I trouble you to provide a link to the bolded part above? Congrats on picking the right parents for your lp(a) value. Do you have an Apo-B value to share?

Thanks,

Hugh

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Genetics load the gun, lifestyle pulls the trigger.

This seems to be the case with everything that is about health or diet.

95% are people with vested interests or they are passionate follower's of people with vested interests

5% are people trying to state the obvious. And getting progressively more frustrated.

(This discussion is especially frustrating because it has both sports nutrition promoters AND "low carb koolaid' promoter's. " Both groups will attack you if you try to inject any common sense).

The obvious:
1)"Low carb," as a diet, served a purpose in that it got some people to focus more on whole foods- meats, vegetables, fruits, nuts.
And eat less on highly processed foods- sugars, white flower, white rice, corn products.

2) Calories are necessary especially for people doing lots of training and racing. The longer and harder, the greater the need for quickly digestible calories. This is where Sports nutrition is helpful.

3) Too much fat, is unhealthy for inactive people.

4) Too much high calorie processed food is unhealthy for inactive people..

5) People who are selling "low Carb Koolaid'" AND people who are selling "sports nutrition" .............
don't really care if they are making relatively inactive people sick.

Decent points, if a little overstated in some cases. I'd add
4a) As a part of regular every day diet, it's way easier to become dependant/addicted on sugar or carbs than meat, eggs, and low carb veg. Feed me pasta or bread, even if I make it homemade with fresh ground wheat and eggs (which I do), and I could eat that stuff all day until I explode. Tell me I can't eat it and have to stick to meat, eggs, broccoli and the like... and I am so bored after a few days I'd rather do anything than eat. The processed foods (cheesesticks, etc) do allow you to hit that snack craving, but you can only eat so many cheesesticks and hard boiled eggs in a day before you're done with them for a week. Pizza and pasta? Myself and most other people can eat themselves into chronic disease on that diet pretty easily.

Ha ha.

I agree that it is much harder to over eat fats, meats and veggies.

Someone took me to one of those all you can eat Brasilian steak places for my birthday. (I was hungry because I had done a 100 mile ride).

But OMG- 2000+ calories of meat and fat.
I will never, EVER do that again.
My body hurts just from the memory.

That said, 2 liters of Soda and half a family pizza (that's mostly white bread and sugar)??
That might also hurt a little when it's done.

I respect your opinion, however, I happen to believe that doctors and cardiologists are more often right than wrong. I am happy that a carnivor diet works for you, however, I go with the overwhelming evidence and research to the contrary, and I tend to listen to cardiologists and qualified experts.

I am not vegan, but consume less than 5% meat and I do not eat processed foods, and my diet works extremely well for me, I am very fit and very healthy.

Interesting in the heart attack thread 2 people with low ldl having heart issues:

https://forum.slowtwitch.com/...ck_at_41_P7852482-3/

If you're calling low ldl anything under 120 then it's not really surprising to see heart attaches especially without also seeing patient's LP(a) values. I'd consider ldl to actually be low if it was in the mid 70s or lower.

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Genetics load the gun, lifestyle pulls the trigger.

When I had my MI, my Total was 195, LDL 113, HDL 66
latest labs in Feb, Total 137, LDL 57, HDL 60

Along the way did you get your LP(a) tested? It's an especially atherogenic sub-portion of LDL. The amount one produces is genetically controlled, with some lucky people having very little or none and others a good deal even if their total LDL cholesterol is reasonably low.

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Genetics load the gun, lifestyle pulls the trigger.

I will go back and check my labs from the beginning and see and also ask Cleveland Clinic about this.

There aren't going to be a ton of studies I can provide that just directly demonstrate the point, short of providing you ~90 minutes of reading on lipid mechanics that explain how and why this is the case (simply put, because lipids function as an energy delivery system). Those types of studies (very short term, healthy subjects) are rare. But for one at least, this is an example of how fasting dramatically raises LDL-C in healthy subjects - Fasting Increases Serum Total Cholesterol, LDL Cholesterol and Apolipoprotein B in Healthy, Nonobese Humans | The Journal of Nutrition | Oxford Academic (oup.com)

On the subject of lp(a) - I obviously won't deny a genetic component (and perhaps even a greater genetic influence than with other markers), but the notion that lp(a) is somehow immutable or predetermined is a fabrication. It's the primary carry of oxidized phospholipids and tracks very closely to measures of oxLDL, and thus is at least somewhat amendable to diet in exactly the ways you would expect it to be (ie. goes up with carbs and PUFA, and down with saturated fat)

Changes in lipoprotein(a), oxidized phospholipids, and LDL subclasses with a low-fat high-carbohydrate diet - PubMed (nih.gov)
Healthy Dietary Interventions and Lipoprotein (a) Plasma Levels: Results from the Omni Heart Trial | PLOS ONE
Effects of reducing dietary saturated fatty acids on plasma lipids and lipoproteins in healthy subjects: the DELTA Study, protocol 1 - PubMed (nih.gov)
Changes in dietary fat intake alter plasma levels of oxidized low-density lipoprotein and lipoprotein(a) - PubMed (nih.gov)

I don't have an apoB unfortunately, although I'll get one (two, actually) in the not entirely distant future. Intending for an "experiment" of sorts in a month or so to see how much LDL goes up during a run. Will get a before and after apoB during that also. Can report back eventually if you would actually still be interested

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Me: https://carnivoreendurance.blogspot.com/...ever-comes-next.html

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Thanks so much for the links you've provided. I'll follow them all and see how much they expand and perhaps shift my understanding of the topic. I would very much enjoy seeing the outcome of you pre/post run experiment but already wonder if it will provide useful information. It would be much more interested to see data through a whole day including a run in the middle. Will LDL shoot upward immediately post run but then ramp right back down, stay elevated for several hours, into the night etc? It will still be interesting to see.

Best Regards,

Hugh

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Genetics load the gun, lifestyle pulls the trigger.

It would depend largely on my food choices after the run. Also the dietary habits in the hours and days before, which I'll of course try to keep as normal as possible. You kind of have me curious about getting ~4 measurements in one day also, but that gets a little trickier logistically with work and/or finding labs open all day on the weekend

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Me: https://carnivoreendurance.blogspot.com/...ever-comes-next.html

Latest: Colorectal Cancer is in the News Again. Don't Blame Red Meat
https://carnivoreendurance.blogspot.com/...news-again-dont.html

Hey, no idea if you'll see this or if you or anyone still cares, but I did say I'd report back. Running experiment wasn't able to happen due to lack of running. Fasting "experiment" and a couple apoB measures instead. Ate excessively for a few days, had apoB of 94 the next morning. After a few days of extended fasting, apoB was 139

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Me: https://carnivoreendurance.blogspot.com/...ever-comes-next.html

Latest: Colorectal Cancer is in the News Again. Don't Blame Red Meat
https://carnivoreendurance.blogspot.com/...news-again-dont.html

I’m out entirely certain how to feel about the results of you test. It does make me happy to have an Apo-B of 66 which is below the 5th percentile for my age.

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Genetics load the gun, lifestyle pulls the trigger.

I've found this post of interest so I will chime in. My bias is that this diet (well-formulated low carb) reversed my own high blood pressure and body fat percentage and was associated with my personal best IM performance (out of 17) at age 43 (sub 10h Taupo). I've since gone on to coach at least 5 professionals to major event victory (Major IM, World Champs) using the diet. I also publish research in the area.

The cholesterol issue has always been an enigma to me. I wonder if its important or not. The recent study by Prins et al (2023) does an excellent job comparing middle age athletes across the two diets consumed for 31 days; repeated measures design. No difference in high intensity running performance (1 mile time trial), fasting insulin or body composition between the diets. Specific to this post however, they found HIGHER total, LDL and HDL cholesterol in the low carb group. Worrisome if we believe that cholesterol causes cardiovascular disease. BUT, blood glucose variation was lowered with the low carb diet, and REVERSED the pre-diabetes detected in 3 of 10 athletes (they were pre-diabetic and didn't even know it). The low carb group also brought their fat oxidation levels to 1.85 g/min, which is massive.

I'm wondering: are we seeing loads of athletes piling up in the cardiac wings for heart surgery due to this diet, or is it more the diabetic and obese person phenotype. What's the key parameter we should be focussing on? My belief is that its the blood sugar/insulin axis.

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https://athletica.ai/
https://hiitscience.com/

all these studies have very short periods for any usable conclusion, and it will be difficult to find long term results since many fall off the diet, or not need to go keto in the first place (someone already thin and athletic)

31 days x 2 conditions is short term? Its one of the longest on record in terms of good control.
We also did a similar study comparing diets and exercise with less trained participants and found similar outcomes. What was most interesting from that one was that exercise didn't do much to alter any of the health related measures. Take home message: you can't outrun a bad diet.
Jeff Volek's FASTER study compared groups of runners that were reportedly on the diet for 9 to 36 months. Is that long enough for you?
Remember, in the original study I quoted, 3 of 10 athletes were pre-diabetic (resting blood glucose over 100 mg/dL). They were thin and athletic appearing. They felt fine. They looked healthy, but they weren't.

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https://athletica.ai/
https://hiitscience.com/

I trained with volek back in the day for a bit,not new to who he is and what he has studied. I'm more interested in folks 5 years + on this diet. 100% agree you cannot out train a bad diet