Quick context: I’m a 39-year-old male, very healthy and athletic, with no family history of heart disease (though there is some diabetes and stroke on my dad’s side).
Before starting my Ironman 70.3 training, my cholesterol was high: 230 total, 184 triglycerides, 143 LDL. Through natural methods—training and eating clean—I lowered it to 180 total, 75 triglycerides, 103 LDL, 79 Apo(B), and an Lp(a) of 92 nmol/L. My glucose was also 96.
Recently, I made even more dietary improvements by cutting out most saturated fats for six weeks (no dairy, cheese, red meat, etc.). Despite that, my latest results surprised me: 193 total cholesterol, 114 triglycerides, 113 LDL, and my Lp(a) rose to 127.5 nmol/L. Additionally, I have abnormal LDL particle numbers, especially small particles, and my glucose slightly increased to 104. My CAC score is 0, and I’m scheduled for a heart stress test and carotid artery ultrasound soon.
While my doctor and cardiologist don’t see this as an immediate cause for concern, they’ve flagged the elevated Lp(a) as an independent risk factor for cardiovascular disease (CVD), which could accumulate over time.
My new primary care doctor, who focuses on nutrition, suggested that my elevated readings—despite eating clean—might be linked to not eating enough, especially before morning workouts. I often skip breakfast before runs or rides and end up fueling during the workout with gels or sports drinks. Post-workout, I’m usually ravenous, particularly at night, craving carbs or sugar.
She believes my LDL issues could improve by eating a bigger breakfast and spreading meals more evenly throughout the day. The theory is that my liver might be overproducing small LDL particles due to metabolic stress from not consuming enough calories or macros, particularly before workouts. Has anyone experienced something similar?
