A few months ago I outlined my own personal journey to low carb wellness. I have had smashing results with weight loss and most every other health parameter. For the first year plus, I did it without increasing exercise. I was testing whether this WOE really delivered the results promised, and it certainly did.
Beginning this summer, I began training at zone 2 on the treadmill and we purchased a Concept 2 rowing machine. Weight and diet have remained constant.
Just a few weeks ago I went for my annual wellness check up. Pleased to report systolic BP is down 20 points with weight down 20+ pounds from last year. It was time for annual labs. I was curious to see what changes may be in store. I had been doing my usual 16:8 intermittent fasting when I went to the visit, so it was easy to pop down to the lab afterward to get drawn.
The labs came back and there were some changes, some better, some "worse". I put worse in quotations because that is the focus of this post.
My labs have always been consistent over the years. Beginning in my early twenties, I had comprehensive physicals for law enforcement. Most physicians, myself included, would not screen for lipids in asymptomatic early 20's-some year old patient absent other reasons, but this was the practice and so I have that data.
So what's better? As far back as age 17, I have had mildly elevated transaminases. These are liver enzymes which can indicate ongoing liver damage/inflammation. It's always been just a couple points above normal. I have had workup over the years all negative for any serious condition. Last year after #NSNG and #LCHF was the first time in my adult life these were normal. I can now attribute this to eliminating sugar, fructose and vegetable oils. I can now report this year's labs show the same normalization.
In 2006 I had labs done for screening prior to an exercise nuclear imaging stress test. My hs-CRP was 8! I chalked this up to a recent infection for which I had been on antibiotics, but subsequent measurements have shown persistent elevation. Hs-CRP is a non-specific marker of inflammation which can suggest an increased risk of ASCVD. Last year, even on low carb, mine was still 8. Today, after another year following the tenets of #NSNG, I have seen marked improvement to 2.4, just slightly over the normal cutoff. First time!
So what is worse? Over the years, my total cholesterol has been normal, about 182. LDL-C always borderline. HDL has been high normal which is generally considered protective, but triglycerides also borderline, until last year, when they also normalized. This year, my total chol+ went up to 204 and LDL to 140. I expected, and got, the statin talk from my PCP. On the plus side, HDL is up too, and triglycerides stellar. A ratio of less than 2:1 is generally protective. and mine is 1:1.
So what does all this mean? In most cases, #LCHF does not adversely affect lipids and often improves them. It has been recognized that there is a subset of patients, perhaps up to 25-30% who will see elevations in lipids due to a low carbohydrate higher fat diet. Some will have quite dramatic elevations of LDL-C. Dr Paul Saladino, author of the Carnivore Code and host of the Fundamental Health podcast freely acknowledges his LDL-C of 533! Dave Feldman of the Cholesterol Code website terms these folks Lean Mass Hyper-responders (LMHR). These people are generally fit, athletic and his hypothesis is that the concomitant LDL elevation is to compensate for the lower carbohydrate ingestion by transporting fats to supply energy demand.
Now, most of us in the low carb space do not believe that isolated LDL-C elevation is necessarily bad. It has been established that high LDL is associated with ASCVD. Association does not mean causation. Many people with heart attacks will have normal lipids. It is been demonstrated that some LDL is more atherogenic than others. What causes this? Factors like insulin resistance, carbohydrate intolerance, vegetable oils and chronic inflammation have been postulated as major drivers, all of which are markedly improved on low carb, healthy fat. It is the oxidized and glycated LDL which have detrimental effects. Research in this area is ongoing, but to be transparent, there are those who are still concerned about this elevation of LDL. I have contributed to the soon to be in-progress LMHR study co-authored by the afore mentioned Dave Feldman and Dr Spencer Nadolsky, a wellness and lipidology physician.
To wrap up, I must acknowledge the changes in my own labs, both good and bad. There are advanced markers such as particle size testing which can be done to help outline risk. You may find yourself in a similar situation, and this should be discussed and dissected in partnership with your own physician. Likely, the benefits well outweigh the risks, but we do not know with certainty yet. On ourlowcarb.com we have links to resources if you wish to learn more.
