Low LDL on Keto

senor_jeff
senor_jeff Posts: 47 Member
Hi all
Ive been on Keto about 2 years now and just recently had a blood test. I'm 60.
My Triglycerides are 44, my HDL is 78, which looks like good numbers.But my LDL is only 89. I think this is a measured LDL number, not a calculated one.
This in turn actually gave me a OK cholesterol reading in the eyes of my doctor.
Anyone have an idea why my LDL is so low? I was expecting it to be sky high. My wife is on Keto too, and hers is 3 times my level and we eat the same food.

Replies

  • ccrdragon
    ccrdragon Posts: 3,374 Member
    edited February 2021
    Do you exercise more than your wife? Some of the difference could be from exercise, but I would bet that the majority of the difference is just genetics.
  • senor_jeff
    senor_jeff Posts: 47 Member
    Actually yes. We both sprint and strength train. I probably do double what she does. Why would that affect ldl?
  • senor_jeff
    senor_jeff Posts: 47 Member
    Nobody knows why exercise lowers LDL on Keto? I'm curious to the why.
  • camtosh
    camtosh Posts: 898 Member
    edited February 2021
    Here are 2 guys that are experts, not sure if they answer that question, but fwiw!

    https://www.youtube.com/watch?v=P3dGhIx1qVM&ab_channel=MarkBell-SuperTrainingGym
  • camtosh
    camtosh Posts: 898 Member
    edited February 2021
    edited to put link above
  • psuLemon
    psuLemon Posts: 38,428 MFP Moderator
    I am struggling here. Are you complaining of a low LDL? In general, a low LDL is a good thing as it's correlated with improved metabolic health.

    There is a genetic component to LDL's. If your wife's is a extremely high, then there would be concern for why her's is high.
  • psuLemon
    psuLemon Posts: 38,428 MFP Moderator
    edited February 2021
    camtosh wrote: »
    Here are 2 guys that are experts, not sure if they answer that question, but fwiw!

    https://www.youtube.com/watch?v=P3dGhIx1qVM&ab_channel=MarkBell-SuperTrainingGym

    Neither of these guys are lipidologist. Paul Salidino holds a PhD in psychiatry. And Shawn Baker is an orthopediac surgeon. Those is far from a research expert in lipidology.
  • baconslave
    baconslave Posts: 7,018 Member
    psuLemon wrote: »
    camtosh wrote: »
    Here are 2 guys that are experts, not sure if they answer that question, but fwiw!

    https://www.youtube.com/watch?v=P3dGhIx1qVM&ab_channel=MarkBell-SuperTrainingGym

    Neither of these guys are lipidologist. Paul Salidino holds a PhD in psychiatry. And Shawn Baker is an orthopediac surgeon. Those is far from a research expert in lipidology.

    Well if you have some better sources, we'd love to have them for reference!

    My experience with folk leads me to believe that for a portion of people, LDL doesn't respond well to keto. At this point, one would need to change their fat profile around to prefer more monosaturated and less saturated. That said, LDL is not the end all be all of cholesterol numbers. Generally, the most important indicator is the HDL:Trig ratio. Good HDLs and low trigs are more indicative of your heart and cardiovascular health than LDL.

    From a 20-sec Google on the subject of LDL and exercise: https://www.webmd.com/cholesterol-management/features/exercise-to-lower-cholesterol

    Some studies show that increasing your exercise up to moderate can decrease LDL by 10%.

    Here's a key passage as to the "why":
    Researchers now believe there are several mechanisms involved. First, exercise stimulates enzymes that help move LDL from the blood (and blood-vessel walls) to the liver. From there, the cholesterol is converted into bile (for digestion) or excreted. So the more you exercise, the more LDL your body expels.

    Second, exercise increases the size of the protein particles that carry cholesterol through the blood. (The combination of protein particles and cholesterol are called "lipoproteins;" it's the LDLs that have been linked to heart disease). Some of those particles are small and dense; some are big and fluffy. "The small, dense particles are more dangerous than the big, fluffy ones because the smaller ones can squeeze into the [linings of the heart and blood vessels] and set up shop there," says Khera. "But now it appears that exercise increases the size of the protein particles that carry both good and bad lipoproteins."

    Read the article for more info. From talking to folk for years, it appears that LDL is a lagging indicator and will fluctuate on your weight loss journey and tends to finally start stabilizing after you hit your goal weight.

    Given all this info. I would suggest that if your wife's numbers are so concerning, before getting drastic, request a blood test to test the particle density of her LDL. If they are a high number of LDL particles that are the low-density fluffies, then I would eye the number but not be concerned. And maybe increase her exercise a little bit.

    Lots of info there to parse.
    If anyone else has personal experience with rogue LDLs and have helpful studies/articles please do chime in.

  • psuLemon
    psuLemon Posts: 38,428 MFP Moderator
    baconslave wrote: »
    psuLemon wrote: »
    camtosh wrote: »
    Here are 2 guys that are experts, not sure if they answer that question, but fwiw!

    https://www.youtube.com/watch?v=P3dGhIx1qVM&ab_channel=MarkBell-SuperTrainingGym

    Neither of these guys are lipidologist. Paul Salidino holds a PhD in psychiatry. And Shawn Baker is an orthopediac surgeon. Those is far from a research expert in lipidology.

    Well if you have some better sources, we'd love to have them for reference!

    My experience with folk leads me to believe that for a portion of people, LDL doesn't respond well to keto. At this point, one would need to change their fat profile around to prefer more monosaturated and less saturated. That said, LDL is not the end all be all of cholesterol numbers. Generally, the most important indicator is the HDL:Trig ratio. Good HDLs and low trigs are more indicative of your heart and cardiovascular health than LDL.

    From a 20-sec Google on the subject of LDL and exercise: https://www.webmd.com/cholesterol-management/features/exercise-to-lower-cholesterol

    Some studies show that increasing your exercise up to moderate can decrease LDL by 10%.

    Here's a key passage as to the "why":
    Researchers now believe there are several mechanisms involved. First, exercise stimulates enzymes that help move LDL from the blood (and blood-vessel walls) to the liver. From there, the cholesterol is converted into bile (for digestion) or excreted. So the more you exercise, the more LDL your body expels.

    Second, exercise increases the size of the protein particles that carry cholesterol through the blood. (The combination of protein particles and cholesterol are called "lipoproteins;" it's the LDLs that have been linked to heart disease). Some of those particles are small and dense; some are big and fluffy. "The small, dense particles are more dangerous than the big, fluffy ones because the smaller ones can squeeze into the [linings of the heart and blood vessels] and set up shop there," says Khera. "But now it appears that exercise increases the size of the protein particles that carry both good and bad lipoproteins."

    Read the article for more info. From talking to folk for years, it appears that LDL is a lagging indicator and will fluctuate on your weight loss journey and tends to finally start stabilizing after you hit your goal weight.

    Given all this info. I would suggest that if your wife's numbers are so concerning, before getting drastic, request a blood test to test the particle density of her LDL. If they are a high number of LDL particles that are the low-density fluffies, then I would eye the number but not be concerned. And maybe increase her exercise a little bit.

    Lots of info there to parse.
    If anyone else has personal experience with rogue LDLs and have helpful studies/articles please do chime in.

    A lot of the data i get comes from Dr. Spencer Nadolsky. But i certainly don't want to turn this into a debate to detract from the discussion. If i can find the LDL meta analysis, i can add that too.

    https://cholesterolcode.com/guest-post-the-case-for-lower-ldl-on-low-carb/

    I certainly would say there isn't a ton of data on low carb dieters as a population, which makes it hard to draw conclusions. I certainly agree that there are several factors that need to be considered, including triglycerides, fasting glucose, A1C, CRP and family history. Interestingly enough, i never have had an LDL less than 99. On keto it was 178. Whats fascinating, is that heart disease does not run in my family and both my parents have high LDL.

    I certainly don't put all stock in LDL, but if it's high, i certainly would agree that focusing on pufa (especially omega 3) and MUFA should be the primary focus. Also, ensuring adequate levels of fiber. Ironically, this is where i think Thomas Delauer has some merit as he promotes a Mediterranean style keto diet.
  • senor_jeff
    senor_jeff Posts: 47 Member
    Thanks all for the references. I will read up on them.
    I was mostly curious as I was expecting my LDL to be super high as most athletes seem to get on a Keto diet. I was thinking maybe I am over exercising (being unemployed and bored) as being the reason. In fact my LDL is barely higher (about 10% more) than when I was eating a standard bad western diet.
    At the same time I also got a Coronary Artery Calcium Score. I got a result of 0, which I was pleased with.
  • senor_jeff
    senor_jeff Posts: 47 Member
    psuLemon wrote: »
    I am struggling here. Are you complaining of a low LDL? In general, a low LDL is a good thing as it's correlated with improved metabolic health.

    There is a genetic component to LDL's. If your wife's is a extremely high, then there would be concern for why her's is high.

    Have you heard that studies on this coming out in the Keto community at least, and in particular for older people, say that people with higher LDL have a lower chance of a heart attack. Just the opposite which we have been led to believe. Also cholesterol has now been determined to have little if any bearing on your risk of heart disease either. Then there is the long term meta-analysis of statin and non statin patients that showed that the statin patients with the lower cholesterol had virtually the same death rate as those who took nothing.

    A more reliable method is doing one of the types of scans. I got a CAC one as it was the cheapest to get.
  • psuLemon
    psuLemon Posts: 38,428 MFP Moderator
    senor_jeff wrote: »
    psuLemon wrote: »
    I am struggling here. Are you complaining of a low LDL? In general, a low LDL is a good thing as it's correlated with improved metabolic health.

    There is a genetic component to LDL's. If your wife's is a extremely high, then there would be concern for why her's is high.

    Have you heard that studies on this coming out in the Keto community at least, and in particular for older people, say that people with higher LDL have a lower chance of a heart attack. Just the opposite which we have been led to believe. Also cholesterol has now been determined to have little if any bearing on your risk of heart disease either. Then there is the long term meta-analysis of statin and non statin patients that showed that the statin patients with the lower cholesterol had virtually the same death rate as those who took nothing.

    A more reliable method is doing one of the types of scans. I got a CAC one as it was the cheapest to get.

    Have you been listening to Dr. Paul Mason?


    I have never stated the cholesterol was an adequate measure. It's an artifact of HDL and LDL. It you have HDL, you can have high cholesterol. I understand there are multiple components to metabolic health. And i recognize there isn't a ton of research as it relates to keto or low carb. So it's truly hard for anyone to make an accurate assessment, regardless of what some new studies suggest. The body of evidence, which stems from multiple meta analyses doesn't show high LDL being beneficial.

    Overall, you and your doctor have to evaluate overall risk. If your triglycerides, a1c, fasting glucose, HDL, etc are in gooe standing, you exercise, at a good weight and have little to no heart disease in your family (like me), i high LDL isn't a bad thing. My doctor didn't worry when mije was 178 on keto because of those factors. I was 168 lbs, 5'11, at 16% body fat, with no heart disease. My HDL was 50 and Fasting glucose was 82. My overall assessment had me at 1 % chance of a cvd event occurring in 10 years.

    If your wife has high LDL, but her other numbers are good, that is a conversation with your doctor. But I'd caution anyone from changing views based on emerging data.

    And i won't ever touch a statin.