I had my blood work done a few weeks back. I didn't change anything. I still ate high fat, even high saturated fat, the week before the test. My results were fine. One thing to make sure, no food or drinks (except water, black coffee, tea) for at least 12 hours before they draw the blood. That keeps your numbers accurate as possible.

You should be fine. If you are really nervous about your cholesterol, you might try and eat less fat. But, it doesn't seem to make a difference for me. I had a total cholesterol of 205 before eating keto, and it was a 168 when I got tested--even eating 70%+ of my calories from fat and 30-42% of my calories from saturated fats. That drop could be from the weight loss, or something else, but I can say that my numbers weren't arbitrarily super high because of my fat intake.

Edit: The absence or presence of ketones in my blood was not noted on either the "Comprehensive Metabolic Panel" or the "Lipid Panel." It's possible they could do additional tests that could show them, but I don't think it's especially likely.

I would only suggest changing something if you know they're going to do a glucose tolerance test (the one where they give you glucose water, wait two hours, and check your blood sugar level), but to my knowledge, insurance companies don't do that (they're cheap, after all). If for whatever reason, they are doing it, then you'll want to increase your carb intake for about a week, so that your body gets through the "peripheral insulin resistance" phase. If they do it and you don't know about it in advance, it might be a good idea to alert them to it, especially if your blood sugar runs high in the test. Otherwise, don't worry about changing your diet.

The idea that dietary fat or cholesterol raises blood lipid levels has been debunked umpteen times. Only a small percentage are even affected by fat consumption in that way, and even for them, the effect is only tiny. Eating low fat won't make a difference, very likely.

Ketosis will show up if they do a urine sample, but not blood tests unless they specifically look for them (which is doubtful -- again, insurance companies are cheap). Even if it does, you should be in a fasting state, anyway, which is by nature a mild form of ketosis, so it's normal for ketones to be present in such tests that are sensitive to them.

I had my blood work done a few weeks back. I didn't change anything. I still ate high fat, even high saturated fat, the week before the test. My results were fine. One thing to make sure, no food or drinks (except water, black coffee, tea) for at least 12 hours before they draw the blood. That keeps your numbers accurate as possible.

You should be fine. If you are really nervous about your cholesterol, you might try and eat less fat. But, it doesn't seem to make a difference for me. I had a total cholesterol of 205 before eating keto, and it was a 168 when I got tested--even eating 70%+ of my calories from fat and 30-42% of my calories from saturated fats. That drop could be from the weight loss, or something else, but I can say that my numbers weren't arbitrarily super high because of my fat intake.

Edit: The absence or presence of ketones in my blood was not noted on either the "Comprehensive Metabolic Panel" or the "Lipid Panel." It's possible they could do additional tests that could show them, but I don't think it's especially likely.

"Fine" is a relative term. What were your numbers?

Your triglycerides could have been a bit lower easily if you had lowered fat intake prior to the blood draw.

Example:
labs drawn when on strict diet low fat (plus cholesterol lowering meds) for about a month:
Total chol: 100
HDL: 39
Triglicerides: 84
LDL: 44

Labs drawn 6 months later with same meds, but eating as usual for several months (because the meds worked so well!):
Total Chol: 158
Triglycerides: 218
HDL: 52
LDL: 62

Only thing changed was that the diet was relaxed. Same meds, same lack of exercise.

Unfortunately the latter labs were used for the insurance physical. If the diet had remained the same, I bet we would have had much better rates.

http://health.yahoo.net/experts/dayinhealth/cholesterol-myths-may-surprise-you

This may not be the best source, but it was the first hit when I googled it.

Life insurance companies know a surprising secret about cholesterol that most doctors never tell patients: When it comes to rating your risk for a fatal heart attack, the least important cholesterol number is your level of LDL (bad) cholesterol. In fact, life insurance actuaries don’t even look at LDL levels, because large studies show it’s the worst predictor of heart attack risk.

Instead, life insurance companies use a simple math formula to rate your heart attack risk: They divide your total cholesterol by the level of HDL (good) cholesterol.

“If the ratio is below three, and there’s no inflammation in your arteries, you’re practically bulletproof against heart attacks and strokes, even if your LDL is high,” reports Amy Doneen, MSN, ARNP, medical director of the Heart Attack & Stroke Prevention Center in Spokane, Washington.

The same article also talks about the increased risks associated with very low cholesterol (of which numbers 125 would definitely be amongst). I am sure the insurance companies are aware of those studies.

Do you have a resource regarding your hunches about how specific values effect risk assessment and rates? I would love to see them.

High fat intake prior to blood draws can be seen in triglycerides levels. Just keep that in mind.

I disagree. I eat high fat always, and my tri's are down to 77 from over 200.....no matter when I have my blood checked, or what I've eaten leading up to the test. As long as I keep my carbs low.

Are you a doctor or a nurse?

Your triglycerides could have been a bit lower easily if you had lowered fat intake prior to the blood draw.

Example:
labs drawn when on strict diet low fat (plus cholesterol lowering meds) for about a month:
Total chol: 100
HDL: 39
Triglicerides: 84
LDL: 44

Labs drawn 6 months later with same meds, but eating as usual for several months (because the meds worked so well!):
Total Chol: 158
Triglycerides: 218
HDL: 52
LDL: 62

Only thing changed was that the diet was relaxed. Same meds, same lack of exercise.

Unfortunately the latter labs were used for the insurance physical. If the diet had remained the same, I bet we would have had much better rates.

Without other information, there really isn't much comparison here. Were they both fasted? How long had you been on the "more relaxed" diet? What, exactly, were you eating? A whole-foods high fat diet is vastly different from a "high fat" SAD/Western diet.

While it's true that your trigs are higher after a fatty meal, that doesn't necessarily translate into higher trigs in a fasted state. That's kind of like saying that because your blood sugar and insulin are higher after a carby meal, you're Diabetic. No, you just ate something that affected the level, temporarily.

In fact, lipid levels are back to normal in about 8 hours ( http://ajcn.nutrition.org/content/47/5/825.full.pdf ), and the linked test was upwards of 120g of fat in a single meal (as cream, of all things; 10oz of it).

Here's a quick comparison of my numbers before and after dropping my carb intake and increasing fat (both are fasted tests).

2/10/2012 (Prior to caring about carb intake; averaged 200g carb/day; weight: 243lb)
Total: 147
HDL: 39
LDL: 96
TG: 60
TC:HDL: 3.77
HDL:LDL: 0.406
TG:HDL: 1.538

10/10/2013 (After some time doing higher fat, lower carb; average 100g carb/day; weight: 257lb)
Total: 170
HDL: 48 (vastly improved, old was high risk, new is optimal)
LDL: 106
TG: 80
TC:HDL: 3.54 (improved)
HDL:LDL: 0.453 (improved)
TG:HDL: 1.667

I "blame" the increases in numbers more on other things -- namely my Type 1 PCOS (PCOS with insulin resistance), which contributed to a not-insignificant weight gain between the two draws, when I stopped tracking for a time due to depression from lack of support and much-needed treatment of said PCOS. The difference in blood numbers pretty evidently has more to do with weight than food content, since halving carbs and doubling fat would create a more significant increase than the above if it were to affect it. It's also worth noting that while the raw numbers increased (which is a mixed bag, since HDL went from "high risk" to "normal"), the ratios improved for the most part. Regardless, like frob's numbers, they aren't arbitrarily high because of my diet.

Here's a good rundown of the problems with the "fat = CVD" myth (though it's only partially on topic here) - http://chriskresser.com/cholesterol-doesnt-cause-heart-disease

An interesting note on the actual conclusions of the Framingham Heart Study and some of the published/media-released "conclusions" - http://www.proteinpower.com/drmike/cardiovascular-disease/framingham-follies/

Dr. Peter Attia's presentation on the muddying of the waters with regard to fat/saturated fat intake (research vs media) - Note at 18:39, the unpublished notes from the FHS that there was no dietary difference between men with a TC of 300 and men with a TC 170 with regard to amount or type of fats consumed. The video also mentions that HDL is a better predictor of CVD risk than TC (in other words, you and I both improved our risk factors, despite seeing an increase in total cholesterol), and mentions that low TC is associated with increased risk for cancer (so again, health improvements). Around 55:00 also shows the results of various popular diets (Atkins, Zone, Ornish, LEARN).

More interesting stuff by Dr. Attia regarding CVD risk factors (fun note - age is the biggest factor in the FHS's calculator) - http://eatingacademy.com/cholesterol-2/the-straight-dope-on-cholesterol-part-ix

UCLA's evidence that LDL isn't really a predictor of heart attacks (75% of people admitted for a heart attack had an LDL under 130, and half had LDL under 100) - http://newsroom.ucla.edu/portal/ucla/majority-of-hospitalized-heart-75668.aspx

What do these have to do with the lipid panels? Well, there's not much doubt that triglycerides are a pretty strong indicator of risk, but the question is - what affects triglyceride levels? Hint - carbs, mostly, especially sugar.

http://www.ncbi.nlm.nih.gov/pubmed/15051841
http://www.ncbi.nlm.nih.gov/pubmed/11584104
http://www.ncbi.nlm.nih.gov/pubmed/15173403 (This one's interesting, because the researchers found that low fat works better for very elevated trigs, while low carb works better for only slightly elevated trigs)
http://www.ncbi.nlm.nih.gov/pubmed/10525047
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC302539/ (This one's interesting, because it notes that fructose is associated with consistently elevated levels of trigs)
http://www.nutritionandmetabolism.com/content/2/1/21# (For this: "Isocaloric replacement of carbohydrate with any type of fat results in decreased triglycerides and increased HDL-cholesterol, the effect on HDL-cholesterol being greater for saturated fat compared to unsaturated fat.")

So...yeah...your assertions regarding fat and triglycerides? They don't really hold up all that well.

However I guess the insurance companies have come up with the best methods of determining statistical risk of death for a number of years with a single physical and blood draw. They must do pretty well because most are still in business.

For life insurance? It's not really required to actually come up with "the best method" of determining risk of death, it's just required that they have some reasonable determination of what is commonly considered risk. For more fuzzy issues like this one, it's more perception and a reason to charge you more (thanks to the muddiness surrounding cholesterol and health risk, it's easy to use reasonable, even if arbitrary, numbers to determine how much someone pays). Insurance companies stay in business, because people generally pay more than what they actually get out of it, it's just paying over the long term instead of lump costs, so it feels more bearable (hence the usual suicide clauses and maturation periods).

On a side note (out of curiosity), if you're so obviously pro-low-fat and seem to have a thing against low carb, why are you in this group?

On a side note (out of curiosity), if you're so obviously pro-low-fat and seem to have a thing against low carb, why are you in this group?

In fairness, the original advice she gave was to stay low-carb and also go low-fat. There are varying levels of fat/protein consumption that people on this group consider acceptable. I don't think it's fair to say that we don't all feel that the low-carb part, at least, is right.

On a side note (out of curiosity), if you're so obviously pro-low-fat and seem to have a thing against low carb, why are you in this group?

In fairness, the original advice she gave was to stay low-carb and also go low-fat. There are varying levels of fat/protein consumption that people on this group consider acceptable. I don't think it's fair to say that we don't all feel that the low-carb part, at least, is right.

Fair point, I missed that part, initially. I'm not keen on the idea of dropping carbs and fat, though (but for only a week, it's difficult, but doable).

Her subsequent responses, though, make it less clear on her low-carb stance (and her diary shows that she's following LF/HC and has been for at least the past 8 months or so). Her snide remark about having to do research for us isn't helping her cause, either. :ohwell: