saturated fat and mild keto--need ideas!

[anne from california]

Those of you limiting saturated fat--how the heck do you do it? Because of high cholesterol and high apoB, I quit the coconut milk and coconut yogurt, pretty much coconut anything, several months ago. I recently had another round of labs and, discouragingly, the numbers I was hoping would improve are actually higher. ApoB is now 114 (up from 94 four months ago). In ratio with Apo-A1 (161) I think not an emergency, but total cholesterol is also high due to high LDL, and LDL small particles are too many. I'll resist the temptation to post every lab value--except for the lipids, everything's within "normal" limits, but some are slightly outside what Bredesen would recommend (fasting glucose at 91, for example, up from the 80s in previous tests--so I'm not liking any of my trends at the moment). I'd love to get some ideas for ways to do mild keto with minimal saturated fat while maintaining about 1600 calories a day. (Lower than that, and I lose weight/muscle mass.) I've been logging things in Cronometer the past few weeks and every day, it's obvious that olive oil and nuts and eggs are driving the saturated fat count up. How the heck do I get enough fat while seriously cutting saturated fat? Also trying to boost fiber--again in an effort to lower LDL--but am not sure how to do that without driving up the carbs/blood sugar/insulin too high. Any and all insight is welcome!

[Whatnow]

Hi. Well, psyllium husk (metamucil?) will add fiber and reduce cholesterol a little. I know there are some authors who believe that leaky gut can be a cause of increased LDL cholesterol, so you might look into that as well. I'm sure others on here could add to this list. Good luck.

[Whatnow]

Oh, one more thing, I substitute soy tempeh for breakfast now and then rather than eggs. And I avoid dairy,

[TheresaB]

Any and all insight is welcome!

Your LDL has gone up, but that’s to be expected if you’ve gone low carb or keto. You might want to watch this 5 minute video that addresses the Lipid Energy Model (LEM) hypothesis. Why LDL Cholesterol Increases on a Low Carb Diet - The Lipid Energy Model

As ApoE4s, we are cholesterol conservers, so we have higher levels of LDL cholesterol. Since we conserve our cholesterol, our bodies don't need to pull as much from our blood supply, so our LDL levels are higher than our ε3 or ε2 counterparts. I hope your doctor has taken your ε4 status into account when evaluating your biomarkers. My total cholesterol (a worthless marker in my opinion) and LDL are always high, my doctor doesn't care. I got my Triglyceride to HDL ratio to an excellent level, lowered my inflammation markers, have an excellent HbA1c, and there are other markers that my doc focuses on for a more complete evaluation of cardiovascular health.

Because the LDL in ApoE4s float around in our bloodstream longer, it is more likely to turn into small dense LDL which in turn oxidizes (oxLDL) and it's the oxidized LDL that causes the damaging cardiovascular inflammation. I've had a elevated sdLDL count with an acceptable oxLDL level before, so while one leads to the other, high LDL or high sdLDL doesn't necessarily mean a high oxLDL.

Are you sure the olive oil is driving your numbers? That is the opposite of what should happen. Are you consuming quality, organic, unfiltered, cold pressed Extra Virgin Olive oil (EVOO)? Real olive oil (not olive oil that’s been cut with cheap vegetable oil) is high in monounsaturated fat. Unfiltered means it has invisible particles (don’t worry you don’t see anything or notice any difference in texture) and those particles bind to oxidized cholesterol. Even if filtered, EVOO has been shown to lower LDL and protect the LDL from oxidizing.

You should also try adding 50 mg of pycnogenol and 100 mg of grape seed extract.

Have you read the wiki on cholesterol? Cholesterol, Lipids and Treatments, including statins

[SusanJ]

As ApoE4s, we are cholesterol conservers, so we have higher levels of LDL cholesterol. Since we conserve our cholesterol, our bodies don't need to pull as much from our blood supply, so our LDL levels are higher than our ε3 or ε2 counterparts. I hope your doctor has taken your ε4 status into account when evaluating your biomarkers.

Hey, T, Anne's tagline says she's a 3/3, so I'm not sure the usual E4 higher cholesterol is necessarily true.

Seems like there might be other genetics in play.

[mike]

Those of you limiting saturated fat

Anne, there is still debate about saturated fat - here is a good article
https://www.healthline.com/health/food- ... urated-fat

[anne from california]

Hi. Well, psyllium husk (metamucil?) will add fiber and reduce cholesterol a little. I know there are some authors who believe that leaky gut can be a cause of increased LDL cholesterol, so you might look into that as well. I'm sure others on here could add to this list. Good luck.

Thanks, Whatnow. It's interesting, because this latest increase in LDL and ApoB followed a 30-day stint on an autoimmune protocol diet--I have a couple of AI disorders (leaky gut is always suggested with these) and I use AIP as a reset sometimes if I start sensing the possibility of a joint flare coming on. It's meat-heavy, coconut-heavy, basically a lot of saturated fat, and low in the kinds of fiber that might help lower cholesterol. (Nuts, seeds, oats, psyllium--all noncompliant.) Part of the deal is to do reintros to see what foods might create symptoms and I've never been able to discern a reaction. AIP shuts down pre-flare achiness pretty quickly, so I'm fairly certain there are foods--or combinations of foods--that I have a tough time tolerating, but it's impossible to ferret out which ones they are because it seems to take weeks, months, maybe even more than a year of exposure to create even a barely noticeable reaction. I've had my diagnosis for over 30 years, and I've never had a worse flare than my first, diagnosing one--it's all very mild and I'm grateful to have AIP as a reliable option. BUT I suspect the significant increase in saturated fat didn't help my numbers. It is, of course, questionable whether my increased numbers really matter--does a high LDL, high small ones, and high ApoB really raise my risk of CVD when I also have high HDL, decent Apo-A1, good triglycerides and am Pattern A? Maybe the million-dollar question, but I would like to bring them down to something that doesn't send up the red flags on the lab report. Since this most recent report, I'm gradually adding psyllium and flax and more nuts, a few oats and legumes, all while trying to keep protein high, blood sugar stable and unsaturated fat relatively high. It's a balancing act! We'll see how things look going forward.

[anne from california]

As ApoE4s, we are cholesterol conservers, so we have higher levels of LDL cholesterol. Since we conserve our cholesterol, our bodies don't need to pull as much from our blood supply, so our LDL levels are higher than our ε3 or ε2 counterparts. I hope your doctor has taken your ε4 status into account when evaluating your biomarkers.

Hey, T, Anne's tagline says she's a 3/3, so I'm not sure the usual E4 higher cholesterol is necessarily true.

Seems like there might be other genetics in play.

Thanks Susan--yes, 23andMe says I am 3/3, and I come here because there's so much great info. But it is true there could be some other genetics in play. All the women in my family have had postmenopausal high cholesterol. I don't know about anyone else's deeper numbers like ApoB or particle sizes, but I suspect what I'm dealing with has somewhat of a familial component. None of my maternal ancestors have died of or even had cardiovascular disease, but they've all had later-onset dementia (70s). Not sure if the dementia is in any way related to the cholesterol levels--in my mother's case, it's perhaps more likely it has to do with her out-of-control blood sugar and possibly the fact that she's taken a statin for 10+ years.

[anne from california]

Those of you limiting saturated fat

Anne, there is still debate about saturated fat - here is a good article
https://www.healthline.com/health/food- ... urated-fat

Thanks, Mike! Yes, there certainly are lots of questions about saturated fat and cholesterol numbers, and I don't think I'm going to find anyone who will come right out and tell me I have nothing to worry about if my LDL is high, my small LDLs are high and my ApoB is high. But it is possible I'm helped along by my Pattern A, my high HDL, low triglycerides and high Apo-A1--so all the key ratios look good. Cardiovascular disease doesn't seem to be a significant factor in my family history, either (but dementia sure is). I don't think it's a question that saturated fat has helped drive my numbers up; but whether or not it really matters is certainly a question I'd love to have answered someday. In the meantime, I'd be more comfortable bringing those highs down into a more moderate zone. Doing some tinkering with the diet and will see how it works out going forward!

[anne from california]

Any and all insight is welcome!

Your LDL has gone up, but that’s to be expected if you’ve gone low carb or keto. You might want to watch this 5 minute video that addresses the Lipid Energy Model (LEM) hypothesis. Why LDL Cholesterol Increases on a Low Carb Diet - The Lipid Energy Model

As ApoE4s, we are cholesterol conservers, so we have higher levels of LDL cholesterol. Since we conserve our cholesterol, our bodies don't need to pull as much from our blood supply, so our LDL levels are higher than our ε3 or ε2 counterparts. I hope your doctor has taken your ε4 status into account when evaluating your biomarkers. My total cholesterol (a worthless marker in my opinion) and LDL are always high, my doctor doesn't care. I got my Triglyceride to HDL ratio to an excellent level, lowered my inflammation markers, have an excellent HbA1c, and there are other markers that my doc focuses on for a more complete evaluation of cardiovascular health.

Because the LDL in ApoE4s float around in our bloodstream longer, it is more likely to turn into small dense LDL which in turn oxidizes (oxLDL) and it's the oxidized LDL that causes the damaging cardiovascular inflammation. I've had a elevated sdLDL count with an acceptable oxLDL level before, so while one leads to the other, high LDL or high sdLDL doesn't necessarily mean a high oxLDL.

Are you sure the olive oil is driving your numbers? That is the opposite of what should happen. Are you consuming quality, organic, unfiltered, cold pressed Extra Virgin Olive oil (EVOO)? Real olive oil (not olive oil that’s been cut with cheap vegetable oil) is high in monounsaturated fat. Unfiltered means it has invisible particles (don’t worry you don’t see anything or notice any difference in texture) and those particles bind to oxidized cholesterol. Even if filtered, EVOO has been shown to lower LDL and protect the LDL from oxidizing.

You should also try adding 50 mg of pycnogenol and 100 mg of grape seed extract.

Have you read the wiki on cholesterol? Cholesterol, Lipids and Treatments, including statins

Thank you, Theresa! I'm actually 3/3, but there could be some similar mechanisms happening within me, because all the women in our family have had post-menopausal high cholesterol. I don't actually think olive oil is driving my numbers necessarily, but it does add to the saturated fat count when I'm tracking in Cronometer. (And, yes, I'm getting the good stuff--Julie turned me on to the Bay Area high-polyphenol, multi-cough Amphora Nueva!) For all I know, though, the evoo has been keeping my cholesterol from spinning even higher. Thanks for the reminder about the wiki. I'm going to revisit it. I don't plan to ever take a statin if I can avoid it; I will always wonder if adding a statin is one of the things that has contributed to my mother's dementia. The timing is suspect, although she had plenty of other things going on that could've tipped the scale.