Lipids and Inflammation

It is frequently reported that a ketogenic diet raises cholesterol. Folks freak out and blame the most convenient target – increased dietary fat.  If this happens to you, focus on the benefits you have experienced from adopting a ketogenic lifestyle and then prepare to do some research.  The ketogenic lifestyle actually improves your cardiovascular health.

One variable is the length of time it may take your body to fully adapt and begin healing.  It is recommended that anyone embarking on a ketogenic lifestyle allow 9 months to 1 year before re-measuring lipids.  Personally, I have come to believe our inflammatory markers (inflammation as a result of high insulin levels) and triglycerides are more important than cholesterol values.  I decided to have a Cardiac IQ blood test October 3, 2016. For some time I have believed that statin medications are overprescribed and that the bruhaha associated with bad cholesterol is overblown.  Among other things, the book The Cholesterol Myth by Uffe Ravnskov, PhD educated me about the negative outcomes of data manipulation in research.  Of late, a number of articles have been published in the mainstream media questioning the use and benefit of statins.  The Diet Doctor website has a great video (and transcript) on the topic: Low Carb and Cholesterol – What’s the Problem? .

Most folks get their cholesterol levels measured in conjunction with routine blood tests. The results of a standard lipid panel blood test are LDL, HDL and triglycerides.  HDL and triglyceride values are quantitatively measured and the LDL value is calculated.  Though LDL has generally been doomed to being “bad” a deeper analysis of LDL and types of particles may reveal important information related to cardiac risks. Out of curiosity I had the Cardiac IQ blood test for the first time.  Below is some information on the test and my values…..and some suggested reading (smile). It is likely that any physician who saw my total cholesterol greater than 200 and my LDL at 149 would advise me to begin statin therapy (and I would refuse!). Given the full picture I feel good knowing that I am decreasing my risk with every carbohydrate I skip eating.

Smaller low density lipoprotein (LDL) particles can cause plaque build-up to progress faster than larger LDL particles. Having too many smaller LDL particles is a powerful risk factor for a heart attack.

Larger high density lipoprotein  (HDL) particles are helpful with cholesterol removal.  Low levels of the large HDL particles can increase your risk for heart disease.  These are sometimes called fluffy HDL.

Apolipoprotein B (Apo B) is a direct measurement of the number of lipoprotein particles.  A high Apo B number indicates increased risk for heart disease

Lp(a) (Liprotein (a), Apo BLp(a)) High levels of Lp(a) are are associated with increased coagulation and increased risk of heart attacks and strokes.

C-reactive protein (HS-Cardio CRP, HS-CRP) elevated values indicate inflammation due to infection or tissue injury. In large epidemiologic studies, elevated levels of CRP have been shown to be a strong indicator of cardiovascular disease.

Fibrinogen is a part of the blood’s clotting process and can be elevated due to inflammation. Continual high levels are linked to an increased risk for heart disease. The combination of elevated fibrinogen with other risk factors can substantially increase potential for cardiovascular disease.

Cardiac IQ &  Inflammatory Markers   Range  Value
Total Cholesterol 214
HDL (mg/dL)  > 46 53
Triglycerides (mg/dL) 62
LDL (mg/dL) desirable <130
boarderline 130 – 150
high > 200 – 499
very high > 500
LDL Particle Number (nmol/L) optimal <1260
moderate 1260 – 1538
high > 1538
LDL Small (nmol/L) optimal <162
moderate 162 – 217
high > 217
LDL Medium (nmol/L) optimal <201
moderate 201 – 271
high > 271
HDL Large (nmol/L) optimal > 9386 moderate 9386 – 6996 high < 6996 3786
LDL Pattern optimal – Pattern A high – Pattern B Pattern A
LDL Peak Size optimal > 218.2 moderate 222.5 – 218.2 high < 218.2 224.2
Apolipoprotein B (mg/dL) optimal < 80
moderate 80 – 119
high > 120
Lipoprotein (a) (nmol/L) optimal < 75
moderate 75 – 125
high > 125
CRP-hs (highly sensitive) (mg/L)
lower < 1.0 average 1.0 – 3.0 higher 3.1 – 10.0
persistent elevation > 10.0
Fibrinogen Activity, Clauss (mg/dL) range 175 – 425 356

Why Dietary Cholesterol is Important


Inflammation and T2D – T2D Part 1

The straight dope on cholesterol – Part V

The Ketogenic Diet Reverses Indicators of Heart Disease

More to come….