Dr. Paul Mason talks about what cholesterol results means for people on LCHF. Here is a quick summary
- Cholesterol is transport via Chylomicron, VLDL, IDL, LDL and HDL.
- Chylomicrons are sort lived and appears when we ingest food.
- LDL starts as VLDL, then to IDL and lastly to LDL as they off load their triglyceride cargo.
- When LDL is exposed to glucose, it can become glycated and then oxidised. Each damaging steps makes LDL fractionally smaller, i.e. small dense LDL. This oxidative process has been shown to be significantly accelerated if we have an access of omega 6 fats (aka mostly from vegetable seeds oils)
- In a standard blood test, VLDL and LDL values are estimated; IDL are ignored. Only HDL is actually measured.
- For lipid sub-fraction test, you want to achieve a pattern A LDL and avoid pattern B LDL as it means you have damaged LDL in your blood.
- Triglyceride levels of < 0.5 mmol/L (40 mg/dl) = Pattern A. Levels > 2 (180) = Pattern B
- HDL level > 1.6 (65) = pattern A. Level < 0.3 (25) = pattern B
- TRI/HDL level < 0.8 (1.8) = pattern A. Level > 1.8 (4.2) = pattern B
- In interpreting blood test, first look at triglyeride, then HDL and then TRI/HDL. If at least 1 of the levels is good, its a good indication of pattern A LDL.
- Increasing the amount of calories which increases insulin also increases LDL receptors in the liver, which is why the Feldman protocol using high carbs to lower LDL works. In the reverse. LDL receptors reduce when fasting, which explains why you may have high LDL count if you are doing long fasting before blood test.
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