Diet and NMR results - Revisited.

Newcomer introductions, personal anecdotes, caregiver issues, lab results, and n=1 experimentation.
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Stavia
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Re: Diet and NMR results - Revisited.

Post by Stavia »

Juliegee wrote: It's stunning to me to see how badly Berkley Labs got it wrong..
gosh YES!!! This is a lesson to look for interventions that more than one opinion leader agrees on.
Juliegee wrote:Finally, on a person note; I'm pissed. I've been strictly following Dr. Gundry's protocol for the past 3-4 months (high plant fat/low animal fat.) I've been eating pristinely. I just re-did my NMR- expecting amazing results... and I got a call from the lab today. My test was messed up and I have to repeat :shock: Dang it. I did what I always do following a cholesterol test- I ate badly. I eased up on my caloric restriction AND I ate some grass-fed pork. Sigh. Now, I have to de-tox and repeat. I wonder how long I have to wait to erase my indiscretion?
Julienne (sorry couldn't resist) ;) - how about turning this into an opportunity? Test again tomorrow anyway, and then again in 6 weeks. You know lipids change rapidly. Then you can tell us if one cheat meal actually makes a difference or not?
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Re: Diet and NMR results - Revisited.

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Its hard to interpret without correlating diet to actual health outcome data (ie... a decrease in CIMT rate of growth or regression) It can take years for our bodies to adapt to diet.

I've pushed LDL-P under 1500 once via an n=1, I was very low carb and eliminated all saturated fat from animal sources. (I basically ate Kale and EVO for 6 weeks). I have no plaque, yet.

Hep

Edit: Even though I was able to drastically reduce LDL-P with the kale/EVO diet, my APOB/APOA1 ratio stayed about the same, .75. (my HDL went down proportionally).

I think once one is ill, dyslipidemia follows and a successful intervention paradigm can not be the same as a preventative/maintenance program. In other words, stopping/reversing atheroma is different than preventing it. Much advice seems ignorant to this.
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Re: Diet and NMR results - Revisited.

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Stavia,
George, but only post a single carb night right? What would happen if you had sustained higher carbs for two weeks? I'd bet a bottle of EVOO your TGs would rise
And I'd bet you'd lose! Here is a test from 2007, it is representative of decades of a vegan LFHC diet and tests during that time.

Quick summary: TC 149 mg/dL, TG 43 mg/dL, VLDL 9 mg/dL, LDL 92 mg/dL, HDL 48 mg/dL (the RDW was high 'cause I'd been donating blood frequently as a veg).

I understand why you'd make that bet. It would be a very good statistical bet!

I don't have the paper handy, but I found a study where they took normals, fasted them then fed them heavy cream. They measured TG's before and hourly after. The results were a fairly high spike an hour after then a decline over hours back to baseline. I think my "3/4" metabolism is a much slower decline. An interesting test would be for me to replicate the study with various kinds of fats. Even fasting spikes my TG's higher than a carb nite. For example, after a 36 hour fast TG 94, while after a carb nite TG 54 (both tests from NMR, not my home tester). The other part of the equation is what I name "a call for fuel." I've not tested after fasted exercise, but it would be interesting. My most anomalous test was after a LC vegan dinner and shortly after sex in the morning. TG 361! Even with a very large sat. fat meal (grass fed beef cooked in plenty of grass fed ghee) I've never had a reading 1/2 that! My interpretation is the sex created a "call for fuel."

The standard view is that the issue with TG's is they are indicative of insulin resistance. Last night I had a LCHF meal of 8 oz beef cooked in EVOO, salad with spinach, cabbage, mushrooms, onion, radish, carrots, a lot of walnuts. This morning TG 145, TC 211 HDL 49 LDL (calc) 133, ketones 0.6 mmol, glucose 74 mg/dL.
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Re: Diet and NMR results - Revisited.

Post by Stavia »

How interesting George. When I come to the US I owe you a bottle EVOO!
I see your last night's meal had a significant protein load. Mebbe gluconeogenesis? And subsequent shunting to TGs?
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Re: Diet and NMR results - Revisited.

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Stavia,

8 oz beef = 50 g's protein. I'd had 2 eggs & EVOO for breakfast (only eat 2x/day, if that) which would be 62g/day for protein. At 79 kg (175 pounds), that is 0.77 g/kg/day. Not in the high range. Also the keto diet guys talk about too much protein restricting ketone production because of gluconeogenesis . Since I was at 0.6 mmol/L for ketones and glucose 74 mg/dL (4.1 mmol/L), I'm guessing not a lot of gluconeogenesis happening. At least not gluconeogenesis that gets converted to TG's (since the sum of excess ingested carbs and excess gycogen from protein gluconeogenesis is a) what inhibits ketone production and b) in much greater excess will get converted to TG's). Also, if I'm not making TG's from a vegan high carb diet or my carb nites with hundreds of grams of carbs, I'm very unlikely to be making them from a modest intake of 50gs of protein. Being generous, the conversion is at a 60% rate (I don't recall exactly, but it is in the ball park). So 50g protein ~ 30 g carbs at night plus the non starchy veggies. It could be enough to inhibit ketosis, but 0.6 is considered in the "therapeutic" range, so not a lot of inhibition.

As an aside, when ate vegan HCLF, my weight tended toward 200#'s. After I got idopathic afib from chronic fitness, I detrained and my weight increased to 210# or so. It was then that I switched to the keto model of eating. I now tend to weigh 172-175#. With my 6'0" height, the BMI range is now 23.3-23.7. From skin fold calipers and the US military equations, my body fat % is 12-15% (an inch above the point on my hip, 4mm thickness).

The standard assumption is the TG's are from excess glycogen getting stored with high insulin levels. For me, TG's get used for fuel, not stored. If it were otherwise, I'd have a lot more body fat. In fact, a lot more got stored in my low TG days on the LFHC vegan eating plan. Though I didn't measure it, I'm sure my fasting insulin levels were a lot higher then than now. I checked a few mouths ago and they were around 3.

I certainly don't have all the answers, but I know I don't fit the standard profile.
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Re: Diet and NMR results - Revisited.

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George, I'm stumped. Your biochemistry knowledge is impressive.
What are you going to do macronutrient-wise?
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Re: Diet and NMR results - Revisited.

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Stavia,

It is a good question. Though I had "perfect" lipid tests on a LFHC vegan diet, my glucose/insulin profile is much better. As you pointed out previously, glucose/insulin trumps lipids. A complicating factor is that I've had a lifetime of IgG food sensitivities, that I'm still working out. When I try to make "interesting" LCHF vegan meals for my vegan fiance', the IgG reactions (nasal secretions and when bad, itchy irritated roof of mouth) usually get worse. So the non-lectin vegan proteins aren't good for my IgG issues. These sensitivities do better on basic fish or meat proteins with non-starchy veggies. On Rocky Patel MD's blog entitled "Does LDL-P Matter?", as Peter Attia MD posted " I wish I could say we "knew" the answer to this question, but clearly we need more work to evaluate the clinical meaning of elevated LDL-P or apoB in the context of a radically different diet (and hormonal milieu) than originally studied. I look forward to incorporating this work into my subsequent work." Patel's blog: http://azsunfm.blogspot.com/2012/09/fon ... amily.html Attia is a founder of NuSI, a nonprofit devoted to raising the funds necessary to answer these questions. His blog: http://eatingacademy.com/ NuSIi's site here: http://nusi.org/

Right now I'm betting the answer to "Does LDL-P Matter?" is no, not in a low insulin, low blood sugar environment. I will be doing repeat CIMT testing to see if I'm correct, at least for my n=1 case.

Meanwhile, I generally stay in a low insulin, low serum glucose state. I tend not to push the ketone levels high but keep them barely in the "therapeutic" range of 0.4-1.5 mmol/L. Testing my serum glucose either before either meal, it is usually in the range of 65-85 mg/dL (3.6-4.7 mmol/L) and commonly around 75 mg/dL (4.2 mmol/L).

It is a work in progress. I will continue to sample and collect TG data, perhaps hourly after consuming various types of fats (and carbs for that matter). Also after exercise. The only downside other than testing cost is that the sample size required necessitates a fairly large hole. Poking 10 or so holes in my fingers per day is not horribly exciting to me...
Triacylglycerols in adipose cells are continually being hydrolyzed and resynthesized. Glycerol derived from their hydrolysis is exported to the liver. Most of the fatty acids formed on hydrolysis are reesterified if glycerol 3-phosphate is abundant. In contrast, they are released into the plasma if glycerol 3-phosphate is scarce because of a paucity of glucose. Thus, the glucose level inside adipose cells is a major factor in determining whether fatty acids are released into the blood.
http://www.ncbi.nlm.nih.gov/books/NBK22436/ So in a low glucose environment, fatty acids would be released into the blood.
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Re: Diet and NMR results - Revisited.

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I did a nutritional ketosis n=1 with testing . One of my test meals was a bacon and eggs breakfast. When I was early in adaption, my postprandial tg's could hit 200+ and stay there for six hours. After a few months of keto adaption and being hypocaloric I was able to gobble down those bacon and eggs with almost no rise in 4 hour postprandial Tg's.

Not being over fed (at a cellular level) in the first place is paramount when untangling the web of metabolic dysfunction.

btw...my LDL-P was over 2000 with a Rosedale ketosis diet. With no inflammation and no oxidation problems that might have been OK but my thyroid was not happy (and neither was my lipidologist)
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Re: Diet and NMR results - Revisited.

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Hepoberman wrote: Not being over fed (at a cellular level) in the first place is paramount when untangling the web of metabolic dysfunction.
Im hoping that this is the answer until I untangle the web of what to eat!!!! I'm still losing weight (14kg in 6 months), bmi 24 atm, so I have a few months to work it out (goal bmi 20 to 22)

George, Im tempted to employ you to design my diet.....whats yr hourly rate? :idea:
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Re: Diet and NMR results - Revisited.

Post by Tincup »

Hey Stavia,

Not sure I'm your guy - I'm not doing all that well designing my own...

However I'll help however I can!

When you went VLC and your glucose & insulin were up, that was unusual.
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