My Lipids under Dr. Gundry's Protocol

[Julie G]

In a word: BAD sigh... But, of course, I'm going to share them with you so that we can continue to learn together.

3/31/14 - 12/9/14

TC- 210, 251
LDL- 114, 142
HDL- 86, 97
TG- 50, 62
_________
LDL-P- 1089, 1370
HDL-P- 39.2, 40.8
Small LDL-P- 112, 122
LDL Size- 21.2, 21.8
LPIR- <25, <25 (A prior full NMR LipioProfile test showed an LPIR of 5. I'm expecting that's similar. This cheapo Walk-In Labs test didn't report to that specificity.)

My BMI was between 18.5-18.6 for both tests. If anything I exercised MORE during the second test period, by adding alternate day strength training to my 45 mins of daily aerobics. My dietary changes included more fat and more carbs. I wish I had more closely tracked my macronutrient ratios, Im guessing for the first test: (Fat-60%, Protein-20%, Carbs-20) Second test: (Fat-65%, Protein-10%, Carbs- 30%)

Unlike Dr. Gundyr, I think LDL-P matters, a lot. I didn't see any benefit to adding more fat than what's necessary to obtain ketosis. I would go so far as to suggest that it might benefit us to consume the LEAST amount of dietary fat necessary to obtain ketosis- easily measurable. I'm also questioning his emphasis on plant fats over animal fats. In the first test, I ate a much wider variety of animal protein- occasional pastured chicken, beef, and pork and yielded a better LDL-P.

I'm obviously disappointed

[Russ]

I too question Gundry's protocol, but I am less sure your numbers are necessarily bad even though LDL-P went up. So did HDL and I notice that avg LDL size also actually increased a bit (21.2 > 21.8), and TG's stayed pretty low. Remember his experience is driven by clinical outcomes associated with markers, not the markers themselves.

That said, I do think Gundry is missing some key things re animal fats. I'm still bothered by one comment he made that I chose not to followup on at the time re fat soluble vitamins. In short, when I asked 'what about fat soluble vitamins', his response was that other non-animal fats are just as good at soluablizing those vitamins. Of course, if there not there in the first place (as they are in animal products) this wouldn't do you any good.

I continue to believe that variability is key to all of this. I did read his whole book, and would say it is more a treatise on hormetic stress induced by variability than anything else. Aside from clear msg that simple carbs are bad, the big idea is that periodic exposure to things that are bad for you are actually good for you (primarily plant phytochemicals). Certainly was not a book dominated by some magic fat/carbs/protein ratios. I also think his ideas on evolutionary origins of shift from apes to humans were interesting, but struck me as incomplete and a bit of oversimplified cherry picking… e.g. in this attached chart...

Gundry diet history chart.pdf

...10% total fat from both veg and animals sources in pre-history seems implausible to me on a regular basis… although it might have been true during extended periods of the year?

So my current model is that he has one piece of the puzzle. He's also quite overboard on supplements in my view. Although the one thing he definitely turned me on to that I think could be very important is this methionine/glycine thing. I am supplementing w glycine daily now, and immediately after any meal when I have animal muscle meat. I've also re-stepped up my broth intake which of course I find tremendously delicious, just time consuming to make all the time…. and the strange side effect that my sleep is worse when the delicious smell of broth is wafting through the house

…and while I'm at it, I note that I'm also still unconvinced on all this olive oil and guacamole I'm eating. I love them both for sure, but part of me still wonders if superposing anything regularly will be good for me? Sardines can stay, as I think ~5 cans/week on salads is a good natural food source of n3 fats and modest protein.

[Russ]

Gundry's defense of a heavily plant based diet arise from this cited paper…

The Garden of Eden
Plant-Based Diets, The Genetic Drive to Store Fat and Conserve Cholesterol, and Implications for Epidemiology in the 21st Century
David J. A. Jenkins,*†‡ and Cyril W. C. Kendall*‡

http://journals.lww.com/epidem/Citation ... tic.3.aspx

Upon reading, the entirety of the (short paper) argument is based on their experiment which lowered LDL-C markers when humans are fed a diet replicating our simian ancestors - nothing to do with overall health. Feels very weak to me. No recognition that we absolutely evolved because of our ability to access and utilize more nutrient rich foods.

The only material citation (of which there are only 9 listed) is Staffan Lindeberg's book which I still haven't read….
http://books.google.com/books?hl=en&lr= ... an&f=false
…but I'm guessing that he gives the subject a much deeper review than this as I know the book is very highly regarded by many.

[Tincup]

Julie,

As you know, my bias is that insulin/blood glucose/Met S is the driver in much of this. From my perspective, your numbers are wonderful in this regard. Your TG/HDL ratio is stellar! I've got friends on a LCHF protocol and their CIMT's are stable at much higher LDL-P's than you (~2,000). They share the low TG/HDL ratio and large LDL-P size with you. To me, Gundry's clinical success speaks volumes. I've yet to rerun my own CIMT, however my blood pressure was ~94/54 the other night and pulse pressure is an indicator of calcification.

[Stavia]

Julie honey, AD is multifactorial. You have heaps of good (actually exceptional) markers.
And yes I personally believe that if one wants ketosis then th least amount of fat needed for this might be prudent. As long as glycaemic control is good.

Russ, I agree about variability. Humans would not have evolved to fill the earth if a narrow range of dietary components was necessary. I think chasing an "optimal' dietary composition is not necessary - I think there is likely to be a wide range that is acceptable.

[Russ]

George,

Do you have any problems with being light-headed with BP that low?

Russ

[Julie G]

Thank you all for weighing in. I appreciate your kind words and support- a lot.

Russ, I tend to share similar concerns as you re. Grundy's approach- especially the lack of diversity, aversion to animals fats, and very heavy emphasis on MUFAS. I plan to mildly temper each of those (as I did earlier) and see if I can improve numbers. I look forward to checking out your links.

George, interesting re.TG/HDL ratio. It DID improve in the 2nd test, from .58 to .64, but this is the HIGHEST my TGs have ever been- ever That's not good. Do you have any references re. pulse pressure and calcification? Like you, my BP is very low and my pulse pressure is crazy low at times, less than 25. I would love to learn that's a biomarker inconsistent with coronary calcium.

Stavia, per these results, I agree with your stance on using the LEAST amount of dietary fat necessary to obtain ketosis. That philosophy has worked well for me in the past. I strongly believe there is much evidence to support ketosis for the neuroprotection element, but applying exercise and CR (which I've consistently done) reduces the need for dietary fat and may be the safest path for us.

I don't regret this experiment, but plan to tweak and re-test within a few months. My goal is to get LDL-P below 1,000 and small LDL-P below 100, while staying in ketosis, keeping IR markers low & HDL high. I see E4 folks at HeartLife Talk achieve this...but always with lipid lowering meds and supplements.

[GenePoole0304]

Do you have any idea what the change was from prior in average sat fat daily consumption?
Or how much more mono or total fat?

And has the vegetable component remained the same before after?
Was it also restricted for lectin containing foods?

The results are just borderline into the unfavorable region which you should easily reverse

All the mono fats he suggests can shift ones omega3 index unfavorably to more inflammatory status

[Tincup]

Julie,

Here is merouleau's post on the pulse pressure topic: https://www.apoe4.info/forums/viewtopic ... sure#p4280.

As to Tg's, my own experience is there is some kind of a "decline curve" function. Variables include how much and what kind of fat. There will be a postprandial spike. Then a decline. Of course each of us will have our own unique function. This will vary every day. It may make a difference if you at a little more, fasted a little less & etc. I've thought about, but have not done, the study to actually carefully measure various fats and see what the spike and the decline are. Here is my attempt to illustrate this within the limits of the software (and I'm making this data up. I know Tg's decline, but I really don't know the curve shape). In my example, if you tested at 12 hours you might get 80, at 16, 60. Eating more, or a different kind of fat could shift the curve up or down. Carbs may also have an impact. I also think you are reading way too much into the difference between 50 & 62. There are also lab variations that could account for some or all of that difference.

Code: Select all

Tg mg/dL vs Time in hours
160    *

140         *      

120               *

100                    *

 80                              *

 60                                         *
                                                             *
 40

 20

  0
Hours   2    4    6    8  10   12   14   16   18   20   22   24

Russ,

Light headedness is not a problem for me. I can be prone and jump up quickly & my system responds normally.

[Hepoberman]

You are a fearless warrior Julie, thanks for your honesty. I wish I could reach out and give you a hug. We're going to get answers as long as we keep asking questions. Your HDL is bigger than your Trigs [good'nuff]...

I think focusing on driving inflammation markers as low as possible is #1. A nutrient dense low sat fat, low carb diet is about all we can do for lipids. I don't know if you supplement thyroid or not but hypercholerstolemia used to be veiwed as low thyroid function. Most of us have lower thyroid function if we cut carbohydrate too far. You gotta find that sweet spot where you keep insulin low but thyroid up. Low thyroid=high cholesterol. I like oranges for that. I show no 1 hour postprandial glucose rise from an orange and I'm sure my thyroid loves it. (might knock you out of keto unless you are exercising)

Thanks so much for sharing, Hep