Whole textbooks have been written on the topic of cholesterol and lipoproteins, yet it’s not uncommon to see folks on the interwebz reduce this complex subject to something that appears simpler than a recipe for boiling water.
Few appreciate that there is a massive amount of information related to the biochemistry, metabolism, and immunology of these critical molecules. Should one desire to be just a bit conversant on the topic there is a lot of material to cover.
That said, there are still so many unanswered questions…this video is a very brief attempt to provide a bit of context and hopefully a sense that if folks are providing a sound bite and calling it a day, they have perhaps not put in much time understanding this topic.
Nicki: So, Robb.
Robb: So, wife.
Nicki: So there’s a notion out there that what you eat in terms of fat and cholesterol barely impacts your blood cholesterol levels in any way. What do you think about that?
Robb: Man, that’s a spicy meatball. There’s a lot to unpack with that. Like there are some people that will just kind of flippantly say, oh you know, so long as your lipoproteins, like your LDL cholesterol, lipoproteins are big and puffy than everything’s good.
Robb: And from 2001, 2003, that’s probably an okay level of understanding to have, but in this day and age with things like the DNMR that’s used to determine lipoprotein fractions, LPIR score and stuff like that, like it’s totally inadequate.
Robb: And when you look at the research that’s been done on folks generally, people see it just can’t be argued otherwise as favorable lipid changes with regards to like the atherogenic process. Like generally HDL goes up, LDL and when we talk about this stuff, you have to be a little bit specific too.
Robb: Are we talking about HDL and LDL cholesterol? Are we talking about HDL or LDL particles, and like with the big and puffy story, it’s interesting because generally if favorable things are going on, we will have fewer lipoproteins and if we have fewer lipoproteins, they will by just the way the stuff works out, they will be larger and puffier.
Robb: And so when people are having problems with a dietary intervention like low carb or maybe they’re reactive to dairy, they will almost universally see smaller lipoprotein fractions and these tend to be more atherogenic. And then there’s also this tendency for the more of the things out there, there’s a higher likelihood for problems.
Robb: It’s just like driving in traffic. If everybody took buses, the bus would be the lipoprotein or vehicles would be the lipoprotein and passengers would be the cholesterol. You can make an argument that if everybody everywhere, if the only thing that they could commute on was a motorcycle, there would probably be a higher likelihood of more accidents cause they’re just more little squirrelly shit going on everywhere versus if everybody was on a singular big bus.
Robb: And so, to some degree there’s this whole gradient driven process in this story. The more that’s there, the more potential there is for problems. Peter Attia has made the case and I think accurately that LDL particles are necessary but not sufficient for the atherogenic process. You need other things to make things kick over for the atherogenic process to fully take shape.
Robb: And so, you know, there’s just a lot that’s going on there. And again, I know I’m kind of bouncing all over the place cause it’s a really complex topic. For most people, they see really favorable lipoprotein shifts and total cholesterol shifts.
Robb: Some people that’s not the case and I think I’ve mentioned in other ten and two’s that for myself, large amounts of saturated fat, particularly from dairy sources will dry plate lipoproteins sky high.
Robb: Like we’ve done a little bit of tinkering which we need to release sometime soon. I usually motor with an LDLP and LDL particle count of about 1100, which is pretty darn good when you think about everything else that’s going on. There are low blood sugar levels, etc., and with a little carnivore experiment that I did where I was doing more saturated fat, I wasn’t even doing specifically dairy, my LDLP within three weeks was up to 2600.
Robb: Now, a good friend of mine, Dave Feldman, he does some really interesting work and he has some ideas around like this concept of the lean mass hyper responder and some stuff like that. And you know, there are some people that I think inaccurately paint a high lipoprotein profile in low carb individuals. They see that it’s just as dangerous as someone who has high lipoproteins and they’re insulin resistant heading towards type two diabetes.
Robb: I don’t think that that’s accurate, but then there are other people that will say that there’s absolutely no risk associated with elevated lipoprotein so long as your insulin levels are low.
Robb: So again, I know I kind of bounced all over the place and if you have another more specific question to kind of literally keep me on the road, we could do that. But you know, it’s just, I think people are really prone to giving these like naive, simplistic answers to these really complex topics, and that doesn’t really do people any service.
Robb: I know that folks are busy and they just like, hey, just the facts, please. But the reality is the facts are really variable, highly individual, highly situation dependent, and there’s all kinds of trade-offs that have to be taken into account when we’re talking about this stuff.