Hacker News Reader

Comment by nmerouze | Hacker News Reader

Cholesterol isn't bad, it's in fact very important for the production of testosterone among other things. The problem comes from the inability to use it because the body isn't healthy. Polyunsaturated fats will produce bad byproducts when it breaks down and over time makes the body sick.

We crucially lack magnesium and potassium in our diet. There are tons of studies showing the benefits of magnesium against heart disease. And it's not just the heart, cholesterol can obstruct the liver and a sick liver will cause a whole lot of problems.

View on HN

Those are very nice points...

"The problem comes from the inability to use it because the body isn't healthy. Polyunsaturated fats will produce bad byproducts when it breaks down and over time makes the body sick."

However you could be easily making all of this up or be using bad/unscientific sources. Could you show us the studies/articles that you are using to gain those insights?

Obviously, this is anecdotal and I'm not advocating that anyone else do what I did until they consult with their own doctor but this is my experience.

I had some long term digestive issues.

I began supplementing my diet with magnesium and within a week, the problem began to abate. Within a month, all of my abdominal cramping was gone. All of my constipation issues were gone.

This is a common and very natural treatment of constipation. The other treatments are very unnatural, because they amount to poisons that the body what's to reject (in the intestines). That's what my gastroenterologist told me 15 years ago.

It was like magic. No expensive drugs. No side effects.

I'm surprised and disappointed that none of the doctors I saw recommended it and I only found it by googling my symptoms.

I had a gastroenterologist suggest that I take miralax every day for the rest of my life but he never suggested vitamin or mineral supplements.

The grey matter in your brain is mostly cholesterol. I've personally lost 10 pounds in 10 days eating a high fat, low carb diet, with light excercise about 3 days a week. Kerrygold is my #1 choice for butter, because it comes from grass-fed cows.

Congratulations on your weight loss!

Separately, I don't know if I understand your point. To me you are saying that because the grey matter in our brains is made of cholesterol that means we should eat more cholesterol and your recommendation for how to get more cholesterol is by using grass fed butter.

Did I correctly state your point?

I think the point was that most of the health-conscious general public has the mindset that fat is the enemy and that things like cholesterol should be avoided at (almost) all costs.

The reality is that you can have a diet that is relatively high in fat and still lose weight, just as you can have a diet that is low in fat and still put on weight. As for cholesterol, it isn’t a toxin that should be eradicated from your diet - it’s something that just needs to be eaten in moderation (perhaps with butter on toast for breakfast, rather than fried chicken for lunch).

That may be so. But it's undisputed (aside from most keto blogs) that an increase in serum cholesterol and especially LDL-C increases the risk of heart disease.

Studies show that you generally need a level of < 150 mg/dL to avoid heart disease. That's quite a bit below the average "normal" level. But today's average is NOT physiologically optimal.

> But it's undisputed (aside from most keto blogs) that an increase in serum cholesterol and especially LDL-C increases the risk of heart disease.

Sure, but show me where cholesterol intake correlates to LDL.

At some point someone managed to convince the public subconscious that food fat = body fat, and that food cholesterol = body cholesterol. And it's a ridiculous notion.

I don't eat protein to become protein.

For starters, saturated fat increases cholesterol and that is almost exclusively in animal products. Animal products are basically the only products to contain dietary cholesterol. So there you have at least a strong correlation.

As for the dietary cholesterol itself, see here: http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.549...

"Serum cholesterol concentration is clearly increased by added dietary cholesterol but the magnitude of predicted change is modulated by baseline dietary cholesterol. The greatest response is expected when baseline dietary cholesterol is near zero, while little if any, measurable change would be expected once baseline dietary cholesterol was > 400-500 mg/d." (That is 2 eggs or 400 g beef etc.)

> For starters, saturated fat increases cholesterol and that is almost exclusively in animal products.

You conveniently fail to mention that it increases HDL and LDL in proportion, when a common marker for heart disease is the LDL/HDL ratio. [1]

> Animal products are basically the only products to contain dietary cholesterol. So there you have at least a strong correlation.

No, that's a non-sequitor. It would have been a correlation if a higher LDL/HDL ratio was contributed to dietary cholesterol, which it isn't. [2]

From your link:

> High-density lipoprotein (HDL) was consistently increased in most studies, with HDL2 increasing more than HDL3 after cholesterol consumption (42,43). Interestingly, the increase in serum HDL cholesterol re- sulting from cholesterol feeding appears to be greater when the background diet is high in polyunsaturated fatty acids (29). .....

> These subtle changes in lipoprotein composition and concentration-apart from changes in serum total or LDL cholesterol concentrations may help explain recent epidemiologic findings that implicate dietary cholesterol as an independent risk factor for coronary disease after fasting serum total cholesterol and other known cardiovascular risk factors have been controlled for (67, 68). However, because changes in LDL cholesterol accounted for most of the changes in total cholesterol, LDL cholesterol will be the focus ofthe remaining discussion.

Even the Dietary Guidelines Advisory Committee doesn't state that cholesterol over consumption is of no concern. [3]

While dietary carbohydrates don't raise cholesterol, they do lower HDL, thus raising the LDL/HDL ratio. [4]

If you'd like, I'll admit that eating animal fats can increase LDL, but it's not the whole picture.

Some bonus sources for low carb (high fat) diets improving cardiovascular health: [5] [6]

But as I've read a lot of them, there's also opposing studies, like: [7]

My point is: approach this from an attempt to find truth, not from trying to prove that animal fat is bad, because it really shines through which one it is.

[1] https://www.ncbi.nlm.nih.gov/pubmed/22037012

[2] https://www.ncbi.nlm.nih.gov/pubmed/24075505

[3] https://health.gov/dietaryguidelines/2015-BINDER/meeting7/do...

[4] https://www.hsph.harvard.edu/nutritionsource/2015/02/25/ask-...

[5] https://www.ncbi.nlm.nih.gov/pubmed/24075505

[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3530364/

[7] https://www.ncbi.nlm.nih.gov/pubmed/16256003

That's a 25-year-old revisit of even older studies dating back as far as 1960... none of which controlled for key elements like carbohydrate intake.

Even so, check out this element of its conclusions:

"The greatest response is expected when baseline dietary cholesterol is near zero, while little, if any, measurable change would be expected once baseline dietary cholesterol was > 400-500 mg/d. People desiring maximal reduction of serum cholesterol by dietary means may have to reduce their dietary cholesterol to minimal levels (< 100-150 mg/d) to observe (even) modest serum cholesterol reductions while persons eating a diet relatively rich in cholesterol would be expected to experience little change in serum cholesterol after adding even large amounts of cholesterol to their diet."

It didn't even differentiate HDL from LDL, let alone the actually harmful subsets like small-particle LDL.

> Studies show that you generally need a level of < 150 mg/dL to avoid heart disease. That's quite a bit below the average "normal" level. But today's average is NOT physiologically optimal.

My point was that people see the “no cholesterol” message and start eliminating cholesterol from their diet...but then they end up replacing all the sources of fat in their diet with carbohydrates, or in some cases end up not getting enough of some nutrients which are often found in foods that are relatively high in cholesterol (e.g. iron or calcium).

The message about cholesterol should be more nuanced - less “don’t eat cholesterol”, more “don’t consume more than X mg”.

Sounds like someone might have been hanging out on /r/keto. I just lost 20lb in a month on keto.

The problem with ketogenic diets is not the weight loss. The diet works for weight loss, that is undisputed. The problems are in the longer term with elevated cholesterol and increasing insulin resistance.

Example: https://www.ncbi.nlm.nih.gov/pubmed/24703903

There's however tons of this. Most keto bloggers will try to tell you that increasing LDL-C is okay for different reasons (depending on who you read). That is however just not true. The link between LDL-C and heart disease is very strong and has been proven over decades.

> The diet works for weight loss, that is undisputed

All I could find was this (although it doesn't seem like they were checking ketone levels) https://www.researchgate.net/publication/311279409_Visceral_...

Do you have a study that shows ketogenic diets are indeed better for weight loss than other diets?

I do not have one. But I also never said it was better (!).

I merely said that it works. People on a keto diet often say something along the lines of "Oh, keto is such a good diet. I lost 20 pounds with it". And I believe them. But that should not be the only measure of how good a diet is for you. Weight is important but not everything.

Ok, fair enough. I just figured that almost any very-low-carb diet would lead to a 15 or 20 pounds weight loss, due to the water loss. Due to the difficulty of the diet (for some), I just always have a hard time recommending it or bringing it up compared to a 'regular' low carb diet.

The water loss in the beginning is real, and accounts for most 1st month loss. After that comes the real progress. Some find the inital loss to be motivating, others feel the lull after is the opposite.

> The problems are in the longer term with elevated cholesterol...

From your link:

> These differences were not significant at 24 months.

-----------

> and increasing insulin resistance.

I'm going to need to insist on sources on this.

Insulin resistance: https://www.ncbi.nlm.nih.gov/pubmed/20427477

As for the cholesterol, the study I linked was probably not a very good example - sorry. Saturated fat does raise cholesterol however - so unless you are on a vegan low carb diet, you will see it rise. (IF you keep your weight steady, weight loss almost always lowers cholesterol)

Counter source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4264021/

Losing weight, especially fat does wonders for insulin sensitivity, though.

The low carb group lost 6.2 kg of fat. That is a lot. I do wonder what happens if you look at insulin sensitivity when weight and fat mass remains mostly neutral. I do not know if there are studies done on that (in humans). I will have a look around.

> Losing weight, especially fat does wonders for insulin sensitivity, though.

Agreed.

> The low carb group lost 6.2 kg of fat. That is a lot. I do wonder what happens if you look at insulin sensitivity when weight and fat mass remains mostly neutral. I do not know if there are studies done on that (in humans). I will have a look around.

Sure, but if it's purely weight dependant, then high fat isn't a factor. And if it's not, why did it increase sensitivity?

I'm not trying to say that fat is the one solution to everything, but I'm definitely saying it's not the one cause for everything. I can cite multiple studies showing the various detriments of carbs, and likewise the pitfalls of fat, but when the circumstances are key, then isn't that simply the answer?

Don't be afraid of butter and eggs, don't be afraid of rice and carrots. Eat everything in moderation. Maybe stay away from sugar and deep fried treats?

I thought that LDL-P had been determined to be a more reliable indicator of heart disease risk? Also hasn't heard of insulin resistance as an effect of ketogenic diets... What's the mechanism for that, do you know?

From a very simple calorimetric pov 1 lbs fat ~ 4000/3500 cal, assuming using 2000 calories for normal daily activity one needs to spend an extra 2000 cal per day for 10 days, which is like running 20 mile with no energy intake whatsoever every day (for 3 days per week it is 40 miles for days when one exercises).

Most of the weight loss would be water weight from glycogen stores being depleted, not fat being burned.

This is correct. You can expect maybe a kilogram of fat (2 lbs) per week on a very restricted diet. Much more than that is hard to maintain over a longer period and unrealistic. When you first start with a keto diet, you can easily expect 3-4 kilogram of water weight being lost.

Exactly, which puts things into perspective regarding claims/opinions/recommendations.

What I've heard, all diets work. And they work because they let you focus on what you eat, and they let you eat less energy. The problem is what happens in the long term. If you regain your weight, you're worse off.

When you eat less, the body adapts by working more energy efficient. So you eat 10% less, meaning the body can use only 90% of the normal energy supply. It react by using only 85%, storing that extra 5% in case things get worse later on. So the body expects that later on, supply could drop to 70% or much less. Then those stored 5% are really useful.

However, when you go back to that original 100%, before the weight loss, meaning that you should go back to that weight, the body still stays in 5% save modus. The effect is that you gain weight in the long run, and it will be harder to lose weight the next time.

NB: the 5% example used here is just a guess to describe the way this works. I have no idea if this is 5% or 20%, and I suppose this is personal, depends on your history etc.

I'm thinking about doing the keto diet myself. So I'm not against it. I'm just aware of the danger of rebound, the jojo-effect.

Citations?

>"It react by using only 85%, storing that extra 5% in case things get worse later on. So the body expects that later on, supply could drop to 70% or much less. Then those stored 5% are really useful."

This doesn't sound right.

As someone who's tried every diet and training regiment under the sun, and never (before or after) being outside of "normal" BMI and of varying levels of athletic (maxing out at 10 push-ups through 30 dead-hang pullups):

On your first point, yes. Most diets work, as long as they fit with your persona and schedule. Anything you feel comfortable with and can stick to. Just by "doing" a diet, you end up being a lot more conscious of what you put in yourself.

When someone asks me for advice, it's mostly the same:

* Write down everything you eat for two weeks, weigh yourself before and after. The initial point was to measure your actual TDEE, but people invaribaly end up eating less and losing weight during those two weeks because they don't want to write down "half a package of Ritz crackers" in their log.

* Take an honest before pic. When you think you've stopped progressing after a few weeks after the initial burst, being able to compare backwards is invaluable as a motivator.

> When you eat less, the body adapts by working more energy efficient. So you eat 10% less, meaning the body can use only 90% of the normal energy supply. It react by using only 85%, storing that extra 5% in case things get worse later on. So the body expects that later on, supply could drop to 70% or much less. Then those stored 5% are really useful.

This is however not anything I'm comfortable believing before I read it from reputable sources. From a strict weight standpoint, I've rarely seen anything that doesn't align to your TDEE mainly differing by your weight and muscle/body ratio, unless chemically induced.

There was a recent study on alcohol in this scenario, but even that mostly indicated the effects on hunger, not on energy expenditure: https://www.ncbi.nlm.nih.gov/pubmedhealth/behindtheheadlines...

While I'd say that the keto diet works, it's not very practical, when accounting for eating in restaurants, socially (other people cooking for you, you cooking for others), etc.

What is your goal? Just losing weight? Being healthier? Body recomposition?

What is your life today? Could you cut out something you indulge in now? Alcohol, snacks, sugar in your drinks? Would you be content in cutting those out?

Do you work out? Could you see yourself doing that a few times a week? What would you enjoy doing? Hard 7 minute work-outs daily? Fun climbing/swimming/rowing/hiking? Lifting in gyms?

TLDR; Whatever diet/routine works is whatever you can stick with. I hate running/endurance training, so HIIT and calisthenics is what I've had most fun with. Would love climbing if I didn't hate heights :)

I just got a Fitbit. The iPhone app that comes with makes it really easy to track what you eat and the corresponding calories. I have lost weight mostly due to that.

I just do not want to record a snack of Doritos (100s of calories) versus a snack of a carrot (30kCal)

This is great, but beware of the relaps. Can you make this a habit? If you have to fight it, you'll lose in the end. Now the Fitbit is a new gadget, really nice app, but what happens in three weeks? Will you still fill in all your calories, and be ashamed of that doritos?

Do something that creates a habit, something that you don't have to put effort in. That will continue to work.

Ah Kerrygold, the tastiest butter on the planet.

It's not just that the cows are grass-fed, it's to do with the lushness of the grass they eat.

Super green (why? because it rains soooo much!), which introduces more carotene into the cows diet.

Compare the color of Kerrygold to regular butter, it's WAAAAY more yellow.

In fact that's the only grass fed butter I can find anywhere I've looked. I always wonder how do you know it's really grass fed?

An easy way to boost potassium is to replace table salt (sodium chloride) with potassium chloride. For example, Morton's Lite Salt (in the USA at least) is half-and-half.

Reply on news.ycombinator.com