Help Me Solve the Riddle of my Unremarkable Cholesterol
My cholesterol suddenly lowered. Whodunit? The suspects: fasting, strength training, reishi mushrooms, better sleep, no coffee, reconstituted gut microbiome.
In case you tuned in just now, here’s a quick summary of previous episodes:
- I started keto 2 years ago, mainly for productivity. I got great results.
- After 11 months, I got a blood test. My cholesterol was alarmingly high.
- After a year of diet experiments, I got my cholesterol back to normal using the “Feldman Protocol,” which unbelievably involves eating even more fat.
More than just a hack to avoid getting prescribed statins, the Feldman Protocol is a demonstration of how dynamic these biomarkers are, and how powerful nutrition is in influencing them.
In the keto community, Dave Feldman is known for this LDL-lowering protocol, and the energy distribution network theory that undergirds it. I think he should also be recognized for opening the possibilities of experimentation with nutrition and cholesterol. If you can lower LDL with just 3 days of caloric overload, what other nutritional interventions can modify it?
Instead of doing the Feldman Protocol again for my next lipid profile, I decided to see how it would look like with my weekly 24-hr fast and 3-times-a week weight lifting. I guessed that my LDL would increase, following Feldman’s theory. Surprise, surprise — it stayed unremarkably low.
What caused this result? My macros were the same as the same as my high-LDL months. Below are my prime suspects. I checked their relationship with LDL by Googling “x LDL”, “x lowers LDL” and “x increases LDL” where x is the suspected cause, and checking out the studies that came up. I did not go beyond the first page of results, and excluded articles from popular press. I only browsed through the studies, and searched for mentions of LDL, then noted the relevant section. I think I’ll call this method “lazy-meta-pseudo-study.”
Links and highlights from the studies are at the bottom. Here are my reductionist one-line summaries:
- Fasting — mixed results.
- Strength training— probably lowers LDL.
- Reishi mushrooms — lowers LDL in animal studies from China. Did not lower LDL in double-blind, randomized, placebo-controlled human trial published in Nature magazine (for 3g/day for 16 days).
- Better sleep — the correlation is not strong in this one.
- No coffee — weak correlation with higher coffee consumption and higher LDL.
- Gut microbiome — mixed results.
So it looks like fat calorie overload (Feldman Protocol) is a bigger lever in lowering LDL compared to all of these. However, the body is a complex system. There are many levers.
Since the body is a complex system, it also means that a single biomarker like LDL has to be read within the context of the entire system. My latest lipid profile shows that I have reduced risk of heart disease based on older criteria (the upper portion of the table below), while I have increased risk based on newer criteria (eg, remnant cholesterol and AIP).
With complexity and variation of human bodies, some riddles will remain unsolved. I’ll just have to N=1 on, and wait for further breakthroughs and commercialization of continuous biomarker monitors, DNA sequencing, and gut-microbiome testing.
Here are the studies that ranked highest in Google for the levers I examined:
I ended a 24-hour fast a day before the blood draw. I started the fast 48 hours before the blood draw.
How can you lower cholesterol without resorting to medications? High cholesterol is considered a treatable risk factor…idmprogram.com
Here’s the study that it cites:
Obesity (Silver Spring). 2010 Nov;18(11):2152-9. doi: 10.1038/oby.2010.54. Epub 2010 Mar 18. Controlled Clinical Trialwww.ncbi.nlm.nih.gov
The trial above involved alternate-day fasting of obese subjects.
J Nutr. 1999 Nov;129(11):2005-8. Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.www.ncbi.nlm.nih.gov
This trial used a 7-day fast with non-obese subjects. To quote its abstract, “Conflicting results have been published on the effects of food deprivation on serum lipids.”
It is unclear if my 24 hour fast resulted in lower LDL.
2. Strength training
There is a direct relationship between chronically elevated cholesterol levels (dyslipidaemia) and coronary heart…www.ncbi.nlm.nih.gov
South Med J. 1987 Mar;80(3):328-31.www.ncbi.nlm.nih.gov
It looks like strength training probably lowers LDL.
3. Reishi Mushrooms (Lingzhi)
I experimented with reishi mushrooms for better sleep. It worked. Was it the cause of my low LDL?
A Berger, 1, 2 D Rein, 1, 3 E Kratky, 1 I Monnard, 1 H Hajjaj, 1, 4 I Meirim, 1 C Piguet-Welsch, 1 J Hauser, 1, 5 K…www.ncbi.nlm.nih.gov
This was a trial with hamsters and mini-pigs.
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2002 Jul;22(7):534-7. Research Support, Non-U.S. Gov'twww.ncbi.nlm.nih.gov
This was done with rats.
“CONCLUSION: LGL could decrease LDL oxidation and AdM-E induced by AGE or oxydative LDL.”
The date on your computer is in the past. If your computer's clock shows a date before 1 Jan 1970, the browser will…www.emeraldinsight.com
Findings: “supplementation of the feed with G. lucidum(0.1 per cent) in rats decreased the TC, TG and LDL‐C level significantly (P < 0.05) while further increased the plasma concentration of HDL‐C.”
Double-blind, randomized, placebo-controlled trial on humans published in Nature. Gold standard in a reputable publication! My only problem is the dosage and the duration. “The dosage was 3 g/day of Ganoderma lucidum, with or without Cordyceps sinensis, for 16 weeks.” I took 2 capsules of reishi mushrooms on each of the 3 nights prior to the blood draw. Not sure how many grams each capsule is equivalent to.
This study aimed to evaluate the efficacy and safety of Ganoderma lucidum for the treatment of hyperglycaemia and other…www.nature.com
Here’s the section relevant to LDL:
The animal trials showed a correlation between high reishi and lowered LDL, but the double-blind, randomized, placebo-controlled human trial did not.
4. Better Sleep
Because of the reishi mushrooms (and some discipline), I consistently slept 5 cycles (~7.5 hrs).
Aim. To investigate the association between sleep quality and duration with lipid and glycaemic control in Caucasian…www.ncbi.nlm.nih.gov
Here’s the section relevant to LDL:
PSQI is a measure of sleep quality. The lower the score, the better the sleep quality. The results were mixed:
- Longer sleep is correlated with higher LDL
- Lower quality sleep is correlated with higher LDL
Although many questions about the role of sleep remain unanswered, it is known that sleep is not only a physiological…www.ncbi.nlm.nih.gov
Here’s an interesting graph.
Longer sleep is correlated with higher LDL for the elderly.
Looking at these three studies, there does not appear to be a strong correlation between sleep quality and LDL.
5. No Coffee
I stopped taking coffee as part of my sleep experiment.
Arterioscler Thromb. 1991 May-Jun;11(3):586-93. Clinical Trial; Randomized Controlled Trial; Research Support, Non-U.S…www.ncbi.nlm.nih.gov
J Intern Med. 2000 Sep;248(3):211-6. Clinical Trial; Randomized Controlled Trial; Research Support, Non-U.S. Gov'twww.ncbi.nlm.nih.gov
Conclusion: “Consumption of cafestol and kahweol cause a long-term increase in CETP as well as PLTP activity; the increase in CETP activity may contribute to the rise in LDL cholesterol.”
Coffee drinking has been associated with increased serum cholesterol levels in some, but not all, studies. A Medline…academic.oup.com
It looks like there’s a weak correlation between coffee consumption and increase of LDL.
6. Reconstituted Gut Microbiome
I had a severe case of food poisoning 3 weeks prior to the blood draw. I imagine my gut emptied itself and had to reconstitute my microbiome. I thought of this because I felt that I was not able to metabolize fat as well as I used to — I felt satiation with less calories.
Here are the top studies on LDL and the gut microbiome:
The human intestinal tract is home to at least 1000 distinct species of bacteria, which collectively number over 100…www.ncbi.nlm.nih.gov
“Surprisingly, there were only weak relationships noted between microbial variation and levels of total cholesterol or low-density lipoprotein cholesterol (LDL)”
Jingyuan Fu, Marc Jan Bonder, María Carmen Cenit, Ettje F. Tigchelaar, Astrid Maatman, Jackie A.M. Dekens, Eelke…www.ncbi.nlm.nih.gov
Serum glucose and lipids are important indicators for host metabolic condition. Interaction of host and gut microbes…www.nature.com
All of these studies correlate the microbiome with the variations in HDL, but only the last one correlates it with variations in LDL.