Is the Ketogenic Diet a Faustian Bargain? (The Cholesterol Edition)
Keto has been great for my productivity and health. But it has doubled my cholesterol. What do I do now?
Who would have thought that the right food choices is key to productivity?
I tested so many productivity techniques in the past years and nothing has given me more mental energy than the ketogenic diet. Of course, I had to write a Medium post on it:
I had another reason. For several years, I have been getting sick almost every other month. Doctors could not figure it out. I would be down for 3 to 5 days at a time, with coughs lingering for weeks.
I knew I had to shake things up. Aside from keto, I practiced nutritional fasting and supplemented with Vitamin D.
It worked. Except for two instances early in the transition, I have not been down from sickness since I went keto — even those times when everyone else in my residence had colds or had the flu.
Weight loss was also irresistible. I actually tried not to lose weight. Based on advanced bro science, I was supposed to maintain my weight if I ate at least 2,000 calories a day. Yet my efforts to stuff myself with gloriously fatty food were futile. I lost 10 kilos and got abs — “blurry” ones though. You still need a bit of imagination to count six.
After months of evangelizing, one of my brothers also went ketogenic. He got serious with Crossfit at the same time (he tells me they have a keto subcult in their gym — not his exact words). As you could see, his abs are not at all blurry.
Could there be a hidden drawback to all of these benefits?
I did a couple of blood tests in the past 3 months and my cholesterol doubled!
So I freaked out the only way I know how — I geeked out on cholesterol. I watched, read and reached out to experts in cholesterol (I share the best in the comments below). And I sent a long-ish email to the doctors among my friends and family. I even bought a book.
Here are the 4 most important points I learned:
- LDL-C is the LDL we see in the usual cholesterol blood test, or the “lipid profile.” It turns out LDL-C is not correlated to risk of heart disease. However, my doctor friends say that in practice here in the Philippines, LDL-C is still considered an important cardiovascular risk indicator.
- On the other hand, LDL-P and “small dense LDL” are correlated with risk of heart disease. I was told that the test for LDL-P costs PhP 20k in St. Luke’s.
- A segment of the population (I’ve heard 20–30% thrown around) reacts to a ketogenic diet high in saturated fat with heightened levels of LDL-P.
- There are other markers correlated with risk of heart disease. For instance low HDL, high Triglycerides-to-HDL ratio, and high non-HDL cholesterol. Other risk indicators include smoking, high blood pressure, lack of exercise, and belly fat.
I’m not going to shell out 20k to know my LDL-P. I’d rather assume that I’m part of the 30% who reacts to saturated fat with elevated LDL-P. Should I be worried, considering all my other markers point to the right direction? Expert after expert say that we don’t know what these mixed signals mean until there is a study of people doing low-carb high-fat diets, correlating their lipid profiles with incidence of cardiovascular disease.
The most prescriptive among my doctor friends tell me, “why take the risk?”
Well, if I were to choose between a sickly guy with brain fog but normal cholesterol, and my current state of mental energy and seeming invincibility to sickness but with high cholesterol, I would definitely choose the latter — especially after nerding out on the topic.
Perhaps I can take my cake and eat it too… or bring home the bacon… and eat it too. Okay, maybe carbs sometimes work better as idioms.
Keto as a secret weapon
I first heard of the ketogenic diet in the Dom d’Agostino episode of the Tim Ferriss podcast. Recommendations from Tim Ferriss and his guests have made a significant impact on how I operate in business and in life. Dr. d’Agostino is one of the foremost experts on ketones. I trust what these guys say.
Tim Ferriss recently did this video on choosing between a ketogenic diet and a slow carb diet. He suggests to only use the ketogenic diet for special circumstances — like losing weight and fixing certain sicknesses. If you don’t do it exactly right, he says, you risk messing up your lipid profile — which is exactly what happened to me.
Dom d’Agostino, in the Thinking Podcast, also warns against excessive ketogenesis from high-calorie, high-fat consumption. There is no research yet on this, but his gut feel is that there must be a downside to producing all that excess brain energy.
I’m never going back to unhealthy, uninformed eating, now that I have seen the power of nutrition. But I’ll be using keto like those special moves in fighting games — or how some chess players and some athletes use it — to boost performance in competition. In my case, this means I bring out my secret weapon when the business needs it.
Ketosis without the Ketogenic Diet
All I’m after is the consistent and high level of brain function that keto brings. After months of experimentation and training, I discovered that I could still reach this state of cognitive grace with this regimen:
- Heavy dinner (around 2/3 of my daily caloric intake) with lots of veggies.
- Very low carb, very high fat breakfast. I discovered I need at least 300 calories of fat get a keto rush — that second wind of mental energy — later in the day.
- No lunch. No food at all between breakfast and dinner.
In the jargon of diets and nutrition, my dinner is paleo, my breakfast is keto, and I do I.F. (intermittent fasting) the rest of the day. This is the best permutation I’ve found for productivity.
To hit my fat targets with normal Filipino food, I used to mix coconut oil with my meats and veggies, and butter with my black coffee. Coconut oil and butter consists mostly of saturated fats. At the advice of one of my doctor friends, I’m currently experimenting with olive oil and peanuts, which are mostly monounsaturated fats, to hit the same fat targets. We’ll see how this affects my productivity and lipid profile.
There are no Faustian bargains
Whatever your mission in life is, you’ll have to do it with your meat vehicle and your meat computer. To reach our life goals, shouldn’t we all become master operators of our bodies and our brains?
It is not easy. There are no Faustian bargains in nutrition — that’s too simplistic for a system as complex as the human body.
Take for instance my unintended weight loss. I ate more but lost weight, mostly fat. The common-sense weight loss advice is to eat less and exercise more. That advice assumes that the body is a simple calorie container. Food comes in and gets converted to energy. You need to expel that energy or it gets stored as fat.
That’s easy to imagine and to remember. But that is a bad metaphor.
A better metaphor is a System Preferences panel for your body.
One setting, for instance, is how much fat you store. You adjust that dial mainly though the hormone insulin. Insulin in turn is influenced by the amount of sugar and simple carbs you eat. You eat very little of these in keto. This is why I kept shedding fat despite eating lots and lots of fatty food.
Ketosis is another setting. You brain uses either glucose or ketones for fuel. You can toggle this setting through the ketogenic diet, through fasting, or through exogenous ketones (ketones you ingest instead of making in your liver).
Adjusting these settings used to be a secret art kept in bodybuilding gyms and ancient religious traditions. It is now available to most, with all the scientific advancements in nutrition in the past decades, and the worldwide exchange of knowledge in the internet.
The rabbit hole of nutrition is deep, a maze of information, full of contradicting and passionate opinions. But the payoff is a better instrument to live your life — a strong body and a vibrant brain (and if you do the work, chiseled abs). It is worth the plunge.
