96 Replies to “Dave Feldman – ‘The Dynamic Influence of a High Fat Diet on Cholesterol Variability’”

  1. So VERY VERY COOL. Thank you Mr Engineer! I love your commitment and am so very impressed. I'll be sending people to this video, where there's a question about cholesterol.

  2. Thank you SO much for this video.  It was highly informative and eye-opening. I, too, teared up a bit.  I especially enjoyed your explanation regarding liver enzymes.  I think you did so well.

  3. OMG, listened again. Great stuff.

    There is some confusion based on the feedback I received in the conference course evaluations. It has generally been advised to reduce saturated fat and even calories when LDL-C or LDLp are high and this is still the case. Dave's experiment however is counter-intuitive to this advice as his results show exactly the opposite. So what's going on here?

    Important to understand that Dave's experiment is highly atypical. Shifting from a low calorie keto diet of 800 calories to a whopping high calorie keto diet of 5000 calories in an attempt to modify cholesterol over only a few short days just to prove a point. This is not a standard keto diet nor are most people checking cholesterol this frequently. The context of Dave's experiment is different then what most of us are doing.

    As Dave mentioned in his talk everyone has a certain cholesterol 'preference point' that usually reverts back following his experiment. I suspect that it is this cholesterol 'preference point' that responds more typically to the standard recommendations to reduce saturated fat and calories. I hope this clarifies.

    What do you think Dave?

  4. Hyper responder here…been on Keto 6 months and have LDL numbers on the very high side with great Trigs and HDL. This video is very informative although it really does not answer the key question which is why does this happen to some people and is it dangerous ? Hopefully further research will answer these questions. In the meantime I have decided to increase my MUFA's and PUFA's (healthy foods and not factory oils) as well as increase my carbs which probably takes me out of ketosis. As I am lean and insulin sensitive this is not a big issue , just wanted to get the numbers more in line with conventional thinking pending further research results.

  5. Thanks Dave, see you found Ivor as I am big fan of his … as you said engineers … I had to do a power point presentation to convince my doctor that Omega-3 testing is critical, since the "Cholesterol" theory has died … doctors are at a loss and do not think that "All Fats" are important. As engineers we "Solve Problems" or else the proverbial bridge will "Fall Down", and as you know the health of the average human is falling down. Doctors have no clue and some use the word "Idiopathic" which makes you wonder where the basic research went or when did we start ignoring metabolic sciences.

    And yes, it is ok to "Fire your Doctor", in fact there is a web site dedicated to this "Run by Doctors …" in my case my hospital is a teaching hospital … so to change anything, you have to change the curriculum … Doctors have a PhD in medicine and just regurgitate what Doctors of Science PhD's discover … very few Medical doctors have additional PhD's,

    70 Going On 100 … the Centenarian Diet

  6. This is amazing! I am a hyper responder. My total cholesterol hit 14 a month last August after I started low carb and my doctor flipped! She referred me to a cardiologist with strict instructions to him that he 'give me a good talking to'. I haven't made that appointment. I am now ketogenic. I haven't retested and I haven't been back to my doctor either. I am trying to find a doctor more sympathetic to my woe but haven't yet.

  7. I like your video really very impressive. could you please tell me any information about the tendency of fatty liver with high fat diet? I am also on ketogenic diet for 2 months and trust me i love it and plan to stay forever but i am also skeptical about high fat doing to my liver with all that chylomicrons from gut to liver in the system. would love to hear from you ! thank you

  8. Despite knowing that cholesterol is a meaningless test, it is always hard to ignore the scare tactics that your doctor plays when you refuse medication. This video has explained it the best way ever. Now, I have a better understanding of cholesterol. Thank you Mr Feldman.

  9. Very interesting video. But what I dont get: studies regarding fat intake show increases in ldl-c with a high fat intake. E.g.

    The Human Metabolic Response to Chronic Ketosis Without Caloric Restriction: Physical and Biochemical Adaptation https://www.ncbi.nlm.nih.gov/pubmed/6865775
    "four weeks of a eucaloric ketogenic diet (EKD)–isocaloric and isonitrogenous with the EBD but providing less than 20 g CHO daily"
    "the mean serum cholesterol level rose (from 159 to 208 mg/dL) during the EKD"
    This wasnt a weightloss study, in which weightloss itself reduces ldl-c.

    So generally fat intake, especially SFA more likely increases ldl-c and ldl-p (when not accompanied by weightloss) and only in a scenario in which you heavily overconsume fat with e.g. 5000kcal/d there is some sort of short term lowering effect.
    While this is interesting, a lot of people might take this the wrong way…

    You can find a paper by Thomas Dayspring, lipid expert, and some case reports that to decrease ldl-c and ldl-p while doing a high fat diet the most efficient way is trying to exchange SFA for MUFA, e.g. olive oil instead of butter.
    or Peter Attia on this

  10. When I started LCHF my doctors seem to ignore that my T2D was reversed and focused on my fasted cholesterol numbers. I had tests done every 3 months and I always scheduled them on a Saturday morning but I was curious why my LDL-C numbers were not as a good as my wife's – I am much more physically active than her too. This presentation just strengthened what I was starting to suspect that exercise really affects the numbers as recalled my activities before the tests. I play hockey Friday night after dinner during 13 hour fast! Or did a lengthy bike ride before the fast… current cholesterol testing is flawed. Now I can't help to think that our dietary guidelines to lower saturated fat was done on purpose for the pharmaceutical industry

  11. Very interesting talk. I think this kind of data is an example of how the health and food industry view things as correlation or causation depending on their own agenda.

    This is an extraordinary display of critical thinking and discipline. Good job Dave!

  12. Hi. Thanks for the video! Do you have any data on people with high Lipoprotein (a)? Are there any recommendations then for people with very high Lipoprotein (a)? I believe Ivor Cummins falls into this category too.

  13. all I can say is wow. as a former bodybuilding and physique competition athlete this information explained it all. my internal medicine doctor was always on me for having "high cholesterol" only being in the 225 range but my HDL was almost 100. can't wait to share your information. OUTSTANDING

  14. I have a different hypothesis for the variation/correlation. On the protocol, your're just taking LDL out from the blood circulation in to the digestive system. Cut down on fat, and it is reabsorbed back in to the bloodstream. Yo-yo. How about finding the cause of the elevated LDL or purge it from the system? My LDL skyrocketed on LCHF, partially because my intake of fiber wet down. I added another HF in LCHF, High Fiber, and my LDL came down faster than it went up. I take 4 doses of psyllium (first thing in the morning, between meals and before bed) Each dose is about 2 teaspoon heap of psyllium with 30ml cold water.

  15. wow. im glad im accidently come across this video. because i also worry about my lipid profile which 324 chol, 75 tri,55HDL, 244 LDL

    i was about to give up a keto.

    but now i know

    thank you.

  16. Dave Feldman's presentation puts the nail in the coffin of the idea that increased fat intake, especially increased saturated fat intake, will induce more atherogenic blood markers. This presentation should make low fat advocates, if they are honestly seeking the truth, rethink their position.

  17. Interesting tech stuff! I'm going to sound a bit like an asshole but I just want to make a bit of a criticism: I applaud what he adds to the conversation but I would warn that though he is a software engineer and thus a scientist, he is in no way an expert on nutrition. Also, this data is basically just anecdotal. He has one test case of himself and from what he presents it appears zero experience in nutritional science or medicine and thus conducting medical research. Bravo for the info but we need to be careful about who we assign the noble title of "expert" to. I wouldn't listen to an MD who decided to look into how to build a better commercial airliner. Don't get me wrong, the engineering science may have methodologies that are useful in medicine, I just think it's important to keep the bar for science, studies, opinions, and experts very very high. Such is under threat today. Everyone thinks their an expert these days. Perhaps I would suggest speaking to the fact that this is not a published study and that he is not a research MD. As it is, the data was presented in this context which I believe is somewhat misleading. That being said, he's done a ton of work and while much of it is over my head, I have no doubt it is valuable to the community. Bravo!

  18. You know what, i had today a conclusion on 'inversion' just by using logic and my knowledge from last months.
    And now YouTube suggested to watch this video.
    Odd events occur.

  19. Well, I'm going to be part of the ones who do this to get their doctor off their back while keto. Great talk, some new info, and I've read almost every book under the sun on this.

  20. What about cortisol levels being raised from being too low carb? I have high cortisol and am told to increase my carbs.

    My cholesterol is 304, HDL 88. VLDL 13. LDL 203. Trigs 66. My doctor told me to go on Lipitor. I told her not even at gunpoint.

    I too have high ferritin levels. 588. My doctor doesn't seemed concerned about this though they are about serum calcium which is 14.4.

  21. I'm confused. The stuff I've been reading all suggests that total cholesterol and even total LDL correlate very poorly with metabolic disease, and that the numbers that do correlate with metabolic disease are the triglyceride/HDL ratio and the VLDL count. So that the idea would be to keep HDL up and triglycerides and VLDL down. It's certainly very clear that, contrary to the official advice, there is absolutely no need to worry about saturated fat and total fat in the diet. If this experiment holds up with large-scale numbers, it would explain why there is no need to worry.

  22. Top man for doing this work. As a GP I'm not a big fan of the cholesterol theory as a major risk factor for heart disease. I agree in the context of insulin resistance this may be an indicator of poor dietary factors. However I run the professional risks of being vilified by my community of doctors and an industry geared towards statin prescription. The work of Malcolm Kendrick is a good summation of the data, you may already be aware of this but it may help you put to bed some of your fears about cholesterol. My brief synopsis (and opinion) is that unless you have a strong unprovoked family history of heart disease there probably is little to worry about cholesterol is vital for some many functions and in many cases lower level can be associated with risk of other chronic disease and inflammation as you are aware and in turn cancer risk. One further note is I ignore all studies on rodents and animals with a dissimilar diet to us and the effects of ketogenic diets which get widely drawn into these arguments for obvious reasons (I imagine I wouldn't live very long if I just ate grass so why a rabbit would be healthy on a high fat diet is fairly self explanatory).

  23. Very interesting! I have been struggling with these issues recently. I have been doing intermittent fasting for 5 months, lost 6kg, BMI down to 23. When I did a checkup 2 weeks ago, I expected to see perfect results. Everything was good except total cholesterol was around 290, LDL around 210, which shocked me. In terms of diet, I avoid refined carbs as much as I can but other than that I basically eat everything. The doctors say I should avoid saturated fat. It seems much more complicated than that.

  24. It's interesting that so many engineers (like myself) have taken such a large interest in the research behind this diet. I haven't been able to tear myself away from the research (as a scientist), long enough to work on my other research (which is nanotechnology and quantum wires). But what this "study" suggests is that a much larger study is needed. These data seem to have turned existing ideas about lipids and cholesterol levels in the bloodstream on their collective heads.

    For one thing, these cholesterol tests, only indicating the "last three days" of intake, suggest that they're virtually meaningless indicators of health, and too many primary physicians, out there, playing "cardiologist" to their patients, are prescribing medications to "stop the slaughter," seem only to be killing us, not curing us.

    Because of my insatiable need for answers, like Dave's, as an engineer, one cardiologist remarked that it appeared I know more about this than most primaries. This is egregious. Why is my primary pretending to be a cardiac specialist in the first place?

    At any rate, a LOT more data are needed for any reasonable conclusions to be drawn about this particular aspect of the Keto diet. And we currently have no or few long term studies on it. What should the norms be on this diet? Should my blood pressure be higher or lower? (Turns out it was higher, and then I noticed in one of the lectures by Dr. Phinney, that you have to increase your intake of Potassium, and I had since dropped several of my high-potassium carbs.)

    At the end, in the Q&A, I recognize the voice of yet another engineer who has become prominent in this discussion/experiment – Ivor Cummins, from Ireland, who gives some interesting talks. I've been a fan of Robert Lustig for many years, and taken to renouncing fructose in my diet, only to find, only today, that some fructose managed to sneak its way back in (YIKES!). And 20 years ago or more, I was telling family and friends to dump those transfats (hydrogenated or partially hydrogenated oils). Today, I'm telling friends that even olive oil isn't all that good for you (for the Omega 6/3 imbalance.

    What a battle! It's not just the food industry, but the powerful corporations, the food and sugar industries, right here in Florida, who desecrate Florida's beautiful and pristine waters, filling them with the nutrient runoff that pollutes our lakes and rivers to the point of being too toxic to swim in.

    But I'm not ever one to jump in and believe everything I see or hear. If you point at a study, likely, I'll chase it down and read it. It's good to be careful which ones you quote.

    Excellent and revealing talk – thanks!

  25. Really helped me. I've been on Keto for 5 weeks and had the same experience as "Jill" I tried to be "good" a few days before my cholesterol, it showed 312. I was crushed because I've been feeling so good on Keto. I'm going to try the Feldman Protocol and send this dude the results

  26. Still listening to your video so I don't know if you will cover this but I was told by a heart doctor if your LDL is large particles(this test isn't covered by insurance yet, I believe) you're are fine and statins should never be used to diminish these protective particles.

  27. Thanks a lot for all your study and experiments, Dave! From my knowledge and experience, total cholesterol as well as LDL are affected greatly by food made out of palm oil-food like baked goods and instant noodles. My cholesterol level dropped dramatically when I spent some time being away from baked goods containing palm oil, refined sugar, and thus fat (like sweets, cake, pastries..) that i had used to have a lot. This means my less intake of fat affected the dropped cholesterol level. And I've seen a documentary proving that a guy who had just fast food for an entire month (he had greasy fast food but never had carbs and refined sugar) and had his total cholesterol and LDL dropped after the month. I'm not sure what kind of fat-containing food you have during your experiments but I think what matters is not just fat but what kind of fat we have. It seems that fat from baked goods can negatively affect cholesterol level but fat from greasy food doesn't (like you have proved) although they are both saturated. I wonder what you think about it? Thank you!!

  28. What a great presentation. Landed on this to research my doctors recommendation to go on statins immediately. I am on a LCHF diet, run 60mpw with an LDL of 228. I'll never go on statins anyway, but your research has given me some great confidence to continue on the diet. Thank you for all your hard work

  29. This was fascinating. Props to Dave for, along with Ivor, bringing a systems-based engineering mindset to biomedicine. I appreciate that he's calculating Pearson correlation coefficients and regressions to demonstrate the mathematical impact of this approach. The next step will have to be to take all these n = 1 experiments and conduct a parallel cohort randomized controlled clinical trial as a short-term feeding study in a metabolic ward, and then a subsequent one for replication as a free-living study (with appropriate biochemical measurements to confirm adherence, etc.) and shoot for publication. The data are so intriguing, someone's bound to be interested, despite "conventional wisdom (e.g. indoctrination)." Great stuff.

  30. As an aside, I think if Dave really wants to help the Jills of the world (although I'm sure he is already), he should also consider delivering precisely this kind of talk to the people who eventually construct and then reconstruct the medical standards of care guidelines – e.g. academic physicians and medical students, respectively. The number of "Jills" they will influence going forward is tremendous. The impact it might have, as he changes perspectives in this arena, could be almost unfathomable.

  31. My recent blood test showed higher ldl with my dr wanting to put me on statins. I refused that route and all 3 of my children are mad at me for refusing those, insisting I'm committing suicide by not taking them.(?) Anyway, my question is: how can I increase my fat intake? I put butter in my coffee and use a lot of butter, etc. I find it hard to eat a lot of veggies, but I do eat fruit such as blueberries and strawberries. Help!

  32. Very very interesting. My HDL marker is higher on keto which increased my total cholesterol hence my natural path was not concerned. I have blood drawn and compared biannually. Thank you

  33. So, a vast majority showing how low carb diets supposedly increase cholesterol … do so only if the diet was low carb HIGH PROTEIN ! Not high fat.
    Now it doesn't surprise me anymore.

  34. I have been on the Keto diet and intermittent fasting since April 1st 2017 and have lost 80 pounds. I still have another 60 pounds to go. Well,I just got my blood test results back today and I am very concerned. My Cholesterol results were as follows:
    Total CHL: 204
    HDL: 36
    Triglycerides: 45
    LDL: 154
    Non HDL/CHL =168
    CHOL/HDLC Ratio = 5.7
    Do you have any advice on what I should do about these results? I

  35. This was awesome information. Now I understand why my cholesterol jumped to 310. I had just finished a 4 day fast. I know a bit extreme. I was in ketosis and couldn't believe it raised my cholesterol but now I now understand why it jumped. I decided to ignore the results and not start taking statins as my Dr would have preferred. I'm glad I didn't . I am worried about the life insurance point you alluded to in the video. I suppose I could game the system and do the 500g of fat for 3 days before the test 🙂 . I heard somewhere that when they lowered which is considered above the norm for total cholesterol from 240 to 200 that most of the people that approved the decrease where associated in some way with statin companies. Awesome video. Keep up the good work!.

  36. Just out of curiosity, when you raise your fat and calorie levels that high and you see the inverse effects on cholesterol levels, what effect does it have on your weight? Would do you recommend as fat levels for an ongoing basis? thx.

  37. Dr Phiney says only triglycerides can be used as fuel in the fat cell, not cholesterol;

  38. We’re about to bio-hack my husbands lipid bloodwork! His a1c is 4.8 and TG 116 and the dr said drastically change your diet bc your total cholesterol of 260 is waaaay to high…this is the first time I’ve heard of hyper-response, going to study up!

  39. Great research! I'm a practicing physician and curious your thoughts on familial hypercholesterolemia and morbidity/mortality rates associated with such. These patients often die at a young age due to CVD. I'm trying to understand if there are any ideas about these people in particular concerning their high cholesterol levels and early onset heart disease. This is probably the one thing that makes me apprehensive about recommending a diet which can elevate LDL numbers so drastically

  40. I am plagued by some zillion questions. I wonder what happens with a person's cholesterol on high fat keto who has extremely little or let's say no stored fat to mobilize during fasting. Their cholesterol would not go higher if there was no fat there to use. It might want to, but it wouldn't be able to. So the question then is why does the body WANT to, and does this mean it NEEDS to, as in are high particles the preference? Or is it the reaction to what it interprets as a bad situation (body fat burning.) And is this reaction good for us or bad for us? Is the only way to mobilize stored fat accompanied by having your particles go up? Is using stored fat then "bad" for the body in the way of, something like "well, you are using stored fat, so you are probably under environmental stress, so here's more stuff to do body repairs?" I mean, it can't be healthy to leave fat in storage forever, but maybe the body feels that way. Why does the need for particles want to go away when food is consumed? Does stored body fat create high particles while dietary doesn't? So our body interprets a bad state every time we burn body fat? Or is it truly just going where it's needed? How else do we get health without removing bad body fat, and why doesn't the body see it this way, or is it instead truly gaining health by increasing particles? Also, does your body prefer to do things differently (at a higher rate) than your sister because your metabolism may actually be higher? I don't remember where I heard this but people who like to store fat actually have higher metabolisms. I'm sorry for all these questions especially if they are already answered in the video but this is what I'm left with after watching. Thanks 🙂

  41. This video is not for the ordinary man. Dave could have done better by sharing the gist of the whole work and his message in say 4 minutes. The experts can spend 40+ minutes on this video if they wanted to

  42. Great Video! I'm only at 5:30 into the video, but I need to say that (even) as a mathematician and systems engineer with a background in philosophy of science, I know that doing science with "N = 1" is entirely defensible. The medical literature is full of individual "case studies" – single persons, about whom massive data is collected across time, and (possibly tentative) conclusions are drawn from it.   Also, I think it's very good for non-medical people to look at medicine using a "systems approach", in order to critique medical theories, and make new medical discoveries. Another non-medical professional who is doing this sort of analysis is Stephanie Seneff , who does research in cholesterol metabolism also.I started Low Carb in 1999, and my triglycerides have ranged from 44 to 69 during that time, with no upward linear trend across the last 19 years.I am a somewhat "high responder" with my LDL. With my total TC about 250. But my HDL ranges from 55 to 80.  My HDL is ALWAYS higher than my triglycerides.

  43. Warning ! The triglycerides over HDL ratios I see recorded here are alarmingly bad. The ratio is a much more important indicator of danger than total cholesterol.

  44. i tried a low carb diet and my triglycerides were measured at 1400…i was extremely careful, no sugar, no fruit, no starches..it was epic fail for me,,

  45. Speaking from flood hit Kerala.
    I have type 2 diabetes and is trying a reduced carb diet. I am 63. No other health issues.
    Do you think this would work for a diabetic?

  46. I'm having difficulty understanding the bottom line here. I'm not an engineer, scientist or physician. Can anyone explain the protocol to a layperson like myself?

  47. Maybe I am daft. But wouldn't ldl particle size best be figured out as LDL-p divided by ldl-c? I buy that often a high ldl-p might mean small particles, but not always. The ratio should give better idea of particle size.

  48. I have been on keto for 6months, losing weight (24 lbs) , went off statins and metformin, and doing great. I was so expecting this visit to the doctor to be great! My HDL's had increased to 87, cholesterol increased from 158 to 343, triglycerides dropped from 63 to 44 and LDL went up from 83.3 to 247.1. My endocrinologist said, "you will look skinny in your coffin!" He wants me to start back the statins and I DO NOT WANT TOO. My A1C is hanging around 5.8-6.0 and he was OK with that. I am very frustrated with my doctor! I will forward this to him and we will see the response. A firing like Jill maybe in the future! Also… what have you found in correlation with hormone swings and cholesterol. I am 50 and starting the change. In the past, my endocrinologist could NOT get my thyroid regular as long as I was on birth control. I fussed then that this hormone was affecting thyroid function BUT he refused to listen then as well!

  49. Great stuff, definitely interesting to see the effects of a severely fatty diet on someone with high cholesterol in the acute setting.

    There is a major issue with applying these results to ketogenic diets in general, and I suspect a large part of the reason the LDL drop has not been reproduced in randomized clinical trials or even consistently in the user comments – Dave didn't wait long enough to see the impact of diet on the liver. As he point outs (13:55), VLDL lipogenesis by the liver is on the order of days to weeks. So why would you measure the serum levels daily? Needs to try the same studies but be more patient, the Pearson/R2 will likely be absent after a few weeks. Otherwise dietary changes are going to be over-represented, which was demonstrated so eloquently with your sibling study.

    Experimental models seem to support the idea that VLDLs get irritated by inflammation → fatty passengers pop off → adhere to the glycosylated arterial wall (sugar turns the walls of your arteries into sticky sandpaper). Diathesis stress. Without fat, sugar is far less impactful and without sugar fat has far less effect, but neither is benign in the aging individual because we will always 'see-saw' in and out inflammation.

    Ideas for future tests:
    Check other more reliable indices of cardiac health coronary artery calcium and intimal wall thickness of your carotids over time. Look at all-cause mortality if enough people jump on board. Then you might have a chance of changing national food guidelines.

  50. This all looks great, but now makes me worry since I don't have a gallbladder, that I'm not processing all of these fats properly.

  51. What can I say? One of the best step-by-step presentations I’ve viewed. May I commend you on your visuals and express my gratitude because those pictures help “make simple” (allow understanding) the information and makes it meaningful and that is empowering.

    I’m one of those people who believe that MY HEALTH is MY DECISION and MY RESPONSIBILITY and I hold ownership of my health … I will NEVER handover my health to a doctor …. I’ve found too many to be OUT OF TOUCH with what is changing.


  53. I would like to know if you can include on the same day of the blood work with high ldl, a coronary artery calcium score test, to see if arteries are clogged.

  54. Question?: daves 10 day lipid protocal… can you avoid the 3 days of fasting and just raise your fat the 5 days before the second blood test? It sounds like yes. just want to check.

  55. I wish I could understand all this Dave. To deep for me.
    I did 3 days of omad plus keto.
    i fasted 15 hours and did the test
    I was expecting great results.
    But no my total cholesterol went up to 6 1. My ldl is the culprit.

    My Doctor wants me to be around 5.
    My triglycerides are 1.3
    My hdl is 1.2.
    My ldl is 4.3

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