Colleague and I had this RCT thrown in our face bc suggested a #ketogenicdiet option. Arguement was this RCT shows LCHF ⬆️LDL, therefore bad. Here's a thread about what I think...
(Spoiler, LCHF = good)...
1/ The LDL increase in the LCHF group may not itself be an adverse outcome. There was no subfractionation and it’s likely the increase in LDL and ApoB was driven by large fluffy healthy LDL particles. This assumption is supported an improvement in HDL levels in the LCHF group.
2/ HDL increased on the LCHF group, not the control group. When HDL is high and triglycerides are low, CVD risk is not meaningfully increased. See figure attached from Framingham. Furthermore, HDL (and waist circumference, below) are markers of metabolic syndrome. LDL is not.
3/ Waist circumference significantly decreased in the LCHF group, whereas WC trended upward in the control group! Waist circumference is a good proxy for visceral fat, the most inflammatory and metabolically damaging type of fat.
4/ The short-term (3 week) nature of study explains the increase in uric acid, as the kidneys take about 12 weeks to adapt to organic acid competition at the kidney. Further, the makes it difficult (impossible) to draw conclusions about the final metabolic homeostasis.
5/ study design overall questionable. “The diet itself was self-selected, thus the type of fat was optional” & insulinogenic sweeteners, processed veg oil, alcohol permitted. Good chance the participants’ diets were suboptimal. We need more infoon properly formulated LCHF diets.

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More from @nicknorwitz

13 Dec 20
Today's FoD is being substitued by a thread of quotes from the below article
Explains how, in 1965, The Sugar Research Foundation (SRF)/Sugar Industry bought off scientists to promote sugar+demonize fats.…
A Must read
Cred to .@ProfTimNoakes lecture
The Sugar Research Foundation (SRF) became concerned with evidence showing that a low-fat [high-carb] diet high in sugar could elevate serum cholesterol level…
The SRF’s vice president and director of research, John Hickson, started closely monitoring the field…
Hickson proposed that the SRF “could embark on a major program” to counter “negative attitudes toward sugar.” …
In 1965, the SRF asked Fredrick Stare, chair of the Harvard University School of Public Health Nutrition Department to join its SRFs scientific advisory board
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