Thread by @DaveKeto

1/ #Thread - Hypothesis on why leanness + low carb likely to lead to high cholesterol

I originally retweeted this with a simple "yep" given how it this relates to the #LipidEnergyModel.

Many have asked me to expand, so this thread will be my simple, layperson-friendly breakdown

https://twitter.com/DoctorTro/status/1406606304605507585

2/ Let's have some fun and use a relatable analogy...

Imagine you had exactly two kinds of stores in the neighborhood: bakeries and butcher shops.

You normally get groceries from both, but recently the bakeries were closed down, so now you just get meat only for meals...

3/ Now that the bakeries are down, there's more demand on the butcher shops, so they are having more inventory sent to them.

But then, the neighborhood increased while the number of butcher shops actually decreased, and this required an even higher rate of shipments to restock.

4/ To recap:

(1) Demand on butcher shops increased when bakeries shut down, now everyone was compensating by getting more meat

(2) Demand further increased as customer number expanded while total butcher shops actually dropped.

5/ Here's what we're positing:

(1) Demand for fat in someone on #keto is increased when stored glucose (glycogen) is low (bakery closed)

(2) Demand for fat trafficking further increased as lean mass increases while fat mass is reduced. (more customers, but less butcher shops)

6/ So how is fat trafficked? It's "carried" by proteins that are soluble in the bloodstream, the most famous of those being lipoproteins.

Like the butcher shop needs more frequent shipments, we posit fat cells (adipocytes) need more repletion from these lipoproteins for efflux

7/ Again, lipoproteins carry multiple lipid types, the two most prominent being the storage form of fat (triglycerides) and the other being cholesterol, of course.

Triglycerides in the bloodstream go way down when you're being fueled successfully by them...

8/ And per the #LipidEnergyModel, we believe this is due to a much higher rate of turnover. (Those shipments to the butcher shop go pretty fast now)

And given cholesterol "ride shares" with triglycerides in ApoB lipoproteins, it makes sense why we'd see higher ApoB/LDL-C/LDL-P..

9/ If you think of this as a rapid redistribution schema, it makes a lot more sense. Fat cells (adipocytes) are important for maintaining a supply of fat for other cells in their "neighborhood" (thus, local supply)....

10/ Whereas the body is responsible for making sure every adipocyte can replete enough to meet that demand (thus, global supply).

So if you're lean, it stands to reason you'd need more carrier proteins to meet that global trafficking demand.

11/ Lastly, there's definitely many technical things I didn't cover in this -- but I wanted to keep it pretty brief and (hopefully) layperson accessible.

For more, check out the #LipidEnergyModel poster 👇

https://twitter.com/DaveKeto/status/1324072850433585152?s=20