1/ Yes, my answer to the poll by @nicknorwitz was "Gain 4% body fat". And honestly, it was a pretty easy one when compared to the others.
But to be fair, I also have quite a bit of direct data on this in particular... let's unpack...
2/ First, if you didn't already know this about me, in 2018 I literally gained almost 20lbs of fat for the Weight Gain Experiment. cholesterolcode.com/weight-gain-ex…
(As an aside, I realize now I did presentations on the findings for this experiment, but didn't do a write up. Bad Dave!)
3/ But spoiler alert -- my total and LDL cholesterol did indeed go down where having gained weight and back up where having lost it.
To be sure, I think there are thresholds to "active fat gain/loss" vs standing, stable fat mass, but we'll save that for another thread.
4/ Here's a scatterplot that illustrates this correlation as well...
5/ Okay, so let's backtrack to the other answers. Do I think the other three *also* impact LDL-C? Yes, just much more marginally given the quantities listed.
That said, I lately consider fiber to be of more interest than I did before for multiple reasons...
6/ I've done a bit more post hoc on some of my other data when I was more commonly consuming a homemade pizza I used to make with psyllium husk as part of the crust ingredients. I think I had a marginally lower LDL with it in my diet, all else equal-ish.
7/ Another set of data points on this originates from @ScepticalDoctor's N=1s with #PlantBased low carb (but not quite keto). Where again we see low LDL, but this could be confounded by true carb levels vs assumed net-out. Ideally, we'd have CGMs involved to confirm glucose intro
8/ Anyway, I just bring this up in regards to the 4% fat vs 20g fiber per Nick's poll answers -- as it might well be that enough fiber could overtake the contribution fo fat %.
Hence, my renewed interest in doing a fiber-only intervention experiment soon #ForScience!
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I'm going to provide some updates and answers to frequent questions of the last several days...
2/ "Dave, can you get me in the study?"
No! You have to contact Lundquist directly through the proper channels and they will decide based on the study design whether you qualify as prescribed by existing eligibility criteria we all determined in advance.
3/ While myself, @DrNadolsky and @DrRagnar developed the protocol in collaboration Lundquist, we in no way can (or should) influence any decision making regarding individual considerations -- and that's a good thing. We want this study as fair and objective as possible.
2/ "Lipoprotein lipase (LPL) is a rate-limiting enzyme for hydrolysing circulating triglycerides (TG) into free fatty acids that are taken up by peripheral tissues."
Translation: LPL is like a key cells use to open lipoprotein boats to offload their fat-fuel cargo (TG)
3/ "Postprandial LPL activity rises in white adipose tissue (WAT), but declines in the heart and skeletal muscle, thereby directing circulating TG to WAT for storage; the reverse is true during fasting"
Sure, post-meal we do more storing in fat via LPL, otherwise we do less.
1/6 I'd like to both retweet and add on to @NutritionMadeS3's point here...
Again, and with emphasis, my position is one of cautious optimism. That's an explicit acknowledgement of uncertainty, even if I have a leaning toward the positive in this context...
I'd hope this were self-evident, but if I were completely certain high LDL + high HDL + low TG = low risk in fat-adapted context, there'd be no effort for a study
3/6 I've chatted with @NutritionMadeS3 and others on evidence I consider very compelling regarding the connection of health and illness for lipid metabolism and their impact on lipid profiles. But I likewise stress we'd be better served with prospective data in this context
The tl:dr -> There's more selective control with fatty acid exchange in tissues than we fully understand... but we have a lot more we've learned recently...
2/ "Preferential uptake of FAs into high demand tissues such as the heart, muscle and brown adipose tissue cannot be achieved by non-specific uptake, which would acutely distribute FAs equally into all cells."
- Translation: there's some selective trafficking going on here.
3/ "A second uptake process modulated by activity of capillary lipoprotein lipase (LpL) involves FAs derived from triglyceride (TG) rich lipoproteins (chylomicrons and very low density lipoproteins." (VLDL)
- Yes, lipoproteins + LPL = hydrolysis of TG to cells
3/6 If you read nothing else, check out this section from the article, and why I'm so vocal about *not* looking only at #ApoB (which lumps non-LDL and LDL) together.
Again -- and with emphasis -- this is part of the larger hypothesis. But all the more reason to research it...
1/ I have a new favorite term: "unadjusted hypothesis-naïve exploratory linear regression"-- and it comes from @Ad_SotoMota, who @nicknorwitz and I are honored to be working with in this new project (news on that soon...)
I don't typically see the term as it's rarely employed...
2/ My layperson explanation is that this is explicitly letting the data speak for itself. Literally starting from scratch and seeing what patterns machine learning tells us are emerging. No adjusting the data at the beginning of the process which can bias the outcome (of course)
3/ I'm much more used to methodology sections describing several steps of adjustment selection by the researchers. This isn't to imply any wrongdoing by any means, but understandably, this can be problematic if one or more underlying assumptions for adjustments are incorrect...