Re: More doubt on the value of LDL particle size

Quentin Wrote:
Thank you for an excellent paper.

Reply:
Yes, Quentin I agree. This was an excellent paper. It provided great
detailed backgrounder information. The paper reviewed the good reasons
for believing that low density ldl might be a factor CVD.

Quentin Wrote:
What is important here is that the TG:HDL ratio remains as a powerful
predictor of CHD risk.  The risk that previously had been attributed
to small LDL size should rightfully be attributed to high TG and/or
low HDL.  

Reply:
While I do agree that TG:HDL remains a predictor of CHD risk, I
disagree that ldl-P (Particle Number) is an independent factors for
all levels of TG:HDL.
The reference that Alan provided is one source of this and I can
provide others.

//************************************************************
Beyond Low-Density Lipoprotein Cholesterol -- Defining the
Role of Low-Density Lipoprotein Heterogeneity in Coronary
Artery Disease
http://www.medscape.com/viewarticle/563857_print
//***********************************************************
The point being that saturated fat intake will increase ldl-P
(particle number) in either a high carb or low carb diet.




Quentin Wrote:
Randy, saturated fats are well established as causing increased
cholesterol concentrations in run of mill everyday diets such as SAD.
I'm slightly surprised you state this as being true in low carb diets.
It is as if you are confining your attack on saturated fats to low
carb diets.

Reply:
I state this as being true because:

1. Evidence supports this a being true.
2. I know of no mechanism in a low carb diet that would stop this from
being true. Saturated fat intake turns down ldl receptors in the liver
and ldl particle numbers increase in the blood. I've never seen any
data to indcate that this is not so in a low carb (or high carb diet)

Here's one reference comparing a very low carb/higher saturated fat
diet to higher carb/low saturated fat diet. This study is better than
most because calories were controlled.

Note the increase in ldl levels in figure 3 for the low carb higher
saturated fat diet.

I have yet to see a low carb high saturated fat diet that did not
increase ldl levels.

//************* Full Paper Here: http://tinyurl.com/cdezby

Ketogenic low-carbohydrate diets have no metabolic advantage
over nonketogenic low-carbohydrate diets1–3
Carol S Johnston, Sherrie L Tjonn, Pamela D Swan, Andrea White,
Heather Hutchins, and Barry Sears
ABSTRACT
Background: Low-carbohydrate diets may promote greater weight
loss than does the conventional low-fat, high-carbohydrate diet.
Objective: We compared weight loss and biomarker change in
adults adhering to a ketogenic low-carbohydrate (KLC) diet or a
nonketogenic low-carbohydrate (NLC) diet.
Design: Twenty adults [body mass index (in kg/m2): 34.4  1.0]
were randomly assigned to theKLC(60% of energy as fat, beginning
with5% of energy as carbohydrate) or NLC (30% of energy as fat;
40% of energy as carbohydrate) diet. During the 6-wk trial,
participants
were sedentary, and 24-h intakes were strictly controlled.
Results: Mean (SE) weight losses (6.3  0.6 and 7.2  0.8 kg in
KLC and NLC dieters, respectively; P  0.324) and fat losses (3.4
and 5.5 kg inKLCandNLCdieters, respectively; P0.111) did not
differ significantly by group after 6 wk. Blood-hydroxybutyrate in
the KLC dieters was 3.6 times that in the NLC dieters at week 2
(P0.018), and LDL cholesterol was directly correlated with blood
-hydroxybutyrate (r  0.297, P  0.025). Overall, insulin sensitivity
and resting energy expenditure increased and serum
-glutamyltransferase concentrations decreased in both diet groups
during the 6-wk trial (P  0.05). However, inflammatory risk
(arachidonic
acid:eicosapentaenoic acid ratios in plasma phospholipids)
and perceptions of vigor were more adversely affected by the KLC
than by the NLC diet.
Conclusions: KLC and NLC diets were equally effective in reducing
body weight and insulin resistance, but the KLC diet was associated
with several adverse metabolic and emotional effects. The use
of ketogenic diets for weight loss is not warranted.
//
*********************************************************************

Quentin Wrote:
IMHO it is established on diets with _normal_ carb levels that
saturated fats increase cholesterol levels, both LDL and HDL. The
problem has been that LDL levels are disproportionately increased.
This leads to increased CHD risk.

Reply:
If your implying that saturated fats raise ldl level less in low carb
diets I'd like to see the evidence.
And yes saturated fats are also harmfull in higher carb diets. I never
said they weren't.

Quentin Wrote:
Whether it is also true with low carb diets I have yet to see the
evidence.

Reply:
In addition to the reference I provided, all the studies I've seen
that have monitored saturated fat intake in low carb diets have shown
the same increase in ldl as seen in the SAD diet.

Quentin Wrote:
As I understand the situation here on ASD, there is only one person,
Susan, who may believe large LDL is harmless and only the small dense
stuff is dangerous.  Susan can correct me if I have misinterpreted the
situation.  
If you know of others I'd be delighted to know whom they
are.

Reply:
Yes, Susan is the only one I heard that specifically stated the low
density stuff is harmfully. But, I believe there are many more
supporters that agree. This includes those that beleive saturated fats
are not harmfull and that all research indicating such is a large
conspricy or very bad science. This includes supporter of Taube, Eades
and Winson (?) Price groupies. Recently there was a thread on how the
"lipid hypothesis" was balony. As far as names go Alan, Nicky,
Trinkwasser(mispelled) come to mind.


Quentin Wrote:
Many people, myself included have believed the risk was a combination
of amount of LDL and particle size.  The figure I had latched onto was
that the small dense LDL was twice as dangerous as the larger fluffy
LDL.   It would now appear this is a trick of the light.  The real
cause is high triglycerides, TG and low HDL.  IF one eliminates the
high TG low HDL factor the apparent increased risk of small dense LDL
disappears.  What is important to realise here is that low carb diets
frequently correct TG:HDL ratios thus reducing CHD risk.

Reply:
As stated before you are disregarding the LDL-P (particle number) I
don't beleive this parameter is eliminated by using only TG:HDL.

Finally, I appreciate a real conversation based on data. How rare and
refreshing.

Randy




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