DownUnder

Long post. Bottom line: Zero arterial plaque of any kind or stenosis at age 53 after nearly 30 years of almost exclusively low carb dieting, likely the vast majority of the time with extremely high LDL by the standards of a Western diet. For the first time, I decided to do a heart scan—not because of any concern about plaque, but for two reasons: 1) I wanted to have a baseline measurement in case of problems later 2) As a public figure in the low carb/Carnivore diet space, my health is often on display, whether I want it to be or not. The state of my cardiovascular health may be considered informative. Background: As many of you know, I was sick for several years after a series of severe gut infections starting in 2018. With that I stopped absorbing fat and many nutrients for a time, gained weight in a very unhealthy way and suffered fatigue and other problems. Prior to this I was very happy and healthy most of the time since starting low carb in 1997, although there was a period between about 2006 and 2009 where my depression had become severe and I had unexplained weight gain despite a low carb diet, that wasn't relieved until I stopped eating plants. I did not get cholesterol tested that I recall or have records of until 2013, when I did for no particular reason except that someone had offered comprehensive tests at a bargain at my doctor's office and I thought it might be interesting. I'm very glad I did then, because I didn't start getting tests again until after the illness, and although I didn't call it this at the time, my initial tests both in 2013, and then again in 2018 after infection but before my health started visibly declining, I fit fairly closely to what is now described as the "lean-mass hyper-responder" pattern of very high LDL and HDL with very low triglycerides. As my health deteriorated my LDL came down. It's only come back up into the extremely high zone again recently, much to my relief. Yes, relief. My last LDL-C measurement, from last week, was 262. I had already researched and written about this pattern on my own blog, arguing that high LDL is not a meaningful risk factor in heart disease, but that low HDL and high triglycerides are. So these measurements didn't bother me in the slightest. But the whole conversation got much larger after @realDaveFeldman started studying it formally. I'll admit that I was slightly worried about this test, simply because I know that between 2018 and now I had some severe metabolic issues. If I had shown some plaque, I would likely have attributed it to the illness, but the Internet at large would have had a field day with it, using it as ammunition against the meat-based dietary pattern and against LDL. Fortunately for me, that's not what happened. My doctor's office called me today and the receptionist excitedly told me she'd never seen such excellent results. Presumably this is because most people getting heart scans had some unhappy reason to look. After three decades of low carb dieting and very likely three decades of extremely high LDL cholesterol (again, only extreme from the context of a grain-based diet in which modem medical ranges are defined), I have perfectly clear arterial health. Zero sign of any plaque, soft or calcified. No stenosis. I strongly believe that I am not an outlier, that LDL is not causal of heart disease in any significant sense, and that it's a distraction in the way of our understanding of the real causes. While my anecdote doesn't prove that, it definitely leaves something to be explained if high LDL were indeed a health hazard.