Dr. Nadir Ali - 'Why LDL cholesterol goes up with low carb diet and is it bad for health?'

my job is to dissect out my LDL cholesterol goes up on a low-carb diet and also to find out and create a narrative if that is necessarily bad and you'd be shocked to hear that I really have no disclosures so I didn't know whether I should include the slide at the end or in the beginning but I thought it would have more impact in the beginning because there are people right sitting right in front of me that medical knowledge is no longer the monopoly of physicians or healthcare professionals and a lot of citizen scientists who have more insight because they can think outside the box and my transformation came because my patients grassroot effort told me that hey I needed to change and unless organizations and physicians higher up heed this warning I feel that if we don't bring the change from top down are we gonna get buggy whipped so for the last five years I've been telling my patients hey eat like this animal fat fatty meat and fatty fish and in my clinical experience this is what I find when people take this to heart and practice it religiously three good things happen out here their HDL goes up the triglyceride comes down their insulin goes down and everybody agrees that this is beneficial but the dawn' LDL that everybody's worried about goes up especially when one is being particularly good at it so before we demonize LDL or cholesterol we got to recognize that it's an evolutionary important molecule important for life the every cell in our body the cell membrane would not have the fluidity and integrity if it were not for cholesterol on the right of the slide is the brain membrane and the structure of the brain membrane is is permitted to be the way it is and neurotransmission happens because of cholesterol rafts that give the brain membrane the structural integrity that it needs in fact the cholesterol is so important for the brain that it does not delegate that responsibility to any other organ but itself now I would not be able to stand here and give this presentation without the LDL cholesterol which is much maligned because that LDL cholesterol is supplying cholesterol to my adrenal cortex giving me the stress hormone cortisol so that I can deal with the stress the LDL molecule that cardiologists want to wipe from the face of the earth is giving cholesterol to the ovaries making all women in here look beautiful and testosterone to men making us look handsome now bile acids are absolutely essential for absorbing fat soluble vitamins for absorbing fats and they are cholesterol byproducts and cholesterol is not a metabolic fuel we cannot use it for energy so bile acids constitute the way in which we eliminate cholesterol in our gut vitamin D is a cholesterol product now both cholesterol and triglycerides are fat and they don't dissolve in blood because blood is watery so our body has created an ingenious system to carry this cholesterol as other speakers have mentioned there's an outer cover of phospholipids that makes the molecule dissolvable in water and the cargo is cholesterol with an identifying protein that is shown out there now on the right side of the slides have shown many beneficial functions of LDL cholesterol and I would be not be able to get into them but people watching this later can pause and peruse them so I wanted to find out why LDL goes up and this paper gave me a big insight now this paper is in seven people who fasted for seven days and what was found is that fasting increased their LDL cholesterol now you would think that fasting is beneficial the LDL cholesterol started at 112 ended up at 119 Mondays a whopping 70% increase fasting makes us do fat metabolism so I had to go back all the way into the 1950s to the workout Josh Cahill and come up with this graph on the right and the reason I have put that up there is because we have very limited carbohydrate results when we stop eating or eating a low-carb diet what happens is that we run out of glycogen very quickly within the first four to eight hours and then you see that for certain tissues that need sugar you see that the gluconeogenesis is slowly going out and then comes down and the reason it comes down is because our body becomes adapted to burning fat as ketones so out here is shown that with prolonged fasting which is an extreme example of a low-carb diet what you're seeing is that the ketone levels go up to five millimoles which is equal our to our blood sugar concentration so what are these amazing ketone molecules RT R is shown on the left of the screen a person who's on a standard American diet who's burning predominantly sugar and his brain but when you're on low-carb diet or doing fasting the brain adapts and turns two-thirds of its used to ketones showing that it becomes fat adapted I'd like to take exception with dr. Moussa Farion yesterday because he said that we are extreme examples we are going too far we want ketosis low carb is enough I'd like to remind him that man's entry into life and the reason that we are still alive is because we are capable of ketosis in fact I'd like your indulgence to read this word for word which says the metabolism of human II new born is essentially katatak blood glucose level Falls strikingly in the neonate and concentrations of beara hydroxy butyrate rise to about two to three milli molar newborn brain consumes 60 to 70 percent of total metabolism at birth nearly half from hydroxybutyrate fitting in with this patent is maternal colostrum it contains much triglycerides proteins and very little lactose startings man entry into society on an Atkins diet so here is a liver cell and I'd like to thank all the speakers ahead of me to making it easy for me since you're not eating carbs you're fasting the cards are reserved for the brain the liver cell is converting fat into ketones and this is the early model as to why the cholesterol is going up and have never shared this data in front of a national audience before the enzymatic machinery that's making ketones in US involves hmg-coa which is a branch point at which point it gets diverted to making either ketones but it can also make cholesterol this figure is a little bit more elegant for people who want to see the molecular structure of these molecules but you can see that as fatty acid is entering the liver it's getting converted to acetyl-coa then becomes hmg-coa which is the branch point that makes either ketones or makes cholesterol so by design if you get very good at fat burning like the lean mass hyper Responder that Dave Feldman has so nicely put out by design you're going to increase your cholesterol levels so here is a little animation the liver is synthesizing a lot of cholesterol and somebody who's predominantly fat burning and if you follow my Twitter feed I have put in all kinds of animal as well as human studies that show this and as it is making more LDL cholesterol it's also eliminating cholesterol in bile and through the gut the terminal terminal ileum is the one that reabsorbs the bile but less of it is reabsorbed so more of it gets out in the feces so by design since the liver is synthesizing more cholesterol it's going to produce more LDL it's also going to produce more bile for elimination now it was pointed out that the oxidized LDL is the culprit the oxidized LDL gets taken up by the macrophage through the scavenger receptor and there are human studies and animal studies that show that on a person on a low-carb diet the elimination of this scavenger receptor filled macrophage is much greater in the feces in a low-carb individual now this is another point that I was shocked about the liver is making a lot of cholesterol and so it is not going to take any of the LDL back into it because it doesn't need it there are human and animal studies that show that there is LDL receptor down regulation these are the receptors that are picking up the LDL and removing it from circulation but since the liver already has the cholesterol that it needs it down regulates them now this is a little geeky slide let's just put in for the people who really want to see it and this is a fasting study in humans and these people were not on a low-carb diet the fasting was not any prolonged but you can clearly demonstrate out here that in a fasted state the liver is making much less v LDL cholesterol which is try grow a triglyceride rich and making a lot higher LDL cholesterol which is cholesterol rich so I said that I wanted my patients to eat like this fatty food fatty animal fat animal protein which is fatty as well as fatty fish when they do this this is the pattern that observed if they are katatak if they are having ketones by design they're going to have high LDL cholesterol they're gonna have high HDL and studies show that they eliminate more fecal cholesterol and their LDL receptor goes down so now I move on to a part which says why do we malign LDL does it have any benefit so this is a rat long there are longer these bacteria and the bacteria want to cause an infection in the rat and what is happening out here is that it releases this protein which is called a gr protein which establishes a quorum and says hey there is enough milieu out here for us to cause bacterial virulence and they take foothold and cause a pneumonia now you would be surprised to know that there are animal studies that show that the lowly LDL is the one that soaks up this AGR protein so that quorum is not established and infection is abolished now here is another bit of information and that is that these bacteria also release inflammatory mediators and these inflammatory mediators cause cell death what is neutralizing these inflammatory mediators which is LPS and LTA it is same the LDL cholesterol and it reduces bacterial virulence now what about human studies I want to go to some prospective human studies this is the light in 85 study 700 patients followed for 10 years and they looked at whether cholesterol predicted their mortality their cancer death and their infection and what we found is that high cholesterol was defined as 300 or greater 250 was middle cholesterol and 200 was low cholesterol the highest cholesterol group had the lowest overall mortality the highest cholesterol group had the lowest overall cancer mortality all people die of infections pneumonias the least risk of infection was in the highest cholesterol group now I told you that brain integrity is dependent on cholesterol rats for neurotransmission now this is a lothian birth cohort kids born in 1936 in the town followed in 2010 when there were 70 years of age and the principal reason that they were being followed is to see whether cholesterol predicted cognitive function this is what happened 300 was high cholesterol 250 was middle cholesterol and 200 was low cholesterol the highest cholesterol group had the lowest risks of hypertension the lowest risks of stroke the lowest risks of heart disease what about cognitive function the higher your cholesterol the better your cognitive function the general ability a processing speed your memory your IQ all dependent on high cholesterol about 300 of these 1000 patients were on statins did statin make a difference in their cognitive skills and what we find is that the 300 people that were on statins their cognitive skills was much lower compared to their cohort that were not on statins so this is what the standard American diet is and fortunately nobody in this audience eats it it's got the trifecta of grains added sugar and plant oils and what it does is that it causes insulin resistance and all causes all the things that we have heard about but the way I want to summarize is what is the optimal diet whether you believe the expensive tissue hypothesis or no we all recognize that we have enormous energy expensive brains and the primary focus of our digestion is a small intestine which is designed to absorb high-quality nutrients without processing them and we have rudimentary fermentation capacity as Zoe pointed out in addition we have an acid-base digestion we have a mono grass trick stomach that makes acid that's absolutely essential for protein digestion and if we dilute that acid with fiber or fiber binds with minerals you're not going to absorb the protein in addition our pancreas we are we are bestow'd with a pretty bad pancreas because it cannot handle the glycemic load or the glycemic index and that's why it dies so quickly now I'm not going to go through the Graff I put it up for people to peruse it later but here are my arguments as to why animals host food predominantly low-carb animal source food is better than whole food plant-based diet because if you're on a whole food plant-based diet by design you're going to eat a lot of fiber in order to reduce the glycemic index and if you're going to do that you're going to need a large amount of time in the day to eat it to supply your brain with calories I would not be able to prepare this talk you would not be able to socialize and the practitioners of this like Zoi pointed out are going to spend a lot of time in the bathroom so I want you to start eating like this and when you start eating like this this is what you're going to notice a high HDL low triglycerides low insulin and a higher LDL and this is my conclusion slide which says that should we celebrate a high LDL rather than Monat especially since most people and these will meet these three criteria they'll have a higher LDL they'll have a lower triglyceride they'll have lower insulin levels because I'd like to submit to you that this is going to make you live longer have better cognitive skills lower infection rate and lower cancer risk so I really thank you for giving me the opportunity to present here [Applause]

Channel: Low Carb Down Under

Views: 829,973

Rating: 4.8881798 out of 5

Keywords: Low Carb Down Under, LCDU, www.lowcarbdownunder.com.au, Low Carb Denver 2019, #LowCarbDenver, Eat Mostly Fat, Nadir Ali, LDL cholesterol, lipids and low carb, Triglycerides, phospholipid, fasting, ketogenesis, ketosis, cholesterol synthesis, statins

Id: qXtdp4BNyOg

Length: 17min 15sec (1035 seconds)

Published: Fri May 03 2019