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hey guys I have a special guest today

Dave Fellman

he’s a senior software engineer

okay so work he is the master at

cholesterol you know and what we you

know as far as a ketogenic diet goes

there’s so many people that have

questions about all different aspects

but one we’re gonna focus on today has

to do with what happens when your

cholesterol goes up because Dave is the

man to go to I mean I think it really

takes someone from the outside of the

now profession that has enough space

enough data on logic and systems and

looking at computers to really observe

this is these interesting phenomena so

because I think your body is very

similar to a computer it has certain

systems and feedback loops and so so I

guess the the let’s just talk about the

the most important thing I want to bring

up can we discuss what happens when you

dookied oh you’re doing in a minute

fasting and all of a sudden your cluster

goes up and then you start freaking out

is that a concern and let’s talk about

that well of course I per your original

comment I like to joke that the human

body was doing cloud computing long

before we were and indeed just like a

computer it can be a bit complex so I

try not to answer you know should I be

concerned or shouldn’t I be by a single

marker but I will say this I will say

that to this very day I’m finding more

and more that LDL is one of the least

useful markers to look at to determine

your metabolic health and that actually

there’s a very mechanistically sensible

reason for your LDL to climb when you

grow on a low card ketogenic diet if

you’re being fueled by fat a lot more

and so I’m gonna try not to get into the

weeds too much I sort of want to keep

this you know friendly for for any

audience member but one of the most

common misconceptions that does need to

get relieved is that

many people think when you’re on a

ketogenic diet that all of the fat you

eat gets burned into or gets gets broken

down into ketones and it’s not actually

true a fraction of the fatty acids you

ingest will get turned into get ketones

and that’s especially important for the

brain but actually the majority of

energy your tissues are using are in the

form of fatty acids that you’re

ingesting and that are also stored in

your fat cells in your body that are

provided directly to your cells and one

of the means by which they’re provided

or in these kinds of boats that I know

you talked about in some of your videos

before that we like to call lipoproteins

lipid carrying proteins these these

boats are actually amazing it’s the

genius of the human body that it makes

it because it carries all of the

different lipids these fats that include

not just what you’re using for energy

but also include cholesterol and

cholesterol it’s a common misconception

people think of cholesterol as being the

same as poison almost and that our body

is weirdly are making this poison to

kill us but the truth is cholesterol is

in every single cell in your body

in fact the animal kingdom couldn’t

function without cholesterol holding the

membranes of every single one of those

cells together yeah exactly and I think

that’s a good point just to bring up

from the very beginning um we need

cholesterol to make hormones doesn’t

would you agree that cholesterol one of

the functions is it’s kind of like a

protective type band-aid or protective

absolutely yeah absolutely well and

another common misconception is that the

cholesterol in your blood is deleterious

and that the lower your cholesterol the

better right as I’m as I’m sure you’re

aware there are many many studies that

indicate that when people really

bottomed out on cholesterol there’s a a

wide range of different problems that

can occur there’s lots of issues with

cognition there are a lot of problems

with sex hormones a lot of females for

example will lose their cycle

unfortunately there there are many other

issues that can come up with for example

infection and disease a lot of people

don’t realize that these same boats were

talking about also clear pathogens in

the body and this is why people who even

have the genetic disneys known as

familial hypercholesterolemia which is

genetically they have higher levels of

lipoproteins are known to survive

pandemics which is why it was considered

an advantage before the 20th century

because you typically had a longer

survival time when infection was a much

bigger concern not that it isn’t a big

concern now but particularly as you get

older I mean the data is very compelling

that the higher your cholesterol the

more likely your survival and it’s

certainly something you want to be very

mindful of before you consider taking

medication wow that’s awesome

being an engineer let’s compare this the

feedback loop with what happens when you

increase or decrease your dietary

cluster

on that that’s right I call it the

inversion pattern so to be sure a lot of

people go on a ketogenic diet and kind

of unintuitive Li the more the more lean

and/or fit you are surprisingly the more

likely it is that your C or LDL

cholesterol go up and that’s what I

found in my case my sister and my dad

had also got inspired to go on the huge

ink guide at the same time I did their

cholesterol went up just slightly mine

went up by a lot and so that’s what got

me very inspired to try to look into

what was going on and sure enough I

found that my baseline cholesterol while

higher if I then added a lot of fat like

I ate a lot more fat it would then go

down likewise if I if I fasted or if I

just brought down the total amount of

fat I was eating it would then go back

up again and this is super important to

get out to your listeners because one of

the common problems that occur with

people who try to go on a low-carb diet

and then try to score a good cholesterol

test is that though often

bring down the amount of saturated fat

they have in the days before the test

and there’s enormous amounts of data

that both I have demonstrated and many

of my followers that that’ll actually

spike your total and LDL cholesterol and

it typically makes your triglycerides go

higher and your HDL go lower

that’s the inversion pattern in inverts

and so I demonstrated in my first public

presentation of my data this inversion

pattern by going the other way

I ate a ton of fat I was in fact through

this conference that I was holding the

presentation for I had a cooler next to

me where I was just constantly grabbing

meats and cheeses and I was taking it

down and in my presentation I said

you’re actually watching my LDL

cholesterol plummet and I’ve bet my

entire reputation all my data on it that

when I get a blood test tomorrow it’s

gonna show that it’s dropped

substantially in 3 days and that’s

exactly what happened and so a lot of

people said would you do a write up for

this and kind of tell us how how we can

do this and that’s what I did at my site

cholesterol code comm it’s now commonly

known as the Feldman protocol I’m Bette

many of your your listeners have done

this as well because it’s shared all

over the place it’s unintuitive but you

eat a lot of fat coming up to a

cholesterol test and there’s about an 85

percent success rate for the likelihood

that you’ll actually see your LDL go

down you know this I mean it’s right in

guidance physiology they found that the

people that eat more cholesterol goes

because there’s a there’s this balance

mechanism the body will it make

adjustments it just produces less it

controls the excess so for those of you

that miss that cholesterol co.com in

fact I want to play this I have a closed

Facebook lab and we do kind of some

experiments here and there I want to

actually see if I can have everyone do

it we have a hundred thousand people so

oh wow and everyone to do that will get

some great data just to just you know I

think you all see you you mentioned

something about hyper responders and you

want to kind of just touch on that I do

so a hyper responder is actually a term

that predates my time

• the ketogenic diet and what it was was

basically a way to refer to those people

when they go on a ketogenic diet see a

dramatic increase in their LDL the the

common refrain is your LDL may go up a

little and may go down a little but odds

are you’re not one of these small

subsets of people for which a lot of

people worried I myself was one of them

when I found out I was a hyper responder

Lucy is a fifty hundred percent increase

in their LDL so my LDL before I went on

huge a diet was around 131 I think was

the last test I’d had and it had jumped

up to 270 which any doctor is gonna say

two things one they’re gonna say stop

doing what you’re doing and two I have

some drugs I would like you to look at

to help get that number back down and

again I’m an engineer I will tell you

there’s a very big difference in the

culture between those and medicine and

those in engineering and those of us in

engineering I’m telling you you could

you could have the biggest bigwig

engineer senior engineer walk into a

meeting with a whole bunch of juniors

and if that engineer says something

that’s ridiculous the junior engineers

will challenge and because every

engineer starts from the assumption that

they’re skeptical of everybody and every

piece of data they’d like to take it

apart themselves and that’s what I did I

started taking apart the lipid system

well that’s that’s where I found what

seems to be a big originating factor -

hyper responders the reason for the

higher amount of cholesterol that I was

getting had a lot to do with my being

leaner and thinner than my dad and my

sister who were very closely related and

I’ll tell you I literally done an

experiment that I’m actually still kind

of in the process of it’s pretty long

one where I’ve intentionally gained body

fat about 20 pounds of body fat and I

incidentally don’t want anyone to follow

me on this one but I have a huge wealth

of biometric data leading up to this

point so I wanted to actually capture

what I believed to be would be the case

where my LDL cholesterol would be

actually

if my body fat were higher and I’m happy

to tell you right now that that’s

exactly what it was at the very last day

of my weight gain experiment I was back

down to 130 LDL but having having what

would be considered a typical standard

American diet because I had to leave

Quito in order to gain weight and it

worked and I was having footlong Subway

sandwiches I was having pizza and I

wasn’t even having that much sugar it

was mainly just starches but it worked

to not only get give me a lot of weight

but on top of that it dropped my LDL

down to 130 milligrams per deciliter I

know my prior position had I shown them

my numbers from Quito and shown that my

numbers from the standard American diet

they probably go you’re doing great

that’s that’s so much better but but it

gives me a segue to talk about the two

metrics and that same lipid panel that

matters so much more and that is your

triglycerides and your HDL cholesterol

and and I’m telling you right now that I

have a challenge that’s not on Twitter

that they haven’t been able to answer

yet which is I’ve been able to find

studies that show if you stratify

populations for having low triglycerides

and high HDL cholesterol is something we

see with people going on a ketogenic

diet their total cardiovascular disease

risk and they’re all cause mortality

improved substantially so it’s only when

they remove those stratifications that

you get a weak correlation with LDL

cholesterol and again this is this is a

challenge I’ve been putting out for

quite a long time now and that’s why for

me I mean I can only speak for myself

but for me I would much rather have an

LDL of 270 so on his mind triglycerides

are super low and my HDL is super high I

see that Wow so let’s just touch on this

one point about let’s say for example

your triglycerides are low and your ADL

hgo is high yet you have high LDL in

someone’s mind initially they’re gonna

go oh my gosh that’s the bad cholesterol

it’s going through my blood what is it

doing do they need to do

special like at Essen and mr test to

figure out what like the type of

cholesterol you want to touch on that

high and I and I will say this the NMR

you’re talking about it’s a nuclear

magnetic resonance test and at the time

that I was coming into Kido I myself was

very adamant about getting that because

it it does more than just capture those

four metrics total LDL cholesterol HDL

cholesterol and triglycerides it also

grabs the boats themselves we were just

talking about the lipoproteins and it

breaks them out into their different

types so you hear about the small dense

versus the big fluffy and the small

dense is apparently more a thorough

genic as they would call which means

it’s more likely to be associated with

the build-up of plaque and the arteries

and the big fluffy are supposed to be

generally benign so they don’t they

don’t have that same risk because

they’re very buoyant they don’t crash

into your your arteries as I heard the

refrain go but the truth is when it

comes down to it I’ve yet to see any

compelling data that LDL particles that

aren’t modified in some fashion that

aren’t oxidized or glycated are in fact

a threat at all and I realize that this

is this is a something that kind of goes

against what is considered to be

conventional medical wisdom the bottom

line is is the pathogenesis the the

actual disease state has never been

demonstrated with a thorough Scott

o’clock in the absence of injury to the

vessel walls or oxidative stress or

basically anything that shows a

breakdown of the system itself so this

is this is why like having low

triglycerides is such a good sign

because if you have a lot of boats but a

little bit of cargo it means the boats

are succeeding at dropping that cargo

off so you don’t even need to be a big

senior engineer to realize this if

you’re watching boats that are going out

of the harbor and they’re coming back in

the– sounds like it’s proper shipping

all around so let’s just help people to

when you talk about boats you’re talking

about the carrier of cholesterol LDL and

HDL

so basically when someone talks about

HDL LDL they’re talking about a protein

that is caring not just cholesterol

triglycerides fat soluble vitamins and

antioxidants yeah yeah so basically

these boats are carrying material for

for healing repair building tissue

cellular functions and things like that

right basically everything your cells

need that is not already water soluble

so if you can’t swim on its own in the

bloodstream again genius of the human

body the body says no worries I’ve got

one kind of boat I’m gonna pack it all

in two and the primary cargo dr. Berg

the primary cargo is fat based energy

this triglycerides and that’s why

triglycerides being low in the blood is

a good sign we’re actually on a

ketogenic diet we’re actually powered by

triglycerides and that gets confusing

because a lot of people say well wait a

sec I think triglycerides go down well

triglycerides left and the bloodstream

go down because the usage is higher but

having low triglycerides in the blood

whether you’re on a fat based diet or

not aren’t tightly associated with

positive outcomes

so basically when we’re talking about

LDL and H and HDL we’re talking about

it’s not just the cholesterol it’s the

triglycerides they’re caring and that

this red is used for energy and other

things yeah absolutely it’s it’s

primarily energy but it can be used for

other building materials so okay so then

let’s just touch on another point that

you mentioned which is the the reason

why it’s going in in the first place

well part of this picture it’s it’s

trying to fix some damage some oxidative

damage a lesion in the inside of the

artery wall right let’s let’s touch on

that and maybe what could cause that

absolutely and you

• forgive me I’m gonna geek out a little

bit here okay so the best way to think

of it is when you get a cholesterol test

and you’re capturing these LDL particles

the truth is the vast vast majority of

them started as something known as the

LDLs very low-density lipoproteins and

these vldls

are the ones that are bloated with the

triglycerides they have tons and tons of

this fat based energy those things

actually drop off the energy very very

quickly and so it’s in just a matter of

less than an hour of the LDL is becomes

what’s known as an ideal which is an

intermediate density lipoprotein and

then in less than half an hour it turns

into an LDL so when you see your when

you see your bloodstream as blood

markers you actually should have a small

number of those vldls and thus a small

number of triglycerides if everything is

working properly so that LDL stage

that’s not an hour half hour that’s 2 to

4 days now you might wonder what why

would the body want LDL particles these

boats if they no longer have any

triglycerides the energy to deliver why

would the body want them in the

bloodstream and the truth is for many

different reasons they actually serve

many roles so I discussed earlier how

they bind a pathogen so they have an

immunological role just just the same as

your monocytes for example they’re

they’re part of that but they’re also

part of the reparative process so

imagine for example a whole bunch of

people whose job it is is to get into

delivery truck and in one hour they

deliver a bunch of food but then they

have kind of an all-purpose job where

they’re traveling the neighborhood

they’re looking for bad guys to run off

the road or they’re looking for a house

that’s damaged where you know they

happen to have some lumber in the back

that they can then pull up and try to

help and fix it right cells actually

have receptors yet that’s they’re like

little they’re like little arms they

actually reach out to grab these when

they’re in need of the things that are

on board and then they can

endocytosis if they actually it’s

calling it’s like golfing it golfing and

entirely and then they have everything

that’s inside it for their own use

cholesterol is one of the things that’s

part of its cargo

but the lipoprotein itself is also made

of something known as phospholipids well

guess what our cell membranes are made

of they’re made of free cholesterol and

phospholipids so cells when they can’t

synthesize enough on their own

fortunately the body wisely make sure a

lot of those lipoproteins are just ready

and able to be provided for the cells to

be able to get use of and that’s why it

doesn’t surprise me by the way when many

people go on statins will report having

muscle pain particularly they tend to be

a bit more athletic this for me I mean I

and again I’m not really put a lot of

research into this but I would not be

surprised at all if it’s the lack of

availability for LDL particles for

muscle repair and growth which is

absolutely what they get used for so

that whole stage I mean the whole stage

of low-density lipoproteins I know it

gets villainized a lot but it’s actually

very powerful and necessary to the body

where we find problems with LDL

particles being associated with

cardiovascular disease and risk is where

we find that they may in fact be getting

recruited at a higher amount so here’s

what I’m going to get a little geeky if

you don’t mind describe those cells that

line our vessel wall they’re called

endothelial cells and endothelial cells

when they get damaged they release a

signaling molecule that signaling

molecule is known as a cytokine and

those cytokines at a certain amount when

there’s really a problem that actually

signals the liver to route to up

regulate more low-density lipoproteins

so it’s actually calling for help very

specifically for low-density

lipoproteins because it’s so important

for muscle repair when you when you

twist your ankle and you see some of the

swelling and some of the heat and so

forth there’s dozens of different

chemical reactions that are going on

right but part of what there

trying to do the swelling itself is

they’re trying to pool blood they’re

trying to get those raw materials to

that area and something a lot of people

don’t realize is there’s something known

as growth hormone particularly

platelet-derived growth hormone that

endothelial cells when they’re in the

presence of will express more LDL

receptors now I am an engineer dr. Byrd

I’m an engineer and when I see processes

already in place that not only say hey

this could possibly have something to do

with lipoproteins but are specifically

receptors that bind to little poor

low-density lipoproteins themselves I

have to say give me a reason why this is

inappropriate for the body to be making

available to the cells right Wow

that is it’s just it must from just the

level of understanding that you have it

must be almost I don’t know how you

react to it but you have this other

group of people out there that are

saying no no no it’s the cholesterol and

fat is that’s the main problem which is

totally the exact opposite and I don’t

know how you react to it but the the one

thing I want to mention is like through

you know some people are saying that no

it’s the it’s the fat it’s the

cholesterol that is causing the insulin

resistance I guess it’s fat within the

muscle receptor for instance I don’t

know I don’t know exactly the argument

but it’s what’s your what’s your thought

on that well in your you’re talking to

somebody who probably has more personal

data points than maybe anybody you’ll

ever even meet I I am close to about a

hundred blood draws since November 2015

and it’s completely ridiculous I’m

commonly referred to as a human

pincushion but I’m a bit OCD and making

sure I conduct these experiments in a

very controlled manner and I the vast

majority of these tests I have fasting

insulin so I’m very very mindful of

exactly

what my basal insulin loads are and from

that perspective I I have to point this

out I have observed these changes and

how much they correlate with weight gain

weight loss how much they correlate with

fasting glucose and so forth and without

question the points in which I am at the

highest levels of saturated fat in my

diet the lowest levels of carbs and at

very moderate levels of protein I have

absolutely floored near bottom insulin

levels typically under a 2 to 4 milli I

am just really really super low but on

top of that there’s a particular group

of people that you may have heard me

talk about that are kind of step beyond

hyper responders I call them lean

massive responders they tend to have the

highest levels of LDL but they also tend

to have the lowest levels the

triglycerides and the highest levels of

HDL so they’re almost like a super class

they operate on really really really low

levels of insulin I I call them in it

basically in a blended fasted state and

I guarantee I know several that eat 5000

calories a day mostly fat and it is

absolutely having nearly no impact on

their insulin levels because you need

insulin primarily particularly the

postcranial insulin to deal with glucose

glucose coming into the blood your body

actually slowly adjusts to exactly how

much insulin it needs to use to shuttle

energy away and it seeks to keep that as

low as possible it does this because the

higher your insulin the less capability

your body has for something known as a

tapa G and that’s that’s kind of like

the housekeeping that your cells get to

to make use of so this is why by the way

I think people on the far end I

speculates totally speculative but I

believe these people these lean mass

hype responders may be enjoying a higher

level of etapa G and might literally be

actually having their cells aged a

little slower because of that being in a

blended fastest state is very powerful

and that’s why the ketogenic diet is so

powerful is you’re in many

is mimicking a fasted state which there

are plenty of studies on long before the

ketogenic diet became big as to why

that’s so good for longevity Wow

so Wow this this is fascinating what’s

your thought on some of the top few

triggers two things that can start this

whole cascade of affect like I know

insulin is gonna be pretty one at the

top the list right yeah you talk in the

Cascade of affect that can bring around

a disease state like with cardiovascular

disease yes endothelial cells yes so

here’s where it’s gonna get a little

there’s there’s kind of almost two

channels two directions we can go and

ironically or maybe not so ironically

they both kind of end up with higher

levels of triglycerides this is why I’m

very mindful to watch for triglycerides

so the first one is you actually reach

what is known as the personal fat

threshold and that tends to be somewhat

individualistic there can be some

commonalities with ethnicities but what

that means is you’re probably insulin

sensitive up to a point where you’ve now

part so much triglycerides into your

adipose tissue again your body fat that

now your body needs to find other places

to park those triglycerides so this is

where you come up with things like fatty

liver fatty pancreas even places you

really don’t want to see fat like say

parts and heart muscle and so forth

right that’s that’s a huge sign and a

very common one for insulin resistance

and this is this is where you also tend

to see a lot of this you see a lot of

things like just a larger waist

circumference and so forth that you want

to be mindful of well this is getting

back to sort of the fasted in fed state

this is where you’re now moving your

body into a place in which it’s more

predominantly in what it believes is a

fed state and how you can know this is

because fasting insulin is high if

you’re if you have fast if you’ve fasted

for 12 hours

and your fasting insulin is above 10 for

example then what’s going on is your

body still feels like there’s too much

energy and that usually is the case you

find your fasting glucose is pretty high

and it’s still keeping the insulin high

to try to put it away

well now you have less etapa Chi you

have less of your cells abilities to do

their housekeeping because it’s like the

lunch Bell is constantly ringing right

well this is a big problem for

cardiovascular health too because now

even the endothelial cells don’t get

their housekeeping time and they need

that state switch because a lot of

people don’t know this high density

lipoproteins the HDL the so-called good

cholesterol they need a fasted phase

they need a low level of insulin to get

their job done so during the period of

time where insulin is high like when

people get really sick for example and

there you’ve heard the term feed feed a

cold right there’s there is a tiny bit

of truth to that and that that as

insulin goes up it’s part of not just

the store and build state but it’s also

oftentimes part of the fight state it’s

often a way by which your body can fight

disease and my colleague Siobhan Huggins

by the way gets into this quite a bit

this is how insulin resistance can

sometimes proceed hyperinsulinemia high

levels of insulin in the blood well

again this is important because if

you’re not getting the switch back and

forth between being fasted and being fed

and being fasted or for that matter

fighting a disease and then getting back

to fasted your your emergency vehicles

these HDL particles they don’t have the

time to also go out and grab the excess

cholesterol that might have been used as

part of the reparative process and what

is also known very commonly in the

literature is reverse cholesterol

transport they’re not able to get as

much of that time as they need to get it

done overall you just want to have a

larger amount of time in a fasted State

this isn’t even by practice and fasting

but just by remaining insulin resistant

so not maxing out your personal

threshold in the first place sorry I

know there was a bit of a long-winded

answer but to really kind of unpack it

it’s important to kind of get that sense

there I mean as an engineer it makes

perfect sense you have insulin handling

a lot of things at the same time so why

not go ahead and piggyback these other

operations on it

if throughout all of our ancestral

history we knew they were infrequent

right we knew when we eat it wasn’t

going to be very common or if we were

eating a small amount that it wouldn’t

take a lot of insulin to deal with the

food that was necessary and therefore we

could count on many other operations you

know piggybacking on to insulin so in

short whether you’re on a high-fat diet

or a low-fat diet or whatever diet

you’re on if it brings about

persistently high insulin in the blood

it’s almost necessarily the worst kind

of state you can be it Wow so let’s go

back because there’s one point that I

want to clarify you mentioned something

about reverse something reverse reverse

cholesterol transport yes let’s just

define that so people drink

sure so LDL particles these ones that

we’re talking about they’re often talked

about as bad because they’ll put

cholesterol into the arterial walls it’s

really a huge oversimplification but

there is some truth to that and part of

the reparative process can be argued is

in fact atherosclerosis

it’s just progressive atherosclerosis is

clearly bad just like progressively just

like insulin is not bad you need insulin

but progressively high levels of insulin

aren’t bad inflammation absolutely can’t

live without inflammation chronic

inflammation is bad right so we fully

anticipate the operating system the

human operating system fully anticipates

that cholesterol is coming in to cells

on a constant basis and for many reasons

both for the reparative and also for the

cells themselves but likewise there’s

this whole fleet of HDL particles these

high density lipoproteins that are on

hand that are constantly also

part of the pulling it back out and

that’s why they’re commonly associated

with having better outcomes for

cardiovascular disease the higher your

HDL see almost universally the better

your outcome with cardiovascular disease

they it’s reverse cholesterol transport

they reverse they bring it out of the

tissues and then they take it back to

the liver and some of that cholesterol

is reusable and they will use it your

body is actually greedy about holding on

to and using cholesterol it’s very hard

for it to make and there’s some that’s

not so good and that that isn’t so good

goes out through bile acids that we make

and goes into our digestive system and

that eventually gets sent back to the

other side if you know what I mean so

basically it’s kind of a a reverse is

that a buffer or is it a reverse

everything just works in Reverse I I

don’t know if I’d say everything works

in Reverse but it’s basically a means by

which cholesterol has taken out of

tissues and brought to the liver kind of

recycling yeah recycling is actually a

really good way of putting it okay in

yeah so that the oxy sterols the the

oxidized cholesterol and so forth that

ends up getting sent out but anything

that’s usable cholesterol that’s going

to end up getting reused so so as a

reparative action you have cholesterol

you also have a calcium right calcium

tell yes calcification that tends to be

on a more advanced level though that

usually tends to that’s kind of to keep

it layperson friendly that’s where

things are bad to the point that we just

want to pave over the area Kathleen but

yes that would be a good way of putting

it so the coronary artery calcium

scoring test that’s a pretty isn’t about

it’s a valuable test right to get great

yes yes and to be sure there is a little

bit of risk that should always be

mentioned and that there is some

exposure to radiation I think the last

one I saw was like 0.6 millisievert

something like that comparable to a

mammogram I believe a mammogram

0.4 so that would be nothing compared to

like a cat scan of your abdomen or your

kidneys right no no no in fact a cat

scan tends to be the equivalent of

around 200 chest x-rays yeah so we by

the way I just want to insert real quick

I know it’s common practice for a

hospital to just give you a CT for any

particular reason be very mindful of

that that really is a lot of radiation

exposure and just you know I would want

to say it feel confident that what

they’re awarding it is appropriate given

the ailments you’re talking about oh

yeah they do and I do think it’s a

modern problem but I’m glad you brought

it up because I do believe that a CAC I

mean as metrics go it is one of the most

powerful neuro but there are if not be

most powerful for disease progression

detection certainly you can have heart

disease without having calcification and

that should definitely be said but if

you do have council vacation you do want

to know about it as soon as reasonably

possible and you do want to understand

its progression so it’s not even if you

get a calcium score right now and like

what would be considered a not good one

would be say like a four hundred right

if you find out that you have a four

hundred it’s not really the end of the

world what you want to be sure of is

that it’s not progressing at a high rate

such as like 50% per year or something

along those lines you want to be sure

that it’s you know if it’s progressing

one or two percent let me put it this

way

I wouldn’t mind have or I would rather

have a calcium score of 400 that was

progressing at 1% per year then a

calcium score of 50 that was progressing

at 50 percent breeder right that’s like

a no-brainer for me right but that’s but

that’s important and I will say this one

of the most heartbreaking thing is

heartbreaking things that we have at

cholesterol code calm is people that

come that have just gotten their first

CAC and they’re now four years into huge

Inc diet they’ve had high LDL but

they’ve they’re now questioning whether

the high LDL was good because their

first days

four years in says that they have like

say a 200 and the problem is is that

there’s now no way to know how much of

that was due to the lifestyle that they

had before going ketogenic and how much

was after and that’s why I generally

give advice to people who are pretty

sure they’re gonna go on keto forever

that it’s it’s nice to get the CAC as

close to when you started as possible so

that you can actually have bookended you

know when that data start it and that

way you can I mean first of all

certainly you would want to know if you

had a CAC of like 200 or 300 or

something at the point that you were

starting to hear genic die anyway right

um yeah okay I mean the you can’t

evaluate something with one number you

need two numbers before and after you

need to see progression was it better

worse and so do you I’m guessing you do

in a minute fasting not exactly I would

say probably my window so when I’m in

the process of doing these experiments

my intermittent fasting window may be

something like 14 hours which I kind of

don’t count because intermittent fasting

I sort of feel like you have to be at

least 16 hours to you know it’s it’s

like at the ride where you have to be at

least this tall I’m not I’m not quite

that tall but but Gian do you do snack

between meals

I probably snack more than the typical

ketover and I and this is actually

fairly common for lean mass hyper

responders you’ll find a lot of people

who are very lean and or athletic who

practice keto and actually they have a

few things that are in common beyond

being lean and or athletic and having

very high levels of LDL they have a very

difficult time doing fasting

particularly law particularly very

elongated fasting like multi day fasting

they also tend to have higher fasting

glucose levels which I believe is due to

more adaptive glucose pairing but it’s

important to keep the context in mind if

if you have higher fasting glucose as

you’ve gotten leaner and healthier and

feel great

don’t freak out

because it’s very likely that you also

have lower fasting insulin which is very

suggested that it’s adaptive glucose

very and by the way lean mass type

responders also also tend to have lower

levels of beta hydroxy butyrate so

relative to a typical kid or for example

they’ll tend to have like say you know

point 4 to 1.0 and then they’ll be

frustrated because they’re couch potato

keto friend you know is running it like

three or four or something along those

lines but again all of this suggests

higher faster utilization the reason I

gave a little bit of that set up is that

I probably like meeting my lean mass

type responder friends and probably just

having a tougher time fasting because my

body is already in such a blended fasted

state when I’m down at those levels that

I get more signaling to do something

about it so it’s it’s okay in fact that

there’s already probably much more of

the benefits of the fasted State in the

first place the downside is that you

know the famine hits Lima Cyprus martyrs

will be the first to go like there’s a

price for getting that way in it I think

you’re not going to worry about the

famine so that’s good anytime Lina yeah

right exactly this is awesome

do you have any um any less last points

you want to bring up absolutely yeah so

I have to tell you dr. bird one of the

very first and biggest things that I

want to get across to your listeners is

please have a fasted cholesterol test or

for that matter any blood tests you

should be 12 to 14 hours water fasting

if you were not and I know the current

guidelines will say you don’t really

need to be fasted but you physically are

putting triglycerides from your food

into your bloodstream and that is why

oftentimes we have a lot of people that

come to our site let’s say ever since I

went keto it looks like my triglycerides

have exploded and look at you know score

of 200 or 300 and so the first question

out of it shoot as we go

was it a water only fasted

what tests often times let’s say no they

then retest later and it’s fine like

everything’s you know below 100 or

something along those lines so that’s

number one number two is whatever your

cholesterol score is if you see just 1%

of my research you’ll find that it’s

insanely dynamic it’s it’s I’ve moved my

I move my numbers up and down hundreds

of milligrams per deciliter in just

three years I I had the unique

distinction of having changed my lipid

numbers more than anybody else in the

world and I believe anybody else could

actually do the same thing bear in mind

this is about any medication supplements

exercise anything and it’s it’s because

the human body is actually fantastically

a depth and very adaptable and

cholesterol is really just kind of a

shadow of the larger energy metabolism

so you you really need to know that the

lipid system is very dynamic and

whatever your cholesterol score is you’d

be surprised at how quickly it can

change assuming that you’re close to

metabolic flexibility I do want to throw

in the caveat because if you’re kind of

down the line it may take a little more

while to recover from where you need to

be but that brings me back to the last

point I really want to get across which

is even for somebody like myself who may

be snacking more than the typical person

or eating a little bit more in the

typical person when I get down to my

leaner levels you do want to have your

body generally in a in a fasted state

most of the time like this shouldn’t

even really be shouldn’t really even

need to say this but that’s what’s great

about the ketogenic diet if you get it

to work properly is you should actually

be operating on very low levels of

insulin overall and I believe that if

you do it’s it’s such a huge benefit to

longevity

so that’s that’s definitely what I want

to fit in awesome that was great advice

Thanks thank you so much for this

interview you guys you need to go to his

website it’s cholesterol co.com

cholesterol code calm alright thanks so

much Dave I really appreciate it

thanks for having me on dr. Berg I

really love your material oh thanks