You are probably going to learn a whole lot more about blood lipids in this blog post than you are about my experience with eating nothing but meat for 30 days.
Oh, and I’m not a doctor, physician, or dietitian.
Don’t make any medical or dietary decision based on what I’ve written in this (or any) post.
By no means do I think I have this all figured out.
I’m just sharing with you what I’ve learned so far in my effort to better understand all of this.
I’d originally intended for this post to be all about the “whats”, “whys”, and “hows” of my carnivorous efforts, with only a small section about my how my blood work has changed, but the latter ended up becoming such an effort that it’s made up pretty much the entirety of this post.
While there’s are myriad ways your blood work can reflect your health status, blood lipids will be the focus of this article since that’s what most people think of when you explain that you’ve been eating nothing but meat, salt, and water for the past month.
Of course, I will at least share a little bit with you about what my implementation of a zero carb carnivorous diet looked like.
What I ate
As of August 5th, 2018 (it’s currently September 9, 2018), I’ve been eating nothing but grass-fed, grass-finished 85% lean ground beef.
No coffee, no tea, no supplements, no vitamins – nothing but beef, salt, and water.
I chose grass-fed, grass-finished because of the reportedly superior fatty acid and antioxidant profile, improved animal welfare, and more environmentally sustainable (regenerative, even) practices involved in producing this meat compared to CAFO meat.
I understand I am fortunate to be able to make this decision and that not everybody can do the same, and I don’t take this for granted.
This is just one way to promote some causes in which I believe by voting with my dollar.
Choosing ground beef played a role in making this a bit less of a financial hit.
I tracked everything, and ate at least 3 lbs. every day, averaging 3063 kcal/day, an intentional caloric surplus to minimize stress during adaptation, for the duration of the 30 days between these two blood draws.
This equates to an average of 265 grams of protein, 214 grams of fat (83.6 saturated, 93.4 g monounsaturated, and 6.2 g polyunsaturated), and 0 grams of carbs per day.
Here’s a screenshot of my vitamin and mineral intake:
I chose not to incorporate organ meat into my eating habits to keep things simple, although I do intend to start eating them regularly in the near future – probably something similar to Paleomedicina Hungary’s therapeutic protocol with a bit more protein if necessary.
Besides ground beef, I just had a few twists of the salt grinder on each patty of meat (roughly 24 twists/day) and drank plain water.
I’ll share more about what this month looked like for me in terms of how I felt and performed in a future post, but for now let’s talk about my blood lipids.
Crash course in blood lipids
First, let’s define some terms.
Cholesterol is a waxy-like substance that’s used for the formation of cell membranes, vitamins, and hormones, and is essential to life.
Triglycerides are molecules comprising three fatty acids attached to a glycerol backbone and are used for energy.
Neither cholesterol nor triglycerides are water-soluble, so they need to be carried around in our blood by what are called lipoproteins.
Our intestines distribute triglycerides from food throughout the body using lipoproteins called “chylomicrons”, which become “remnant chylomicrons” as they empty and are taken up by the liver.
Our livers distribute triglycerides along with cholesterol throughout the body using lipoproteins initially called “very low density lipoproteins” (VLDL).
As VLDLs drop off triglycerides throughout the body, they shrink to intermediate density lipoprotein (IDL) and then low density lipoprotein (LDL), at which point they are mainly distributing cholesterol throughout the body.
High-density lipoprotein (HDL) acts as kind of a cholesterol manager, exchanging cholesterol from throughout the body, LDL particles, and the liver as needed.
A standard blood lipid panel will measure the concentrations of total cholesterol, triglycerides, and HDL in the blood.
From these measurements, concentrations of LDL are most often calculated, rather than directly measured.
For those of you who care, my own LDL-C was calculated using the Martin-Hopkins equation.
Initial testing was on August 6th, 2018 and follow up testing was on September 4th, 2018.
Yes, technically there were only 29 days between tests, but the follow up is still reflective of 30 days of carnivory.
Below is a summary of how my blood lipids changed over 30 days of eating nothing but 85% lean ground beef, salt, and water.
Total cholesterol (TC): 156 mg/dL to 276 mg/dL
High-density lipoprotein (HDL-C): 79 mg/dL to 95 mg/dL
Low-density lipoprotein (LDL-C): 70 mg/dL to 166 mg/dL
Triglycerides (TG): 23 mg/dL to 57 mg/dL
Ideally, I would have gotten some additional information.
There are plenty of non-lipid factors we’d consider – blood pressure, fasting insulin, hbA1c, and C-reactive protein, for example – when assessing my risk for CVD.
Even in terms of my lipid profile I could use a bit more information.
For example, a higher number of small, dense LDL particles would be more indicative of a problem than a lower number of large, buoyant LDL particles, even though the two might result in identical total LDL-C.
While I did get tested for markers of liver, kidney, blood health and will be discussing these in a future post, I didn’t have these other CVD risk factors mentioned above measured, so we’re going to look solely at my standard lipid panel results for now.
Let’s look at these numbers through the lens of the National Heart, Lung, and Blood Institute (NHLBI), whose standards are summarized below:
Less than 200 mg/dL Desirable
200-239 mg/dL Borderline High
240 mg/dL and above High
Less than 40 mg/dL Major heart disease risk factor
60 mg/dL and above Gives some protection against heart disease
Less than 100 mg/dL Optimal (ideal)
100-129 mg/dL Near optimal/above optimal
130-159 mg/dL Borderline high
160-189 mg/dL High
More than 190 mg/dL Very high
Less than 149 mg/dL Desirable
150-199 mg/dL Borderline high
More than 200 mg/dL High
Right off the bat, we can see that the NHLBI would consider my TC and LDL-C levels to be pretty high, but even when using a standard lipid panel these two aren’t necessarily the best indicators on their own.
We can also see that my HDL-C is pretty FN high and my TG levels are pretty low so far as risk is concerned, so let’s explore some studies that look at the how these different lipid measurements factor together in terms of CVD risk.
Triglycerides, HDL-C, and LDL-C
One such study tracked 3600 men and women without history of CVD or lipid lowering therapy from 1987 to 2011.
The researchers looked at the effects of baseline HDL-C, LDL-C, and TG levels on the odds of fatal or non-fatal heart attacks, stroke, or CVD death, using 40 mg/dL as the cutoff point for “High” and “Low” HDL-C.
Before we look at the results, here’s an explanation of “odds”:
“Odds ratios are used to compare the relative odds of the occurrence of the outcome of interest (e.g. disease or disorder), given exposure to the variable of interest (e.g. health characteristic, aspect of medical history). The odds ratio can also be used to determine whether a particular exposure is a risk factor for a particular outcome, and to compare the magnitude of various risk factors for that outcome.
OR=1 Exposure does not affect odds of outcome
OR>1 Exposure associated with higher odds of outcome
OR<1 Exposure associated with lower odds of outcome”
Here are the results of the study with my own OR highlighted by the black lines:
According to these results, I would have fallen within an OR of 0.7 (0.6 using pre-carnivore lipids).
Next we can look at various ratios within my lipid panel result to assess risk.
Total cholesterol to HDL-C and LDL-C to HDL-C
Two ratios that have been shown to be predictive of CVD risk, even more so than LDL-C alone, are the total cholesterol to HDL-C ratio and LDL-C to HDL-C ratio.
My TC:HDL-C ratio is 2.9, up from 1.97 but still below the target of 3.5.
My LDL-C:HDL-C ratio is 1.75, up from 0.88 but still below the target of 2.5.
On a related note, it looks like the TC:HDL-C ratio is the more powerful of the two in terms of predicting CVD, due to the fact that it accounts for lipoproteins other than LDL and HDL (which we’ll discuss in a bit).
Triglycerides to HDL-C
Remember how we discussed that the size, number, and type of LDL particles in the blood were strong predictors of CVD?
Well, if you can’t measure this directly, you might consider using TG:HDL-C ratio.
One study found that 79% of individuals with a TG:HDL-C ratio above 3.8 had more small, dense LDL particles, whereas 81% of those with a TG:HDL-C ratio below 3.8 had more large, fluffy LDL particles.
Another study found the cut off point between a majority of small, dense LDL particles and large, fluffy LDL particles to be a TG:HDL ratio of 3.0
The TG:HDL-C ratio was also found to strongly correlate – more so than total cholesterol, LDL-C, HDL-C, or TG – with the extent of CVD for those who had already developed it.
My own TG:HDL-C ratio increased from 0.29 to 0.60, but is still well below the thresholds shown in the two studies cited above to be indicative of small, dense LDL particles.
Non-HDL-C is a measure of the concentration of cholesterol being carried in lipoproteins other than HDL – VLDL, IDL, LDL and Lp(a) – and has been shown to be a better predictor of CVD risk than LDL-C.
Target non-HDL cholesterol levels are 30 mg/dl above LDL-C targets:
Less than 130 mg/dL Optimal (ideal)
130-159 mg/dL Near optimal/above optimal
160-189 mg/dL Borderline high
190-219 mg/dL High
More than 220 mg/dL Very high
My non-HDL-C increased from an “optimal” 77 mg/dL to a “borderline high” 181 mg/dL.
However, non-HDL-C is typically used for assessing risk in individuals with TG > 200 mg/dl.
This makes sense, as non-HDL-C includes LDL-C, which may or may not be indicative of a problem depending on whether the LDL particles are small and dense or large and fluffy.
So, for an individual like me, whose TG:HDL-C ratio indicates a majority of large, fluffy LDL particles, non-HDL-C might not be an appropriate measure of CVD risk.
You might have noticed the 30 mg/dL difference between the targets for non-HDL-C and LDL-C and thought to yourself, “wait a minute, what else is there other than HDL and LDL?”
So did I.
I’d always assumed TC = HDL-C + LDL-C, but that’s not the case.
Recall that cholesterol is not only carried throughout the blood by LDL and HDL, but also by VLDL, IDL, and LDL
The cholesterol included in the other two lipoproteins is what we call “remnant cholesterol” (RLP-C), which has been shown to be another powerful tool for assessing CVD disease risk, irrespective of LDL-C.
My RLP-C increased from 9 mg/dL to 15 mg/dL, which still leaves me in the lowest quintile of risk for heart disease.
My RLP-C:HDL-C ratio is 0.158, which is also in the lowest risk quintile:
So, that just about does it for a summary of various measures and calculations of my risk of CVD based on a standard lipid panel.
There are a couple of things that I’d like to discuss, now that I’ve laid all of that out there.
My TG:HDL-C, TC:HDL-C, and RLP-C – the two risk factors that appear to me to be most relevant – both increased from my previous blood tests, which suggests that I am, in fact, at a higher risk of CVD than I was at the beginning of this whole thing.
If this trend continues, then I may have to re-evaluate my eating habits and lifestyle.
Also, as mentioned above, there is SO much more involved in health than lipids that would need to be considered, and I intend to have all of these things looked at by a professional at my next physical.
I chose not to elaborate so much on these other things in this blog post because the subject of lipids alone ended up taking all of my time and energy for the week.
Perhaps next week I’ll share some of the other changes I saw in my blood work.
I do have a theory that I’d like to share about what I might expect in future testing.
Yes, there will be future testing, because I’m not sure that 30 days and one follow up test is sufficient to get a feel for gauging how this is affecting my health.
First of all, I did fast for 12 hours prior to my follow up blood draw. However, the meal that I finished prior to kicking off that was three pounds of ground beef, with over 200 grams of fat.
While it’s assumed that post-meal triglycerides are cleared from the bloodstream within a few hours of eating, I’m not sure that the data that supports this idea was based on meals comprising 3 lbs. of meat.
Therefore, I’m not so sure that this meal didn’t have an effect on my elevated triglyceride levels.
On a related note, elevated triglycerides (as well as TG:DHL-C ratio) are associated with insulin resistance.
One factor that drives insulin resistance is positive energy status (eating more than you need), which absolutely applied to me over the course of the past month.
So, I’m curious if my triglyceride counts was influenced by either this large pre-test meal, or perhaps serve as a reflection of decreased insulin sensitivity due to being in an extended positive energy state.
I am going to proceed with my carnivory and report back about this.
I’m not sure yet whether I’m going to dial down my food intake, as I’ve been enjoying filling out a bit and from my measurements this seems to be a fair amount of muscle (I can share details of this in a later post) .
I will, however, make sure not to eat ridiculously large meals prior to testing as I did last time.
Anyhow, there’s no way I’m going to cover everything that I want to in this post, so I’m going to have to make this a two-parter.
Until then, have a most excellent week!