I don’t know who to believe anymore

[mono]

info: male, early twenties, 63kg (skinny-fat), 167cm. not a us-resident
diet(daily stable): 8 eggs, a lot of butter,some meat or fish, some yogurt, carbs.

before I started my NLP I got into keto because my hip and back was aching,
I felt great and concentrated although a bit restricted … long story short I couldn’t stick with it more that couple of weeks and listened to some podcasts where rip said that you can’t do starting strength on caloric deficit so I started eating carbs again, gained some weight (74kg 25% body-fat) and honestly for the first time in my like I feel like iam a real man.

I have two problems:

1)my heart is aching and I feel a burn in it, did a lipid profile and my LDL was (219) mg/dL and my cholesterol was (291) mg/dL in total, A1C (4.7), went and saw the doctor and he said it was my diet that was causing my heart, that I should lower my cholesterol and I said to him that the lipid theory is wrong and cholesterol is a good molecule that don’t cause heart disease but we need it to make hormones and good for the integrity of the cell, and he said I was wrong, I’ve been following SS podcast and Dr. ken d berry MD on YouTube, and I know for a fact that cholesterol is not Le bad, having said that … am I wrong?
I don’t wanna go back to being that week or skinny ever again. And at the same time can’t stop consuming eggs as they are my cheap form of protein.

2) I can’t meet my daily requirement of protein because iam a student (even when I did keto), should I continue doing NLP or wait till I get into some job to be able to spend money on supplements and buy more protein, or should I continue to train.

[Robert Santana]

If your lipids are that fucked up in your 20s, it's likely a genetic predisposition. The consequences of poor diet take place after decades. You could still afford to clean some things up though. Elaborate on the protein issue. Is it a money issue or logistical issue?

[mikiekimi]

Interesting thread. I would say that Dr. Ken is speaking in general terms and your doc is addressing a specific issue in a specific patient. Both docs can essentially be correct given the circumstances.

I would also say that quoting someone on YouTube is not likely to move your doc in a specific direction or influence their opinion on root cause or recommended course of action. Don't you know you can't believe everything you read on the interwebz?

The nice thing is that you are young and have plenty of time to change dietary habits to see if they net any changes in your blood work. Just like dietary habits in general, it all comes down to what works for you.

[j410s]

If your lipids are that fucked up in your 20s, it's likely a genetic predisposition. The consequences of poor diet take place after decades. You could still afford to clean some things up though. Elaborate on the protein issue. Is it a money issue or logistical issue?

Given his age it's also not out of the question that [URL="https://pubmed.ncbi.nlm.nih.gov/24239151/"]alcohol intake could contribute.[/URL If] you drink weekly (for example, at frat parties) it will almost certainly have an effect on your lipids.

OP is also parroting the non-sense keto cultists always do. "Cholesterol is a lie, it's particle size that counts!" Which, in a strictly biological sense is true of course. However, for the vast majority of people (as in almost everyone including OP) elevated lipids are not due to a particle size difference but rather because of a fucked up diet, alcohol intake, genetics, etc. Here is a related study: https://pubmed.ncbi.nlm.nih.gov/28460374/. However, even this study concludes:

LDL particle size, on the other hand, has not been independently associated with CVD risk after adjustment for other risk factors such as LDL cholesterol, triglycerides, and HDL-C and that routine use of information pertaining to particle size to determine and manage patients' risk is not yet justified.

Cholesterol is not bad. What people mean by it is you shouldn't go out of your way to avoid it. However, overconsumption can have deleterious effects if you're in an at-risk population. You may not even know you are until you get popped on a blood test. Certainly, eating 3 eggs in the morning won't do damage to most people. However, following "modern" keto and composing your diet entirely of cheeseburgers (no bread), eggs, and sticks of butter is not the same thing. It may be worth experimenting with a normal diet as described in the SS book.

[Robert Santana]

Given his age it's also not out of the question that [URL="https://pubmed.ncbi.nlm.nih.gov/24239151/"]alcohol intake could contribute.[/URL If] you drink weekly (for example, at frat parties) it will almost certainly have an effect on your lipids.

OP is also parroting the non-sense keto cultists always do. "Cholesterol is a lie, it's particle size that counts!" Which, in a strictly biological sense is true of course. However, for the vast majority of people (as in almost everyone including OP) elevated lipids are not due to a particle size difference but rather because of a fucked up diet, alcohol intake, genetics, etc. Here is a related study: https://pubmed.ncbi.nlm.nih.gov/28460374/. However, even this study concludes:



Cholesterol is not bad. What people mean by it is you shouldn't go out of your way to avoid it. However, overconsumption can have deleterious effects if you're in an at-risk population. You may not even know you are until you get popped on a blood test. Certainly, eating 3 eggs in the morning won't do damage to most people. However, following "modern" keto and composing your diet entirely of cheeseburgers (no bread), eggs, and sticks of butter is not the same thing. It may be worth experimenting with a normal diet as described in the SS book.

1) The OP is not a middle aged Japanese man. He is a young man of unknown ethnicity. The mean age in this sample was late 40s for both groups or drinkers and mid 40s for the nondrinkers.

2) This cross-sectional study reported associations between self reported alcohol intake, which, like self reported dietary intake, is subject to social desirability and recall biases.

3) They also illustrated that heavy drinkers had the highest HDL levels and lowest LDL levels compared to non drinkers and occasional drinkers despite having higher triglycerides.

4) You know what else is interesting? The drinkers reported more activity than the non drinkers.

That said, I'm not endorsing heavy drinking and smoking but I stand by my original assertion that this man is too young to have cardiovascular complications from lifestyle factors alone. If he is abusing drugs and alcohol regularly then I do agree it is plausible that such a behavior would negatively alter blood lipids, increase inflammation, and negatively impact the cardiovascular system and we don't need a p-value to know that especially if the abuse is substantial. He has not mentioned drug or alcohol abuse and has only mentioned food intake, which would damage the cardiovascular system over a longer timeline than drugs or alcohol unless the person has familial hypercholesterolemia.

[HailMary]

Heart aching and burning? Did your doctor rule out reflux? Any tests ordered besides the lipid panel?