Danny: Hey, Chris, yes.
Thanks for letting me have a second question.
So the question is around just macronutrient combinations in meals and fat metabolism.
In early 2000s, John Berardi, I don't know if you're familiar with him-
Chris: I know him, yeah.
Danny: ... posted an article on T Nation that outlined
the rationale for eating and maximizing muscle, minimizing body fat, where you...
It was called massive eating, so if you've read or know about it, stop me and I'll go
to the question, but the context- Chris:
I know who John Berardi is but I haven't read that article.
Danny: Okay.
So the rationale that he outlined in that article was to avoid substantial amounts of
fat combined with carbs in meals.
And so the idea was eat protein plus fat or protein plus carbs, but minimize the combination
of carbs and fat.
Not to exclusion, but like say, 5 grams of fat in a protein-carb meal and 10 grams of
carbs in a fat-protein meal.
And the idea was really around body composition and minimizing fat storage.
And so, anecdotally, I did that for probably eight years and it worked really well and
I amassed a good amount of muscle and weaned myself quite a lot.
And so anecdotally, it seemed to work, but I've also kind of since changed to more of
a 40, 30, 30, or 50.
You know, 30, 20 kind of ratio and maintain the same body composition.
But the question I had around that was besides the body composition aspect, do you have any
thoughts around whether that could help with regard to cholesterol levels and LDL levels
and calcification?
Atherosclerosis?
Chris: Yeah.
Well, I think a lot of it is contextual around your metabolic response to these things, as
well as your body composition.
So generally speaking, if someone is overweight and hyperglycemic, then they're probably going
to get a lot of benefit from trying to separate their carbs and fat, whereas if someone has
amazing body composition and a totally healthy blood glucose level while they're eating a
mixed diet, then I think it's kind of pointless.
I would say that for blood lipids, generally, if macronutrients are going to affect your
blood lipids, that's probably involving...
Well, I mean your fasting blood lipids, which is what's usually measured.
If changing your macronutrients around is going to affect those, I think it's probably
going to be in the context of some level of insulin resistance or overweightness, really
insulin resistance or it would just be one of several ways to get there with carbohydrates
generally pumping the sort of VLDL production and triglyceride content.
Chris: Whereas, I think in a very healthy, lean body
composition, very healthy metabolic control, generally blood lipids are going to go down
on a lower-fat, higher-carb diet.
And I don't think either of those are going to be all that affected by the combination,
but probably if there is an effect of combining them, it's probably in the first case where
fat and carbohydrate together are more likely to pump the triglycerides and VLDL particles
out in the postprandial state than if you had fat alone or carbohydrate alone.
So I guess if I were to summarize that, I don't think the combination is going to be
all that relevant to blood lipids, but the healthier you are, metabolically and body
composition wise, the less likely I would consider it relevant.
And it's probably more relevant to eat a lower carb diet if you are quite insulin resistant
for the benefits and to do a higher... like whole food starch diet, if you are very metabolically
healthy and very lean for blood lipids.
Danny (01:33:47): That makes sense.
So if your trigs are low and you have no indications of insulin resistance, lean body composition,
good muscle, then probably higher-carb lower-fat would be the way to go to try to reduce lipid
levels, I think.
Is that what- Chris:
Yeah.
Danny: ... you're suggesting?
Okay.
Chris: And the reason is that, I mentioned before
that in people with insulin resistance, they're generally hypersensitive to the lipid synthesis
pathway.
This was in some other question about EPA.
Insulin-resistant people are generally hypersensitive to the lipid synthesis pathway of insulin
and resistant to the glucose-handling pathway of insulin.
And generally, the glucose-handling pathway of insulin also upregulates the LDL receptor,
whereas the lipid synthesis-related pathway of insulin downregulates the LDL receptor,
not directly on the LDL receptor but actually on PCSK9, which is the target of those super-expensive
drugs like Repatha.
And so generally, if you are insulin resistant, pushing the lipid synthesis pathway also hurts
your LDL receptor activity, whereas if you are very insulin sensitive and you have very
good glucose handling, more pushing of that insulin pathway actually helps your LDL receptor
activity.
So yeah, that's that.
Danny: That makes sense.
For one that's in that latter category where the higher-carb lower-fat would be the direction,
how far would you push that to say...
I've listened to some of your other discussions on the topic and the 20% fat levels, 50% carb,
30% protein would be kind of where I'm at.
How far would you push the fat down and the carbs up just to try to get into fat.
I haven't seen much effect going from 30% fat to 20% fat with 40 carbs to 15 carbs.
Chris: When you say 40 carbs, you mean 40%?
Danny: 40% yeah, sorry, yeah.
So started at 40% carbs, 30% fat- Chris:
Yeah.
Well, I mean, you're on kind of a moderately low fat to quite low fat, and that might not
be the main thing for you.
I wouldn't really list that as the main thing, anyway.
I think the biggest factors that are going to affect blood lipids in most people are,
excluding weight loss and things that impact inflammation, are going to be saturated fat,
cholesterol, and fiber.
And probably the biggest one that's most common is saturated fat as a trigger, but not everyone
is sensitive to all those different things.
So if you don't know what you're most sensitive to, what your blood lipids are most responsive
to, then they might not be that responsive to your diet.
Period.
But if you're trying to figure out your blood lipid sensitivity to diet, then I would take
those different potential triggers and do one at a time.
Test it for four weeks, and retest the blood lipid panel.
Chris: And to avoid a false positive...
I mean, a false negative, I would make those as extreme as possible.
So if you're testing low saturated fat, I would make it least to 75% cut in your saturated
fat intake because, otherwise, how many four-week periods are you going to keep testing your
blood lipids to try to figure out if this one dietary component has an effect?
So if you want to test the fat-to-carb ratio, I would go on as extreme of a fat-free diet
as you can just to avoid getting a false negative because right now you went from 30% fat to
20% fat, I don't know if going to 10% fat or 15% fat is going to do the trick.
I'm less inclined to think that based on you not getting results from 30 to 20, but if
you went 30 to 10, I'd be even more confident that you really couldn't get any benefit out
of doing that.
So the more extreme, the better.
Just for the sake of collecting a data point.
Danny: That makes sense.
That's probably the next step for me.
I've tried the saturated and that definitely reducing that... or rather increasing it makes
it go up, so probably more extreme low fat.
And I think fiber was the third thing you mentioned, which I guess would translate to
increasing fiber intake to a much higher level to see the effect.
Chris: All right, cool.
Yeah, I would just go through those, I guess, four things.
Make them pretty extreme.
Test them for four weeks.
And then once you sort of know the maximal effect of each of those factors, then you
can start exercising the trade-off of, "Well, I know this works, so how far do I want to
push this for my maintenance diet?"
Danny: Very helpful.
Thank you, Chris.
Chris: You're welcome.
All right.
Take care, Danny.
Thank you for your question.