Summer Health Update Part 2 - What 3 Pounds of Meat Every Day Does To Your Blood Work

 

While my neurological health remains a few percentage points short of ideal, I’ve also been increasingly in touch with other aspects of my health as I continue to seek optimal recovery. The amount of “general health” bloodwork I’ve sought, measured, and ordered has increased significantly and, with that in mind, I’ve decided to share the most recent round of (semi-) comprehensive of blood work.

Conventional wisdom suggests that eating a diet high in meat and fat is dangerous for cardiometabolic and chronic health. For over a decade, I’ve progressively ignored that conventional wisdom. For years, this meant eating a lower carb (for an athlete, at least) paleo-type diet. Since my vaccine reaction, it has meant consuming various degrees of low-carb and ketogenic diets. And for more than a year now, it has meant more than 90% of my diet as beef. While I was largely sedentary for the first two years of my illness, the last several months have featured increasing amounts of exercise.

Despite the extended lack of activity and the ostensibly hazardous dietary reliance on meat and fat, you can see below that my chronic health markers are generally quite good. Below are the relevant results from my latest check-in and my commentary on each of the metrics. My recent diet and exercise statistics for reference:

Background statistics - 

Height – 6ft 3in        Weight – 161 lbs.         Age - 32y, 7m

     

8 week exercise averages –

~47 miles/week hiking and jogging, 2-3/week ~20 min strength training

8 week dietary averages –

~3320 calories/day        

70.5% fat/27.1% protein/2.4% carbohydrate (~19g/day)

48% saturated fat/48% monounsaturated fat/4% polyunsaturated fat

3 day dietary averages –

~3430 calories/day

71.2% fat/23.7% protein/5.1% carbohydrate (~43g/day)

48% sfa/48% mufa/4% pufa

 

 

 

 

Triglycerides – 87 mg/dL (Reference range 0-149)

I eat tons of fat, but don’t have tons of fat moving around my blood. What gives? Well, your triglyceride levels don’t reflect fat consumption or triglyceride production by the liver. Trigs reflect fatty acid utilization and fat metabolism. If you efficiently metabolize/utilize fat for energy, you should have low triglycerides. Common recommendations suggest under 150 to be normal, but realistically 150 is pretty sketchy and any values north of 100 suggest room for improvement.

 

HDL – 68 mg/dL (Reference range >39)

HDL levels are primarily responsive to two factors – triglyceride levels, and fat consumption. Elevated triglycerides resulting from metabolic inefficiency subsequently lead to a reduction in HDL-C (you can read about why here!). Meanwhile, fat consumption directly increases the concentration of the structural lipoproteins that eventually form HDL particles. Ergo, low trigs + high fat consumption = high HDL.

 

Triglyceride/HDL Ratio – 1.28

Not a unique measurement, but a reasonably meaningful reflection of metabolic health. Because poor metabolic health increases triglycerides and subsequently decreases HDL, a ratio between the two is a decent proxy for metabolic health. Conventional wisdom would suggest something like 3.5 to still be a fine value, even though cardiometabolic disease rates start exploding once you inch above this level. Personally, I wouldn’t feel great about anything higher than 1.5-2. For fun, I’ll include comparisons to bloodwork taken the day after a brief spring “binge” (3 days of higher carb, higher calorie consumption) as well as the day I ended an 8 day extended fast.

	April “Binge”	April Fast	June
Triglycerides	127	84	87
HDL-C	50	52	68
Trig/HDL Ratio	2.54	1.61	1.28

 

LDL – 113 mg/dL (Reference range 0-99)

Just about the least meaningful standalone marker out there, despite the medical and pharmaceutical indu$try’$ endle$$ obe$$e$$ion with $elling $tatins in order to force it lower in basically everyone. You can read tens of thousands of words I’ve written about the problems with LDL here or here if you’re interested. I’ll say this for now though – LDL is hyper-agile in a metabolically healthy person. My values can effortlessly bounce between roughly 100 and 200 depending on what I eat on any given day. I don’t care to ever see numbers lower than that, as I see no benefit whatsoever (and, for whatever its worth, low LDL is associated with significant increase in death and disease for several plausible reasons). Furthermore, you’ll note that despite consuming tons of fat and saturated fat, this value is actually slightly below the population average, even if its slightly above the recommended level. That’s because saturated fat is absolutely not the prime driver of LDL levels.

 

Apolipoprotein B – 84 mg/dL (Reference range <90)

ApoB is the structural protein that forms LDL particles, and is slowly beginning to replace LDL as the en vouge cardiovascular risk measure (It is a better measure than LDL, but is subject to many of the same flaws as well). This value reflects the number of LDL particles in circulation, and you’ll note once again that despite eating tons of fat my values are actually below average and in the “approved” medical range. 

 

LDL/ApoB Ratio – 1.35

My ApoB, which reflects LDL particle count, is in the recommended range, but my LDL cholesterol is still high. How does this work? The answer lies in particle size – fewer ApoB particles carrying a given amount of cholesterol suggests those particles are on the larger size. This matters for a couple reasons – small particles indicate poor metabolic efficiency, while being themselves highly susceptible to the oxidative and glycemic damage that commonly triggers the immune-mediated atherosclerotic process. A ratio of 1.2 or so is a common cut point in the literature, with ratios below that suggesting significant cardiometabolic risk. I’ve previously forced mine as low as 1.15 with just a couple days of higher carb consumption, but would prefer not to see values below about 1.3 in typical conditions. Prior comparisons included here as well.

	April “Binge”	April Fast	June
LDL-C	108	180	113
ApoB	94	139	84
LDL/ApoB Ratio	1.15	1.29	1.35

 

C-Reactive Protein - <1 mg/L (Reference range 0-10)

CRP is a measure of systemic inflammation. You’d like to see this number as close to zero as possible, generally speaking, and the reference range extending to 10 is flat-out crazy. In the absence of some other relevant factor like a recent race, I’d really hate to see even a value of 2. Unfortunately, LabCorp doesn’t report values below 1, meaning you never really want to see an actual value on one of these tests. The one time I managed to have this tested at another lab, it was at 0.2.

 

Hemoglobin A1C – 5.1% (Reference range 4.8 - 5.6)

HbA1C is a measure of long-term blood sugar (specifically a measure of how many red blood cells have been glycated by sugar in the blood). Its commonly used to assess or monitor diabetes status. Values for HbA1C exist across a fairly narrow band – 5 is great, 6 is pretty terrible (though plenty of people hit 8, 9, or even higher). Current guidelines consider 5.7 or higher to be “prediabetes” and you really don’t want to see this above the low 5s.

 

Glucose – 95 mg/dL (Reference range 0-99)

This is on the high side for me, as fasting glucose usually bounces around between about 85 and 95. I don’t think a single number is worth all that much when you can just look at A1C and capture a long-term picture, but it’s a normal enough number regardless

 

Insulin – 1.7 uIU/mL (Reference range 2.6-24.9)

Arguably the single most important measurement on here in my view. Insulin is a storage and growth hormone secreted primarily in response to carbohydrate consumption. Chronically elevated levels of insulin are instrumental in metabolic dysfunction and contribute to the insulin resistance that defines diabetes and so much of cardiometabolic disease. The normal reference range of “less that 25” is absolutely off the rails. A person with fasting insulin levels in the 20s is so metabolically sick. Just ridiculous to label it normal in any sense of the word. This is a number you want in the low to mid single digits, with numbers closer to 10 more than sufficient to disrupt optimal metabolic health and function. As mentioned, carbohydrates are the primary driver of insulin levels. I consume very few, and thus have very low fasting insulin.

 

HOMA-IR - 0.4

The Homeostatic Model Assessment of Insulin Resistance is a simple, non-invasive method of estimating an individual’s resistance to insulin using fasting glucose and insulin values. Insulin resistance is a prime driver of heart disease and other chronic diseases, and quite literally is diabetes. HOMA-IR values under 1 are considered optimal, with values north of 2 indicating moderate or greater insulin resistance. A low HOMA-IR and high insulin sensitivity are generally to be expected when consuming a low-carbohydrate diet. I'll add the binge/fast comparison here as well

	April “Binge”	April Fast	June
Glucose	106	66	95
Insulin	11.4	1.3	1.7
HOMA-IR	3.0	0.2	0.4

 

Uric Acid – 3.5 mg/dL (Reference range 3.8-8.4)

Say it with me – “red meat doesn’t cause gout.” This is bit of nonsense that continues to be propagated throughout nutrition and medical circles, but it doesn’t reflect reality. Uric acid is a nitrogen-containing compound that forms from the breakdown of purines, which are indeed found more abundantly in animal products than in plants. But then a healthy person just pees the uric acid out, while a metabolically dysfunctional individual will not. Which is why elevated uric acid levels are tightly linked to insulin levels, obesity, and metabolic syndrome, while mine is out the bottom of LabCorp’s reference range.

 

Vitamin D – 39.1 ng/mL (Reference range 30-100)

This is lower than I’d like. The reference range says above 30 is fine but would realistically like to be double that. I already triggered neuro symptoms trying some vitamin D drops so now the strategy will be a bit more eggs, salmon, and mid-day sun before maybe assessing again.

 

Thyroxine (T4) – 1.2 ng/dL, TSH – 1.14 uIU/mL (Reference range 0.82-1.77, 0.45-4.5) 

My thyroid hormones are perfectly normal.

 

Blood pressure – 110/70, 110/64 mmHg (Reference range <120/80)

These are my two latest doctor’s office BP readings, although I somewhat regularly measure my own BP and find these values to be quite typical. Elevated blood pressure is really just another manifestation of chronic insulin resistance, rather than salt consumption or any other acute dietary factor (I literally drink salt in my water for whatever that’s worth). Its only chronic carb/sugar consumption and elevated insulin that will raise blood pressure, so again optimal measures are unsurprising.

 

Testosterone: Total – 183 ng/dL, Free - 4.4 pg/mL (Reference range 264-916, 8.7-25.1)

And here’s the one that was actually a problem. Normal testosterone for a healthy 30-something should be a few hundred points higher than this. This proved to be a big sign that I wasn’t eating enough, as downregulated hormone production is one obvious consequence of underfueling (this is just one reason that “calories” is a quasi-worthless way to approach weight and metabolism). Unsurprisingly, I was more sluggish than I should have been and slowly losing weight as well. But while my testosterone was quite low, the good news is I’ve since rectified the problem pretty much by just eating more. A month later, my total testosterone was up to 543.

There you have yet...meat and fat aren't killing me yet!