I don’t understand why some prople claim that diet does not impact cholesterol. I did ‘keto’ with bacon/steak/chicken/etc for 3 months, got bloodwork done before and after and my LDL went through the roof.

In contrast, I had a high LDL of 190, largely genetic, and panicked and switched to a vegan diet. I had my LDL tested again 10 days later and it was 120. I couldn't keep up with the strict diet, but learned some good habits and to avoid saturated fat. My doctor hasn't recommended statins... yet.

There’s an offshoot of the keto community that has become die-hard cholesterol deniers. They don’t necessarily argue that keto doesn’t raise cholesterol. They argue that it doesn’t matter to have high cholesterol. They believe doctors and science are wrong on the subject. They think statins are evil. They embrace a few fringe doctors who agree with them.

If you do try keto again, bacon and such are the worst way to do it. Getting your fat content from a monounsaturated source like avocado oil can be helpful. Taking statins is also a good idea.

Years ago I also experienced very high LDL after a few months of low carb. A doctor was convinced it was genetic (familial hypercholesterolemia) even though multiple earlier tests over the years had been in the normal range. He had never heard of low carb cholesterol hyper responders and dismissed that diet could have to do with it.

Nowadays I am convinced that what happened was completely explainable by the Lipid Energy Model [0]. Five days a week I was doing 60~90 minutes of cardio in the morning after skipping breakfast. Exercising in a fasted state while on a low carb diet meant that I had very low glycogen in my muscles and liver, which meant that the muscles had to mobilize fat as an alternative source of energy. Since fat is not water soluble, transporting fat through the blood stream requires packaging it inside a micelle wrapped in phospholipids -- a lipoprotein. Hence the elevated LDL & apoB.

The solution is simple: consume some carbs before and/or during exercise, and learn about the translocation of GLUT4 receptors if you are concerned about hyperinsulinemia.

[0] https://pmc.ncbi.nlm.nih.gov/articles/PMC9147253/

Have you seen/read cholesterol code? It doesn't deny cholesterol but rather has interesting, and unusual findings.

https://cholesterolcode.com/

There’s a good talk as well that presents this information in a very accessible way:

https://youtu.be/jZu52duIqno?si=NCEf4UGtgHG9sBOP