I joined a large FB group called "The Great Cholesterol Conspiracy" ... wow. I really am at a loss as to why in this day of the internet and easily searchable medical research via AI, people cling to these pseudo-scientific notions as widely represented by recent diet fads like carnivore, keto, etc... You look at these individual's pages, they are a mix of FB influencer followers, conspiracy theorists, they are often research and scientifically challenged, are often people who have "turned their life around" with a new short term diet, and often fall into the anti-vax - RFK Jr. - MAHA - MAGA groups. Their most common conspiracies are about vaccines, "Big Pharma", and generally mainstream science research ... often asserting they've been "lied to" or "victimized" in some way... by the gov't, drug industry, Fauci, etc... you name it, you get the idea.
From what I've been able to discern from the "advice" they give me, is that their entire concept hinges around these assumed "truths":
If the Triglyceride / HDL ratio is favorable (low) it negates all other potential cardio vascular risk
This is what Claude AI says:
If someone has a high LDL particle count (high ApoB or LDL-P) but a "good" TG/HDL ratio, that combination should not be read as low risk. Most lipidologists would treat the ApoB/LDL-P number as the dominant driver of atherosclerotic risk in that scenario and would not consider a favorable TG/HDL ratio reassuring enough to offset it. This is part of why ApoB (or LDL particle number via NMR) is increasingly recommended as a primary risk marker over ratios like TG/HDL, especially when the two disagree... No major RCT has shown that deliberately improving the TG/HDL ratio, in isolation, causally prevents CVD.
However, an unfavorable Triglyceride / HDL ratio can predict disease. That doesn't mean a favorable TriG/HDL ratio can prevent heart disease in the presence of high LDL particle burden.
The other thing is the idea that one diet - their carnivore / keto diet - benefits all people. The dietary affect on blood lipids is highly individual and this statement is clearly false. And the development of CVD is multi factored, involving inflammation, innate blood chemistry, and numerous risk factors (polygenic tendencies, Lp(a), etc..). It is not solely diet.
My general anecdotal observation - most people touting the carnivore diet are not 'athletic fit-for-life’ types. They are formerly obese types that have ‘turned their life around.’ These are not people who have always maintained a life long normal BMI. Very few of them have actually had CAC scans or advanced lipid profile testing. The vast number of carnivore adherents been doing it less than 10 yrs, most less than 5 yrs. It's clear, carnivore can be therapeutic in the short term and an effective way to lose weight. The success stories are mostly because of what meat replaces in the diet, rather than the meat / animal fat itself.
The Mediterranean diet has by far the strongest, most direct random controlled trial evidence of any dietary pattern for cardiovascular prevention and longevity. The PREDIMED is a real, large-scale, multi-year randomized controlled trial with hard clinical endpoints (actual heart attacks, strokes, deaths) — not surrogate markers, not observational association, not mouse data. It's frequently cited alongside the older Lyon Diet Heart Study as the gold-standard evidence for any dietary cardiovascular intervention. This is a substantially stronger evidence base than exists for keto. Some of longest lived cultures in the world eat a mediterranean diet and that is not anecdotal. Carnivore is a fad. The longterm evidence on longevity and disease for keto diets is thin.
https://pmc.ncbi.nlm.nih.gov/articles/PMC12845189/
Claude AI:
Recently, a meta-analysis covering over 100 peer-reviewed studies found associations between keto diets and increased risk of heart disease, elevated LDL cholesterol, kidney problems, Alzheimer's disease, diabetes, cancer, worsened outcomes for people with existing chronic kidney disease due to the high protein load. .... The honest state of the science is: short-to-medium term (up to a few years) data is reasonably reassuring for most people regarding cardiac health, but a meaningful and growing body of peer review-level and mechanistic evidence — including new animal studies — raises real questions about longer-term effects on the liver, kidneys, bone, and lipid profile. This is a diet where individual lipid response varies enormously, so, checking your ApoB/lipid panel would be genuinely informative a risk picture on a keto diet... there's no randomized trial evidence showing that lowering the ratio (e.g., by raising HDL specifically) reduces cardiovascular events.
https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2021.702802/full
So no, eating lots of animal fat to boost HDL isn't doesn't generally seem to prevent heart disease.
