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Genetics plays a very large factor in fat and cholesterol metabolism, and one that I think explains the variance in success with the ketogenic diet.

e.g. FTO, PPARG, APOA5, FABP2, and APOE.

Essentially, not everyone processes fat the same way, and for some, especially those with APOE4/4, a high fat diet may actually be deleterious to health.

People with the right genes will have great success with ketogenic diets... but convincing their friends to join in might not have the outcome they expect.



This is key.

Apoe status appears to control the absorption rates of LDL cholesterol (tiny balls of fat).

Individuals with apoe4, appear to have really low LDL cholesterol absorption rates between cells, and high blood-LDL cholesterol concentrations.

Having done a bit of research on optimal dieting, its pretty inconclusive.

This study shows negative consequences resulting from high fat diets for apoe4: https://www.ncbi.nlm.nih.gov/pubmed/27656136




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