Ep. 5 Why Keto Backfired: MCT Oil, APOE4, and the Cholesterol I Couldn't Fix With Diet

<p>I've had high cholesterol since I was nine years old. I know, because my mom took away my chicken nuggets and put me on a diet. Three months later it came back to normal. Problem solved — or so I thought.</p><p><br />It took until I was twenty-seven, two years into being vegetarian, to see a normal reading again. Total cholesterol of 139. I remember thinking: I finally figured it out. That one number became my proof of concept for the next 15 years.</p><p><br /></p><p>In this episode, I walk through five years of serious dietary intervention after getting my APOE4 result and a baseline LDL of 220. High Fiber Keto. Bulletproof coffee with MCT oil. KetoFlex 12/3. Extended fasting. Paleo. Plant-based. Supplements. And as of August 2025 — after all of it — my LDL was 149. Still high. Still not where it needs to be for someone with my risk profile.</p><p></p><p>So I started a statin.</p><p></p><p>This episode is about what that journey revealed — about the APOE4-specific reasons keto and MCT oil backfired, about why plant-based eating barely moved my numbers, and about what it looks like when the pillar you believed in most turns out not to be the lever you thought it was. I also get into why someone who's been eating well for twenty years shouldn't expect the same results from dietary intervention as someone who hasn't — and why that distinction matters more than most nutrition advice acknowledges.</p><p></p><p>Note: this is the first of three nutrition episodes. Episode 6 covers the cholesterol mechanism and why APOE4 carriers have a fundamentally different lipid problem than most people. Episode 7 covers the broader nutrition and Alzheimer's prevention research — blueberries, the Mediterranean diet, omega-3s, and what the science actually says.</p><p></p><p><a rel="noopener noreferrer nofollow" href="https://raceagainstmind.com/episodes/why-keto-backfired" target="_blank">Show Notes</a></p>