My numbers

[Winston]

Tot. Chol 246
Tri 185
HDLcalc 61
LDL 148

I also had a bit of a problem with my fasting glucose number (110). Max should be 99. So, my doctor had me do a glucose tolerance test. This time my fasting number was 101, with the 2hr post glucose dose number being 87. Thus, he concluded that I did not have diabetes. However, this does indicate that I have a bit of a problem controlling my blood sugar.

So, these are my numbers. I thought I would post them now, then again when they are retested in 3 months. I plan to follow the protien power, and/or the Paleo diet guidelines which are similar.

A bit about me. I exercise 5-6 hours a week in order to train for triathlons. This is only my second year of training, but I am in pretty good shape. Even with all of that exercise I have about 10 extra pounds around my middle. I eat really well, lots of veggies and protein, with a bit of carbs thrown in here and there. Almost zero processed food. Now that I have been told to try and reduce these numbers I will eliminate the periodic carb binges (pizza, etc).

I have been a bit of a skeptic when it comes to research on various issues. I spend a bit of time on Pubmed reading the abstracts and am frequently amazed at the conclusions stated by the researches that often do not follow from the study data.

Not surprisingly, my doctor told me to cut back on fat, especially saturated fat, continue my exercise, and have my cholesterol numbers rechecked in 3 months.

Any comments are welcome.:)

[Mitra]

Welcome, Winston :). I look forward to hearing how you get on.

[lczeledoc]

My latest test results

Fasting glucose---------103, last time was 110
HbA1c------------------Not measured, last time was 5.6
Total Chol--------------303, same
Direct LDL--------------209, about same
HDL---------------------56, up from 47
Triglycerides-------------70, down from 88

Overall, I am happy with the results, though I wish my FG was < 99. Not worried about Chol, since I don't buy into the lipid theory causing CVD.

I have been following the PPLP since Feb. 2007. Lost about 42 lbs. At theat time my FG level was 125! That was what got me into the program!

[Winston]

Im finally back. Put off getting retested for a while. The main difference is that my carb intake has been reduced dramatically. I also eat an egg for breakfast every day. (with a half piece of WW toast and a piece of cheese, and a small piece of fruit) Other than that my weight is about the same as before. I want to loose about 10lbs. I am 6'-1" and weigh about 182.

New numbers:
Tot. Chol 241
Tri 59 (Woot!)
HDLcalc 77
LDL 152

I am really happy with these numbers. I think everything is fine now, although my doctor thinks my cholesterol is still too high. I go in to see him on Monday to discuss.

[gitfiddle]

Great triglycerides, Winston! It took me much longer than that to get mine down.

[mcsblues]

Welcome back Winston - and congrats on the great numbers!:)

How about you blood sugar - are you keeping an eye on that?

In respect of the cholesterol results, note that it is highly likely it is the LDL number which is calculated (not HDL) - and once you triglycerides are slashed (a routine result of low carbing) the calculation for LDL results in an error (the number will be higher than a direct measurement would show) - and of course it doesn't show the all important type of LDL (also routinely improved by low carb).

Mike blogged (http://www.proteinpower.com/drmike/weight-loss/low-carbohydrate-diets-increase-ldl-debunking-the-myth/) about this recently - and a calculator here (http://homepages.slingshot.co.nz/%7Egeoff36/LDL_mg.htm) - suggests your LDL is more accurately calculated as 125 ... all of which is likely to be news to your doctor, so bear that in mind if medication or a change in diet forms any part of the 'discussion'!;)

[Frank Hagan]

You're doing great! Reducing carbs was the fastest way to reduce triglycerides for me (from 344 to 105 in 6 weeks, but now holding there). Unless you added something else in, it looks like the carb reduction did the trick for you too.

The LDL is calculated as mcsblues noted, and when your triglycerides get below 100, the calculation can be off by quite a bit ... since you mentioned you like to read the research, see more about this issue here (http://arpa.allenpress.com/arpaonline/?request=get-document&doi=10.1043%2F0003-9985(2001)125%3C0404:LTLACO%3E2.0.CO%3B2) and here (http://www.ncbi.nlm.nih.gov/pubmed/18426324?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum). Your doctor might want links to those if he questions it; most know that the calculation doesn't work well with very high triglycerides, but few know about the problem when triglycerides are low.

For my doctor, the total cholesterol number is less important than the right levels of HDL, LDL, triglycerides and blood sugar (both the fasting glucose level and the "hemoglobin", "long term blood sugar level", or what is usually stated as "HbA1c" on the test). You might want to have HbA1c tested as well (or check to see if its already on the results).

[amdawson]

winston, it sounds like you may be a candidate for dr. mike's new promotion with his book if you have that 10 pounds to lose. he may already have enough people, but see his blog posting here (http://www.proteinpower.com/drmike/lipid-hypothesis/request-for-help-promoting-our-new-book/#more-3296)for deteails

[Winston]

Thank you for the links. Especially the links to the studies. I think I will fax them to my Doctor and ask him to prescribe a test to measure my LDL directly.

He gently tried to get me to take meds, but I refused. He was very surprised by the drop in Triglycerides. He said that based on how I changed to Low Carb, that the triglecerides should have gone up. I expressed that there is plenty of debate on that subjuct. He also said that he has never seen a male over 40 with HDL over 65. Anyway, we agreed that I would start taking fish oil supplements, eat more fiber, and try and exercise a bit more.

[mcsblues]

He said that based on how I changed to Low Carb, that the triglecerides should have gone up ...

Sorry, but that at that level of incompetence/ignorance I would be looking for a new doctor.

If you decide to persevere with his education (I guess a worthwhile but probably impossible goal) then if he/you want to know what is going on with your LDL it isn't just about the number - it is the type of LDL, that is much more important (he will doubtless not know that low carbing routinely improves this too!:p) Perhaps you could get him to read this (http://www.proteinpower.com/drmike/weight-loss/protein-power-low-carb-diets-and-lipids/) - and if still in doubt, contact Dr Mike (to discuss what treating literally thousands of patients with a low carb diet actually reveals) and be brought just that little bit closer to the light ...;)

Now about those blood sugar levels ... (much more important than cholesterol ever will be)

[Karole]

Yes, MC I agree --the doc should know that lower carb intake would lower triglycerides.

I remember years and years ago my trigs were in the 300's and I asked my doctor what to do to lower them and he said "Quit eating pie" which of course meant sugary things... ie high carb intake.

[Frank Hagan]

Yes, MC I agree --the doc should know that lower carb intake would lower triglycerides.


Its interesting. I really like my doctor, although he is not a LC doc, he's open to me doing whatever it takes to get healthier. I remember one time he told me that you can raise your cholesterol levels dramatically by eating ribs a few hours before taking the blood test. I never understood that because ribs are meat, right?

I looked at a package of baby back ribs in our local supermarket Sunday night. They had both raw ribs and also some slathered in barbecue sauce, with nutritional labels.. The raw ribs had zero carbs, but the ribs in sauce had 11 grams of carbs per rib. Eating a full rack of baby back ribs would be somewhere around 88 to 110 grams of carbs. Yikes!

The fat in the meat isn't metabolized quickly enough to show up in a few hours, while the carbs make the body swing into action immediately. That increase in cholesterol levels isn't due to the fatty meat, but the carbs slathered on them. I may bring this up again when I see him in December.

[Winston]

I dont think the carbs will immediately raise your cholesterol. It is the fat in the ribs that will raise it. Temporarily at least. I might have misheard him about the carbs raising the triglycerides. He did say something was supposed to rise, but I did not feel like educating him or anything. Just wanted to hear his opinion on things.

[Frank Hagan]

I dont think the carbs will immediately raise your cholesterol. It is the fat in the ribs that will raise it. Temporarily at least. I might have misheard him about the carbs raising the triglycerides. He did say something was supposed to rise, but I did not feel like educating him or anything. Just wanted to hear his opinion on things.

Low carb diets are much more successful at lowering triglycerides than a low fat diet due to a paradoxical relationship; its not fat that increases the fat in your blood, but carbs:

When the content of dietary carbohydrate is elevated above the level typically consumed (.55% of energy), blood concentrations of triglycerides rise. This phenomenon, known as carbohydrate-induced hypertriglyceridemia, is paradoxical because the increase in dietary carbohydrate usually comes at the expense of dietary fat. Thus, when the content of the carbohydrate in the diet is increased, fat in the diet is reduced, but the content of fat (triglycerides) in the blood rises.

From Effect of Dietary Carbohydrate on Triglyceride Metabolism in Humans (PDF file) (http://www.ebmonline.org/cgi/reprint/225/3/178.pdf)

Other things people use, and are sometimes successful with, to lower triglycerides is Niacin and pretty healthy doses of EPA and DHA (omega 3's found in fish oil, krill oil, almonds, walnuts, etc.) There is also a prescription drug, Tricor. These things did not work for me (well, a bit, they lowered my TGL level from 440 to 334). Within 6 weeks of starting a LC diet, my TGL were down to 105, and 3 months later they were 106.

[Winston]

Wow another great study, although I need to read it again, as some of the terminology got a bit confusing. So they clearly showed that low fat/high carb diets raise Triglyceride levels, and High fat/low carb diets lower trig. levels.

So, how do you lower LDL levels?

[Frank Hagan]

Wow another great study, although I need to read it again, as some of the terminology got a bit confusing. So they clearly showed that low fat/high carb diets raise Triglyceride levels, and High fat/low carb diets lower trig. levels.

So, how do you lower LDL levels?

The general thing you hear is to lower dietary fat levels. But just as the "total cholesterol number" is less important than its component parts, research is now showing that the type of LDL you have might be more important than the total level.


. . . let me remind you that numerous studies have shown that whenever subjects go on low-carb diets, they end up increasing the size of their LDL particles. Large, fluffy LDL particles are not only harmless, but may be protective. If they are protective, what’s wrong with having a bit more of them?

At the same time, numerous studies have shown that low-fat diets usually decrease LDL levels, but do so while reducing the particle size. Followers of such diets end up with lower levels of LDL made of smaller, denser, more atherogenic particles, which, in my mind, isn’t a good trade off.


From: Dr. Mike's Blog (http://www.proteinpower.com/drmike/weight-loss/low-carbohydrate-diets-increase-ldl-debunking-the-myth/)



He has the citations to some of the studies in that blog post.



The reason this isn't measured often is that most of the time the LDL number is calculated by taking Total Cholesterol - HDL - (Triglycerides / 5), and not directly measured. Cheaper and faster that way. New technology does give an easier way to measure the exact amount of LDL, and also the particle size. It may take a while for that methodology to become as cheap as the current blood test.

[mcsblues]

So, how do you lower LDL levels?

I see Frank and I have both linked to the same blog from Mike (great minds!) ... but you can always use another one.

This one (http://www.proteinpower.com/drmike/weight-loss/protein-power-low-carb-diets-and-lipids/) talks about what low carbing - specifically what PP does to cholesterol (and triglycerides, blood pressure, blood sugar etc) - because it examines the data on patients treated by the Eades. The simple take home message is summarised in this graphic;

http://www.proteinpower.com/drmike/wp-content/uploads/2008/09/pp-stats-blog.jpg

- but if you are still concerned about your LDL (which contrary to your doctor's opinion is normal), you might like to spend a bit of time on the THINCS (http://www.thincs.org/) site - articles by Makcolm Kendrick and Uffe Ravnskov are particularly helpful.