Four patients who changed my life

In the early 1980s MD and I were laboring away in anonymity in our clinics in Little Rock, Arkansas.  By that time I had gone through my thin-to fat-to thin again metamorphosis, and I was starting to treat patients for obesity.  My own transformation had been fairly striking, a fact not lost on many of my overweight patients, a number of whom were seeking my professional advice on treating their own weight problems.  I was still doing a fair amount of general primary care medicine, but more and more of my time was being diverted to helping people lose weight.

When I, myself, had gotten fat, I had tried a few diets that were then being extolled (including the Pritikin diet) and had experienced pretty much the same thing most people did with these diets:  I lost a few pounds, drifted from the diet, and regained the lost weight plus a little.  I then started thinking seriously about obesity as a medical problem, and, in an effort to learn all I could about it, I turned to the medical textbooks on my shelves.  Unfortunately, none of them contained any information I found particularly enlightening.  The texts went into great detail about the risks associated with obesity and the many diseases that it either caused or made worse, but, other than recommending caloric restriction, none really discussed the treatment.  None really discussed (at least not to my satisfaction) what happens metabolically that makes people store excess fat.

I next turned to physiology texts, which didn’t help a lot, either.  I then grabbed my old medical school biochemistry textbook (I hadn’t been out of med school all that long at the time, so it was fairly current) and struck gold.  I started tracing out all the pathways for fat storage and noticed that in virtually every one insulin turned up somewhere.  Then I started reading about all the pathways involving insulin and realized that excess insulin had to be the agent driving the storage of excess fat.  I then went back to the physiology texts, reread them in light of my new found knowledge, and discovered that they reinforced what I had learned from the biochemistry text. I just hadn’t realized it, until I had made the insulin connection. (I drew out all the different pathways insulin worked through on piece of paper that we’ve saved, but I can’t lay my hands on it right now.  If I find it, I’ll post it.)

This was long before the days of Google and online searches; in fact, it was at least two years before I owned my first computer.  So I did what you did in those days: I trekked to the medical library at the med school, ran a search on insulin and obesity through their system, and came up with a handful of papers. The research into this field was quite new and sparse back then, but I learned about the newly proposed theory of insulin resistance, which answered my question as to why anyone would ever develop excess insulin levels in the first place.

Then I asked myself the big question:  If I have too much insulin (and I was guessing I did – it wasn’t something you measured in those days unless you were in a scientific lab), how do I get it down?  There were only two conclusions.  Don’t eat.  Or don’t eat carbohydrates. The latter seemed to make a lot more sense over the long run.

I remembered the Atkins diet.  I had read his book ten years before, but that was before I went to medical school and was while I was still rail thin.  (Why did I read it?  Because it was a huge bestseller, much in the news, and I wanted to see what all the fuss was about.)  I dug out my copy and reread it.  Nowhere was insulin mentioned in the original book.  He talked about some mysterious fat mobilizing substance (FMS, as he called it), which couldn’t be insulin because insulin doesn’t mobilize fat – it stores it.  The references cited in the back of the Atkins book for FMS listed scientific papers written in German. But, by then, I was on to insulin, so I didn’t bother trying to seek them out.

I decided to design a diet for myself with lowering insulin in mind.  What I came up with (with MD’s help) was the basis for what ultimately became Protein Power.  I lost weight like crazy.  Many of my patients noticed my weight loss and started clamoring for me to help them to become thin.

At the time I started treating patients with the low-carb diet, cholesterol was just starting to be demonized.  For the first time, people were concerned about their cholesterol levels (and at that time, the upper level for normal for total cholesterol was 220 mg/dl, 20 units higher than it is now) It was the era Taubes discusses in his great paper The Soft Science of Dietary Fat and that Tom Naughton shows in his movie Fat Head.  Low-fat diets were the rage.  The 8-Week Cholesterol Cure, a book about eating giant oat bran muffins daily and taking sustained-release niacin was in the writing and destined to be a mega bestseller.  The fear of fat was settling in on America.

And here I was starting to put patients on low-carb, high-fat diets to help them lose weight.

Back then I had bought into the lipid hypothesis and truly believed excess cholesterol did indeed lead to heart disease.  As a consequence, I was a little squeamish about putting people who might actually be at risk for heart disease on the diet.  I had read the biochemistry texts, and I knew that insulin stimulated HMG Co-A reductase, the rate limiting enzyme in the cholesterol synthesis pathway;  and I also knew that glucagon (insulin’s counter regulatory hormone) inhibited that same enzyme.  So, in theory, lowering insulin and increasing glucagon with diet should work to treat elevated cholesterol.  But, knowing those things theoretically didn’t really give me a whole lot of solace when it came to taking care of real flesh and blood patients who were entrusting their well being to me. (The picture at the top left of this post is one of the handouts I used in my early practice to demonstrate the many effects of too much insulin.)

Stupidly, when I started on the diet myself, I didn’t check my own labs, so I didn’t really know what happened to me.  The patients that I did put on the diet were typically women who were premenopausal (a group who rarely develop heart disease), so I didn’t worry about them.  I checked everyone’s labwork, but no one’s was really out of whack lipid-wise at the start of the diet, so I didn’t have a lot to go on data-wise.  The few who did have minimally elevated cholesterol tended to lower it over the first six weeks (I rechecked everyone at six weeks), so I figured the theoretical underpinnings of the diet were okay.  But I was still uneasy.

I had visions of myself in the witness box with a sneering plaintiff’s attorney saying to me:  So, Dr. Eades, are you telling the members of this jury that you put the deceased – whom you knew to have high cholesterol – on a diet filled with RED MEAT! IS THAT WHAT YOU’RE TELLING THIS JURY, SIR? YOU, SIR, CAUSED THIS MAN’S FATAL HEART ATTACK, DID YOU NOT?

But more than being worried about this scenario, I didn’t want to do anything harmful to anyone.  I knew it would be difficult to live with myself if I thought I had killed someone or caused a heart attack out of pure negligence.

You’ve got to remember that at this time there was no one in his/her right mind recommending a low-carb diet.  There was Atkins, of course, but he had been totally discredited in the eyes of the medical profession by that time.  It wasn’t until over 20 years later in 2004 that he and the low-carb diet got even minimally rehabilitated.  I was very uneasy to say the least.

Then four patients came into my clinic, one almost right after the other, who changed my life.  In my actual practice, I’m kind of old school and always refer to my patients as Mr, Miss or Mrs. But for purposes of this post, I’m going to refer to them by a bogus first name just to make it easier to keep track.

The first of the four patients we’ll call Angie.  She was referred to me by MD, who was working at a different clinic than I at the time.  Angie came into see MD for nausea and vague abdominal pains, symptoms that, along with tenderness in her upper right abdomen, led MD to suspect gall bladder disease.  Angie was a 32 year old woman who was mildly overweight and had vague abdominal pain, but no other remarkable findings.  MD drew blood on her and sent her for a gall bladder ultra sound.  The ultra sound came back negative, but her blood work was a doozy.   Her total cholesterol was over 300, and her triglycerides were about 1900.  MD called me and said “Have I ever got the patient for you.”  This was what I had been waiting for.  A patient who was female and pre-menopausal with terrible lipids.  I figured I could treat such a patient without any risk of her developing heart disease over the short term, and I planned to recheck lipids way sooner than the normal six weeks.  Since her lipids were so out of the ordinary for one so young, I asked MD to repeat them, fasting, have the results sent to me and to send Angie to see me after her repeat labs had come back.

When I got her labs, I knew the first reading wasn’t an error.  In fact, they were a little worse than when MD checked them the first time.

Total cholesterol: 374 mg/dl (all values in mg/dl)
LDL: ?
HDL: 28
Triglycerides (TG) 2080

(There was no value for LDL because LDL is a calculated number and can’t be calculated when the triglycerides are over 400 mg/dl.)

Upon examination I found a pleasant mildly overweight young woman who had no real physical signs except for mild tenderness in the right upper quadrant of her abdomen when I really pushed on it.  She had no family history of heart disease and she didn’t smoke – both pieces of information that made me feel better about what I was preparing to do.

(Not only were her lipids a mess, Angie’s liver enzymes were way abnormal as well.  I now know that she had non-alcoholic fatty liver disorder, but we (the medical profession) didn’t really recognize that as a common disease back then.  I’m sure her liver was inflamed to some degree, which explained the mild pain she was experiencing.)

I gave her a fairly rigid version of what became the Protein Power diet.  I explained exactly what she should eat and what she shouldn’t and sent her on her way with my home phone number and my beeper number (this was before the days of cell phones). I told her to call me if she had even the slightest problem and to return to the office in three weeks for a recheck no matter what. And I gnawed my nails.  I had the staff call her after a few days to see if she was doing okay.  She reported that she was fine.

I got no emergency calls from her and in three weeks she returned.  Her right upper quadrant pain had vanished as had her nausea.  She reported that she had never felt better.  She had even lost nine pounds (which was a fair amount for her since she wasn’t that overweight to begin with).   I rechecked her labs and waited anxiously for them to come back from the lab the next day.  When they did, I was stunned.

Total cholesterol: 292
LDL: 192
HDL 70
TG: 149

I had hoped for a change for the better, but I hadn’t in my wildest dreams expected this kind of change.  I kind of figured that her triglycerides and cholesterol would come down slowly over several months, not that they would drop like rocks in only three weeks.

The second of my life-changing patients was a casual friend of mine who came to see me about a week after my experience with Angie.  He was a 55 year old guy we’ll call Lynn who worked in advertising.  I had gotten to know him when his company created some brochures for our clinic.  He came to see me for an insurance physical.

He arrived, we chatted, and then I looked him over.  I poked and prodded and listened at all the appropriate places.  He seemed fine. He was a thinnish white male who was just starting to develop a little (and I mean little) paunch.  I would never have even noticed it had he not been sitting there with his shirt off.

Talk turned to my own weight loss, and he asked me if I could put him on a diet to help him lose his little pot belly.  I said ‘Sure,’ and told him about my meat, cheese, salad and green vegetable diet.  I told him that I had lost my weight eating a ton of steak and had continued to do so.  He was thrilled because he loved steak and had been avoiding it because of everything he had been reading about red meat and heart disease.  I had our nurse draw his blood for the lab part of his physical and sent him on his way.

The next day I was going through all the results from the bloodwork that had been drawn the day before when I came upon his.  I nearly dropped my teeth.

Total cholesterol: 312
LDL: ?
HDL: ?
TG: 1515

(There was a note on the lab sheet that said they were unable to determine the HDL because the serum was too lipemic (cloudy with fat)?!?!)

I thought, Whoa!, a 32 year old premenopausal woman is one thing, but a 55 year old male right in the middle of major-heart-disease-risk age is something else.  And here I had put this guy with totally disrupted lipids on a red-meat diet, which, according to current medical thinking, would almost guarantee to make the situation worse.  I put in an immediate call to his office and was told he had left that morning for vacation for two weeks.  (Why he had neglected to even mention this trip when we talked for 30 minutes the day before baffled me completely.) I asked for the number wherever he was.  His secretary told me that he was on a Caribbean Island and couldn’t be contacted.  I told her that if he called in to have him call me immediately.

My fears were somewhat assuaged because I figured, hey, the guy is on vacation, he’s not going to diet anyway.  Why should I worry?

He called me the day he got back and before I could get a word in told me “Hey, your diet works great.  I lost five pounds while I was on vacation.”  As it turned out, he was on a Caribbean Island, but it was a resort of some sort.  As part of his deal, all the food was provided.  He had chowed down on steak just about every day.

I was mortified.  I told him about his labs and told him to get into the clinic the next morning to have his blood rechecked.  He came in.  Here are his labs taken 15 days after his first ones.

Total cholesterol: 195
LDL: 124
HDL: 26
TG: 201

I was really stunned this time.  How could these values change this much in just 15 days?

He wanted to stay on the diet, so I told him to go for it. But I kept an eye on him.

Not long after this experience I had a very nice lady, named Jesse, who was the mother of a friend of mine come to see me.  She had had labwork done somewhere else and her cholesterol had come back as 735 mg/dl.  Her doctor had put her on a cholesterol-lowering medicine, but she was still distressed because she had a friend who remarked to her, “I didn’t know you could even be alive with a cholesterol that high.”  I examined her and found her to be a very mildly overweight 72 year old lady with no signs of anything out of the ordinary.  I rechecked her blood.

Total cholesterol: 424
LDL: ?
HDL: ?
TG: 1828

Along with these lipid labs, her fasting blood sugar came back at 154 mg/dl.  So, not only did she have major lipid abnormalities, she had blood sugar that was in the diabetic range.

I gave her instructions on the diet and told her to stay on her cholesterol-lowering meds until we checked her again in three weeks.

Three weeks later:

Total cholesterol: 186
LDL: 118
HDL: 27
TG: 201

I was surprised this time, but not stunned.  Along with these mega improvements in her lipids, Jesse’s fasting blood sugar was 90.

I told her she could go ahead and discontinue her cholesterol-lowering medications because her cholesterol was normal.  She looked at me kind of funny and said, “I stopped them when I started the diet.  That’s what I thought you said to do.”

The last of my four patients came along about two weeks after Jesse.  This woman, we’ll call Betsy, was famous in Little Rock.  Actually, she wasn’t the famous one – her husband was – but she got plenty of notoriety herself.  And just in case you’re wondering, it wasn’t Hillary.

She came to see me because she had picked up a little excess weight and wanted to get it off.  I went through my normal workup and found Betsy to be a moderately overweight woman with no other physical signs of ill health.

Her labs told another story.

Total cholesterol: 416
LDL: ?
HDL: ?
TG: 2992

(Like Jesse’s and Angie’s labs, Betsy’s didn’t show HDL because the serum was too lipemic.)

After three weeks on the program, Betsy lost 11 pounds and came through with the following labs:

Total cholesterol: 177
LDL: 122
HDL: 36
TG: 94

By then, I was kind of getting used to these seemingly miraculous lipid improvements, so I was no longer stunned.  But it did confirm that I was on the right track.

After my experiences with these four patients, all of whom came to see me over about a three month period, I became convinced that my theorizing about the potent effects of reducing insulin was based in reality.  Over the ensuing years, I saw many, many more patients with disturbed lipid metabolism whom I successfully treated with low-carb, high-fat diets, but these four, coming as close together as they did in the early days of my feeling my way along in my low-carb career, gave me the conviction to press on.

I am eternally grateful to them.

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114 thoughts on “Four patients who changed my life

  1. Great and touching story Dr. Eades. You certainly evolved from mainstream health dogma into something much greater – making the insulin connection. It has provided the world’s health entities a much more sophisticated portrait from which the majority of our health problems stem – although, as we know, they have failed to listen. There is no doubt that a low-carbohydrate diet helps to mitigate insulin resistance by keeping insulin levels down.

    But just as you followed the insulin trail, I too have followed the trail but have gone further. Insulin is not the master hormone. Leptin is part master, and potentially cortisol is involved as well – as high levels can induce insulin resistance. Both work in concert to create this state of “carbohydrate intolerance.” But it can be overcome by simply overcoming leptin resistance, raising leptin levels, and lowering cortisol.

    I believe that I have discovered the best dietary and lifestyle strategy to achieve this (although it will no duobt undergo some fine-tuning). It has worked so well that hardly any food can raise my blood sugar on postprandial or fasting readings (Fasting levels are around 70 mg/dl and postprandials after huge meals with high GI carbohydrates runs around 75 mg/dl). Even I am shocked to see how effective my theories have been when put into practice. I encourage you to check it out.
    http://180degreehealth.blogspot.com/2010/01/leptin-and-reversing-type-2-diabetes.html

    • Dr. Eades:

      Thank you so much for all your knowledge and information. My husband had 1 stent and angioplasty in March 2010. Triglycerides were 430(non-fasting-maybe actually a little lower), HDL -31, and LDL unknown. After 2 weeks on Pravachol 40mg he discontinued due to pains in feet and hands. I started researching and learning two days after procedure and continue to do so. Knew nothing about chlesterol, triglycerides, etc. At this point I know a whole lot!! I have read Protein Power Life Plan, and it has been a big help. Hubby seeing a ND, is on supplements, and fish oil for inflammation. He recently had his LDL checked and it is 103. The Nurse Practioner at the Cardiologist called to tell us to increase Pravachol to 80 mg to bring number down to less than 100. I think the number is fine. I have pretty much cut out carbs, except for oatmeal, nothing refined or processed, no junk! My husband is losing weight, exercising, and making progress. He eats eggs, meat ,fish, nuts, fruits, green leafies, loves the Paleolithic Punch, as do my children. What I am concerned about are the triglycerides and HDL. jWhat do you think?

  2. Thank you, these people and the many others that will comment that these discoveries have changed their lives. Mine included. Best blog ever!

  3. Dear Dr. Eades,
    thanks a lot for sharing your exciting first steps into the right direction.
    Your articles are always high standard and also kind.
    When it comes to the last pounds to drop do you think it is better to go on more fat than protein or vice versa? I’m in ketosis and have to count calories for those last pounds.

  4. Hey, Doc – we should ALL be eternally grateful to them, right after we’re grateful to you for sticking to your guns in spite of all the nonsense “out there.”

    Once again, thanks for the post.

    Marcia

  5. These are huge changes, even in just three weeks! I’ve been trying to move to a more low-carb or paleo diet and lost over 30 pounds in the total process. I did some low-fat, more sports for a while when I just started my effort to loose weight, that worked for the weightloss, but was not sustainable (need to sport quite a lot, and issue of hunger). Found out about omega-3, then fats and cholesterol, got more and more interested in health and finally switched to low-carb. Now I’m planning to incorporate a more paleo style, trying to limit processed foods, and going for real meat and some veggies now and then.

    Lost weight, feel great, and had my trigycerides and cholesterol checked last week: all numbers are good/ideal. It’s a pity that I didn’t have those checked before I started this new way of eating…

    Question: Are the kind of numbers your presented applicable not on just a fraction of the population, or roughly on the population in general? If these number aren’t anecdotes, why are there still loads of people on statins? Is it really just a continued ignorance on the subject of diet and health? If one of my parents was advised by the MD to take statins I would really push’em to try strict low-carb for a month and ask for a new trigliceride measurement.

    Another question: my mother is an irritable bowel syndrome patient. You indicated before that fibre is probably not needed in your diet. My mother is prescribed to ingest ‘sachets’ of fibre (looks like ground tree-bark) with her meals. She now might want to try a lower carb diet for a while, also removing bread from her diet. I think removing bread/gluten might already solve IBS. I don’t know yet if my parents are really going to try this low-carb style for a month, but what’s your idea on the “fibre-sachets” in combination with IBS and/or low-carb diets? I think a month of carefull self-experimentation when there no serious health risk is a very valid option.

  6. This is like a window into history, Dr. Eades. Thanks for sharing.

    At the start of my medical career in the early 1980s, I’m thinking the “normal” cholesterol levels were up to 250-300 mg/dl or so. That was before statins existed. Most people didn’t seem to tolerate niacin at the effective doses. People above 300 we tried on special diets – low fat, high carb – which almost always failed. Doctors and patients were both frustrated.

    My, how things have changed.

    -Steve

  7. I just stumbled across your site today while researching some recent advice by my doctor. I’ve been on a low carb, low glycemic diet for about six months now (after being diagnosed with PCOS), and I can’t even begin to describe how much my entire life has improved. However, my doctor was concerned that my “good” cholesterol number was too low on my latest lab workup. I’m admittedly quite dense when it comes to this fat and cholesterol business, and I was excited to see your entry about this topic.

    Without getting too lengthy, the long and short of my doctor’s advice was that I “stop eating cheese” (I only have one serving a day at most as it is) and keep my dairy consumption to “foods lower in fat like yogurt”. I’m sure I don’t have to tell you how high the carb and sugar counts are in most yogurts, so this advice seems out of the question for me. I was wondering then, based on what you’ve seen with your own patients, if you had any suggestions as to how I might improve my good cholesterol. To be honest with you, I don’t even know how important this number really is or if there was something I might have done before the tests to skew the results in some way, so any information you offer would be very much appreciated.

    And thank you so much too for putting so much work into such a great and medically sound blog. I loved some of your bits about Dr. Oz :-) and am really looking forward to perusing through more of your archived posts.

    • If you see this again, a lot of people find that increasing their saturated fat increases their HDL (“good” cholesterol). I’ve been shoveling lots of the stuff in hopes of *raising* my cholesterol in general (it’s always been near 160, around where total mortality and mental illness go up, up up).

      Triglycerides seem to be more important than the other numbers, the liver produces them in response to insulin and directly from fructose (and glucose, although less).

      I’ve got a diagnosis of PCOS, too. I was a middle schooler at the time and my insulin and sex hormones resembled that of a woman in menopause, but things have leveled off and normalized with better eating habits. I’m terrible about going off plan so I’m still hugely fat (it comes off really, really easy when I stay away from the sweets), but I don’t need birth control or metformin anymore.

      I actually have the Eadses to thank for that, because I picked up Protein Power at the bookstore when my doctor told me I needed to be on low-carb, but to avoid Atkins (too much saturated fat, heehee). It didn’t seem skeezy and the writing style was enjoyable. If you haven’t read one of their books, I’d really recommend it.

  8. Dr. Mike, thanks for the fantastic post. The results you saw with these patients mirrors my own experience. My numbers weren’t as high, but I had the same drop in triglycerides and cholesterol, and the increase HDL. I wrote about the benefits of a low carb diet and my results here: http://www.healthy-eating-politics.com/low-carb-diet.html

    Thanks to you both for leading the way. You and MD have really helped so many people, and that’s not something that everyone can say. I recommend your books frequently on my site because, in my opinion, not only is the advice in them sound, the books are fun to read.

  9. Thank you for this beautiful article. It’s a moving portrait of a very fine young doctor, his continuing education, his solicitude for his patients. It brought tears to my eyes.

    And of course, the info about carbs and insulin are important too! :)

  10. @ Maria

    To lose the last few pounds, you have to be careful of calories. The combination of fat and protein seems to work as well as anything. Watch the cheese, nuts and nut butters, though. Those are foods that provide an enormous number of calories and few carbs. In other words, you can stick within your carb limit yet still get a whole lot of calories.

    @ Eric

    I’ve seen these changes countless times. I truly don’t understand the widespread use of statins given the ease of treating abnormal lipids with the correct diet.

    I don’t give my patients with IBS fiber. I put them on low-carb, high-fat diets, which usually do the trick.

    @ Steve Parker, MD

    In the late 70s/early 80s the normal values for cholesterol were higher than they are now. The switched from what was normal, i.e., two standard deviations from the mean, to what they felt was a more ‘healthful’ number. It has allowed them to put many people formerly considered normal on cholesterol-lowering medicines.

    @ Carrie

    The best way to get HDL up is to eat a low-carb diet high in saturated fat. Saturated fat makes HDL go up while carbs make HDL go down. Even the lipophobes recognize the HDL-lowering effects of carbohydrates, a subject I will post on soon.

  11. What great stories! I guess now is as good a time as any to pop in and say that I’ve been reading your weblog for a while now and have read and (mostly) followed Protein Power. Since July, I’ve lost about 30 pounds, going from 180 to 146 (I’m a 5’7″, 27 year old male). I look great and feel really good – better than I did in high school or anytime in my 20s.

    What I’m still amazed about is how effortlessly I lost the weight. I had dieted before using conventional methods and even though I would get down to a satisfactory weight occasionally, I would always shoot back up within months. Cutting out the carbs, even though I stopped exercising obsessively around the same time for unrelated reasons, I lost weight like crazy.

    The best thing about losing the weight I have is that it’s really increased my desire (and ability!) to lead a healthier life in general, outside of just weight. I’ve started strength training recently and now much more closely monitor what I eat, avoiding not just carbohydrates, but all the other dangers that lurk in our foods like processed garbage and meat from suspect factory sources, etc. With the weight aspect of my health taken care of more or less effortlessly, there is so much more mental energy and time to devote to other important areas that I used to neglect.

    So, thank you for doing the work you’ve been doing! I’m very glad I was introduced to all this relatively early in life – before my previous diet caused life-long problems.

  12. “Betsy” somehow morphed into a “Barbara,” didn’t she, which was almost as amazing as her evolving lipids. Another miracle! (Just joshing here. SInce I’m also a Barbara — really and truly — I couldn’t help but notice).

    Thank you for these case histories. This column will be especially helpful to show others, as I go about proselytizing the Protein Power Life Plan among friends and family members — my mission for the past few years. Can’t stop myself because my own results from following your plan have been life changing too: at age 73 I have never felt better or more vigorous, and my lipids are like a healthy teen’s. I was never fat, but had become “pleasingly plump,” as my husband used to call it when in a generous mood. Those wretched 30 lbs. are long gone, as is the IBS I suffered from for nearly 50 years. Many blessings on you and MD.

  13. Thanks for such a quick response Dr Eades. I think the saturated fat area is definately where I’ve been going wrong here, since (I think like a lot of people) I always thought this was something I needed to avoid or keep to a minimum. I’m going to try increasing this now though and will definately post my results after my follow up (just a little over 3 weeks from now). Thank you so much again and take care.

  14. Hi Dr. Eades,

    Would this qualify as a story where a n=1 clinical trial (your own self-experiment with diet) led to a breakthrough in medicine?

    I enjoyed this essay immensely.

    Cheers,

    Brent

  15. Dr. Eades:

    After years of constantly carrying a few more pounds than I should – nothing serious, but always difficult to impossible to lose – I started on Protein Power last October at 201 lbs with typical BP of 130/80. I’m 5′-8″. I am now 181 lbs. Typical BP is 120/75 and still falling. 181 pounds is about what I weighed when I was 22 years old – I’m 50 now. I sleep better. I have more energy during the day – no droopy eyelids at 3 pm each day. Last but not least: a rash I get EVERY winter since I was 6 years old is barely there at all this time around. Blood work I had done right before starting the diet was TC: 235; HDL: 47; LDL:150; TRIG:191.

    I get my annual physical next week and we’re doing a VAP test instead of the standard lipid panel. I can almost guess the results based on what I’ve read in your book…

    I cant thank you and MD enough!

    Paul

  16. Any chance you know what they were eating before they came to see you? It would be interesting to know what their staple foods and standard diets were like to turn up such high cholesterol levels. I’m 100% paleo – eliminated grains and most sugar from my diet back in March 09. I’m still working on friends and family and will be sharing your article with them.
    Thanks!

  17. @ Paul451

    Thanks for the kind words. But as I always tell my patients, I’m like the Auto Club. I just give the directions, you have to do the driving to get there. Don’t sell all your hard work short. Congratulations on your success. And do let us know what your VAP reveals.

    @ Garth Huckabay

    I don’t know what they were eating. The standard American diet (SAD) I presume. Not all people on the SAD develop such off-the-charts lipids, but, as this post shows, a few do.

  18. Wow, those blood lipid changes were remarkable! I low carbed half-heartedly for three years (2006-2009) and lost 60 pounds that way, and then in January of 2009 I got super strict about my low-carbing, and have lost an additional 40 pounds – gluten free, sugar-free, PUFA-oil free. And my blood lipids are *still* not as good as your patients above after their mere three weeks on the diet.

  19. So good to see more blog postings Dr. Mike! I’ve missed them. I just wanted to share how well I have done on your plan that my dh and I have been following for about 2 years. The last blood work that I have a record of was back in May of 06, when I was eating the SAD. Total Chol: 209, HDL: 45, LDL: 139, Trig: 123. My latest blood work was last week (1/6/2010) Total Chol: 272, HDL: 48, LDL: 217, but, drum roll please, Trig: 38!! My doctor is concerned, I am elated! I printed off a blog post of yours back from June about the myth of LDL and took it to her office. Thank you so much for doing the best work possible for all of us!! I figure my risk of CVD is 0.79.

  20. Dr. Eades,
    Interesting post and I wand to echo the thanks–but I’m most grateful for the freedom from heartburn and 10 inches off my belt line.

    I’ve picked up a few pounds (10) over the last 6 months due to getting lax and the holidays (now back on the wagon). What was funny is though I started to get some of my symptoms back (gerd and increase in skin inflammation) my waist line didn’t really change all that much even with the additional weight.

  21. Has anyone asked someone who keeps animals to eat about dieting? It’s pretty simple IMHO, they feed them grain to fatten em up before slaughter, feed them too much grain and don’t slaughter and they die. Give them unlimited access to grain and many animals will eat themselves to death and die. Pretty much it.

  22. Dr. Eades,
    A comment mentioned that reading this post was like going back in time, it certainly was. I was imagining the fog that you, other med professionals and patients must have endured when the politics of diet reversed with the onset of the low-fat dogma like the magnetic poles doing a switch-aroo.

    On a different time travel note, I recalled in going to your site today the helpful advice I received when reading your Protein Power Lifeplan book shortly after I adopted a paleo diet. I had diverticulitis symptoms and was taking 3 different kinds of medication. The glutamine supplementation, berry breakfasts, and other pieces of advice were really helpful. Totally off medication now, and if there’s pain from my own admitted overeating/gluttony I go back to some of the recommended treatments and it passes rather quickly. Last week, I passed this piece of advice on to an elderly lady I bumped into at the supermarket who (this doesn’t happen everyday!) told me a bit about her IBS. You could tell she was in such great pain. I mentioned my experience, gave you a plug, too. I gave her my quick “elevator speech” (explanation done in 2 minutes or less) of leaky gut, etc., consumption of grain, insulin and metabolic syndrome… it seemed to sink in.

    I hope she and others going through pain of one kind or another are able to see through the fog with the help of lighthouses such as yourself. Thanks for drawing out all the pathways on that piece of paper years ago, I hope you find it, and are able to frame it for as family heirloom.

  23. Yes, Dr Atkins did go on about a supposed FMH (originally called FMS) but so what? That was not the main theme in his 1972 book. He discussed insulin and called it “The Fattening Hormone” (p. 45). Also, contrary to your assertion, there are 20+ references to insulin in the index. It is quite easy to find fault with anybody’s ideas of previous decades. Witness your own Protein Power idea of soaking steaks in olive oil to reduce sat fat. Here is an interview with Gary Taubes explaining how Atkins became interested in FMH and verifies Atkins’ knowledge of insulin. http://www.scientificblogging.com/seth_roberts/interview_with_gary_taubes_part_8

  24. I plotted my lipid lab results from 1995 to 2005 a while back. I too had a drop in my triglycerides from 191 to 58 over the span of a year when I changed to PPLP. But my plot shows to other side of the story, how fast it can go up. I drove to Iowa for Thanksgiving with my son and his family. My DIL is from a farm family and we had dinner at their house. Do I need to tell you how much food was on the table???

    Another factor, that I now no longer do, was I don’t eat lunch on the road. It is a two day trip. Instead I would stop at a Dairy Queen and get a large Blueberry malt to sip on as I drove. Plus at least one a day with my son while I was there as he likes malts as much as I do. I had my annual physical a week after I got back, early December. Triglycerides were 127, up from 54 in June, but note they went back down to 46 in March. Here is URL of the plot for those that might like to see it.
    http://www.intergate.com/~berts8nford7/LipidsGraph.JPG

    Thanks to you and MD for all you do trying to help people become healthy and stay that way.
    Larry

  25. Great Story! What it really shows…..is how VERY difficult it is to go against the conventional dogma. Even though you are one of the most intelligent, well read, and professional people that I am aware of (assuming you were at the time of the story also)……..you were concerned about offering your proven results diet to patients.

    Your story shows exactly the difficulty in challenging conventional wisdom…….regardless of results.

    Thanks again for all your efforts and your persistence in trying to help folks improve their health.

    “There is no greater aspiration or a goal more noble than helping people achieve optimum health.”

  26. I loved this glimpse into how the greatness came together. : )
    More personal stories / details about Protein Power success please!
    Maybe guest posts, or a post of several success stories?

  27. I had a recent patient (my best friend from college 35 yrs ago, who lives 300 miles away) on a low carb, higher fat/protein diet who in the past 9 months lost over 40 pounds and blood lipids did similar reversals as Dr. Eades’ patients.

    His internist wanted him to give a testimonial about how he did this incredible improvement.
    When my patient told him how he did it, the internist basically shook his head and said it was probably due to something else!

    “Facts can never compete with beliefs.”

    Last month, while my patient had been simultaneously fighting a chronic hepatitis C infection with interferon/ribavirin cocktail he started having lower right abdominal pain. He developed a gangrenous appendix. He was in ICU for a few days. His attending surgeons and other specialists, when told of his past history of weight loss, IBS, GERD, and other GI problems, stated he would not have survived if he had not previously lost all the weight and reversed the other GI problems.

    This is another reason to start eating a more normal (low carb, higher fat/protein) diet. You might need your strength to survive a life or death surgery.
    Dr. John

  28. Happy New Year! It’s that time again, time to watch all my Facebook friends “try and lose weight and get healthy,” generally by exercising more (too much) and eating less. Until they binge on something delicious of course. It’s sad because of all the wasted effort and the potential for injury.

    Even though I’ve lost a lot of weight, no one really wants to follow my diet/exercise regime, which is low carb and slow burn weight lifting at home. Not enough torture to feel like a life changing process, I guess. With all the time I saved from going to the gym multiple times a week, I’ve done some knitting to keep toasty in this time of global warming.

    Thanks for posting these inspiring stories! It is really amazing how fast the body can heal when given the proper fuel!

  29. It’s pretty interesting to me to hear your thought process; several years ago a similar but more naive guess about high insulin levels (which I actually did not know was likely or common, I was just putting 2 and 2 together based on then-new-to-me bodybuilding post-workout nutrition recommendations and some highly publicized studies about insulin-sensitive gluteo-femoral fat) is one of the factors that helped push me in the direction that eventually led to reading your blog…along with many other materials, online and on paper. It’s probably not out of line to say that that seemingly crack-addled theory changed the entire direction of my life.

  30. Its easy, these days, with all the evidence supporting it, to follow or recommend a low carb diet, but it’s easy to forget how challenging this must have been when “conventional wisdom” was so much more influential.
    I’m grateful that you were brave enough to trust the evidence of your senses and recommend low carb to your patients. I forget, sometimes, that doctors have to watch their backs when they give advice.

  31. I discovered your book in the late 90s, fresh out of residency. It really was an “a ha” moment when I pulled out MY biochem text book to confirm what you were saying…it truly just made sense like no dietary advice had before. I started the program, promptly lost 20 lbs and since I was paying back medical school in the military, I frequently checked my lipids–first for my own peace of mind, then to appease the critics I worked with who just “knew” it couldn’t be healthy.

    Needless to say, my trigylcerides dropped like a rock and my HDL went up. You made a lot of converts at one military hospital and hopefully those have helped spread the news across the globe. Thanks.

  32. Your comment that saturated fat increases HDL matches my experience exactly, as long as it is on a low carb diet. My HDL would only increase if I increased my saturated fat intake. The problem is that every time I increased my saturated fat intake my LDL would go up; it reached 162 at one point, when my HDL went up to a modest but encouraging 47. That was my highest HDL until I eliminated refined carbs (e.g., bread, pasta) and sugars from my diet.

    When I reduced my intake of refined carbs and sugars, my intake of protein and saturated fat went up. Either that would happen, or I would starve, because you have to eat something. That is when my HDL shot up, to 66 (from the 30s), and my LDL went down. As with your patients, my LDL levels seem to be negatively correlated with saturated fat intake, as long as my consumption of refined carbs and sugars is low.

  33. hi dr. eades….

    could you please elaborate more on the ‘fairly rigid version’ of the protein diet you instructed ‘angie’ to follow?

    her numbers were quite close to what I recently found mine to be (although I am post menopausal)

    would like to follow the rigid version and have my blood lipids checked again in 3 months…

    Thanks!

  34. Thanks so much for sharing this story Dr. Mike! Something you’d said about fatty liver disease struck a chord with me. In 1996, after years of low-fat dieting, I had my gallbladder removed due to them finding about 40 small stones. (My Doctor at the time told me that it was probably my low-fat diet that caused it, and of course I thought he was crazy. If only I’d understood how right he was!) While removing my gallbladder they did a biopsy of my liver. They said they saw something in my bloodwork that concerned them. I never got the whole story on what they did or why they did it or what they even found, but I wonder if it was fatty liver disease they detected. I was certainly overweight – I’d just had my first child 3 months before and gained over 50 lbs while pregnant, even thought I was following the standard american diet.

  35. Thanks for this fascinating account. This story is very powerful!

    I have a friend with degenerative disk disease who is basically disabled with pain now. Have you any experience with changes in diet helping any of your patients with this condition?

    Thanks for all you do!

  36. Dr. Mike do you have any opinions on treating childhood obesity? I just read that Mrs. Obama is going to make this her cause of the year for 2010 and I suspect she and her advisors are going to advocate low-fat and lots of vegetables. Would this diet be bad for children?

  37. Dr. Eades,
    Thank you for these inspiring stories. I regard you as a beacon in our murky corporate-controlled culture.
    Now, what are your ideas on the disastrous state of our economy?

  38. I have GERD and IBS ( IBS is self dignosed no doctor could find it ) I have gone on a low-carb diet and I do see improvement in the IBS . I hope it will help the GERD, because my insurance will not pay for the meds I am taking. Old habits are hard to break but in my heart I think this is the way to eat . I will be checking your diet info more. I thank my friend for sending this to me.

  39. Hi Dr Mike – I am not sure if you have seen this study:

    http://www.ncbi.nlm.nih.gov/pubmed/19720791?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=6

    “CONCLUSIONS: This study demonstrates comparable effects on insulin resistance of low-fat and low-carbohydrate diets independent of macronutrient content. The difference in augmentation index may imply a negative effect of low-carbohydrate diets on vascular risk.”

    Any thoughts?
    Cheers

  40. Hi Dr Eades,

    i’ve just re-read your book (i’ve had it for a decade; lost around 25 pounds, then got married had 2 kids…you know the rest i’m sure :). anyway, i started the atkins diet lst year and have been doing/feeling great….but with lots of “cheats” haven’t come as far as i’d like, so am now recommitted. anyway, after reading your book my question to you is – has anything changed? i’m asking because i would say that if i got a lot of my carbs from higher-gi veggies in the day (like carrots) i would not do well (i know from experience, before starting atkins i would do low carb but have apples or carrots etc – still no potatoes or starch, but i was not losing). for me – i need to stick to the low-gi’s like brocc, cauli, salad veggies, zucchini, etc to make any headway – i still have 30 pounds to lose. OH and more importantly – is the formula for determining your ideal weight range changed? i hope not but i was wondering if the newer version of your book has any change there – i did the calculations and my ideal is 139-150 or so, for my age-height-and apparently i have 110 pounds of lean…:)

    too long a post i know – but thanks in advance for any help!

  41. It’s too bad that most other doctors didn’t figure out what you did and turn the low-fat diet tide around early. It was about 1995 when I went in for a check-up at age 43 and with a cholesterol total of 218 and triglycerides at 402, my doctor suggested I go on a low-fat diet to see if I could bring down my cholesterol. I went low-fat for a year and the cholesterol went up to 230 and triglycerides to 438. So his solution was to put me on a statin to reduce my cholesterol, which it did, to 163 a year later with triglycerides down to 252. He said to continue on the low-fat diet, even though my weight was creeping up steadily. I bought all the foods that were labeled “low-fat” and they were all full of sugar to make up for the great taste of fat that was missing. I ended up gaining about 40 pounds trying to do the low-fat diet. I have finally managed to lose that weight by cutting carbs, minimizing sweets, and more recently by adding IF. I ditched the statins four years ago and I am now drug-free except for a few beers every now and then. If only that doctor had recommended a low carb diet !!!

  42. Hi Doc, haven’t posted in awhile, thought you’d like to know my VAT ‘stuff’ since subbing a high-protein shake for b’fast. At apnea diagnosis in ‘07, TC=221, Tri=189, HDL=54, calc LDL=129 eating lower carb but still around 120 gms/day. Switch to low carb. Last June, TC=231, Tri=119, calc LDL=150, HDL=57 – docs demanding statins or niacin; told cardio no studies showed bennies for women, he says there’s 1, I ask how powerful was the bennie and was it from the reduced inflammation, he says weak, I just looked at him and he says red rice yeast and I say natural statin & statins are associated with muscle weakness and new or worsened apnea, I remind him I’m eating low carb and LDL is likely large-fluffy), he says he doesn’t trust that it works that way for diabetics *sigh*. I tried niacin with too much rise in BG. Sept TC=235, Tri=145 (oops), HDL=60 (vit D finally 66, taken 18 months to get there), calc LDL=147; I start eating more sat fat, mostly coconut shakes and drop all veggie oils. After losing 57 pounds since ’07 (still got lots to go), Dec VAT, TC=202 (baseline pre-apnea), Tri=127, HDL=53, LDL=122, Pattern A! Lpa=7. Probable metabolic syndrome=No. VLDL-3=13 (should be <10) so still need improvement. My APAP pressure has been reduced and my RBC and hemocrit are now reduced to normal so body is not compensating for oxygen deprivations…hoorah! I’m not there yet but I’m making progress. My TSH is still waay too high at 5.91, I’m now on 50 mcg levothyroxine which I gotta fail before primary will switch to natural thyroid…what do I hafta do, lose the rest of my hair? Get more depressed? Why are tests more important than patient symptoms? Sheesh. No more talk of statins or niacin at least *G*!

    Love this blog, sent it to my docs and lotta friends. Thanks for posting it, I still need to read success stories to keep me inspired…one day I'll be one of 'em!

  43. Mike:

    Thanks for everything. You have given me a way to save the quality of my life.

    When I showed up with insulin resistence, I went into full panic-learn-everything-you-can-right-now-and-fix-it mode. I am very determined to avoid medications except as treatments of last resort, so I went to Barnes&Noble and skimmed everything they had that might be relevant. Out of dozens of books, PP and Good Calories, Bad Calories made the cut – they just made the most sense to me (BSci, Bio). I did some internet research, read the books, and immediatly thereafter started consistently exercising and low-carbing. In 4 months I lost 45 lbs, normalized my blood values (BG normal, TG’s and VLDL’s dropped like a rock, and HDL shot up – and your links to the papers explaining the limitations of the Freidewald calculations reassured me no end re: LDL), and feel so much better, even as I contemplate the tiresome process of reducing my calories to get me off center and on my way to losing yet more of me.

    This regimen (and the research behind it) may not be the last word in treating the ills of hyperinsulinemia, but it sure seems to beat the crap out of anything else I’ve read. One thing is for sure:
    I could not have done this if I had been fightin insulin swings and hunger. Simple as that. And my internist is just over the moon.

    So here’s a message to all you low-carbers out there – buy the two books (PP and GCBC) and give them to your doctor. Just to let them know where you are coming from, understand. It’s what I’m doing – putting my money where my mouth is, so to speak. And then buy as many of each pair as you can afford, and give them away to friends and family. Some will be used as doorstops or firestarter, but I will bet that a lot of them get read – they are free, after all. Then, if one of these folks waxes enthusiastic, encourage them to spread the word. In a nutshell, if the conventional establishment is STILL fighting the evidence and spouting ancient and arrent nonsense, it’s up to the enlightened to go viral.

    Again: thanks to you and MD for your curiosity, tenacity, courage and kind generosity.

    TRH, LeC (Leaf-eating Carnivore)

  44. Dr. Eades,
    I read your moving post to my wife. She said “how come I eat like that for days and I never lose weight?”
    She hasn’t had her lipids checked in a long time. She just wants to lose weight. She has never had any success with low carb, never. I’m more strict and am thin but still can’t get my total cholesterol below 215.
    What do you think?
    Dana Law
    San Diego

  45. @Carrie

    I’ve told my story here before, but you might find it particularly interesting. After 20 years of being on a low-fat vegetarian diet, my HDL was 15. I switched to a low-carb high fat diet, and got my blood work done about 6 months later. While my total cholesterol went from 140 to 180, my triglycerides went from 100 to 40 and my HDL went from 15 to 50. I basically eat as much saturated fat as I can squeeze into my diet. I eat plenty of meat, cheese, eggs, cream, and butter. I even recently started making my own yogurt from organic whole milk since it is impossible to find full-fat yogurt in the supermarket. Remember, saturated fat is your friend! :-)

  46. My n=1 experience is just the reverse of the four patients….except in HDL.
    May 2008 Jan 2010
    TC 222 472
    TRIG 85 114
    HDL 44 80
    LDL CALC 153 373 Iranian forumula=347
    BG 100 95
    TSH 6.10 38.72
    Vit D3 67ng/ml
    For 12 months now, I have been eating salad with olive & vinegar, veggies with melted butter, bacon & eggs fried in coconut oil, lots of meat and fat, fish, hard cheeses, cottage cheeses, high fat yogurt. Only berries once a week
    Lost 30 pounds in first 6 months, then another 5 and now stable at 165 pounds.
    I will get a VAP done tomorrow and hope that everything is fluffy.

    I could not find anything regarding TSH skyrocketing on a ketogenic diet. I suspect it is a lab error as I do not display any symptoms of thyroid deficiency.

    Thoughts on the doubling of TC and the doubling of the LDL?

    Dex

  47. Thank you so much (as always) for your article, it comes just at the right time for me in that I’ve just had a slightly abnormal lipid panel.
    But the numbers are nothing like your four patients there, the bloods were taken just before xmas (so diet was a little carb-heavy), and I’m reassured now that I’m on the right track.

    Cheers!

  48. Dr. Eades,

    I came across your site today while researching krill oil and have read your posts with great interest. In the past year I was introduced to the work of Dr. Ron Rosedale and his study of leptin, which agrees with your findings on insulin. I began a low-carb, high-fat, moderate-protein diet the beginning of October 2009. After three months, I had not lost weight but did begin to have gallbladder attacks, with nausea and vomiting. I had some mild discomfort in the RUQ and rather sharp pain in the right side of my back prior to this diet but it has worsened. Now my doctor says I must go off all saturated fats, eggs, chicken, etc. etc. Can you shed any light on this for me? Does the high-fat, low-carb way of eating cause gallstones/gallbladder problems, as most of the literature says? If not, why the increase in gallbladder problems for me and why no weight loss? I don’t know what I was doing wrong. I was not eating white flour, white sugar, starchy vegetables, grains or pastas. I ate lots of vegetables, eggs, nuts & nut butters, cream, cheese, grass-fed beef, free-range chicken and wild-caught fish. I had desserts and baked goods made with coconut flour, flax meal or almond flour and used coconut oil or butter in baking. I used olive oil or grapeseed oil in salad dressings and butter on vegetables.

    I am confused and want very much to get to the bottom of this and find the truth so that I can do what is truly best for my health.

    Thank you sincerely!

  49. Thank you for your story….this gives me even more confidence in your advice.

    I recently met a doctor who told me that I fatigued from eating too many carbs. He checked the inside of my eye lids and apparently saw little fat deposits in the eyelids and he said this was a indicator. He was right – I had gone astray badly…. the great part about it was that he was a doctor who actually had done his homework on nutrition! Most doctors still seem to be geared toward the low fat mentality or the _________ food guide by default and don’t keep themselves up-to-speed about nutrition. This is dangerous when we are geared to believe that a Dr. is never wrong simply because he is Dr. You took your responsibility seriously.

    thanks for caring!

  50. Slightly off topic: I rarely tout the messages of journalists (Taubes is the exception) but did anyone see the article in Men’s Health (Jan 2010) titled Your Unstoppable Heart?
    It’s great to see some of this info reaching the lay readership even if I’m not thoroughly convinced by all of it.

  51. i read an article by a nutrionist in my fitness first (gym) magazine that was so refreshing! she was saying to have steak for breakfast if you like; avoid grains etc – all the stuff we love to hear :) – BUT of course in the very next mag, it was all low-fat again. must be so confusing for new people to read all the different opinions…

  52. Pamela,

    My understanding is that gallstones and sludge in the bladder form when fat intake is too low to trigger gall bladder contractions, so the bile salts sit there unneeded and solidify over time. Therefore you could have had asymptomatic (silent) stones for a long time. But then, when you start eating fats again and your gall bladder tries to contract and squirt bile out, it can’t squirt sludge and calcified stones, so it’s painful. Very painful. Very common. I know many who have suffered from this and nearly all had followed fairly low fat “healthy” diets for a long time.

    It’s similar with kidney stones, btw, except that the new way of eating starts to reduce the size of the huge asymptomatic stones in the kidneys (too big to go anywhere). When the new diet causes stones to reduce in size enough to start moving into the narrow tubes, all hell breaks loose.

    But the erroneous conclusion most people make is that the high fat, low carb diet “caused” the stones, when in fact, they were there all along due to the SAD. There was some discussion of this on Peter’s Hyperlipid blog recently (maybe on Nephropal, too).

    Sorry to hear about your troubles.

  53. Anna, Thank you for your message. I appreciate the information. Is it necessary for me to avoid fats until I can get rid of the gallstones? Then go back to a low-carb, high-fat diet safely? I don’t want to be making more stones by eating low-fat again, but also don’t want to aggrevate things and cause more attacks by eating fat when I have gallstones.

  54. Pamela,

    I’m sorry, I really don’t know the best thing to do for your situation. There are probably other facets of modern living and modern foods that contribute to stone formation, too, such as lack of fat soluble Vit K2 (I’m speculating) from low fat, grain-fed dairy, etc. Gradually dissolving the stones (reversing the conditions which favor stone formation) might not be standard in the conventional medicine toolbox of meds and surgery (& 10 minute appointments). Perhaps other PP readers with gall stone experience will chime in with their successful experiences.

    If it were me, and it was my HMO doctor who said to avoid fat to avoid GS attacks (and didn’t advise me that avoiding fat actually contributes to gall stone and bile sludge formation) then I’d put some effort into finding a different doctor who could guide me, one with a more holistic view of health and well-being (perhaps even outside my HMO system, though not necessarily “super-alternative”). I’ve learned to seek out better care within my HMO (switch primary care docs, advocate for myself instead of being passively accepting) and if needed, to also “step outside” my HMO system and consult with “independent” doctors for my hypothyroid care. It made a tremendous difference in my total health and well-being (not to mention my family’s well-being) and it was worth the extra out-of-pocket expense. Finding the right care isn’t easy, though, and takes effort and sometimes much persistence, which is difficult if you aren’t feeling well or informed.

    Best wishes for recovery of your health.

  55. Pamela: re gallbladdder, are you 100% gluten-free at the moment?

    Gluten could be a trigger, more so than the fat (at least in my own experience it is). Just a thought.

  56. @Pamela & @Anna

    Most gall stones are cholesterol stones, i.e., they are formed from cholesterol. When fat travels from the stomach into the upper part of the small intestine, it has to be emulsified or broken down as the first part of the digestive process. This emulsification of fat is accomplished by bile salts from the gall bladder (where they’re stored awaiting a fatty meal to come along) released into the upper part of the small intestine through the bile duct, a small tube leading from the gall bladder to the small intestine.

    Bile salts are made of primarily water and cholesterol with a few other compounds thrown in in small amounts. The liver makes the bile salts out of cholesterol and secretes them into the gall bladder via the bile duct, a small tube running from the liver to the gall bladder. These bile salts sit around in the gall bladder until fat enters the small intestine. When fat hits the upper part of the small intestine, the gall bladder contracts and squirts its contents – the bile salts – into the small intestine where they are mixed with the fat. If one eats a fat-restricted diet, the gall bladder doesn’t really ever dump its contents completely, and so the bile salts tend to concentrate as the water is absorbed. The liver sends more bile salts, which means more cholesterol, into the gall bladder, and over time this concentrating effect can produce sludge and/or stones. Often the sludge and/or stones don’t cause much of a problem because they stay in the gall bladder. But, if you have this condition and eat a fatty meal, the gall bladder contracts and can move one of the stones or the sludge into the duct going from the gall bladder to the intestine. When this happens, it hurts. A lot. And is a gall bladder attack.

    From my time in surgery I can tell you that once the stones are there it’s probably best to just have them (and the gall bladder) removed because this is the definitive treatment. There are medications that can dissolve the stones, but most doctors don’t like to give them because people who form stones once are likely to again. If they dissolve them once, they simply come back. Removing the gall bladder solves the problem.

    If people eat fatty meals regularly, there is no reason for them to develop cholesterol stones because their gall bladders are emptied regularly. Unless, of course, there is an anatomical anomaly of the gall bladder that prevents its complete emptying, in which case removal is a good option.

    We did a study in our clinic once of a weight loss drug. The lead in to the study required that subjects do a low-fat diet for six months before starting the drug, which was going to be tested as a maintenance drug. Because of the known gall bladder problems with low-fat diets, we did gall bladder ultrasounds of every subject at the start of the study and after six months on the low-fat diet. No subjects were allowed in the study who had gall stones or sludge to begin with so all were clear of gall stones. At six months a full 10 percent of subjects had developed stones and/or sludge.

    As a comparison, we’ve treated about 10,000 patients with low-carb diets, and I can’t remember a single one who developed gall bladder disease during their time with us.

  57. Thank you so much, Dr. Eades, for your detailed and helpful reply. I was hoping to soften/dissolve the stones, do a liver/gallbladder flush and then go back to a high-fat, low-carb diet. I’ve been doing castor oil packs for two weeks, eating apples and radishes and a green veggie soup recipe I found online, in preparation for the flush. I was trying to avoid surgery. If stones were formed by a very low-fat diet combined with very rapid weight loss, am I still likely to form stones again if I stay away from that kind of thing?

    Thank you also Anna and caphuff for your replies. I appreciate all the help.

  58. @Pamela

    Anatomically, there is no way to do a liver ‘flush.’ It’s not a hollow tubelike organ as is the intestine, so you can’t really flush it; it’s a solid organ that looks like the liver you eat. There is nothing to flush. About the only way you have of normalizing (a word I much prefer) the liver is to avoid those things that occupy its detoxification capacity and allow it to heal on its own. Tylenol (acetaminophen) and other OTC meds along with alcohol and caffeine are toxic and have to be detoxified in the liver. We explain this in detail in the 6-Week Cure, but if you avoid those things (while following a proper diet), your liver – over a few weeks – should pretty much return to normal. But the gall bladder problem isn’t a liver problem. It’s a stone problem. There is no way to ‘flush’ the gall bladder out other than to send the contents through the duct between the gall bladder and the small intestine. If there are stones in the gall bladder, they have to travel through this duct, too, and that’s a problem because if they get stuck along the way – which they often do – everything behind them backs up, you have an acute gall bladder attack, usually requiring emergency surgery. You can speak with your doctor about taking the meds that dissolve the stones – assuming you do have stones – and if you get the stones dissolved, you should be able to follow a high-fat diet fine. And the constant contraction of your gall bladder should keep it clear. But, your physician knows much more about your situation that I do, so I encourage you to speak with him/her about it and come up with a game plan.

  59. Dr. Eades, Thank you again for taking time to answer my questions. I really appreciate it.
    I believe I eat a healthy diet (no white flour, white sugar, hydrogenated oils, refined or packaged foods – I spend a lot of time in the kitchen, cooking from whole ingredients) and don’t use alcohol or tobacco and very rarely an OTC medicine. I think my problem came from doing the HCG diet several times two years ago. I had very rapid weight loss and it is a strictly no-fat diet. I believe that’s likely when I formed stones, if I actually have stones. My doctor suggested a sonogram to be sure but I’ve read that a sonogram doesn’t always show stones. I am assuming I have gallstones because of the attacks of nausea and vomiting I’ve had a few times over the last year. I don’t have severe pain with them, actually, just unrelenting nausea for an hour or two until I finally vomit. I’ve had sharp pains in the mid-right side of my back for several months, but not associated with the nausea/vomiting attacks. Since I am female and mid-fifties, the first assumption is that it’s my gallbladder.

  60. Can anyone comment on the risk of putting your body into ketosis by switching the main form of energy from glucose to amino acids? Does this have other health implications?

    • Ketosis is perfectly normal and natural. Burning fat instead of glucose has a number of fundamental benefits way beyond weightloss. Ketones are antioxidants and stimulate gluthatione levels (google that one!). Your speed of ageing is reduced because of reduced ROS damage. Cancer risk is reduced. I could go on for ever.

      But think about it. There have been times without shops to get your food. In the wild carbs are not an easy to get nutrient. Fruits only come in the season, not all year round. And sugar rich substances like beets and canes are impossible to eat and digest unprocessed. Carbs entered the human menu about 10.000 years ago when people settled down and became farmers. But we are really designed to eat meat.

      Relax and enjoy the low carb lifestyle.

    • 02/06/10: I ate a high protein, low carb, low fat diet and got severe kidney problems from it. It took me 1 1/2 – 2 years to get my kidneys back to normal. No kidding. I now eat a high fat, very low carb, adequate
      protein (46 g) diet, and that has been working for me so far.

  61. Pamela: I would add that just avoiding only white flour might not be sufficient if you have gluten issues. Peter at Hyperlipid has an interesting take on gluten and gallbladder: http://high-fat-nutrition.blogspot.com/search/label/Gluten%20and%20gall%20bladders

    A quote:
    “If you have coeliac disease you don’t seem to produce cholecystokinin (CCK) when fat hits your small intestine. So under these circumstances, you may as well not have a gall bladder anyway!

    There is obviously a trade off between the severity of the coeliac disease and the degree of cholestasis. The link above mentions active disease… I get the impression that villous atrophy is needed to get the blunted CCK response.

    But then it’s worth remembering that 1mg, that’s one milligram, no typo, of gluten per day will sustain villous atrophy in unlucky individuals. They will be clinically and serologically normal under these conditions. I bet they don’t make a lot of CCK though! Or get picked up by the average gastroenterologist.

    So is subclinical coeliac disease any worse than having no gall bladder? Many many many people have sub clinical coeliac disease. Perhaps this is the wrong question. Maybe it would be better to ask whether THE reason you have had your gall bladder removed is that sub clinical coeliac disease was the underlying cause of your gall stone anyway. No CCK means no gall bladder contraction, which means no bile acid deposition, which means cholestasis, which means gall stones. Also means blunted fat absorption. Which means no CCK release… It’s a chicken and egg situation.”

    I must say the above rings very true for me. I found out I had gallstones (with symptoms) years ago while still on the standard American diet. Since going low-carb/high fat and wheat free, the gall bladder only complains when wheat (gluten) is reintroduced. Fat alone does not cause an attack. With this discovery I now doubt I will ever I have it removed, although I respect Dr. Eades take on it.

    I’d also be curious to know Dr. Eades views on the gluten angle as Peter lays it out .

  62. Dr. Eades-at my last blood draw my cholesterol levels were all within normal limits according to the lab but my HDL was still on the low side. Can I assume that bringing up the fat content in my diet and lowering the carbohydrate a bit (I do enjoy oatmeal in the morning, otherwise I’m mostly paleo) will improve the HDL? Also, I’ve asked this question to other health bloggers and still have not gotten a satisfactory answer (maybe you can point me in the right direction): what are the best outcome markers for a healthy diet in your opinion (ie. blood values, BMI, body comp, pain levels?)?

  63. This turned out to be long, but, after reading this website for a long time, I wanted to address this issue.

    To JANET JACKMAN, who commented above: “I have GERD and IBS ( IBS is self dignosed no doctor could find it ) I have gone on a low-carb diet and I do see improvement in the IBS.”

    Janet, I had all sorts of gastro issues since…well, nearly forever. They used all the acronyms: GERD, IBS, etc. and nervous stomach, hyper-acidity, allergies, etc. I was anemic as a child (even though we ate lots of meat) and began having upper GIs in high school. I had major issues with bloating and abdominal pain. So much so, that I had once confused my “normal” painful bloating with the rupturing of my appendix!

    Guess what? Around 1998, I picked up a copy of Protein Power, because I had been looking for the Atkins book and the store didn’t have any. I was going to skim it and have more ammunition to talk my friend out of doing Atkins. Well, I skimmed…and skimmed…and bought the first Protein Power book and took it home. The more I read, the more the pieces of the puzzle came together – finally, an explanation – not just, “Eat this. Don’t eat that.” Not long afterward, I had 5 friends, including 2 registered nurses, following the Protein Power plan. The nurses said the book reminded them of their textbooks: good and bad eicosanoids, arachidonic acid, etc. We all loved the fact that the book explained the WHY of overweight and poor nutrition.

    I have a family history of diabetes, and I was a gestational diabetic in 1980. I always knew there had to be a connection between insulin, overweight, and diabetes – and not just in the way commonly thought. Like so many others who have commented, this diet WORKED for me – but there is another reason it worked.

    JANET, I would encourage you to do some reading at Celiac.com. My mother was finally diagnosed with Celiac late in a life riddled with gastro and other health problems. I was diagnosed in 2000. Celiac is an auto-immune disease whereby the villi in the small intestine are damaged/destroyed by ingesting GLUTEN. When the villi are damaged, the body can not absorb the nutrition from food. Gluten comes from wheat, rye, barley, and oats (Although Bob’s Red Mill now has an Eisha-certified gluten-free oat, thank God!) Contrary to earlier belief, Celiacs are not all scrawny, stick-thin folks, and can be overweight.

    The fact that, on Protein Power, I had quit eating so many gluten products, like bread, was a key factor in the improvement of my health! If a Celiac does not ingest gluten, they don’t have the problems that accompany the disease. If they continue to ingest gluten, they can die. If you decide to be tested (blood tests, EGD), do NOT quit eating gluten beforehand. That is important, as it can confuse the results.

    The gluten-free diet is so much easier now that it was even 10 years ago, when it was considered the most difficult diet to master and follow. Gluten masquerades under so many different names, but the food labeling is getting better, as well as having some restaurants with a gluten-free menu, by request.

    The U.S. medical establishment is finally recognizing what Europe, Australia, and New Zealand knew far earlier – that Celiac is rampant here – it just wasn’t diagnosed in the U.S. Its symptoms were blamed on GERD, IBS, etc. For example, when I was diagnosed in 2000, the thinking was that 1 out of every 5,000 in the U.S. had Celiac. Now, that number is 1 out of every 100-120! BIG CHANGE!

    Also, they are discovering that so many patients with Osteoporosis also have Celiac, that it is now recommended that an Ostoporosis diagnosis be accompanied by a test for Celiac.

    Even though many doctors are more familiar with Celiac, realize that you must take responsibility for your own health. The average time between a patient’s having enough problems that they began seeking an answer until they were accurately diagnosed (if ever) recently was 11 YEARS! Celiac.com has a list of doctors across the U.S. who are recommended by Celiacs.

    Don’t give up, and don’t accept the first thing you are told, if you do the research and still believe that you may have Celiac. I was told (after blood tests) by a gastroenterologist that I did NOT have Celiac. Then, after more blood tests and ESPECIALLY an EGD, where a biopsy of my small intestine was viewed by a Pathologist specializing in Celiac diagnosis, that I DID have Celiac.

    Since getting (and staying) on a gluten-free diet, my bloating and abdominal pain have been almost non-existant. I no longer have migraines, and I seldom ever have a sinus infection. A word of caution: Celiacs now have many gluten-free grains and products from which to choose, and most are very high in carbs. I always have to remind myself, “Just because I CAN, doesn’t mean I SHOULD!” The Protein Power diet is actually perfect for a Celiac!

  64. A short ,important addendeum to my above comment regarding Celiac and GLUTEN:

    Celiac is an auto-immune disease, wherein the body damages itself after ingestion of gluten.

    Gluten-Intolerance is a sensitivity to gluten, wherein the body experiences symptoms after ingestion of gluten, but is not damaged. It is not an auto-immune disease.

    One reason Celiac has been historically difficult to diagnose is that the symptoms can be many and varied – or none at all until major damage has been done.

  65. A short, important addendum to my above comment regarding Celiac and GLUTEN:
    Celiac is an auto-immune disease, wherein the body damages itself after ingestion of gluten.
    Gluten-Intolerance is a sensitivity to gluten, wherein the body experiences symptoms after ingestion of gluten, but is not damaged. It is not an auto-immune disease.
    One reason Celiac has been historically difficult to diagnose is that the symptoms can be many and varied – or none at all until major damage has been done.

  66. caphuff,
    Thank you for your message regarding gluten. When I started the high-fat, low-carb way of eating the beginning of October, I was eating no grains at all, so was completely gluten-free. I had two of the “attacks” during this time. Since we’ve suspected gallstones and I’ve backed off from some of the high-fat in my diet, I’ve eaten very small amounts of gluten, but very little. I haven’t had any more of the nausea/vomiting attacks so it doesn’t seem that a small amount of gluten is doing any further harm. My plan is to read Protein Power and follow that way of eating again, as soon as the gallbladder/gallstones issue is resolved.

  67. I have steaded on my low-carb diet (thanks to my friend Jennie) and I have improved my IBS and lost 10 lbs and I just got a good report from my Dentist about my gum disease that I have been fighting for years !!!! With all this improving I will stay on a low -carb lifestyle forever. Thank-you Jennie .

  68. I agree with everything Judith has said but I’d like to add a couple points to her excellent comment about a life of assorted GI symptoms, gluten, and undiagnosed celiac conditions.

    One shouldn’t rule out gluten issues due to lack of severe GI Symptoms. One can have non-GI symptoms with gluten intolerance, too, including infertility, skin rashes, joint pain, mood issues, thyroid conditions, etc. (though these symptoms can also be caused by other things, but gluten should be ruled out). It’s very difficult to “connect the dots” and I know from personal experience how easy it is to dismiss the possibility of gluten playing a role in such varied symptoms, especially the assorted things we dismiss as minor or completely unrelated and might not even mention to our doctors.

    The current testing protocol typically uses blood tests and intestinal biopsies to diagnose celiac and gluten sensitivity and unfortunately, they are actually quite limited as they miss the mark a lot of the time. A negative test result isn’t conclusive: it just means that the test didn’t detect antibodies in the blood and biopsies can be taken in the wrong place in the intestine. In other words, the standard tests can rule celiac in but can’t rule it out. Many, many people have negative test results for years and so go on consuming gluten-containing foods, only to have positive tests results later when even more damage is done. And many people are not celiac but *are* sensitive to gluten (non-celiac gluten sensitivity); they won’t ever have GI symptoms or flattened intestinal villi, but the gluten instead triggers an auto immune response against other tissues (thyroid, pancreas, skin, joints, nerves, and so on).

    If there is any gluten-related or auto-immune family history it is a good idea to get at least a simple cheek swab gene test, as there are several HLA genes that can be identified that indicate a predisposition to celiac and gluten sensitivity. Having one or two copies of these genes doesn’t guarantee that one will develop gluten-related health conditions (a trigger is thought to be needed), but it can at least be an alert to the possibility and a gluten-free diet can be considered.

    There is another way to test for gluten-related problems. Dr. Kenneth Fine of Enterolab (www dot enterolab dot com) has developed a stool test protocol for detecting gluten (IgA antigliadin) antibodies, as well as anti-tissue transglutaminase, and IgA antibodies to casein (milk protein), soy, egg, and yeast, based on the theory that the antibodies originate and persist a long time in the GI tract (where the immune system encounters the “dangerous” proteins), even if the antibodies aren’t detectable in blood tests or if villi damage isn’t detectable with an invasive biopsy. With the stool test, one doesn’t have to be actively consuming gluten, either (I think it can detect IgA antibodies in the stool for many months after removing gluten from the diet). Enterolab also offers testing for stool fat malabsorbtion (an indicator of impaired nutrient absorption) as well as genetic cheek swab tests. These tests can provide clues that might not show up on the standard testing protocol (if you can even get your doctor to order them for you).

    Enterolab’s stool tests aren’t yet the standard protocol for diagnosing gluten conditions, and most doctors will not yet be aware of their existence. A few states (like NYS) require doctor’s authorization to order tests, but in most cases people can order it themselves via telephone or online. Insurance may or may not reimburse (our HMO doesn’t, but a second policy we have did when I submitted the lab test codes). Enterolab mails a test kit with detailed instructions. It isn’t as, um, unsavory, as it sounds (the sample is easy to collect with the kit materials, is well-sealed then frozen overnight, and sent back via express delivery). Also, the tests are easy to do in the comfort and privacy of your own home, which isn’t such a small matter when one thinks about invasive intestinal biopsies.

    My son and I used the complete panel of Enterolab tests just over a year ago after I became aware that his behavior, moods, attention to schoolwork were different when he was eating bread and wheat foods (our house is pretty LC overall, though I was still buying bread, etc., for him now and then). I wasn’t very surprised that my son was positive for a number of the IgA antibodies, but he also had fat malabsorption, and has two HLA genes that predispose to gluten problems (one for celiac and one for non-celiac gluten sensitivity); there is at least one serious case of celiac sprue in my husband’s family health history. I *was* very surprised to find I was positive for IgA antibodies and anti-tissue transglutaminase, too (also soy); I carry two HLA genes for non-gluten sensitivity. I did the test because I am hypothyroid which is on the list for people who should be tested.

    We have been gluten-free for just over a year (generally avoiding most typical GF-labeled products because they are quite high in “empty” starches) which wasn’t a very hard for us as we were already so adapted to low or no grain (and I prepare a lot of our food from scratch anyway). My son had the most changes to make and he has adapted very well. Now if he has a gluten exposure, he’ll often get canker sores in his mouth, which turns out to be a good reminder for him to be more vigilant.

    We also tested positive for soy antibodies so we avoid soy, too. Like gluten, soy can also be difficult to break down in the GI system, creating discomfort, and sometimes triggering damaging immune responses. Many processed low carb products (low carb breads especially, but also chips, cheap meats and fake “vegetarian” meats, too) contain a lot of soy aditives. Unfermented soy in particular is a huge problem as now appears in all sorts of processed foods, even if one is unaware of eating soy.

  69. Dr Eades,
    If you have time I’d love to know your response to books like “The China Study” by T. Colin Campbell and “Prevent and Reverse Heart Disease” by Dr. Caldwell B. Esselstyn, Jr. – both books supposedly based on years of scientific study and good clinical response but very anti-animal protein and completely anti-fat. My husband has been very influenced by these books and has a hard time believing that it is healthier for me to be eating a low-carb, higher fat and higher protein diet. He always says, “We just shouldn’t have that much animal protein.” We don’t eat a high-protein diet, but a moderate amount of animal protein with lots of greens and vegetables, small amounts of fruit and he eats whole grains, as well. I would like to be able to give him a good answer that might alleviate his fears. He says these books are based on scientific studies so there is no reason to believe that they’re not true. I’d very much appreciate your thoughts on this.

    Thank you!

  70. @Pamela

    Problem is, I don’t have the time. The studies Campbell refers to are all observational studies, which don’t prove causality. These are the kinds of studies that trap and influence those unschooled in reading scientific studies. You can find a thorough review of the The China Study by Chis Masterjohn here. He’s already done it so I don’t have to.

  71. Dr Eades:

    It was a joy to start a nw year and NOT Have TO Start a DIET!

    I have lost 30 lbs on your program. My lipids have reversed extremely well. Trig 69, HDL 74, LDL down to 171. I should lose another 10 lbs to be in my ideal wt zone, but according to my measurements/wt I am at 28% body fat now. I have been working out cardio and weights. I feel good, clothes fit great. I also did the 6 week diet and lost 3 lbs the first week , then nothing more. I did lose a 1/2 inch in waist.

    Right now I am just holding, so I don’t know if I can lose the other 10 lbs (It is all SQ fat in hips and thighs, a little below navel belly bulge, I have had 3 kids and am now 67 years old).

    I may try to go lower when the weather warms and i can get outside more.

    Thanks for your Hard work going against mainstream hogwash and saving lives.

  72. It all sounds good but what is the list of foods to eat. Tell me what to eat to lower cholisterol.The list is what I want to know. Every one talks about it but no one put a list to it.

  73. I’m having trouble locating Luecine and DAG oil. Health food stores around me don’t stock them. Should I look on the internet. I need them fast since I’ve already started on the diet?

  74. I hope the Amazon.com link that I posted is your’s. I want to support this web site. How do I determine that this is your portal? Please let me know your portal, if you determine it is not correct I am not a techie, but I am willing to learn what I can about your correct Amazon.com portal.

    Thank you.

    • If you click on the picture of The 6-Week Cure in the upper right hand part of the blog, you’ll be taken to Amazon through our portal. You’ll land on the page for the 6WC, but you can head anywhere from there. Once you’re in Amazon through our portal, anything you purchase gives us a little commission.
      Thanks very much for your support.

  75. I have another medical question. I have lost muscle tissue in right hand and my joints are inlarged. Doctors don’t know what caused it but it is getting worst. My bones are show bad. They took my blood and x-rays. Nothing showed up and being wrong. What up with that. Now I am being sent for a nerve test to see it I have nerve damage. No they said it was not arthritis. What could it be???

  76. Dr. Eades,

    I’m 56, 71″, weigh 190, and have Body Fat Percentage of 9%. I follow a paleo/zone/low carb diet and CrossFit 4 to 5 times a week.

    On my annual physical, I had the following readings:
    HDL 75
    LDL 170
    VLDL 11
    Total Cholesterol of 256.
    Triglycerides 57
    Resting HR 55
    Blood pressure 113/64

    My doctor wants me to go on Zocor to reduce my LDL. From what I’ve read about Statins, I feel this is unwise.

    What are your thoughts?

    Many thanks in advance,

    Mike

  77. Hi Dr. Eades,
    4 years ago I read a book of Dr. Jean Kwasniewski named HOMO OPTIMUS about
    optimal diet.
    I began a diet high fat low carbohydrate.
    I didn’t have any problem with my weight.
    I began this diet for good health.
    I stayed on the diet for exactly six months.I was eating fat pig meat milk,
    milk cream, cheese, cow butter.
    Plus 6 raw eggs per day. The carbohydrates I was taking them from raisins in
    the end of the day.
    Always my cholesterol was in the are of 180 – 230.
    After the diet I made on blood test
    and my total cholesterol was 304.
    my HDL was 55 my triglycherides 158.LDL 221.
    Lipoprotein a Lp(a) 9
    Fast insulin was 7.9
    Something went wrong can you have any idea why?Sometimes I was eating also
    1/2 kiwi.
    I was trying to eat arround 60 grams carbos per day.
    I stopped the diet and in three days the cholesterol was 275 and after 4
    months I cheched again and was 220.
    Any opinion will be highly apreciated.
    Sorry for my English
    Thanks
    Dimitris
    Greece.

  78. I don’t know why cholesterol gets the blame for harm since it is the body’s first line of defense against invastion and cellular damage from things like glycation end products damamging cells. if your cholesterol is high your inflammed because damage is being done whether microbe or internal combustion damage. look at glucose and fructose as gasoline. mix in oxygen and a little spark and wammo.

    fat cells from my understanding give off inflammatory chemcials not because it is fat but because it is sick. it is being damaged. things like glycation? microbe invastion? damaged cellular membranes due to damaged to transporter proteins that transport cholesterol to the membrance of the fat cell, who incidentally can literally explode if it can store cholesterol without being able to remove it. mcacrophages are there to clean up the mess and try to salvage the fat cell.

    our bodies require alot of nutrients for handling gluocse well, otherwise the poor fat cells are recruited in order the handle the overabundance of gasoline.the liver having so many tasks gets overwhelmed. fat cells multiply when they are overwhelmed due to poor calcium and vita d and other fat solable vitamines being in lack due to low fat dieting. you need saturated fats to absorb and use calcium, vita d, e, etc. if cells cannot use glucose due to not having the proper lipid raft to transport the glucose to the mictrochondria the cell can’t accept the glucose.lack of sun exposure without sunscreen is also a culprit in low vita d.

    I am sure the ciculating sugar keeps triggoring the insulin receptors to release insulin in pulses, because it is getting the message that the sugar is like still there and not absorbed like it should be. and of course too much sugar hanging around causes severe damage to proteins which most of our organs and muscles are made of.

    so carbs are not the problem, it is the cellular resistance to it that is the problem. while a low carb diet works it is only a temporary lets get the body the rest it needs diet. not for long term.the mayo clinic found in one study I read that the ones who did the best (insulin resistant and overweight) were those who followed fresh fruit/veggie and whole dairy diet. their insulin resistance reversed and they lost weight. makies sense the fat in the dairy helps you absorb the nutrients in the fruit and veggies better.the sat fat helps take the burden off the fat cells who now become redundant and unecessary. fat helps absorb the vita d, calcium in the diary.

    our organs like the liver and heart get larger, fat cells get larger simply because when your weakend state due to malnorishement more hands lighten the load for everyone, more cells means less work for each cell. so the enlarged heart especially if your glucose intolerant means more hands on deck.

    I have been eating alot of dairy whole, as much fruit as I crave, which is weird doesn’t happen often like it used to, I eat alot of low gi stuff, and occassionally (especially since I have had energy to exercise like crazy) a couple of servings of bran cereal. with whole milk to lowr the gi. I lost some weight don’t know what my parameters are. I do know my triglycerides were high, but not nearly as those numbers you have here were, not by a long shot.

    was eating for a long time bacon, love bacon, but have lost interest my protein drinks with strawberries and whole milk and a small banana if I can get it, really satisfies been following this diet for a year now, tweaking it as I go along, so my low carb is actually moderatly low, around 30-35 percent of total caloires, and mostly low gi. in fact lower the gi the more nutritious the carb is. eat alot of green beans I cook myself, was eating alot of salads but lost interest in it, eat alot of broculli cauliflower carrots mixed in.onions garlic and green peppers alot of that . last year especially over winter I was eating alot of buckwheat pancakes with real butter and coconut oil to lower the gi and get sat fat in my diet. one serving is all I ate, so carbs are not the problem how fast it gets in blood and how much nutrtion you have to handle it properly.

    I followed a pretty strict low carb diet more than a year ago and never lost much, peed alot at first had the flu like symptoms and it never helped my fasting hypoglycemia at night thing, or help me have energy or help me sleep better. nor did it help me get rid of the headaches I used to get before starting it. this diet I have been following has done all the things above and more. by the way I followed this low carb thing for more than two months. veggies are just not my thing, tho I seem to crave it alot from time to time. guess my body knows what it needs.

    rosa