Low Carb and Cholesterol – A Case History

Three months ago I had a visit from a 53 year old gentleman who was worried about his health. His name is Peter. He had been gaining weight for some time, his knees were aching and he was having trouble playing his weekly tennis with his old classmates. He told me he had probably put on approximately 55 lb (25 kg) in the past five years. “It all started when I quit smoking,” he said.

Low Carb and Cholesterol - A Case HistoryPeter was working as an accountant. There was a lot a stress at work, long working days and sometimes he had to go in on the weekends as well. Apart from his weekly badminton, he wasn’t really exercising at all. Although he had quit smoking, he had never really bothered about his lifestyle and was totally uninterested in diet and nutrition.

His wife took care of the cooking at home and was trying to limit his intake of calories. She was very conscious about cholesterol and tried to use low-fat varieties. At work however, Peter relied mainly on fast food, sandwiches, sodas, chocolate bars, chips, and an occasional fruit in between. Usually a few beers and some red wine on the weekends, bot otherwise not much alcohol.

Peter had suddenly become worried about his weight gain and felt his general condition was slowly becoming worse. He was feeling out of breath.

For the first time in his life he was really thinking about his health. He appeared to have suddenly realized that, he himself might have to take action.

Peter told me he wanted to try a low carb diet. A friend of his had been getting good results with such an approach, was feeling well and had lost a lot of weight. Peter thought this might be the way for him to go.

However, his wife was reluctant. She didn’t like the idea of eating so much fat. She had a history of elevated cholesterol herself, and had been trying to avoid animal and dairy fats for years. Her brother who was a physician recently started taking a cholesterol lowering drug. She wanted Peter to see a cardiologist before starting on a low carbohydrate high fat diet.

When I saw Peter he didn’t have any obvious signs or symptoms of heart disease. He was 5 ft 11 (181 cm) long and weighed 260 lb (118 kg). His body mass index (BMI) was 36. He had many of the classical features of the metabolic syndrome, his waist circumference was 47 inches (120 cm), and his blood pressure was 156/102 mm Hg.

His blood work showed the following results:

  • Total cholesterol: 251 mg/dl (6.5 mmol/L)
  • Calculated LDL-cholesterol (LDL-C): 169 mg/dl (4.4 mmol/L)
  • HDL cholesterol (HDL-C): 31 mg/dl (0.8 mmol/L)
  • Triglycerides (TG): 257 mg/dl ( 2.9 mmol/L)
  • Glycated hemoglobin (HgbA1C): 7.1 %
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A Low Carb Hig Fat Diet – A Bad Idea?

Peter’s main problems were obesity, metabolic syndrome and type-2 diabetes. Glycated hemoglobin is a measure of long term blood sugar. A value higher than 6.5% indicates diabetes. His TG/HDL ratio was 8.3. A ratio higher than 3.5 is associated with insulin resistance. His LDL-C was certainly not ideal, but possibly not the biggest of his worries.

I told Peter and his wife about the risks associated with the combination of obesity, metabolic syndrome and type 2 diabetes. I tried to educate them about the problems associated with insulin resistance. His wife was mostly interested in his cholesterol numbers. I certainly don’t blame her because that’s been our main target for decades when it comes to the prevention of cardiovascular disease.

“Doctor, I would like to see him cut down on the fast food, eat less calories and exercise more” she said. “I don’t see how starches and whole grains will hurt him. It’s just the sugars and the beer he has to get rid of”.

“Okay Peter” I said. “What do you say?  We all agree that weight loss is essential to improve your health. If you don’t change your lifestyle and lose weight there is a risk that your health will get worse. In order to cut your risk we may have to put you on medication for high blood pressure, another one for your diabetes and a drug to lower cholesterol. There are many ways to go when it comes to losing weight. There are no simple tricks. The most important thing is to keep focus and understand what it is that you have to do”.

He seemed to have made up his mind. “I don’t like the idea of just eating less and exercising more”. I’ve tried that before. It sounds very sensible, but it hasn’t worked for me. It works for two weeks and then I’m back to the same old shit.  I need to try something else. I’ve read a few articles on the low-carb high fat approach and it appeals to me. Do you think that’s a bad choice doctor?”

“No” I said. “I certainly don’t think so. Indeed there is a lot of scientific data showing that such an approach may help you lose weight, reduce insulin resistance, improve your blood sugar and lower blood pressure.”

Three Months Later

I saw Peter and his wife again last week. He seemed quite happy. He had avoided refined sugars entirely, throwing candy and beverages out of the window. He had cut down on other types of carbohydrates, avoided potatoes, bread, pasta and rice. Basically, the only carbohydrates he had eaten came from vegetables and fruit. He had eaten a lot of eggs, cheese, meat and fish.

He was feeling better and less out of breath. He had lost almost 18 lb (8 kg)  in three months. His body mass index was 33.6. His blood pressure was 142/88 mm Hg. His tennis was going better and his knees were aching less

This was his blood work:

  • Total cholesterol: 290 mg/dl (7.5 mmol/L)Three months before: 251 mg/dl (6.5 mmol/L)
  • Calculated LDL-cholesterol (LDL-C) 210 mg/dl (5.4 mg/L)Three months before: 169 mg/dl (4.4 mmol/L)
  • HDL cholesterol (HDL-C): 54 mg/dl (1.4 mmol/L)Three months before: 31 mg/dl (0.8 mmol/L)
  • Triglycerides (TG): 132 mg/dl (1.5 mmol/L)Three months before: 257 mg/dl ( 2.9 mmol/L)
  • Glycated hemoglobin (HgbA1C) : 6.2 %Three months before: 7.1%

Peter was quite happy but his wife was worried. Her brother doctor had seen the blood work and pointed out that LDL-C was way too high, and would likely increase risk of having a heart attack or a stroke. He should start treatment with a cholesterol lowering drug as soon as possible.

I went over the positives and the negatives with Peter and his wife. He had certainly lost weight and his blood pressure had improved. His glycated hemoglobin had improved as well and the value was below the cut-off for diabetes. His TG/HDL ratio was 2.4 indicating less insulin resistance. I also told them that the fact that TG were so much lower could mean that the size of his LDL particles had improved, with less small LDL-particles and more large LDL-particles. A number of studies indicate that this may be a positive thing and associated with less risk of cardiovascular disease, despite the higher LDL-C.

What Does All This Mean?

Peter’s response to a low carb  high fat diet is quite typical. Weight loss usually occurs. Total cholesterol and LDL-C often increase and so does HDL-C. TG usually go down. Blood pressure often improves and typically blood sugar and glycated hemoglobin improve. Of course the big question is: “Is his situation better or worse than before”? Does the high LDL-C mean that his risk of heart disease is higher than before, despite all the other positive findings?

Peter’s wife wanted to change direction, cut out the fat, cut down the calories and believed he was better of with a cholesterol lowering drug. She is a sensible woman and she definitively wants the best for her husband.

 What Should Be the Next Step?

Because his wife was the one taking care of the groceries and cooking, Peter felt a bit like a misbehaving child not taking her advice. He was feeling better and definitively didn’t miss the weight he had lost. He felt a bit insecure because he had never before had an opinion about diet, and about what to eat or not to eat.

I’m quite curious to know my readers opinion so I’ve put up this poll for you. This is the firs time I do this on my blog. Please give me your vote and don’t hesitate to explain your choice in a comment. Last day for voting will be Wednesday, July 31, 2013.

Vote Results

What dietary approach would you recommend?

    • Continue with the low carb high fat approach and don’t worry about the LDL- cholesterol, partly because it is likely that LDL-particle size has improved 76% (176 votes)
    • Continue with a low carb high fat approach, but eat less saturated fat and cholesterol (less animal and dairy fat and eggs), and consume more poly-and monounsaturated fats 12% (27 votes)
      Adopt a Mediterranean type diet. Such a diet has been shown to improve type 2 diabetes and reduce the risk of heart disease 5% (12 votes)
    • Adopt a plant based diet. Skip all animal products, eggs and dairy products. Basically go vegetarian 3% (7 votes)
    • None of the above 3% (6 votes)
    • Drop the low carb high fat approach. Eat less fats and more carbs, focusing on good carbs, whole grains and starches, and try to reduce total calories 1% (3 votes)
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Dexter
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Dexter

On the LCHF program Peter is headed in the correct direction and the wife and her brother physician are going to die before Peter does. Coconut oil or MCT oil and butter and fish, oysters should be Peter’s main fuel along with leafy green veggies. There are no essential starchy carbs. Live like a polar bear and eat like a Great White Shark gets people well. Why not run an NMR profile to get the LDL particle number and the percent LDL large bouyant of his total? Did you rule out thyroid disorders? Did you do an Iodine Loading test… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Dexter. Thanks for the comment. An NMR profile, LDL-P in particular would certainly be interesting and probably helpful. However, we don´t have access to it here in Iceland. The only thyroid test done was TSH which was normal.

Lucy Bryant
Guest
Lucy Bryant

Recent studies have shown that coconut oil is NOT good for you. It’s a saturated fat, and it’s bad for your arteries. All of the hype about it amounts to nothing more than a fad.

Rose
Guest
Rose

I have followed a LCHF diet and had the same cholesterol result. Further test revealed my raised LDL-C was due almost entirely to large particles. My doctor wants me to go to ezetimibe but that is shown to lower LDL-C particle size. Sometimes you have to read and study and make your own decisions.

Given Peter’s improvement in 3 months, he could continue for another 6-9 months and reassess then, perhaps having further analysis of his cholesterol fractions.

Axel F Sigurdsson
Admin
Axel F Sigurdsson

I agree with you Rose. A follow-up after a longer time period is very important.

Bill
Guest
Bill

I voted “none of the above”

I suggest he opt for modified DASH diet…consume 150 mg of cholesterol daily and supplement with vegetables, fruit, and healthy oils, as well as low fat dairy.

He will get adequate protein. Stay away from the heavy carbs in whole grains and stick to plenty of vegetables, 1/2 cup legumes, 1/2 cup sweet potato.

From what I read, this will work for weight loss….and should also lower cholesterol and blood pressure.

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Thanks for the comment Bill. There certainly is a lot of scientific data on the usefulness of the DASH diet. It has been recommended for individuals with high blood pressure for years. And you are right, such a diet would probably lower Peters LDL-cholesterol.

GA
Guest
GA

1st one, continue.

JimF
Guest
JimF

Although my overall weight, fitness, lipid profile and blood pressure characteristics in combination were better than “Peter’s,” I decided to pursue a low carb/high fat diet because all metrics and health profile were moving in the wrong direction over the previous two years. My GP and the cardiologist wanted me to take a statin, with the potential looming of a high blood pressure medication. Subsequent investigations into their recommendations forced my hand. I knew I had to change to get healthier because their recommendations meant I lost control of my body, my independence and my own health-sanity that comes with… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

That´s an interesting story Jim and certainly something we could learn from. It also tells us that there are a lot of options in choosing the types of fats to eat on an LCHF diet. That choice may certainly affect the level of LDL-cholesterol.

I agree that a coronary calcium score is helpful to assess cardiovascular risk. However, due to costs we don´t use it often in the risk assessment of asymptomatic individuals.

Dr. Robert Oliva
Guest
Dr. Robert Oliva

Peter needs to continue the low carb diet but I would try and get him to add more low glycemic vegetables, especially green vegetables, and cut down on the meat and grains while increasing fish intake, especially fatty fish like salmon. Salads every day may work wonders for him. A moderate amount of fruit could be used if it didn’t cause weight gain. If he can handle Walnuts and other nuts, he mat feel bette and feel full besides.

Philip
Guest
Philip

I think that the LCHF terminology is misleading ,especially for somebody defined as obese. Its only high fat in the sense that as the percentage of carbohydrate intake falls and protein intake remains about the same then the percent fat is higher. This means that to get out of the obese group definition you should reduce carbohydrates , eat vegetables and protein and maybe some modest amount of fruits.No need to eat fats because you have them on your body, ready and waiting to be metabolised. At least until you reach your target weight. In any event this is the… Read more »

Amanda Saunders
Guest

I was a vegetarian for almost a decade with my health going down hill. When I saw the sunday night sweet poison video my sugar addiction stopped immediatly. I then started doing a lot of research into nutrition. What I have noticed in my recent blood tests is that the HDL and LDL has gone up but the triglycerides have gone down. I queried it and learnt that the drop in your triglycerides (which is very common on a LCHF diet) can put your numbers out and give you an inaccurate result. Next time you see your doctor ask for… Read more »

Doug Beard
Guest

Health advice is theoretical until the shit hits the fan, my wife at 43 slim and fit had a MI and double CAGB we were on a low fat diet, we’ve been on LCHF diet for about 10yrs, full story here: https://dougiebeards.blogspot.co.uk/2013/01/eating-to-avoid-heart-disease.html

Carol
Guest
Carol

Thank you for writing that piece and providing the link. Amongst all the diet controversy there is only one thing of which I am certain and that is that the medical community is confused.

Rory
Guest
Rory

I think this also comes from the fact that there isn’t one diet that fits all…period. Our genetic makeup ensures that. If you take Dougs story above, Ive seen a blogger also comment about how she after 3 years being Paleo, saw her TC and LDL climb through that period and ended up suffering a mild MI and has now re-evaluated her diet. Certain people, myself included probably just cannot handle these types of diet…maybe…. or is there just one small variation one needs to make..who knows?. I saw a statement from a lipidoligist state that almost a third of… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Rory. Thanks for the comment. You make a very interesting point. I couldn´t agree with you more. There is very much individual variation. I´ve seen cholesterol and LDL-cholesterol go through the roof on low carb high fat diets. I´ve also seen cholesterol levels go down on such diets. So, we all act differently which is very important to keep in mind.

Halldor
Guest
Halldor

Does that really make sense? Do we know that from the animal kingdom? Are farmers trying to figure out what’s best to give each individual cow? Are our bodies really that different that we can’t know which food are good for us and which are bad? Don’t get me wrong, of course people react differently to different food but my point is, aren’t there certain foods which we all thrive on?

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Yes it does make sense Halldor. Farmers know exactly what to give their cows to get what they (the farmers) want. Of course there are certain foods we all thrive on, certain nutrients, vitamins and minerals we all need. Apart from that, what we eat contributes significantly to our health. It affects our well being, our body weight, our blood pressure, our blood sugar, the insulin levels in our blood, the levels of different fats in the blood, the inflammatory response of our immune system, and it determines what substances our cells use for energy production.

Halldor M
Guest
Halldor M

It sounds like you don’t agree with me but then go on to say exactly just what I said 🙂 or at least was trying to say. Let’s say the farmer just wanted the cows to be healty, would he then give them all different things to eat? Cows out in the wild all pretty much eat the same thing and the same applies to apes and just most animals. If we know what foods we thrive on, isn’t it then just our taste buds that are getting in the way and making this complicated? Like, eat lots of fruits… Read more »

Halldor
Guest
Halldor

I always look to what is traditional in each person’s ethnic background since I’m a big believer in my theory of what we have genetically adapted to. I believe Icelandic food is great for Icelanders, especially those who are as active as our ancestors physically, as they had to struggle in the harsh environments. However, I think our modern day life doesn’t demand quite as much nutrition as back then. I also believe that the French handle bread better than we do, as that tradition is stronger for them. My measures for myself is to look at the health buffs… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Thanks for the comment Halldor. I think you are absolutely right that we are all different. Therefore I don´t believe in a “one size fits all” formula when it comes to dietary recommendations. I´ve learned from my practice that LDL-cholesterol and other lipid parameters respond very differently to low carb high fat diets. Peter´s response is the most common with lowering of TG and elevation of LDL-C and HDL-C as well as total cholesterol. There is still much we don´t know about cholesterol and it´s causative role in heart disease. Although LDL-C correlates strongly with cardiovascular risk it may sometimes… Read more »

Kevin O'Connell
Guest
Kevin O'Connell

22 months ago I weighed 123kg (188cm tall), BMI-35, 42-43% body fat, was taking Rosuvastatin (Crestor), ‘Coolmetec’ (Olmesartan + Hydrochlorothiazide), Allopurinol and Fluindione (Previscan=warfarin, replacing Amiodarone which had been fingered as the cause of peripheral neuropathy) and about to start a course of ADT (Triptorelin – standard side effect weight gain). Bloods at the time: TC-171, LDL-63, HDL-66, TG-208, TG/HDL-3.2. (not good at all, although some doctors would be happy with them) I was worried, did a lot of research (multi-pronged: cholesterol, cancer, biochemistry, nutrition, …), decided to cut down heavily on starches, sugar and vegetable oil, ‘persuaded’ my doctor… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Kevin. Congrats on your results, I think they are fantastic. I believe you have substantially improved your health although you are seeing higher LDL-C numbers than before.

Circulating cholesterol is not a problem in itself. It is not until cholesterol is trapped within the vessel wall that it becomes a part of the atherosclerotic process. Oxidation of cholesterol within the arterial wall certainly plays a role among many other factors, inflammation being one of them.

Franziska Spritzler
Guest

I voted for staying with the LCHF diet as is for the reasons pointed out by some of your readers. Many people experience a transient increase in LDL-C initially when eating LCHF, particularly if they are losing weight. However, eventually it usually goes back down. Some people will always have higher LDL cholesterol than others,and whether elevated levels contribute to heart disease risk is a controversial topic. At any rate, the benefits of lower TG, higher HDL, and well controlled blood sugar are universally agreed upon, and I feel Peter should stick with LCHF, which will likely result in further… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Thanks Franziska. Sounds rational as expected from you.

Red
Guest
Red

I voted to stay on the low-carb, high-fat diet, but I think it’s very useful to point out that you don’t have to “assume” or “guess” that the LDL cholesterol is switching over to the large, fluffy type that seems to not be a concern as it comes to heart disease. You can do a test and see for sure. I’d have him continue on for several more months and with the next bloodwork do the more detailed test that will tell him what type of LDL he is producing. Then, depending on the results, you and he can decide… Read more »

Halldor
Guest
Halldor

Try to get most of his calories from fruits like bananas and dates and those kinds of things. Make fruits be the number one snack and what ever possible. Endless benefits and nothing negative, the people who just eat fruit, even crazy amounts of fruit are extremely skinny. Add to that vegetables, nuts, bread, rice and things like that. I totally agree with his wife, avoid animal fat and animal protein. A billion skinny Asians eating rice proves that rice does not make you fat so nothing to worry about when it comes to rice and potatoes even though they… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Halldor. The emphasis on low fat and plant based foods usually works very well. You just have to adhere to it.

Raymund Edwards
Guest

Stick with Low carb , but tweak the types of fats.

We need a variety ,, saturated , Mono , Poly ,, They each are needed and need each other.
As is found in the fatty acid profiles of wild game meats ( both hot and cold blooded ( often overlooked ) ) and plants.

Important information here I feel . make sure to open the graphs ( Figures )

I myself am doing plenty of tweaking .. fatty acids are not just energy , but important factors that trigger gene expression too.

https://people.brandeis.edu/~kchayes/bginfo.html

Cassie
Guest

Please everyone remember Vitamin K2 along with the LCHF diet (4 years now for us). Vit K2 is essential for laying calcium into the bones not the arteries and kidneys. Since I have taken K2 not only is there a reduction of arterial plaque in my husbands arteries there is also hardly any tartar on my teeth. My husbands osteoporosis is improving with his bone density showing a much better Dexa scan result this year.
Natural sources of K2 is grass fed meats not grain finished. We take a supplement also.

Rory
Guest
Rory

Ive had a similar situation that Im seeing more and more of as I research. Been Paleo for 1 year now. Prior to Paleo I had a low fat/high carb diet. TC was always under 200 and the only elevation were trigs (150) 6 months into Paleo this was my lipid panel: TC-200 LDL-122 HDL-57 TG-50 1 year later and my TC and LDL had jumped. TC-245 LDL-157 HDL-57 TG-100 (did not fast) So I went and got an NMR 3 weeks later and another big jump in just that short time frame: TC-287 LDL-211 HDL-67 TG-49 LDL-P-1979 (more type… Read more »

Carol
Guest
Carol

My before and after numbers resemble those of your patient, although I went from “heart healthy” food pyramid on whole grains only to low carb. I haven’t lost any weight, already being at a healthy weight and BMI, with consistently good life style habits. I’m a good “control” , therefore, for some of the confounding factors in diet studies. I can’t say about others, but for myself low carb is a great improvement. My doctor promotes DASH and drugs, but I disagree.

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Thanks Carol. That´s interesting because often low carb is recommended primarily for those who are overweight/obese or suffer from the metabolic syndrome. But I presume the best diet for you is the one that makes you feel best.

Carol
Guest
Carol

Actually I don’t feel any different, except that on lchf I am not hungry all the time. The transition to a ketogenic state was effortless. I miss the whole grains, but now I can eat cheese without guilt.

Halldor
Guest
Halldor

If you go on youtube and search for “Durianrider : Low carb diets vs High carb diets” you’ll find an interesting video. The guy is not very politically correct or nice..or polite but what he does there is quite interesting. He compares how the authors of diet books are doing, the one’s who recommend plant based diets, low fat high carb diets to the one’s who recommend animal based diets and high fat, low carb diets.

Rory
Guest
Rory

So I got another cholesterol test done…this was another 3 weeks after the NMR above. This was just a regular lipid panel so no LDL-P count which I WISH I had now done based on the latest numbers. You can see what I changed above. This also wasnt done by the same labs as above so sure there are variances. TC-194 LDL-120 (Calculated) HDL-56 Tri’s-90 (I knew this would be higher as the day prior I has consumed almost 300g of carbs) Im pretty stunned as I was not expecting this dramatic of a drop in such a short space… Read more »

Doc´s Opinion
Guest

Your experience is interesting Rory. Your lipid response is quite typical for a low carb high fat diet. You have certainly managed to lower TC and LDL-C by cutting down on saturated fat and introducing healthy carbs. It will be interesting to see your LDL-P. Keep us informed.
Thanks for sharing.

Randy
Guest

Hi Dr. Sigurdsson, thought I’d add myself as an additional case study on the top of low-carb diets and cholesterol.

I’ve been on a low-carb, high-fat diet for over 4 months now and have gained a six-pack but also a 56% INCREASE in my total cholesterol. The fat burning benefits of a low-carb diet are undeniable but my lipid biomarkers have gotten worse in pretty much every respect. I’ve listed my detailed figures here:
https://www.chinabiohacker.com/blog/cholesterol-with-your-six-pack

I would greatly appreciate any advice/suggestions you might have as I continue to experiment with my diet. Thanks!

Matt
Guest
Matt

Hi Dr. Sigurdsson, I’m glad to have found this site…great info!. My story: About a year and a half ago my Naturopathic Doctor (ND) diagnosed me with a number of “things,” including adrenal fatigue, depression, MTHFR Gene Mutation (can’t process folate), low thyroid function, insulin resistance / pre diabetes and high cholesterol…geez, I read this and want to pull the covers back over my head. Anyway, back in January of this year (2014) my weight was 202 (I’m a 51 y/o male, 5’11”) and my lipid panel was “bad.” My ND told me to lose weight, and cut back on… Read more »

Chris
Guest
Chris

Great stuff! Im 41 and fit. Always have been. Ive ate a low fat diet my whole life. 5 months ago I switched to high fat vey low carb.
Exercise a lot.
as a carb eater
TC 211
LDL 125
hdl 54
Tri 117
low carb
TC 325
LDL 210
HDL 100
Tri 46.
My doctor is going nuts as well as a cardiologist. I plan on doing the NMR test. Im not sure what to do next. I think I will increase good carbs to 100g a day and see what happens.

Jon Booker
Guest
Jon Booker

Your tg/hdl ratio is very good. From what I’ve been reading is that this is predictive of large,fluffy ldl. Please update when you have NMR results

Christine Straight
Guest
Christine Straight

Hello…while researching whether I should
go on a lchf diet I found this discussion…my TC is about 425 and always has been…I’m 58 female…both parents same numbers…but I’m a little afraid …I know from past experience that you can drop weight easily without being hungry but I am not trying to commit suicide here either….your opinion appreciated…thanks!

Eliot
Guest
Eliot

425 is in the FH range I think. Are your parents still alive? Do you have any more details on the numbers, like HDl-C, LDL-C, TG, LDL-P etc?

Even most anti-statin people like Dr Mercola say to take a statin if TC is over 330.

Bradley
Guest
Bradley

I’d been on a mostly vegetarian (occasional fish and beef) diet for about 2 years. Lots of raw food, greens, grains, veggies (Forks over Knives poster-child). I decided to see what kind of awesome results my near perfect diet would produce. To my shock my scores looked bad. I also did the NMR test and I had high scores in all the wrong areas. Total – 222 Ldl – 146 HDL – 47 Tg- 146 After three weeks on a Ultra-LCHF diet, (still was taking Lipitor and 500mg niacin). Total:137 Ldl: 65 HDL:59 Tg:64 Two Month later on LCHF (Off… Read more »

Jon Grant
Guest

I can’t tell you how to interpret your results, but if these were my own results, I would look at TG, HDL, and TG/HDL ratio. TG is very low (excellent), HDL is good, TG/HDL is excellent. Those numbers alone would make me very comfortable. I personally wouldn’t do anything to lower total cholesterol (or LDL) because I don’t think they correlate very well with cardiovascular risk. I might be interested in knowing the total LDL particle count since that seems to be a good metric as well, but I would not dwell on the LDL-C number after seeing the low… Read more »

Chris
Guest
Chris

Way to make the switch on the diet. That must have been hard. To answer your question, we have to define what perfect or ideal is. The guideline ranges for blood lipid are based on a sampling of people who may have been healthy or unhealthy. Probably unhealthy and on the SAD diet. We hear about normal ranges. That does mean ideal for health. Dont take the pills. I went through a similar thing. I ate healthy exercised a lot but numbers weren’t too good. I switched to a vlc diet and trig were 47 hdl 100! However my TC… Read more »

Bradley
Guest
Bradley

I posted earlier today my results and questions…. but for those of you who want to see what a LCHF did to my NMR profile in 3 weeks (while still on statin and niacin): Pre-LCHF (mostly HCLF): LDL-P 2053 LDL-C 146 HDL-C 47 Triglycerides 146 Cholesterol, Total 222 HDL-P (Total) 35.1 Small LDL-P 1037 LDL Size 21.0 After 3 weeks on LCHF (but still taking Lipitor and niacin): LDL-P 789 LDL-C 65 HDL-C 59 Triglycerides 64 Cholesterol, Total 137 HDL-P (Total) 40.7 Small LDL-P 378 LDL Size 20.8 My plan is to keep up the LCHF lifestyle for a while… Read more »

Jon Grant
Guest

I would almost be concerned that the LDL-C of 65 might not be healthy.

Chris
Guest
Chris

Correction…in my previous post…. …..”…that doesN’T mean ideal for health” oops.

Jon – I agree.

Michael Suede
Guest

A physician recommending a high fat low carb diet, such as the Atkin’s diet, is absolutely inexcusable given the totality of nutrition science that has been published over the past several decades. Does the human body resemble a carnivore in any way whatsoever? The human body is designed to consume complex and simple sugars (carbohydrates) as its primary fuel. This is absolutely scientifically indisputable. Our taste buds are designed to primarily seek out sugars and salts. We have no taste buds designed to taste specifically for meat, unlike your cat. Since we have no meat specific taste buds, most of… Read more »

Sircornflakes
Guest
Sircornflakes
Christina
Guest
Christina

All you clever people. I was diagnosed with FH Cholestrol 8.50 LDL 5.9. which differ from normal cholestrol. Please tell me which diet to follow to lower my LDL? As I almost eat NO FAT and NO saturated fat food at all. It is quite an emergency as my son is also no diagnosed with fat around his liver.
Your soon response would be appreciated.

wendy trauth
Guest
wendy trauth

I also have Heterozygous FH. Sorry to tell you this but you need to be on meds. I tried every statin and could not tolerate any. I’m now on a PCSK-9 inhibitor- Praluent at the highest dose. I was on the Dean Ornish heart Reversal diet- extremely low-fat (7% of total calories) vegetarian diet and after 1 year every lipid was terrible. A diet won’t work for FH. Before Ornish diet- Total- C, 289, LDL 162, HDL 40, Trig.90. Then at 8 months on diet-an improvement- Total C 212, LDL- 106, HDL 30, Trig. 150. At 1 year- Total-C 278,… Read more »

Joan
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Joan

When I went on a ketogenic/ atkin type diet, my total cholesterol went up to 350. I would not ever go on that type of diet again. By eating much less fat, proteins, vegetables, oatmeal and whole wheat types of carbs, I’ve managed to keep my cholesterol to 220. That, I guess is good for me. I’ve known about the tendency for my body to manufacture cholesterol for 40 years. Lucky that I found out about so I am still here, not fat, and can effectively keep my total cholesterol to an acceptable level for me.

Lucy Bryant
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Lucy Bryant

I’m skeptical about high fat diets lowering cholesterol. I’ve had a milk allergy since birth, and I recently discovered that I could tolerate ultra-pasteurized dairy products (the extra boiling time alters the proteins so that my body doesn’t recognize them as allergens). Anyway, I went crazy, scarfing down heavy cream, whip cream, milk, etc. As a result, my cholesterol sky rocketed to 200–and it has never been high before. I saw this happen in a dog I had years ago as well. She had kidney disease, and there were few foods that I could give her, but I could increase… Read more »

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