Low Carb and Cholesterol

[RacerBill]

I know there is little evidence that eating cholesterol-rich foods will raise serum cholesterol, but it would appear in my case, that's exactly what happened. I've been eating TNT-A since January.

Last year my total was 180, triglycerides 47, HDL 41, LDL 130.

Today's test: total 281, triglycerides 60, HDL 58, LDL 211.

Triglycerides are still pretty low, and trigl/HDL ratio is still fine at 1.034.

The Doc thinks I need a statin drug. I've told him I want to have another test in six months and we'll see then. I really don't think a drug is necessary based on other things Alan's said before, but the sudden 101 point rise has the doc concerned.

Alan, Jamie, others -- any suggestions? Do you think eating less cholesterol might help? Thanks!!

[cycomiko]

Originally Posted by RacerBill

I know there is little evidence that eating cholesterol-rich foods will raise serum cholesterol, but it would appear in my case, that's exactly what happened. I've been eating TNT-A since January.

Well, there is good evidence that in specific individuals eating high fat.high cholesterol will raise plasma cholesterol.

Last year my total was 180, triglycerides 47, HDL 41, LDL 130.

Today's test: total 281, triglycerides 60, HDL 58, LDL 211.

Triglycerides are still pretty low, and trigl/HDL ratio is still fine at 1.034.

The Doc thinks I need a statin drug. I've told him I want to have another test in six months and we'll see then. I really don't think a drug is necessary based on other things Alan's said before, but the sudden 101 point rise has the doc concerned.

Alan, Jamie, others -- any suggestions? Do you think eating less cholesterol might help? Thanks!!

Whats the fat sources in your diet.

[Milko Georgiev]

Originally Posted by cycomiko

Whats the fat sources in your diet.

Yes, Bill?

[LisaS]

bill - I wouldn't worry about LDL unless I knew the particle size - which is another specialized blood test.

[Lost Dog]

Here's an excerpt from the TNT book.

Contrary to popular opinion, not all LDL cholesterol is bad. Doctors have known for many years that LDL comes in different sizes. There’s pattern A, which are large, “fluffy” particles, and pattern B, which are small, dense particles. Back in 1997, Canadian researchers reported for the first time that men with the greatest number of small, dense particles had a nearly 4 times greater risk for developing heart disease than those with the least number. As they followed these men over the next several years, they confirmed this finding. They also determined that large, fluffy particles of LDL were not even associated with heart disease. So it’s not just how much LDL cholesterol you have, it’s the type of LDL cholesterol that matters. Bottom line: Small LDL particles have been shown over and over to be associated with increased cardiovascular disease.

Can you guess the number one factor determining LDL size? It turns out it’s the carbohydrate content of your diet. You know how enthusiastic we are about low-carbohydrate diets, so you won’t be surprised to find out that they change the LDL particles from small to large—that is, from harmful to harmless. Even though total LDL cholesterol may stay the same or even increase slightly with the TNT Diet, the size of those LDL particles increases. As a result, the amount of the small, dense artery-clogging particles floating around in your blood stream is reduced, which significantly decreases your risk of heart disease. For example, the low-carb dieters in our lab experienced a 10 percent reduction in small LDL particles. Thus, even if you are one of the people who experiences an increase in LDL cholesterol levels, this is likely due to an increase in the non-threatening large, fluffy LDL particles. At the same time, you probably also increased HDL cholesterol and reduced your triglycerides—a finding you should share with your doctors should they ever raises their eyebrows at your LDL numbers

Cut a Key Predictor of Heart Attacks by 54%

The trouble with asking your doctor to check your LDL particle size is that few will accommodate you—at least not if you’re paying with insurance. That’s because insurance companies are behind the times when it comes to covering charges for some of the emerging risk factors. But you can probably figure it out for yourself, by calculating your ratio of triglycerides to HDL. To do so, simply divide your triglycerides by your HDL cholesterol reading. Researchers at the Albert Einstein College of Medicine determined that this ratio is inversely related to LDL particle size. That means the lower your ratio, the larger and fluffier your LDL particles. For instance, scientists found that in people whose ratio was 3.8 or greater, 83 percent of their LDL particles were of the small, dense variety. Once that ratio dropped below 3.8, though, only 11 percent of the particles were found to be harmful. Let’s walk through an example. Suppose your triglycerides are 125, and your HDL cholesterol is 50. You’d divide 125 by 50, for a triglyceride-HDL ratio of 2.5. Congratulations: Your LDL particles are as big and fluffy as the Stay Puff Marshmallow Man.

Your ratio is 1.03, which is pretty low, which would indicate that you have some fluffy LDL, man. Good job!

I have to point out that all I know about it is from this one book...

[cycomiko]

The ratio is only a guestimate of ldl particle size, but then a lot of labs dont actually measure ldl anyway.

[RobLL]

puzzling, another factor, if you are losing weight you body is running on a higher fat diet than just your diet. This usually raises tryglycerides more than low density. But different bodies do different things. I take statins, but there are major questions out there as to just how they do their good things, and that there may be more bad than is known. In any event I think LDs post on 'fluffy' low density indicates getting those tested may be in order.

[Alan Aragon]

Originally Posted by RacerBill

I know there is little evidence that eating cholesterol-rich foods will raise serum cholesterol, but it would appear in my case, that's exactly what happened. I've been eating TNT-A since January.

Last year my total was 180, triglycerides 47, HDL 41, LDL 130.

Today's test: total 281, triglycerides 60, HDL 58, LDL 211.

Triglycerides are still pretty low, and trigl/HDL ratio is still fine at 1.034.

The Doc thinks I need a statin drug. I've told him I want to have another test in six months and we'll see then. I really don't think a drug is necessary based on other things Alan's said before, but the sudden 101 point rise has the doc concerned.

Alan, Jamie, others -- any suggestions? Do you think eating less cholesterol might help? Thanks!!

I actually want to hear what Aaron has to say about this - the guy is a focking tomb of knowledge when it comes to clinical stuff.

In any case, the 1st Q that I have is whether or not you increased or decreased your total kcals when you began this diet.

[Jean-Paul]

Bill, I had the opposite results on this diet. My caloric intake is pretty similar (maybe more since I'm eating so much fat).

My cholesterol before I started had climbed up to the 220's, but my ratio (like yours) was still in the safe range. My LDL had gotten to be around 170. Now my total cholesterol is in the 170's, and my HDL is identical to yours (58).

I eat real butter, oil based dressings, GOOD steaks (ike ribeyes and NY strips), bacon a couple times a week, whole eggs every day (2-6), real cream in my coffee, lots of cheese. Of course I eat a bunch of veggies and protein sources as well, but my numbers all dropped. Triglycerides were in the 80's last time I had them tested. Glucose the same.

Maybe our unique chemical make-ups make me ideal for this style of eating, but perhaps for you not so much. When you come to the summit you can meet Alan Aragon in person and pick his brain over many beers.

[RacerBill]

Originally Posted by cycomiko

Well, there is good evidence that in specific individuals eating high fat.high cholesterol will raise plasma cholesterol.

Any data on which individuals? Is there a test? Sounds like I may be one of them.

Originally Posted by cycomiko

Whats the fat sources in your diet.

Currently fish oil, eggs, cheese, olive oil, butter, nuts, meat (generally I don't eat much fatty meat, though). I use a little canola when cooking in cast iron. I try to avoid soybean oil.

Originally Posted by Alan Aragon

I actually want to hear what Aaron has to say about this - the guy is a focking tomb of knowledge when it comes to clinical stuff.

In any case, the 1st Q that I have is whether or not you increased or decreased your total kcals when you began this diet.

No, I actually decreased kcal. I've lost 14 pounds since January.

I aim for about 2300-2400 per day when I'm cutting. Previously I did that with ratios of 40% P, 30% C and 30% F. With TNT it worked out to 40% P, 10-15% C and 45-50% F.

Originally Posted by Jean-Paul

Bill, I had the opposite results on this diet. My caloric intake is pretty similar (maybe more since I'm eating so much fat).

My cholesterol before I started had climbed up to the 220's, but my ratio (like yours) was still in the safe range. My LDL had gotten to be around 170. Now my total cholesterol is in the 170's, and my HDL is identical to yours (58).

I eat real butter, oil based dressings, GOOD steaks (ike ribeyes and NY strips), bacon a couple times a week, whole eggs every day (2-6), real cream in my coffee, lots of cheese. Of course I eat a bunch of veggies and protein sources as well, but my numbers all dropped. Triglycerides were in the 80's last time I had them tested. Glucose the same.

Glad it did so much good for you, JP. Sounds like we're eating very similarly.

Originally Posted by Jean-Paul

Maybe our unique chemical make-ups make me ideal for this style of eating, but perhaps for you not so much. When you come to the summit you can meet Alan Aragon in person and pick his brain over many beers.

I'm planning on it. Maybe not so many beers since I'm carb-phobic.


And everyone -- thanks much for the input. It's greatly appreciated!!! Can't imagine trying to be healthy without this place!

[cycomiko]

Originally Posted by Alan Aragon

I actually want to hear what Aaron has to say about this - the guy is a focking tomb of knowledge when it comes to clinical stuff.

He's full of something, thats for sure.

I will reply some more when I get back to work from the jim

[cycomiko]

Originally Posted by RacerBill

Any data on which individuals? Is there a test? Sounds like I may be one of them.

Not really.

Typically the people are higher in cholesterol to start with *hypercholeserolemic* and are eating a good whack of saturates to start with. Which the list below shows a reasonable amount of saturates.

there are genes involved (cant remember them off teh top of my head) but the above pretty much covers the basic setup.

Currently fish oil, eggs, cheese, olive oil, butter, nuts, meat (generally I don't eat much fatty meat, though). I use a little canola when cooking in cast iron. I try to avoid soybean oil.

In some people, raising the intake of fats in general can influence their cholesterol levels. Like fish oil can lower LDL, if it replaces another fat in the diet, if the fish oil is consumed in addition to other fats, it can raise the levels. Fish oil will generally lower TAG's adn VLDL tho.

Since you are carbophobic, how much fibre do you have in the diet, specifically relating to the soluble fibre. Something as simple as reducing the fibre in the diet can raise the level of cholesterol nicely, due to decreased losses through the GI tract (fibre can bind cholesterol).

I have seen peoples cholesterol improve dramatically from low carb, and I have seen others double...

No, I actually decreased kcal. I've lost 14 pounds since January.

In general losing fat will lower cholesterol levels, however this are some issues with this.

I saw a presentation a year and a half ago from a researhcer who performed a posthoc analysis on subjects who were involved in a trial of three diets, low carb, zone and the standard ADA style diet (not exactly, different country different diets but its similar enough). During this time, they took a ton of blood samples, examined their plasma fatty acids (erythrocyte, esters and shit - memory is fading), cholesterol levels and a few other measures.

the plasma fatty acids did not change significantly during the diet, and did not represent what the dietary fatty acid spread looked like.

This is because the plasma fatty acids at rest were influenced by the fat being released from your cells (which is representative of the diet months/years ago) and thus the stimulatory effect on cholesterol is based upon these fatty acids. Dietary fat in the terms of this has minimal effect, as its being used by the body relatively quickly as an energy source/ketones, where as its availability increases re-esterification in the fat cell (keeps as much of the the fat that was in the cell, in the cell, as it can). It gets complicated... I havent seen enough long term work examining it.

If you have no other risk factors (BP, Tags, waist/hip ratio, bmi yada yada yada) push back on the statins in the short term.

Try some short term trials (2-3 weeks is enough to have a good change in cholesterol from diet) with raising the fibre content, soluble where possible, supplement or food based. Niacin is another option, but it also blunts lipolysis. Also, dont be afraid of the carbs. They are great within context of a whole diet.

[Milko Georgiev]

Originally Posted by RacerBill

Currently fish oil, eggs, cheese, olive oil, butter, nuts, meat (generally I don't eat much fatty meat, though). I use a little canola when cooking in cast iron. I try to avoid soybean oil.

Cheese - no vegetable oil or/and soy added?!
Olive oil - virgin?!
Butter - whole fat?! No vegetable oil added?!
Nuts - raw?!
Canola - use butter!
Avoid soybean oil at all! Avoid soy at all! Soy is hidden everywhere!
Hydrogenated oil is hidden everywhere!
Drink pure water! At least 3 liters daily.

[Dhocott]

This sounded weird and I have not heard it before but my doctor told me in February when I had my blood work done that the numbers were actually a representation or our body's condition about three months prior to the test.

My LDL's were a little high, but since I started dieting in December and had lost some weight, he suggested I continue my program and we get it checked again in June.

I told him about the TNT diet and he believes the amount of fat you eat does not affect cholesterol as much as the amount of fat you carry.

Food for thought

[RacerBill]

Originally Posted by cycomiko

Try some short term trials (2-3 weeks is enough to have a good change in cholesterol from diet) with raising the fibre content, soluble where possible, supplement or food based. Niacin is another option, but it also blunts lipolysis. Also, dont be afraid of the carbs. They are great within context of a whole diet.

Thanks much, Aaron. Alan's not kidding when he says you're a tomb of info.

I played around with Fitday and figured out my fiber intake went down by almost half when I started TNT. I'll start experimenting and go back to some daily oatmeal and fruit.

Originally Posted by Milko Georgiev

virgin?!

I say, that's rather a personal question...

Originally Posted by Milko Georgiev

Cheese - no vegetable oil or/and soy added?!
Olive oil - virgin?!
Butter - whole fat?! No vegetable oil added?!
Nuts - raw?!
Canola - use butter!
Avoid soybean oil at all! Avoid soy at all! Soy is hidden everywhere!
Hydrogenated oil is hidden everywhere!
Drink pure water! At least 3 liters daily.

I use real cheese, real butter, extra-virgin olive oil, dry-roasted nuts without salt. I stay away from processed and prepackaged foods since, yes, there is soy and hydrogenated oils in many of those.

Plenty of water, too. Probably more than 3 liters. My coworkers know not to keep me in a meeting for more than an hour because I have to trot off to the restroom.

Dhocott - interesting about the 3 month thing. Did the doc say that was for cholesterol in particular, or just blood tests in general?