Instructor teaches Friedewald equation and bad cholesterol

This week sees the publication of yet another study showing the superiority of the low-carbohydrate diet as compared to the low-fat diet.  This study, published in the prestigious American Journal of Clinical Nutrition, demonstrates that subjects following the low-carb diet experience a decrease in triglyceride levels and an increase in HDL-cholesterol (HDL) levels; and that these changes are accompanied by a minor increase in LDL-cholesterol (LDL), which prompts the authors to issue a caveat.

Yes, although just about all the parameters that lipophobes worry about improved with the low-carb diet, the small increase in LDL has caused great concern and has prompted the authors to gravely announce that this small increase is troublesome and should be monitored closely in anyone who may be at risk for heart disease.  Since most people who go on low-carb diets do so to deal with obesity issues, and since obesity is a risk factor for heart disease, it would appear that this small increase in LDL often seen in those following a low-carb diet could put these dieters at risk.  Does it?  We’ll see.

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In the last post I wrote that I would explain why George Bray and his brethren in the academic obesity research world are in great measure responsible for the toxic world they all blame for the obesity epidemic.  We live in a world, they say, filled with impossible to resist foods that throw us into hedonic overdrive.  As long as we live in such a world, there is no hope – other than drugs, of course – for the obesity epidemic to be reversed.  They may be correct.  But, as I said, they are in part responsible.  Let’s see why.

You can’t just go around gibbering as they do about a toxic environment without defining what it is that is toxic about it.  If pressed, these folks almost always default to the position that it is the elevated levels of fat in the diet that are toxic.  They will often say – as Bray did in his rebuttal to Taubes – that the ready availability of high-fat, high-sugar foods is what makes the environment toxic, but that is just a kind of code for high fat, which is what they really believe causes obesity.

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Almost ten years ago when we were in practice in Boulder, Colorado we started looking for a good weightloss supplement to help our patients on low-carb diets lose a little more quickly.  We evaluated a lot of supplements on the market that were supposedly weight loss accelerators – chromium, hydroxycitric acid (HCA), ephedra, phenylpropanolamine, pyruvate and a few others – with out a lot of success.  The ephedra and, to a lesser extent, phenylpropanolamine unquestionably helped people lose weight, but were fraught with side effects.  Pyruvate showed promise, but was pretty expensive.  Our partner found a couple of medical papers using a combination of supplements, some of which individually didn’t work all that well but in combination seemed to show promise.  We cobbled together from healthfood-store supplements a sort of beta-prototype of this combination and used it on a number of our willing patients.  The vast majority, all of whom were on low-carb diets, tolerated the supplement and felt it made them lose weight better.

Happy with these results MD, our partner and I decided to take the next step and get an actual product made.  We did, and let patients try it.  Again, the patients liked the supplement and though they lost weight better on it.  Although we, too, thought the patients did better, we couldn’t really say because we hadn’t compared the supplement with a placebo in a controlled fashion.  We decided to take that next step.

We contacted a clinical lab that does testing for a fee (a substantial fee, I might add) and talked to the director of the facility, who was pretty discouraging.  He told us that he would be happy to take our money and test our supplement, but that we shouldn’t get our hopes up.  He related that his company had tested scores of nutritional supplements and had never found one that really did much.  And that he figured ours wouldn’t do well against placebo either.

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I’m going to toss off a question about the paradoxical nature of low-carb diets.  Here is the set up.  Most people reading this post will have – at some point, at least – enjoyed the benefits of a low-carb diet.  They will have had more energy, slept better, rid themselves of heartburn and GERD, stabilized blood sugar, reduced blood pressure, normalized lipids and lost weight.  Many will have been able to rid themselves of one or even a handful of drugs.  All will have felt much, much better than before starting the diet.  And, if most are like me, will marvel on what a wonderfully filling and satisfying diet it is and will tell them selves that the low-carb diet is really the only diet worth following.

Okay, that’s the set up.  Here is the question:

Why are low-carb diets so difficult to stick to for so many who have had the above experience?

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