Comments on: Low-carbs and lipids

By: Ram

Ram — Fri, 09 Jan 2009 17:11:00 +0000

Hi,
Today, we had a lecture by one ‘eminent’ doctor (who heads the diabetes treatment division in a big hospital at Bangalore-India) on prevention of diabetes through diet and exercise. He appears to have published a lot. When I asked him about low carbing, he had the guts to say that it is irrational and there is no published evidence showing that it works. When I mentioned about my lab values (after an year of LC, that too falling off the wagon every three weeks-for two weeks) the only thing he pointed out was that my Triglycerides are high due to low carbing. I had got it checked two years ago and it was 175. While I know that he was bluffing through his hat (since I have personally read many papers on LC benefits-thanks to your books and blogs) my high! TG and VLDL put me to a great disadvantage in front of the gathering which did not want to believe me anyway. Am I doing something wrong to have those TG numbers?

My wife is in US (NJ) since one week and we (2 kids with me) will be joining her in March hopefully by the time the 6 Week cure.. gets out. Could we be fortunate to get your signatures on our copies?

My lab work:
HBA1C- Jan 2008: 8.5, Jul 2008: 6.9 and Jan 2009: 6.5. I am on 1000 mg Metformin for a year
Lipids (Jan 09)- TC 189, TG 220, HDL 41, LDL 104, VLDL 44

Could you please suggest something for staying on LC continuously? I am doing it typically for 3weeks – 2weeks of mindless eating – 3 weeks LC again… pattern.

Regards,
Ram

The ‘eminent’ doctor is an idiot if he thinks your triglycerides are high because of low-carbing. Triglycerides always fall on low-carb diets. I suspect your triglycerides are high because of the two weeks of backsliding you do after every three weeks of low-carbing. I’m planning a post soon on how you can maybe prevent that.

By: g

Tue, 15 Jan 2008 05:15:38 +0000

Hi,
You wrote earlier in response to Dr. Davis and his plaque reversal tome “Track Your Plaque”

‘Good to hear from you. I read your blog from time to time and read your book Track your Plaque over the holidays. I was already pretty much sold on the idea of calcium scores, but your book really convinced me of their merit.’

CAC scores are calcium scores on EBT/CT scan (calcium is pathognomic for plaque). What are your experiences and insights on plaque regression with Protein Power? I would imagine that the potential to reduce small dense LDL is there, but does it have any effects on Lp(a) or Homocysteinemia (as Track Your Plaque does)?

THANK YOU IN ADVANCE FOR YOUR TIME!

Much respect, g

Hi g–

I’ve not worked much on reducing calcium scores because when I left active practice these things were just getting started. I do know that a Protein Power style diet drastically reduces triglycerides and increases LDL particle size because I have measured those directly. And the increased saturated fat in such a diet markedly reduces Lp(a), another phenomenon I’ve seen first hand. The work on homocysteine was also just becoming known – at least to me – when I stopped practicing, and I didn’t have enough patients whom I had checked homocysteine levels on to really get a feel for whether the diet worked for that as well. I would assume that the program as we administered it would have worked because the patients got plenty of vitamin B12 from the diet and plenty of folic acid and vitamin B6 from both the diet and additional supplements.

Cheers–

MRE

By: Karen J

Karen J — Sat, 12 Jan 2008 06:17:07 +0000

In response to Janet,

I, too, get RSS comment feeds. It is the primary way in which I’m alerted to new comments, but also a primary way in which I’m alerted to new posts (by way of comments).

I completely agree that sometimes comments show up weeks, months, or even years after the original posts, yet they are worth reading (and even commenting on ).

Anyway, wouldn’t it be funny if anthropologists of the future lamented the lameness of Total Cholesterol and LDL particle size?
Of course, anthropologists of the future would need an adequate brain to do so… uh oh!

Darwin weeps. And Homo sapien sapien regresses ever more…

Or, the other scenario: the Darwinian one, suggests that the Ornishes shall become extinct, and the low carbers (the meek) inherit the Earth?

I’ll settle for just the Ornishes becoming extinct.

Cheers–

MRE

By: Daedala

Daedala — Fri, 11 Jan 2008 21:17:33 +0000

Wow, no, certainly no controlled studies (aiee!). But more followups. I’ve hardly found anything. Do they just not want to know?

No, I don’t think they do.

By: Robert

Robert — Fri, 11 Jan 2008 20:16:57 +0000

Reminds me of my new favorite quote..There ae lies, damn lies and there are statistics”

By: dhania

dhania — Fri, 11 Jan 2008 20:06:16 +0000

There you go:

http://news.bbc.co.uk/2/hi/health/7180733.stm

“Statins for all diabetics urged

People with diabetes should receive cholesterol-busting drugs regardless of whether they have signs of heart disease, UK researchers say.

Statins cut the risk of heart attack, stroke and death in diabetic people even in those with low cholesterol levels, analysis of 14 trials shows.

It means hundreds of thousands more people could benefit from treatment, the Lancet report said.

There are 2.5 million people diagnosed with diabetes in the UK.”

Jesus wept.

Bawled his eyes out more like.

Cheers–

MRE

By: g

Fri, 11 Jan 2008 05:03:00 +0000

Hi Dr. MRE, Thank you for your blogs — I’ve lost myself 45 lbs on low carb for the last several yrs and really appreciate the info and ideas that share here! the ADA shortly may not be on everyone’s target list b/c their practice guidelines will advise ‘low carb diets’ for wt loss x1yr (not for glucose control, read, wt loss only ). see diabetes.org (under publications) just fyi! I’m a CDE so I counsel many T2DM patients — I’ll tell you this will make the job 400% easier finally.
I’m glad to see that you’re getting into TYP — I’ve been investigating it since Sept (I wish that I found the light sooner!) and have found studies that back up nearly every strategy (I just haven’t had the time to look e-v-e-r-y-t-h-i-n-g up yet ;-/ ) and have personally seen it work in a secondary CAD individual (ie, cessation of stable angina). I’ve just had another guy tell me yesterday that his ED is ‘TWO TIMES better’ (translation: he stopped using Cialis). DO you see any changes such as this?
I was curious, how protein power affects CAC scores? I imagine it would improve it significantly but would it dramatically reduce CAC score 10-30% CAC annually as some people are achieving on TYP (conventional TYP *ha* in case you know what that is)?

Have you been on Oprah yet? How do we get both you and DR. D and MD on that show? (get Oz impeached?)

guess who is Vit D deficient (which triggered her hypothyroidism, I conjecture)? probably Oprah… wonderful Oz, think u missed that one…

THANK YOU IN ADVANCE FOR YOUR INSIGHT and humor! g

Hi g–

You wrote that you were glad to see that I’m getting into TYP…I suppose I would be glad, too, if I only knew what it was. And CAC scores. What are those?

Haven’t been asked to be on Oprah yet, and I’m not waiting by the phone.

Cheers–

MRE

By: David Godot

David Godot — Fri, 11 Jan 2008 04:36:48 +0000

Hi Dr. Mike,

I have two questions for you that don’t really fit this post, but hopefully you’ll find interesting enough to be worth your while:

1) I’ve always been skinnier than I’d like to be. I’ve been low-carbing for about a year, and had up til recently gained a healthy-looking layer of subcutaneous fat for the first time in my life. I’ve recently lost it again (along with almost 10 lbs), and I suspect this may be due to my holiday-season sweet tooth, but I simply can’t make heads or tails of the biology behind what might be happening. Would you be willing to offer any insight into the inner workings of those of us on the opposite end of the metabolic spectrum?

2) Do you have any opinions on conjugated linoleic acid (CLA), and whether supplementation with it might be a good or bad idea?

Thanks for your always entertaining blog, and happy new year to the Eades family.
David Godot

Hey David–

Sorry it’s taken me so long to get to your comment, but for some reason you got hung up in my spam filter. I’ve got to apologize, but I’ve just got to say it: Godot has been waiting for me.

The problem of inability to gain weight is as frustrating to those who have it as is the inability to lose weight to the rest of us. As I’ve pointed out before, and as Gary Taubes makes much of in his book, the calories in/calories out side of the energy balance equation are not independent variables. When you decrease calories coming in, the calories going out (i.e., energy expenditure) don’t stay the same: they tend to go down as well. Which makes it difficult to lose weight for most people. Overfeeding studies have shown that when calories are greatly increased, so is energy expenditure so that the people consuming the increased number of calories tend to dissipate more of them than expected, and, hence, gain less weight than simply the caloric intake would predict. In your case and in the case of most of those who can’t gain weight, this system works efficiently.

As to your gaining a nice layer of sub Q fat on the low-carb diet…about 20 years ago Wolfgang Lutz, a German physician, wrote a medical textbook in German (subsequently translated into English) about the use of low-carb diets to treat a multitude of disorders. The book contained a number of photos of patients who had gone from being underweight to being normal weight on low-carb diets. I think a low-carb diet will tend to normalize weight: it reduces excess fat and puts on fat when there are inadequate amounts.

CLA is not a single fat but a conglomeration of various isomers. Studies have shown many different effects from the administration of CLA. But most CLA supplements contain just one of the many isomers, which leads me to believe that some are probably beneficial while some others are maybe harmful. Until it’s all sorted out, I would prefer to avoid CLA supplements and confine my CLA consumption to that found in meat from animals that are grass fed. Grass feeding increases CLA content of meat and dairy products considerably.

Cheers–

MRE

By: Janet

Janet — Thu, 10 Jan 2008 11:04:00 +0000

In one of your comments above you said, “The ones who get the posts by RSS (over 1000 people per day) don�t even get the comments I don�t think.” As well as the RSS for articles, there’s a feed for comments – which I use, and which is how I saw the comments on this post. I find it very helpful, because, as you say, interesting stuff often comes up in the comments, and sometimes it’s long after the original article was posted. I’d never go back over all the old posts looking for new comments. So, thanks for setting up the RSS feed for them, even if you didn’t know you’d done it.

Hi Janet–

I certainly didn’t know I had done it, but I guess I’m glad I did.

Cheers–

MRE

By: Michael Richards

Michael Richards — Thu, 10 Jan 2008 05:19:06 +0000

Hi Dr Mike,

Another dodgy scientific paper on nutrition. It makes me despair, especially with people like my cousin who is a doctor and married to a very rich property developer. She believes all the mainstream stuff and has no hesitation in prescribing statins. My opinion doesn’t count because I’m not a doctor. (I could have been one, just chose not to.) I mean, she’s actually a very nice person and all, but I thought she had better critical faculties than that. Never mind that before I went low carb, my trigs were through the roof, had an enlarged fatty liver and kidney stones. Why don’t I have these any more?? Couldn’t be the way I eat, could it! The lack of kidney stones alone — passing one is a charming exercise — is enough to keep me on the restricted carb straight and narrow. A couple of months ago said cousin was nonplussed when I said that the way I eat will be mainstream in 5 year’s time. Yes, I am an optimist.

Now for the actual reason I’m posting this comment: I get RSS feeds via a Firefox toolbar bookmark. When you look up an item you sure do get the comments. It’s probably the reason why I read the comments, being a lazy kind of guy.

Finally, the usual irrelevant stuff: Am currently on dial-up because the whole family plus my kids’ friends are on summer holidays. Wifeypoos and the kids have been eating junk, junk, junk. I’ve been a bore eating the right stuff. Except that the town we’re staying at has the best oysters in the country, possibly the world, and oysters do have quite a lot of carbs. Mmmmm…..

I’m on the net now because of beach sunburn and because the seas have been huge, like 4 metre waves. (But fun!!!!) Only been able to make it to the beach the last couple of days due to rain and really rough weather.

But before we left Sydney, I caught MD’s Messiah excerpts. Fantastic. I bet She Who Must Be Obeyed had fun working up to those high Gs in the Halleluiah Chorus! The American accent seems a bit strange to me in this music, but then I guess Handel’s original performance was with an Irish lilt or brogue.

Michael Richards

Hey Michael–

Enjoy your time at the beach. Sounds like fun.

You and a couple of others let me know that the comments come through on RSS. I didn’t realize that.

MD doesn’t mind the high Gs – but the B flats in Beethoven’s 9th nearly killed her.

Cheers–

MRE