The formula is correct, but it works only if the triglycerides are below 100 mg/dL, which your wife’s are not.

Thanks for the report. I’m sure many will find it helpful.

I’ve followed your guidelines since 5/1/09: To compare:

12/06 results:
cholesterol, total: 188
Triglycerides: 53
HDL: 87
Est. LDL: 90

7/09 results:
cholesterol, total: 229
Triglycerides: 34
HDL: 81
Est. LDL 141

My doctor is concerned about my LDL but had nothing to say about the favorable HDL and triglyceride levels. Your explanation of what goes into an LDL calculation is a great comfort. So was losing 12 pounds.

Weight 129/ Height 5′4″/Age 48/Active, but not daily exercise due to work and graduate program

Told (stressing over phone again, by nurse!) that I needed to follow a strict diet to reduce LDL or I would be “put on meds”.

Current diet consists of chicken or fish each once a week, salads, vegetables, lots of fresh herbs, whole grain cereal/bread, fruits, tea, occasional snack of low fat cheese (mozzerella), low fat yogurt, lots of non-sweetened seltzer water, olive oil to cook; nothing ever fried, no chips, rarely eat out, but if I do….fish/salad. Willing to try stricter diet and committ to exercise over the summer, but did not like threat of meds without talking to me!!!

How can you be worried about the “threat of meds”? Are they going to hog you down, hold your nose, and force pills down your throat? It’s up to you whether or not you take whatever medications they recommend. Sounds to me as if your diet could do with a few less carbs. And your lipids look okay. Considering your low triglycerides, your LDL levels are actually lower than the test you got showed.

Clinical

No major advantage with low-fat vs low-carb diets in overweight diabetics

Last Updated: 2009-07-07 8:00:31 -0400 (Reuters Health)

NEW YORK (Reuters Health) – Overweight patients with type 2 diabetes who follow either a low-carbohydrate diet or a low-fat diet have similar outcomes after one year in terms of weight and hemoglobin A1C levels, according to results of a new study.

Dr. Nicola J. Davis of the Albert Einstein College of Medicine in Bronx, New York, and colleagues conducted the study in 105 adults with type 2 diabetes, body mass index (BMI) of 25 or more, and A1C levels between 6% and 11%.

Participants were randomized to a low-carb diet modeled after the Atkins diet or to a low-fat diet based on that in the Diabetes Prevention Program. They kept daily food diaries and were interviewed during study visits regarding their food intake in the previous 24 hours.

“The greatest reduction in weight and A1C occurred within the first 3 months,” the researchers report in the July issue of Diabetes Care. They note that “at 6 and 12 months, there was an increase in calories and macronutrients in both groups, suggesting decreased adherence.”

Although patients on the low-carb diet lost weight faster than those on the low-fat diet, after one year, both groups had “a similar 3.4% weight reduction” and neither group had a significant change in A1C level or blood pressure.

The low-carbohydrate group did have a significant improvement in mean HDL level (p=0.002).

The authors point out, however, that “the lack of change in A1C should…be taken in the context of reduced medications.” In fact, a third of subjects had been taking thiazolidinediones, which were stopped at the beginning of the study and not restarted. Furthermore, there was also a reduction in insulin and sulfonylurea dose overall.

“Perhaps we would have observed greater reductions in A1C if we did not make medication adjustments during the study; however, because we were concerned about hypoglycemia, not making adjustments would not have been appropriate,” the researchers comment.

Diabetes Care 2009;32:1147-1152.

Insane indeed.

anything you can tell us will be helpful.

This is very timely for me. My husband recently started eating low-carb (I’ve been low-carbing for years).

He is healthy, 33 yrs old, tall and skinny (6′2″ and 150lbs), but I’m convinced of the health benefits of low-carbing no matter what the weight, so we figured he’d give it a try.

He had to have his blood tested because he had an infection, so we took the opportunity to get his blood lipids tested too. He’s been seriously low-carb for about 3 or 4 weeks.

Before, his triglycerides were 103, his hdl was 36.3 and his ldl was 171.6

he just got his results back after the low-carbing, and is basically in a panic.

triglycerides are 72, hdl was 61.7 but ldl was 351!

so his triglycerides and hdl have improved, but his ldl has gone up almost 200 points in under 2 months (since the last test).

I remember reading that ldl can sometimes jump temporarily when starting low-carb, but that much? should we be concerned about this? or could it all be big and fluffy ldl so it doesn’t matter, or calculated wrong? is it possible this could be bad for him?

also – he actually lost weight in the past 3 weeks despite trying to eat lots of calories (in the form of protein and fat). he really cant’ afford to lose weight, he’s on the verge of underweight anyway. so how does he eat higher carb healthily?

thanks so much for your advice,

Deborah

Usually when I find something totally off base like this, I have the labwork redone just to be sure. Labs do make errors…often. So before I make any decisions about a really out-of-whack lab, I repeat it. Having said that, I have seen fairly dramatic elevations of LDL in a few people after starting low-carb. In the cases I have followed, it cleared up after a little time on the diet. I usually checked blood work on my patients every six weeks while they were actively under my care, so these high LDLs dropped by the 2nd 6 wk labs. When I have checked the particle size in these cases, it has always been of the big, fluffy variety.

I wish you would write something on the “French Paradox”. A paradox is defined in the dictionary as: “A seemingly contradictory statement that may nonetheless be true” which in this case I guess it is but NOT for the reasons the low fat people believe. What caused me to think of this was an article on resveratrol which I just read. Resveratrol is contained in the skin of grapes which is supposedly the reason why the French don’t have the incidence of heart disease we have in the US even though they eat a high fat diet with lots of butters, fat and cream. The article I read states that they could not find enough resveratrol in wine to explain the “French Paradox.” Gee really? I wonder why?

In this case the paradox is only a paradox because the nimrods who named it that are lipophobes. They can’t understand why the French live longer and have less heart disease when they eat so much of that ol’ devil fat, so, to them, it is a paradox. To people who have good sense it isn’t a paradox; it’s the expected outcome.

“Are you sure you don’t have the VAP and calculated values reversed? Using the CALC values as listed, the Freidewald equation calculates LDL to be 118 not the 108 you wrote. Or is that a typo?”

The values weren’t reversed, but yes, there was a typo. The CALC TC should have been 172 not 182. (My bad.) However, all the other values were correct. Here are the corrected values:

VAP: TC=181, HDL=43, LDL=119, TRI=69
CALC: TC=172, HDL=49, LDL=108, TRI=74

So using Friedewald’s to calculate LDL:
TC – HDL – TGL/5 = LDL
172 – 49 – 14.8 = 108.2

The point I was trying to get across was there didn’t seem to a sigificant variation between VAP and standard lipid panel, except perhaps in the other fractions provided by the VAP.

Since the 2005 comparison, my (Friedewald) lipid panel has improved. As of Dec 2008: TC=169, HDL=63, LDL=99, VLDL=7, TRI=33

Steve

Thanks for the update. Glad to see things have improved.

I’ve read Weston Price’s info on soy based products and make a real effort to avoid it in anything I eat. I have since found that the packaged sausage I used to buy has soy flour, which it didn’t have a few years ago, and that restaurant breakfast sausages now have soy also. One can tell by the texture.

We are being slowly poisoned by the array of artificial and processed ingredients(soy, corn oil, HFCS and MSG put into mainstream products. Sometimes all these ingredients are found in one product(the packaged sausage)! There is a huge conflict of interest between the stockholder and the end user in so many corporations, not just food corps. and this is where we get the all-out attempt to substitute the cheapest ingredients in food products, consumer’s well-being be damned.

You’re right. Read a report the other day showing that 10 percent of calories in the American diet come from soybean oil and another report today that 17 percent come from sugar. Is it any wonder we’re having problems.