Not everyone experiences a reduction in their cholesterol levels after going low-carb. I was diagnosed as "pre-diabetic" back in February, 2008 (very borderline: A1c was 6.5, and my FBGs were 127 and 123; it was that 123 alone that kept me from being diagnosed as a Type 2). I found Dr. Bernstein's book,
The Diabetes Solution, within a couple of months thereafter, and have maintained a low-carb diet since then. (No grain, virtually no fruits, other than avocados and limited amounts of tomatoes and berries, no milk, no starchy vegetables--40-60 total carbs per day, 25 or so of them from fiber.) My A1cs run 5.3-5.5 (most recently 5.4), and my monthly meter average (7-8 tests a day) is--and has been, since late 2008--in the low-to-mid 90s.
On January 28, 2008, my lipids were (sorry, folks, but most of these are 'Merkin numbers, my understanding is that our recommended LDL level of 100 corresponds to something like 2.6 in the system used in the UK (at least, using spacedoc's converter tool, at: http://www.spacedoc.com/converters.html):
TC: 281
LDL (direct) 215 [5.6, in the UK]
HDL: 40
Trig: 142
By August, 2008 (down 55 pounds, A1c at 5.5) my lipid profile looked like this:
TC: 269
LDL (Direct): 194 [5.0 UK]
HDL: 48
Trig: 77
Between August and November, 2008, I lost another 15 pounds (total weight loss: 65 pounds, from 220 to 155, on a 6-foot frame). My total cholesterol soared 100 points:
TC: 369
LDL (Calculated): 287 [7.4 UK]
HDL: 65
Trig: 85
In March, 2009, my A1c was 5.3, but I didn't have another lipid panel until September, 2009 (A1c 5.4):
TC: 337
LDL (Direct): 219 [5.7 UK]
HDL: 79
Trig: 41
It's stayed more or less in that neighborhood since. I had an NMR assay done in September, 2011; it showed that more than 92% of my LDL was the light, fluffy kind. Still, my LDL particle concentration (LDL-P) was 1793, as compared to a recommended high of 1,000, and, that summer, I began to experience chest discomfort while doing my daily exercise (climbing 24 flights of stairs on my way back from lunch; riding a stationary bike). In mid-December of last year, they did an angiogram, found a 90% blockage in one of my coronary arteries, and inserted a stent. So, low Trig/HDL ratio, high HDL, low trigs, decent TC/HDL and LDL/HDL ratios, large, fluffy LDL particles cannot guaranty elimination of risk.
It's looking, in fact, like mere cholesterol concentration measurements--the typical LDL-C, for example--do not indicate actual level of risk as well as the particle number measurements you can get with an NMR test, and, since 2009, at least, there have been reports in the medical literature to that effect:
- http://www.cardiovascularbusiness.com/index.php?option=com_articles&view=article&id=26891:jcl-ldl-p-levels-may-better-predict-cvd-risk-than-cholesterol ("JCL: LDL-P levels may better predict CVD risk than cholesterol")
http://www.diabeteshealth.com/read/2009/07/29/6293/considerable-risk-of-cardiovascular-events-may-linger-despite-achieving-target-ldl-cholesterol-level/ ("Considerable Risk of Cardiovascular Events May Linger Despite Achieving Target LDL Cholesterol Levels with Statins in Patients with Metabolic Syndrome: LDL Particle Concentration More Closely Related to Risk of Cardiovascular Events than is LDL Cholesterol")
http://www.theparticletest.com/uploads/pdf/Otvos_MESA2011.pdf ("Clinical Implications of Discordance between Low-Density Lipoprotein Cholesterol and Particle Number"):
When LDL-P and LDL-C were discordant, LDL-P was more strongly associated with the risk of CVD events and with atherosclerosis as measured by carotid IMT than was LDL-C. This finding has potentially important implications regarding our understanding of the etiology of atherosclerotic cardiovascular disease.
According to Dr. Thomas Dayspring, Director of Cardiovascular Education at the Foundation for Health Improvement and Technology, an acknowledged expert in lipidology, many of these issues can best be dealt with by eating a low-carb diet: http://www.thelivinlowcarbshow.com/shownotes/6371/585-lipidologist-dr-thomas-dayspring-explains-the-truth-about-cholesterol/ ("585: Lipidologist Dr. Thomas Dayspring Explains The Truth About Cholesterol"). Even so, it is possible to eat a low-carb diet and still have a concentration of LDL-P that--at least, according to much of the research--places you in the "high risk" category.