Good and Bad Cholesterol and Fats

[phoenix]

then you are getting energy from oxidised body fat, instead of fat in your diet. This is a good thing if you're trying to lose weight, but one way or another, the fat is still going to get sloshed around your blood plasma. The good news is, that on a low-carb diet, your metabolism becomes more tuned to burning fat, leading to lower levels of blood triglycerides, even though they are now your major source of energy

YMMV. We all have very different forms of diabetes; stick very low insulin production into the mix and those fats do indeed slosh around.
cholesterol at diagnosis, after presumably surviving at least partially on metabolised fats for awhile:

serum, initial: opalescent (unchanged after 24hr @ 4C)
Trigs 3.19mmol/l
TC cholesterol 8.38mmol/l
LDL 5.75mmol/l
From it's description I think my plasma looked something like this:
http://www.duke.edu/~ema5/Golian/Slides ... ages1.html

Unfortunately I had probably had this type fats in my blood for some time and there was more plaque in parts of the femoral and carotid arteries than was normal for a woman of my age.
I was put onto 40g simvastatin and told to see the arteriologist at 6 month intervals.

2 months later with diet exactly as prescribed moderate carbs, low sat fat, but not low fat; for example a salad with tbs of olive oil every day; oily fish twice a week etc, not told to avoid butter or cheese just to eat in moderation. There aren't that many low fat products here in any case; and on the whole those that are tend to be dairy made with lower fat milk rather than with substitutions. The advice was perhaps nearer that on the Havard link than some of the advice I see in the UK.
serum clear/lemony colour (well I think thats what citrin means!)
Trigs 0.83mmol/l
TC 4.72
LDL 2.97mmol/l
Seven years down the line, seven years of good diabetic control and eating a conventional 'healthy diet' + some exercise I now have far less plaque in the arterie. I only have to see arteriologist every 2 years now and no longer take statins.

Obviously there are a lot of variables in the mix, we all vary. My problems were caused because I had too little insulin.
As things have improved so much I'll stick to what I know works or me; ie keeping my intake of sat fats fairly low (and avoid trans fats like the plague... something we can all agree on ; label reading is essential as they pop up in the most unlikely places)

 

[clearviews]

Recently heard someone say that if you cannot manufacture it in your own kitchen, don't eat it! Sounds like wise advice to me. That would rule out many of the vegetable oils. I know I can make butter as I used to help my grandmother churn the cream until it was butter. I reckon I could press olives for the oil so that one is OK in my book. Coconut oil I haven't tried to make but as the natives of the South Seas have eaten it for centuries I am guessing it is not necessary to manufacture in a laboratory.

Animal fats I have re-learned to eat and adore our slabs of pork crackling I roast up every few days or so. No trans fats as I don't eat the processed foods that need them to hold the product together on the supermarket shelves.
Alison

 

[Defren]

I'm one of those people for whom the first time I very low carbed was a 'once in a lifetime shot'.

I just tried Atkins out of curiosity a few years ago and I was losing over a pound a day.
Not fully understanding the implications then, I eventually drifted off course and began to eat carby stuff again and eventually the weight came back on.

I've tried really, really hard to very low carb again a couple of times since then (and again now), but once I've lost the predictable 'water weight', I plateau and that's it. Despite being an avid reader of Atkins, Taubes, Eades et al I find that it just doesn't work for me any more. However I do find that I feel a lot better inside when I'm low carbing. The bloating disappears, the aches and pains go away and the snoring stops.

So it's mainly for that reason that my chosen diet (as in eating regime, not weight-loss program) is low carb.

I'd love to hear of someone who had the same problem and then it suddenly started working again! :cry:

This hasn't happened to me (yet) but I have read a few stories where it has. It seemed the answer lies in riding the plateau, as disheartening as it is, and the weight begins to shift again. Non diabetics swung between Atkins and Dukkan, and believed that was the key, however later updates showed that it wasn't the swing from diet to diet, but rather a couple of weeks on strict Atkins induction.

You said to me yesterday you are impatient, and believe me, I am your match there. I want it all sorted out yesterday, but I do think based on what I have read, accepting there will be plateau's and riding them out, seems to be the answer. Good luck.

 

[stevolution]

Well I'm stuck with it now anyway, so I've got plenty of time to see if the plateau breaks! :lol:
DSN has today increased my Met to 3x500g so this may decrease my appetite (and thus calories) even further.
If I get a reading below 4 between now and next week I can come off the Gliclazide which would please me greatly as I feel after reading all about it that it's not working entirely in my interest. :***:

Don't suppose I've got much chance of being offered Byetta with these figures have I? :twisted:

 

[Defren]

Well I'm stuck with it now anyway, so I've got plenty of time to see if the plateau breaks! :lol:
DSN has today increased my Met to 3x500g so this may decrease my appetite (and thus calories) even further.
If I get a reading below 4 between now and next week I can come off the Gliclazide which would please me greatly as I feel after reading all about it that it's not working entirely in my interest. :***:

Don't suppose I've got much chance of being offered Byetta with these figures have I? :twisted:

The Metformin smashed my appetite, that was why I lost so much weight so quickly, I just couldn't eat, I felt physically sick. So the Met does work that way for some of us. Strangely, now I am on the ND when meal times come around I am hungry, so am hoping this is going to bode well post diet. I wouldn't want any other drugs, and to be honest, if it wasn't for the protection Met affords our hearts etc I would be off that as well now.

I'm not sure why you would like to be on Byetta?

I'm certain if you just push through the plateau the weight will again begin to come off. For some weight loss seems relatively easy, others struggle a lot more. Keep going, you're doing great!

 

[xyzzy]

now I've seen that my Cholesterol levels are the best they've been in years.

Can I ask if you have been prescribed statins since your diagnosis too and they have helped, or have your cholesterol levels come down as a result of your changes in diet?

Yes been on Simvastatin 40mg for just around 18 months so yes they will account for some of the drop and yes again I have no proof that if I had kept on High Carb Low Fat that they may not have been the same or even better. In my own mind that is not really the issue as I was more concerned the Low Carb High Fat hadn't shoved them back up again. What is unique this time is that the change to LCHF made my good cholesterol significantly better which has never happened before in the four previous tests I have had. It got so much better that my DSN seemed equally impressed with that as she was with my BG's.

I do view statins with suspicion but think I take a pragmatic approach which is I had very high Cholesterol (family trait) which needed to be reduced. In my mind I weighed the short term risk of taking a statin until my levels normalised against the long term risks of keeling over from CVD especially as I suffer(ed) from stress related high BP as well. I am now looking at asking the gp if I can come off the statin or at least reduce it. Actually I'm not convinced it's time yet, maybe in another 3 months when I've improved my levels some more but that's what gp's are there for.

Hope that helps

 

[viviennem]

I'm on the plateau to end all plateaus at the moment, have hardly lost anything since I got rid of my Christmas pounds! This is because I'm drinking wine - not only full of 'empty' calories, but also because our bodies can run on alcohol, much like a Jeep! :lol: so I'm not in ketosis all the time so not burning enough fat. My fault! I know if I get back on to the Induction phase and stick to it, I'll start losing again. DOn't worry too much, Steve; forget the weight and concentrate on the BGs - that's what I'm doing :wink: .

Regarding fat -I eat natural, unprocessed fats, and olive oil. I certainly don't avoid them, and on some things I'm a pig - I butter the holey side of the Ryvita but I only have 2 Ryvita a day, and not every day.

These are some of my favourite facts, culled from the USA national nutritional database (http://www.nal.usda.gov):

Lard - you know, that awful white pig-fat that just screams saturated fat at you, surely nothing could be worse? contains:

45% monounsaturated fat;
39% saturated fat - of which 35% is stearic acid. Stearic acid metabolises to oleic acid, which increases HDL (good cholesterol) and lowers LDL (bad cholesterol) at the same time.
and 16% polyunsaturated fat - you know, the good stuff.

I'm no scientist, but that looks to me as if lard isn't as bad for me as people make out. It also shows how complicated the whole subject is, and the black-and-white argument about saturated bad, polyunsaturated good, is very simplistic.

Olive oil (you know, the wonderful Mediterranean Diet?) contains 16% saturated fat. Confusing, isn't it?

I found a good article by Mattson, F H and Grundy, S M Comparison of Effects of Dietary Saturated, Monounsaturated and Polyunsaturated Fatty Acids on Plasma Lipids and Lipoproteins in Man, in Journal of Lipid Research Feb 1985: 26(2): 194-202. Sorry I can't provide a link - I think I went to the Journal's web site.

I think the comment about if I can't make it in my own kitchen I don't eat it is a very good one to live by.

Incidentally, alcohol increases blood cholesterol, particularly triglycerides; never drink the day before a cholesterol test

Viv 8)

 

[stevolution]

I'll have a look at that article thanks. I'm not at all afraid of natural fats either!

Of course I'll concentrate more on the BG levels but I'm itching to get lighter as I desperately want to get to the stage where I can do pull-ups (a CrossFit staple) unassisted. Having the equivalent of a full bag of spuds tied to my waist isn't helping that particular goal! :lol: Incidentally, most CFers live on a LCHF diet.

 

[xyzzy]

Yep with you there catza. I have recently been very brave and swapped from margarine back to good old fashioned butter! My wife and my own attitude is "low carb high fat but watch the calories" so I have no problem doing a few more carbs than an ultra tight VLC regime by say eating more veg rather than more fat or more white meat rather than more fat or use soya milk in cooking rather than cream etc. What I would say is the "watch the calories" bit is progressively more down to us wanting to lose weight than any real worry that cream or whatever is harmful especially now I've seen that my Cholesterol levels are the best they've been in years. In fact when I reach my target weight and want to stabilise then using cream in cooking rather than soya milk and similar high calorie things sounds like a good option.

You see, I think one of the least advertised benefits of the low-carb diet is that you don't have to watch your calories - not because calories don't count, but because if you include enough fat and protein in your diet, then you satiety is increased to the extent that you eat less calories than on a conventional diet.

I eat huge meals at lunch and dinner, but I hardly ever snack, and I manage to consistently lose about 3lbs a month.

I have to agree with this. I never eat breakfast so only had lunch and dinner. The only time I really snacked was what would have been supper time. I would have some ham and Philly wraps or a sugar free jelly. My weight slid off.

Well it's good to disagree with you two occasionally

MW's with you all the way. She doesn't give one hoot about calories these days and is losing weight nicely. I however got "educated" by both you Stephen and Phoenix which is no bad thing. Phoenix know's my thoughts on the priority of carbs v GI and we agree to disagree I think although we found common ground on that insulin index stuff a few weeks ago but I digress.

What I did find most compelling soon after I joined was stuff Phoenix pointed me at regarding energy density of foods which is very broad terms is calories. So nowadays I do see the same carbs v calories thing in much the same way as carbs v GI. Carbs take precedence (because of "eat to your meter") and I have no doubt a high calorie VLC regime will make you lose weight ... slowly ... Me I wanted to lose weight as fast as possible but obviously without starving so a nearly VLC with less calories does it for me.

What I do agree is an "average" VLC diet is likely to have less calorific input to begin with despite all the "fatty" food and like I said earlier on the only differences I am making is say substituting low carb low calorie soya milk instead of low carb high calorie cream and eating more veg which implicitally will have higher carbs.

 

[phoenix]

I found a good article by Mattson, F H and Grundy, S M Comparison of Effects of Dietary Saturated, Monounsaturated and Polyunsaturated Fatty Acids on Plasma Lipids and Lipoproteins in Man, in Journal of Lipid Research Feb 1985: 26(2): 194-202. Sorry I can't provide a link - I think I went to the Journal's web site.

One problem Viv; neither you nor I are men :lol:
Interestingly there may be a difference :lol:
Sex-specific differences in essential fatty acid metabolism
http://www.ncbi.nlm.nih.gov/pubmed/22089435

 

[xyzzy]

I found a good article by Mattson, F H and Grundy, S M Comparison of Effects of Dietary Saturated, Monounsaturated and Polyunsaturated Fatty Acids on Plasma Lipids and Lipoproteins in Man, in Journal of Lipid Research Feb 1985: 26(2): 194-202. Sorry I can't provide a link - I think I went to the Journal's web site.

One problem Viv; neither you nor I are men :lol:
Interestingly there may be a difference :lol:
Sex-specific differences in essential fatty acid metabolism
http://www.ncbi.nlm.nih.gov/pubmed/22089435

Talking about ladies and gents Phoenix (my underline)

Libra has given some articles to read ;inevitably you can find opposing views.Therein lies the problem. These 2 for example are highly critical of the last source she cites.

Geoff will be pleased :lol: ... Now who else makes those mistakes

 

[phoenix]

whoops .
Sorry Geoff

 

[lucylocket61]

If a woman was post-menopausal, would she be in the male category as there would be no more hormonal protection?

 

[noblehead]

Yes been on Simvastatin 40mg for just around 18 months so yes they will account for some of the drop and yes again I have no proof that if I had kept on High Carb Low Fat that they may not have been the same or even better.

That is the dose that my GP wants to start me on for protection from CVD despite having excellent cholesterol readings, I was reading that a drug called Artovastatin (soon to be out of license) is as effective in a lower dose as what Simvastatin is in a higher dose, when I see him at the end of May I'll be asking about this.

 

[phoenix]

If a woman was post-menopausal, would she be in the male category as there would be no more hormonal protection?

HDL in women tends to go down after menopause. The Normal HDL range on my lab test results is higher for pre menopausal women than men and the same after.
HRT was supposed to protect against cardiovascular disease but increased the risk slightly
http://www.mayoclinic.com/health/hormon ... py/WO00131
Fat is certainly deposited differently in women and we have a lot more of it so it wouldn't surprise me if there were differences in the ways we metabolise it. I only found that paper by accident today, I think it would be interesting to follow it up.

 

[catza]

Just playing catch-up reading all the posts since I had to retire from the thread with information overload last night. I just have to say that this is a very very interesting thread and thanks to all the knowledgeable members who have given such a wealth of information and links. :thumbup:

 

[viviennem]

Haven't read your link yet, Phoenix, but I will - 1985 is still in the time when everything was tested on men and extrapolated for women - wouldn't surprise me if they tested the oral contraceptive on men and extrapolated . . . :lol: :lol: (that was a joke!)

I know us girls naturally have extra subcutaneous fat than men - gives us those lovely curves!* - so it wouldn't surprise me to find out that we metabolise it differently. Aren't we supposed to be statistically better off, post-menopause, with higher cholesterol than men?

I do appreciate your input, Phoenix - things that I half-remember, or that I've half-understood, you can always give me chapter and verse on - or at least the latest version. I remember that 1985 was a long time ago - I was thinner then! :roll:

Many thanks

Viv 8)

* some of us have so many curves that you'll want us in your village, come the famine! :wink: :lol:

 

[librarising]

Libra has given some articles to read ;inevitably you can find opposing views.Therein lies the problem. These 2 for example are highly critical of the last source she cites.
http://www.sciencebasedmedicine.org/ind ... -get-thin/
http://www.sciencebasedmedicine.org/ind ... er-review/

I've now had two goes at reading these. Seems to be a case of 'if you don't like the message, shoot the messenger.'
In the first Harriet Hall claims that Dr Miller "is a very poor public speaker." By her own standards she is a very poor article writer.
I just kept writing down example after example of attack, poorly disguised as writing.
In the second his distrust of peer review is attacked.
Both writers reminded me of the Flat Earth Society.

What won me over with Gary Taubes' The Diet Delusion was the straightforward way his argument was laid out. That would help explain perhaps why he has won the Science in Society Award of the National Association of Science Writers three times.
Most writers, bloggers in the 'fat' camp (under whatever banner) seem to write reasonably intelligent articles.

I'm happy to read any link you mention, but find these two uninspiring :thumbdown:

Geoff

 

[borofergie]

YMMV. We all have very different forms of diabetes; stick very low insulin production into the mix and those fats do indeed slosh around.

Well I was actually talking to the OP who is a T2 diabetic. I'm unclear why low-insulin levels should lead to higher blood lipid levels. Wouldn't you expect the reverse to be true?

 

[borofergie]

I'll give you another link. This isn't to a paper. It is a source that I would say is moderate and takes into account recent research. It doesn't say eat a low fat diet but it does say to choose fats sensibly including smaller portions of those that may be less healthy for us.
http://www.hsph.harvard.edu/nutritionso ... olesterol/
I agree about preferring butter to spreads. I just don't spread very often... when I do then it's butter.

Yes. It doesn't say "eat a low-fat diet" but it does say don't worry about the quantity of fat you consume, just worry about the quality:

It’s time to end the low-fat myth. That’s because the percentage of calories from fat that you eat, whether high or low, isn't really linked with disease. What really matters is the type of fat you eat.

I take that as an implicit endorsement of the low-carb/high-fat diet. At least we are now all agreed that there are no legitimate health concerns over deriving energy from fat rather than carbohydrates. Accepting this is the first step towards persuading NICE and DUK to reverse their negligent dietary guidelines for T2 diabetics. As I said elsewhere, the false consensus is crumbling fast..

Different people, different opinions You will find advocates of all sorts of views on the internet and sorting out the wheat from the chaff is difficult for any of us.

I would humbly suggest that the Cochrane Review and the Havard School of Public Health are good sources of "intellectual wheat". If eating fat is bad for you, it seems that no-one can demonstrate that fact scientifically. As Richard Feinman says "the scientific evidence now establishes that dietary saturated fat has no effect on cardiovascular disease, obesity or anything else".