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HFLC diet working for sugars but cholesterol higher

E

Em16

Well-Known Member
Messages
93
Type of diabetes
LADA
Treatment type
Diet only
Hi,

Hope everyone is as safe and as well as possible.

I was diagnosed with Type 1.5 in Feb. I'm currently still producing some insulin and I'm controlling blood sugars using the High Fat Low Carb diet. However, my last blood tests showed my cholesterol had increased to:

Overall: 6.0
HDL: 1.4
Triglycerides: 1.9
Cholesterol/HDL Ratio: 4.3
Non HDL Cholesterol: 4.6
LDL: 3.7

DN said he was sure this increase was down to diet and asked if I wanted to begin medication. As I wanted to wait for appointment with consultant (in May) I decided to defer that, continue with diet and try to swop in more healthy fats eg. more nuts/avacado/olive oil.....rather than lots of cheese/dark choc/crackling etc. and hopefully keep an eye on what that did to the cholesterol levels - especially good v bad measures.

However, given that it's unlikely I will be able to get a blood test for a long time due to Covid I'll have no idea what's happening. If I don't have plenty of fats I immediately lose weight (I'm 5ft 2 and weigh 7 stone .....I really don't want to lose any weight) so I can't forgo fats - but I'm a bit concerned that I've no idea what's happening with cholesterol.

Has anyone had any similar situation? How did it all pan out? I would welcome any advice/thoughts anyone has - especially before my (presumably telephone appointment) in May. Had my cholesterol been ok then I would have continued with HFLC diet for as long as possible, but now I'm not so sure???

Many thanks, Em.
 
Hi @Em16

Can I ask how long had you fasted before the blood sample was taken for your test?
 
Hi Bulkbiker, yes - I had fasted for 12 hours before the blood test
 
Em16 said:
Hi Bulkbiker, yes - I had fasted for 12 hours before the blood test
Click to expand...
Only water? Your trigs look maybe a little high..
but it’s still very early days ... in your shoes I’d wait another 6 months and get a retest.
 
Em16 said:
Hi Bulkbiker, yes - I had fasted for 12 hours before the blood test
Click to expand...

Also, I had been doing the HFLC diet since around December if that helps? Initially, I didn't eat enough fat and lost over a stone in weight in a matter of weeks, so I upped my fats intake probably around mid January.

I was enjoying the diet very much and eating absolutely as much as I liked and especially lots of cheese, greek yoghurt, butter, dark chocolate, bacon, treats etc. Despite being very slim I have always had a huge appetite, so we are not talking small amounts here.....! I could see it was controlling glucose and I felt great on the diet....plenty of energy, mentally as sharp as a pin etc. etc. Just the blinking cholesterol that's a fly in the ointment.

Thank you for looking at it with me, Em
 

* keto treats that should've said: cocoa/coconut brownies etc.
 
Ah, thanks for the reply ...I'd not seen it as I was busy typing.

Yes, maybe a wait and see scenario
 

I'm a "cholesterol" sceptic so wouldn't worry about it at all..

If you want to delve deep into more current thinking than your HCP's will be used to then there's a fairly detailed thread here.

You might need a coffee or three to get through it though...

https://www.diabetes.co.uk/forum/threads/cholesterol-and-statins.156985/
 
Hi. I wouldn't worry about the fats. Just have enough fats and proteins to keep you feeling full and helping with the weight. Do you have a glucose meter which is essential? What are your typical readings? As a LADA you surely must have some medication for diabetes otherwise you would have BS too high. Even with early days in Honeymoon period most LADAs would need some meds before moving to insulin. Being slim also implies your body may be burning body fat as it can't metabolise the carbs you do have with it's own insulin hence the probable need for meds.
 
Hi, Bulkbiker I will read those through - thank you very much for that link.

Daibell, thank you: that is interesting. Previous to any problem I ate like a horse, anything I liked ( mostly what I considered as healthy) and never put on weight - I assumed because I'm very active - although I do wonder now if other things were going on. If I do the HFLC diet then I can keep my sugars in range of completely normal eg 4 - 7 mmol (regular before food/2 hours after food checks with meter). I can tolerate a little bit of carb eg. one small new potato raises glucose no more that 2 mmol so long as eaten with no other carb. When I began this journey, I was seeing glucose raises with (not large) amounts of carbs going into double figures each time for example, one 30g spoonful of brown rice with no other carb took reading from 4.2 to 13.4 x2 hours later. I dread to think what was happening with normal sized portions....I'm glad I will never know, as I wouldn't dare risk checking to see.

I have also had a collapse/spells of confusion and shakiness coinciding with readings below 4mmol. I was admitted to hospital due to high ketones when unwell with a virus in Feb, discovered incidently when the GP took ketones 'just to see' as, ironically, I was picking up a meter from her and I was beginning to feel unwell and was incredibly thirsty - although notably I did not have raised blood sugars at the same time, and I did question if ketones were due to diet, to which there wasn't really a confirmed answer. I certainly hadn't starved that day, which is how my condition was described to me ...I had had a lovely lunch!

DN has said that I have been lucky that it's all been caught so early as usually this type of diabetes rumbles on in the background for much longer before being discovered (I had a reading of Hb1ac which was at 43 mmol in November....it was only when I started testing glucose I realised that this measure, as an 'average' was missing deep fluctuations not consistent with 'prediabetic' and pressed for further testing etc.) DN was advocating some form of medication prior to beginning insulin, but was happy for me to continue to HFLC diet and monitor carefully until consultation in May.

Thank you again for your time in helping me to sort this out and fathom what is going on. I know people have immense amounts of knowledge of what is clearly a very complex range of related conditions and it is extremely helpful to have knowledge behind me before I discuss with consultant. So far, I have only discussed with DN who has said it's type 1.5 - maybe the consultant will come to a different conclusion?! I really appreciate your reading of this long and detailed message!
 

If you are looking for information about cholesterol on a low carb diet, look up Dave Feldman. He also has a FB page called LMHR (Lean Mass Hyper Responders) and the people in that group share their experience and can also give you some pointers.
Others to look up would be Ken Sikaris, Paul Mason, Peter Attia and some others via Diet Doctor. They all have slightly differing opinions as no one really knows the long term effects of keto / low carb on cholesterol. Although the Atkins Diet started a long time ago and I imagine there must be someone who started eating low carb years ago and is still around to talk about it. If not, then maybe it doesn't work long term...

I hear that elderly women with high cholesterol tend to live longer.

But before you worry too much, you could look into having the lipid subfraction blood test (you might have to pay for that one). It can tell you how much of your LDL is small and dense (or oxidised from too much sugar in the diet). It gives a clearer picture if your LDL is high whether it is all bad or only partly bad. High trigs is something else to look at.

As far as statins go, I'm sure for some older folk, they can prolong your life, but taking them earlier in life may not be wise if the side effects catch up with you. I've been offered them - I'm 45yo and breastfeeding an 11 month old baby. The young doctor I saw assured me I could have a heart attack or stroke in the next 5 years with my high cholesterol (I think the total is about 8 mmol). My trigs are low but my LDL and HDL and total are pretty high. But quitting breastfeeding my then 2 month old to take statins didn't feel right to me. The lipid subfraction test results say there is only a small increased risk for someone with my profile so that made me feel a bit better about not taking medication. But I think having high cholesterol is probably something to keep an eye on considering not everyone who eats low carb ends up with high cholesterol.

As far as high triglycerides go, Dave Feldman wrote an article here which might help https://cholesterolcode.com/high-triglycerides-on-low-carb-and-what-to-do-about-it/
 
There was an article on the BMJ Open website which was an analysis of cholesterol and age at death. It was taken down - as it had to be wrong - how could having more LDL mean you lived longer. Maybe they wanted to get a second opinion.
Anyway - I took a copy if you are interested - but basically - there was no indication that having a higher LDL shortened life.
 
Wow, thank you to everyone - I feel overwhelmed that you've taken time to reply to me with the information you have all sent - I have some serious reading ahead of me, but I am looking forward to trying to get my head around everything. Coffee will be needed, yes!!

Cocosilk, I can imagine how carefully you will have considered the issue of cholesterol alongside wanting to give your little one the very best of starts - and I can't thank you enough for pointing me towards some reading which seems quite specific ....I've not heard about LMHR before, but think it may well describe me.

Bulkbiker, reading your own stats re: cholesterol also gives me some comfort as I can see they've come down and you use the HFLC diet - this feels like a comfort in itself - and thank you for the links you've sent.

Resurgam: yes please, I would like to see that article if you can send it. Would I see it here or elsewhere? I'm not good at techie stuff (which using this Forum constitutes for me!)

Thank you all so much again. I am sure that, had this website not been here, with people like yourselves so generous with their time and their care for others, I may well have been on my way to being very ill by now - by virtue of not being typical in presentation.

Em
 
I'll see if I can put it on here.
Abstract from bmjopen.bmj.com

Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review


Objective It is well known that total cholesterol becomes less of a risk factor or not at all for all-cause and cardiovascular (CV) mortality with increasing age, but as little is known as to whether low-density lipoprotein cholesterol (LDL-C), one component of total cholesterol, is associated with mortality in the elderly, we decided to investigate this issue.

Setting, participants and outcome measures We sought PubMed for cohort studies, where LDL-C had been investigated as a risk factor for all-cause and/or CV mortality in individuals ≥60 years from the general population.

Results We identified 19 cohort studies including 30 cohorts with a total of 68 094 elderly people, where all-cause mortality was recorded in 28 cohorts and CV mortality in 9 cohorts. Inverse association between all-cause mortality and LDL-C was seen in 16 cohorts (in 14 with statistical significance) representing 92% of the number of participants, where this association was recorded. In the rest, no association was found. In two cohorts, CV mortality was highest in the lowest LDL-C quartile and with statistical significance; in seven cohorts, no association was found.

Conclusions High LDL-C is inversely associated with mortality in most people over 60 years. This finding is inconsistent with the cholesterol hypothesis (ie, that cholesterol, particularly LDL-C, is inherently atherogenic). Since elderly people with high LDL-C live as long or longer than those with low LDL-C, our analysis provides reason to question the validity of the cholesterol hypothesis. Moreover, our study provides the rationale for a re-evaluation of guidelines recommending pharmacological reduction of LDL-C in the elderly as a component of cardiovascular disease prevention strategies.
 

Link to the full paper..
https://bmjopen.bmj.com/content/6/6/e010401.full
 
Try consuming more extra Virgin coconut oil instead of other fats / oils. I have about 30g of coconut oil per day, and have done for over 6 years. I feel it helps lower LDL (the bad cholesterol) and increases HDL (the good one). Just my belief. May be worth trying.
 
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