How to Proceed

I was told I was prediabetic a little over three months ago after two raised HbA1c test. The first was 42 and the second 44. I was already on the forum and, having read about here, decided to try low carb as a way of reducing it.

On low carb I started loosing weight quite soon. I was carrying too much belly fat but I wasn’t overweight. To try to stop the weight loss I added in a high fat element. I’ve still been loosing weight but it has slowed. I am now below my recommended BMI and would prefer not to be.

I read an article on the Diet Doctor earlier this week where it suggested adding a chunk of cheese to your lunch, drinking hot chocolate made melted butter and various other high fat options. All good I thought until yesterday when the results of a home cholesterol test arrived telling me my cholesterol is high. I wasn’t expecting that.

The following are my results:

Tryglycerides - 1.4
Total Cholesterol - 6.9
HDL Cholesterol - 2.6
LDL Cholesterol - 3.7
Non-LDL Cholesterol - 4.3
Total Cholesterol to HDL Cholesterol Ratio - 2.7

At the same time I had my HbA1c checked and they say that is 38 so the diet seems to be working for that. I don’t know what my cholesterol was previously.

Now I’m not sure how to go forward. Do I continue as I am and hope cholesterol doesn’t rise any more and my weight doesn’t continue to fall. I don’t feel I can now add more fat in to combat that. Do I cut back on fat and reintroduce some carbs. As a predibetic I have possibly cut out far more than I need (I eat around 20 to 25 grams per day) but until I have a test at my surgery in November and get confirmation of the A1c I won’t be confident about it now being down to 38, and there’s the worry that I may add too many carbs and push it back up.

I could go and chat with myMy GP but as things are they might want to put me on statins, which would presumably not be compatible with a HCLF diet?

Just when I thought I might be getting a handle on things there’s now another spanner in the works…..

Redshank said:

If you are losing weight, your cholesterol will probably rise.
I am also Prediabetic and slim. When I started Low Carb I lost more weight than I needed to.
I spent some time working out how many calories I was taking in (as well as doing the carb count). I found I wasn't eating enough.
I found I need about 2500 calories of the food I eat to keep a stable weight. I was usually eating less than 2000, sometimes 1500, but I wasn't hungry.
I introduced more tree nuts (eg walnuts, pecans), used more olive oil, ate more cheese, avocadoos are also good. My weight stabilised and has remained stable for a number of years (as has blood sugar). Having learned what foods work for me, I don't have to think about them very much. I weigh myself once a week. If I lose weight, I just eat a bit more of the right foods to nudge it up a bit.

Well done on lowering your blood sugars

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Many thanks for the reply. I hadn’t released the possible relationship between weight loss and cholesterol. That’s an interesting one. I’ve just Googled it and the site I looked at suggested up to 12 weeks after weight has stabilised for cholesterol to find it’s normal levels.

I also hadn’t thought to check how many calories I’m taking in a day. I guess I really should look at that.

For now I’ll stay as I am dietwise. It seems to be working for the blood sugars and if, with your advice, I can raise my weight a little and then stabilise it, it might also be okay for the cholesterol levels.

I‘ll aim to up my fat intake with unsaturated fats for now so as not to stoke the fire too much.

Thanks again

TriciaWs said:

My triglycerides, which had been a little high improved on low carb but other numbers rose a bit, enough to upset my nurse. However, 5 years in my weight loss stabilised (still much too high) and my latest total cholesterol was 4.4 - the lowest ever since they started testing it and all the numbers look great. I'm eating slightly more carbs but having olive oil dressings, butter, cheese, bacon fat, etc.

So maybe suggest they wait for the next round of tests?

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Thank for giving me your experience. It very much sounds as though I should continue as I am for another six months and then see how things are.

KennyA said:

When my weight loss started, my total cholesterol first rose, and then fell. It's now 18% below its previous lowest. As around 80% of your cholesterol is made by your body rather than coming from diet, I expect it just takes a little time to adjust to its preferred level.

I have to say I don't buy into the cholesterol worry, and I find that there is other research gpoing back a number of years that supports this.

Is the use of cholesterol in mortality risk algorithms in clinical guidelines valid? Ten years prospective data from the Norwegian HUNT 2 study - PMC

Many clinical guidelines for cardiovascular disease (CVD) prevention contain risk estimation charts/calculators. These have shown a tendency to overestimate risk, which indicates that there might be theoretical flaws in the algorithms. Total ...

www.ncbi.nlm.nih.gov

Conclusion: Our study provides an updated epidemiological indication of possible errors in the CVD risk algorithms of many clinical guidelines. If our findings are generalizable, clinical and public health recommendations regarding the ‘dangers’ of cholesterol should be revised. This is especially true for women, for whom moderately elevated cholesterol (by current standards) may prove to be not only harmless but even beneficial.

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Thanks Kenny. That’s very interesting research.

AndBreathe said:

Grace, have you upped your protein content in your daily diet?

As someone who is slight, if I lose weight these days, I firstly add a bit more protein, then if that doesn't do the trick increase my fats. If I overdo the fats, my tummy gets to be unhappy, sending me to the small room more than anyone would want.

Vis-a vis your lipids, I'd urge you to play the long game with those, and ensure you are always fasted before you test.

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Many thanks for your reply.

I’ve started eating some meat again, I was pescatarian. I’ve also been eating more cheese. I perhaps could up it a little more though.

HSSS said:

I agree with the comments above. I’d add that it’s pretty much established fact that diabetes will cause trouble and in the not too distant future. The jury is very much still debating the whole cholesterol issue and it’s getting less and less clear that slightly higher levels than currently recommended will cause problems or when. I’d deal with the sure bet issue first then swing back around and see what cholesterol results are then what and research is saying once the hba1c is stable at a good level.

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Thank you. This seems like sound advice

ajbod said:

The Cholesterol that you eat, is transiting through your body on it's way to expulsion. All Cholesterol tests should be done with a 12 to 14 hour water fast prior to the test, they don't tell you this nowadays which ensures a higher test level, and hence Statins. KERCHINGGGGG.

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I did the test around 9am and had not eaten since 7pm the evening before. I did drink a couple of glasses of water in the hour leading up to the test. I’ll repeat it all in six months and see what that gives me.

AndBreathe said:

As a pescatarian, you could up the portions of salmon, tuna, mackerel and so on. Whatever fish is best value/appealing to you. Obviously meats and cheese are also fine and nutritionally dense.

(In my Lidl app at the moment, I have a 50% off coupon for canned MSC Wild Sockeye Salmon - down from £12.99 to 99p. I can't see if there are limits on quantity for the offer, but someone in-store would know if you asked.)

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Wow! That’s a good coupon. I don’t have the Lidl app but I’ll get it downloaded. Thank you