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Low carb has shot up my cholesterol

transiting

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I was diagnosed as being prediabetic a year ago and have made changes to my diet and lifestyle over the last year. I adopted a low carb, high fat diet and exercised a lot more - although I was already fit and within the normal BMI. I did lose 8.5 kg of weight - but put back on 2 kg after friends and family said that I had lost too much weight. I put a couple of kgs back on by not being too worried about quantities - although I stuck to the low carb and avoiding snacking, and my weight has been consistent for the last 6 months.

I have just had my blood tests back and while my HbA1c is now at 38 (from 44) the doctor is now concerned abut my cholesterol levels which have shot up to 9.0. the good cholesterol (HDL) has increased over the year from 1.05 to 1.5 and also triglycerides reduced to normal levels (1.4), but the LDL (bad) cholesterol has increased a lot. I don't really understand it since I eat no processed meats - but before doing low card I did not eat much meat and I have increased my consumption of meat and dairy (full fat yoghurt and cheese). I've also increased many other things - nuts, seeds, fish, olive oil, oats.

The recommendation from the doctor is to ease off low carb and reduce significantly all foods with high saturated fats - all I can see that this means is reducing/eliminating cheese, yoghurt, meat, smoked mackerel which are the only things I eat which appear to be high in saturated fats. I now feel I am caught between a rock and a hard place - eliminating these foods and staying low carb (while maintaining a healthy weight) feels challenging, easing off on low carb and reducing saturated fat foods will probably push my HbA1c levels back up and the doctor is adamant that I can't ignore the cholesterol problem. I am very opposed to going on cholesterol medications.

Does anyone have any suggestions or experience of low carb and eliminating high saturated fat foods? Is it achievable?
 
You appear to be a 'hyper-responder', someone whose cholesterol goes up on low-carb. Here's a useful talk about it :
http://www.biohackerslab.com/ep8-dave-feldman/
Trigs appear to be a good marker of LDL particle size, the important factor with LDL i.e. not the amount. Reducing trigs turns your LDL (which was NEVER 'bad' cholesterol) from small and harmful LDL into larger, friendly LDL.
Geoff
 
Agree with Geoff above..
You are having great results with your HbA1c levels.. I'd be tempted to maintain that and not worry too much about cholesterol. If your doctor is really worried ask him to send you for a Coronary Artery Calcium scan which actually looks at the build up of plaque in your arteries rather than using cholesterol as a bad proxy for heart disease.
 
Thanks Geoff - very interesting link which I've only skipped through but will listen to in detail tomorrow. Always impressed by the quality of responses on this forum.

Thanks also Bulkbiker - not a bad idea at all to try to bypass 'the bad proxy' of Cholesterol.

In answer to Hotpepper - this recent one was a fasting test (I did that voluntarily since the doctor never asked me to fast before it).
 
One question: I've eliminated simple carbs from my diet (pasta, rice, bread, potatoes, most root vegetables apart from carrots) - is it feasible/advisable to also eliminate foods with high saturated fats from my diet as well e.g. move to low fat yoghurt, milk and eliminate red meats, cheese, eggs and smoked mackerel (which I eat regularly - at least twice a week - but is very high in saturated fats)? This might be my only route to lowering cholesterol naturally? I can't do more exercise than I do - I live in the hills in the Highlands of Scotland and climb a hill almost every day no matter what the weather (1 hour speed ascent of 250M on average 6 times a week) - so it has to be diet I change.
 
Remember how you went through a steep learning curve when you started low carbing?

Time to go through the same steep learning curve about cholesterol and heart risk.
There is so much new information around nowadays, and when I started reading up on cholesterol I was shocked at how basic an understanding the NHS risk calculations and general assumptions are.

Well worth becoming your own expert on the subject, just as you now are on your own personal way of eating.

There are some great you tube videos on cholesterol by leaders in the field. They are usually recordings of lectures and presentations to healthcare professionals or conferences, so they are of a high standard (I would avoid the blogs and the self-styled 'experts' who just spout their pet theories at their desks into a webcam).

A couple of names of speakers you make find useful are Ken Sikaris and Ivor Cummins.

Hope that helps.
 
You could try but you'd probably be very hungry.
Have you taken a look at Dave Feldman's www.cholesterolcode.com yet? If you really want to get your numbers down then try his protocol but to be honest if your trig/HDL ratio is good then your LDL should be the good size particles rather than the small ones which have led to LDL mistakenly being labelled as "bad".
As @Brunneria says above it's now time to each yourself cholesterol.. (as your doc seems to be taking total cholesterol or even total b*ll) then they don't seem to know that much about it.
 
I lose weight on low carb low fat. I've lost 4st in 10mths. And I'm on insulin and no statins. I cannot do any exercise other than painful walking, yards at a time.
The low carb is what works for me. I'm on insulin thou. Maybe a lot different exchanges going on for you.
The above posters aren't on insulin.
I don't think insulin injections like fat or rely on the fat to keep a stable weight. When I eat more carbs and fat I don't lose weight. I either stay the same or add.
Is losing weight your main aim of lchf diet or just to regulate your bgs which can help some lose weight, anyway?
 
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This is just a small point, but I would be inclined to switch from the mackerel to some other oily fish. Not so much because of the fat content. (Heart UK includes mackerel in their list of oily fish the recommend eating twice a week) but because it is a bottom -feeding fish and hoovers up any pollution around. Personally I eat fish every day, oily fish every other day, but I choose wild salmon and pollock caught off the shores of Alaska, in the hopes that they are the least polluted fish to be found. I find frozen salmon fillets in Morrisons and other supermarkets at quite a reasonable price, and pollock is really cheap. I also eat the occasional tin of sardines, as they are too small to eat lots of other fish and accumulate pollution that way.

I love your avatar and am impressed by your hill-climbing routine. Myself I try to climb at least 50 Fitbit floors daily, but on tarmac!
 
I see nothing wrong with your cholesterol numbers. Without a particle size distribution test, I would assume they are OK, so will your GP provide you with the particle size distribution test?

(I think your GP is a few years out of date on his views.....)
 
Thanks for all the replies. Some great points that need to be considered. You've opened my eyes to the particle size aspect of LDL cholesterol. I am definitely going to continue the low carbing - but will probably also try to substitute some of the saturated fat foods with other fat foods. I'll also try to push my doctor for a nuanced test. Just heard that the plan to do a genetic test on me - although doubt that is going to do much other than potentially show the issue is inherited (nobody in my family appeared to have high cholesterol though - or perhaps they didn't know - and I am unaware of anyone having heart disease. Although I have a very small family). The test will probably just result in them finding out its not dietary and suggesting taking statins (which I am very resistant to). Really like the idea of pushing for a particle size test.

Alexandra100 - My photo is was taken in Nepal where I go quite a bit for pleasure and work. Interestingly it was on a trip to a very remote part of Nepal/Tibetan border that I believe the symptoms of poor blood sugar control appeared. I had done 5 days of very strenuous walking at high altitude and I was just with two Nepalese colleagues so I was eating very 'locally' - effectively variations on white rice with the occasional addition. I must admit to being rather flippant about eating when I am on such trips. I had two days with some Nomads near Tibet (the focus of my trip) and ended up drinking copious amounts of a (pretty grim) butter tea that they provide around social activities. When I was beginning the walk out I was suddenly hit by dizziness and weakness - a bit like being drugged, very weird. I had a grim few days getting out - had to climb a 5100M mountain pass suffering what I think was a kind of hypoglycaemic attack. When I got back to Kathmandu I got some checks at the mountain hospital and the blood sugar problem emerged. Bit of a bad way to find out about it - and its taught me a lesson about being much more careful about food supplies on such trips (I'll need to pioneer a low carb/ low weight mountain expedition diet).
 
transiting said:
ended up drinking copious amounts of a (pretty grim) butter tea that they provide around social activities
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That "pretty grim butter tea" formed the basis for "bulletproof" coffee which is much lauded by the ultra low carb community..
 
One small factoid that I would like to add is that only 15% of cholesterol is dietary the other 85% is made by the body and it is absolutely essential for life. Trying to remove every scrap of cholesterol from your diet is imo useless as the body ends up increasing production to make up the shortfall.

Saturated fat is not your enemy, cholesterol is not your enemy. I agree with the commenter up thread who recommended lectures by Prof. Ken Sikaris and Ivor Cummins.
 
bulkbiker said:
(as your doc seems to be taking total cholesterol or even total b*ll) then they don't seem to know that much about it
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But that is how doctors see our cholesterol the total level and for those with diabetes they want it below 4
 
transiting said:
I'll need to pioneer a low carb/ low weight mountain expedition diet).
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Look at ghee (easy to make yourself) and coconut oil as they will both keep for a long time without being in a fridge. The traditional solution is Pemmican that is a mix of ground dried meat and rendered fat, make correcly it has been proven to keep for 50 years outside of a fridge. There are also lots of "meat sticks" on the market that don't need to be kept in a fridge and of couse nuts last outside of a fridge.

But dired meat will not work on its own, as you MUST have fat or veg in a diet.
 
transiting said:
Just heard that the plan to do a genetic test on me
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There is one pathway in the liver that does not work for a few people, if the test shows you are one of these people you need to take a spasal statin to keep you alive. (This is normly done by a lipid consultant not a GP.)
 
I would try substituting some of the cardio exercise for graduated heavier weights sessions, exercise is meant to have a significant impact on cholesterol, maybe for your body type you require a mix up.
 
Pinkorchid said:
But that is how doctors see our cholesterol the total level and for those with diabetes they want it below 4
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Based on what though.. have you actually looked at any studies about cholesterol?
There is little (if any) evidence that a level of "4" means anything at all. It's a completely arbitrary number.
 
I heard a great way to question a GP when he/she starts mithering you about cholesterol levels.
Simply ask your GP this 'What is cholesterol?'. Apparently the vast majority of GPs do not have the answer. Furthermore, even if they understand what cholesterol is they cannot say what role/s cholesterol play in the body or even that there are a whole range of them other than thosed tested for.
 
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