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Low fat or Full fat?

ButterflyWine

Member
Can anyone tell me which is best - low or zero fat, or full fat? I also have high cholesterol and keep reading conflicting things on the internet (even from reliable sources).

I dabbled in keto a few years ago and it was full fat all the way but with my cholesterol my diabetic nurse says low fat and cheese only at weekends?

How do I work this with both diabetes AND high cholesterol?
 
Serum Cholesterol: 6.66mmol
Serum Triglycerides: 8.52mmol
Serum HDL: 0.87mmol
Serum Cholesterol / HDL ratio: 7.7

I've never been given any nutritional advice for my diabetes in the 12 years I've had it!! I've only just got a glucometer as well but I've been starting to get to grips with it.
 
And do you know what your cholesterol numbers were when doing keto?
Personally, when my blood glucose got better (in my case with insulin together with lowering the carbs and upping the fats) I found my cholesterol numbers got better too, so eating more fats definitely didn't do my lipids harm!

We have quite a few members knowing way more about cholesterol than I do, I'm mainly interested in diabetes. Here's a very long thread on cholesterol: https://www.diabetes.co.uk/forum/threads/cholesterol-and-statins.156985/page-20

ButterflyWine said:
I've only just got a glucometer as well but I've been starting to get to grips with it.
Click to expand...
A meter is the perfect start!
Especially as I've just read you like your intellect best about yourself in the Greetings and introductions thread

A meter allows you to see how food influences your BG real time, without biases or beliefs muddying the information. If you test before a meal, and around 2 hours after, your meter will tell you how well your body was able to cope with that amount of carbs, and you can adjust your meal next time.
You might like to read this on how diabetes works: https://www.diabetes.co.uk/forum/threads/basic-information-for-newly-diagnosed-diabetics.17088/
And this on how one of our members explains it: https://www.diabetes.co.uk/forum/blog-entry/the-nutritional-thingy.2330/

Good luck!
 
I would say the choice of how much fat is context specific. In order to get fat adapted, it would be necessary to have a higher fat content to build up the bodily mechanisms to switch over to using eaten and stored fat.

Once fat adapted you can slide the fat content up or down to suit satiety, how you feel and potentially athletic / aesthetic goals.

All of the views on cholesterol are hypothesis, there is not a definitive answer. The consensus view that the lower the better, has not played out when tested, either via randomised control trials or when compared to higher evidence such as a CAC scan. In short just as many die with low cholesterol as do with high. There is agreement that in post menopausal women higher cholesterol is protective (consensus stretches to the Vegan hierarchy also).

Generally in "our" space HDL improves (goes up), triglycerides improve (go down), LDL goes up in around a third. A well formulated low carb / keto diet will adjust LDL to be bigger (better in "our" view). "We" tend to believe that LDL is benign unless it is damaged by sugar and or vegetable òils, where it becomes smaller and dense. The other view is that LDL is just bad and leads to increased risk of heart disease. You will need to weigh the evidence on both sides. I go with the Keto advocates due to the other view being built on a lie, the 7 countries study, I don't believe our body has a sabotage mechanism built in by nature, the Japanese have shown the mechanism of glycation of the LDL, many with cholesterol above 7 have had CAC scans which show no disease in the arteries, etc.

In your shoes I would cut carbs, prioritise protein at every meal and eat the fat that came with the protein. I don't personally add extra butter or do fat bombs and the like.
 
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If you were to take a statin and go low fat I'd predict that you would lower LDL but it would not help you become less diabetic (your numbers show you are rather insulin resistant trig/hdl is a good proxy for this and your bio says you are on insulin) nor less at risk of a heart attack which is what I think you mean by expressing concern about your cholesterol. I appreciate that a mainstream DSN or various medical sites will have been trained to view saturated fat as directly linked to heart disease but there are many researchers who now think this is very out of date advice because the link between sat fat, raised cholesterol and heart disease hasn't been proved.
As I understand it your risks come from having too much insulin and higher diabetic blood sugars which can cause damage to your micro and macro vessels (the latter being your arteries in legs and coronary ones). Having a high trig level such as yours together with low HDL is unfortunately a risk factor for heart disease because it may show you've got quite a lot of small dense LDL that can hurt your artery walls. The only way to know for sure would be to get a calcium scan to see how those arteries are.
One of the reasons you might consider a higher fat/real food approach e.g. eating meat, fish, eggs and dairy plus above ground veggies with the fat they naturally come with would be that this would help you eat less starches (bread, pasta, rice) and sugars since it is the latter foods which are driving your need for insulin and raising your triglycerides and making your diabetes/insulin resistance and any arterial disease worse.
If you are taking insulin it is very important to get some help with any changes to diet as these would impact your medications especially insulin and blood pressure tablets.
Lastly you've got a baseline of results so you can try low carb again just to see what happens to that trig/hdl ratio which is thought to be more important than the total cholesterol number.
 

The Trigs are very high and the HDL low. Are they prescribing a med? As well as diet, I would consider a med.

This may help with what a (keto) low carb with more fats diet can do.
https://www.sciencedirect.com/science/article/pii/S0899900714003323

 
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Hi @ButterflyWine

oh, what a worry

Serum Cholesterol: 6.66mmol
Serum Triglycerides: 8.52mmol
Serum HDL: 0.87mmol
Serum Cholesterol / HDL ratio: 7.7

All i can add is the above posts all make good sense to me, but that's perhaps easy for me to say..

when i was DX'd as T2D, i became quite interested in my blood works, as you do.

in fact i then tracked back all my Blood works since 2010.
(had a concern back then that caused me to get checked out)

For me I was either high risk or at risk across the board in 2010, and no one mentioned it

Cholestrol was up, so began cutting back

Since DX I have learned so much about how we work inside

While a lot still to learn, I do now know how the ratios are important and to my mind the trigs dictate a lot of how the lipid panel looks.

and my trigs in
2010 jan was 6.7...
2018 at 2.7
at jan 2019 2.4..
and july 2019 1.2

8 years of a low cal diet dragged it down at first but then it dawdled
it was LCHF that booted it back into shape

and i didn't do fat bombs, I simply used butter over Marg, olive oils rather then vegetable oils,
ate a bit more cheese
And didn't trim any fat of the steaks/ meat I cooked

Normal rule was REAL FOOD.

Meat that liked like meat.
Veg that looked like veg

And all cooked by me
Herbs spices added to taste for flavour

No Saint, went off piste occasionally, but in General, it was the above.

So from 2010's horrific readings, by 2018 I had got most down to just risky ..oh joy

6 months of LCHF.
(And for me that was "healthier" fats,)

my panel was full of either GOOD or IDEAL

A difficult call for you to make .

I personally think processed food cut to the very minimum, and real food, got me back to a far healthier state in 6 months with my bloods then 8 years of low cal low fat ever dud.


No expert, just offering my personal experience, in the hope that may help.

Best of luck moving forward.
 
Alcohol raises triglycerides sharply. Carbohydrates too. My cardiologist suggests avoiding carbs and sticking to veg and lean meat- easier said than done perhaps, but I'd say it's a sensible guideline. I would say 'low-fat' foods tend to be full of sugar, so stick to unprocessed real food.
 
As far as I can find out, there has never been any study done where lowering cholesterol resulted in good things happening.
When I took statins for a few weeks my brain was affected - because brains are cholesterol based. My memory was badly hit.
Cholesterol is present in cell membranes - you don't want to damage them.
Cholesterol is used in making hormones in your body - pretty essential I'd have thought.
I've seen CoQ10 for sale - it is used to make ATP part of the energy supply for your cells - you get it for free from cholesterol.
The 'BAD' cholesterol LDL is what transports all the fat soluble vitamins around the body - and it also carries fatty acids for use as energy. It might have been mislabelled.
I cannot find a single good reason to reduce cholesterol.
 
You may consider looking into the PE diet, focusing on lean protein and green leafy veggies, then play around with the fats sources, avocados, nuts, olive oil, salmon.

how’s your fiber intake? I’ve been pounding down some creative salads. Steak salads with boat loads of spinach and zero cal dressing. Good gut health may help you break down fats.
 

Might be worth thinking about rotating greens. Nothing wrong with spinach, but it has one of the higher concentrates of oxylates. There are many different types of lettuce, book choy etc. Add unpeeled, spiralised zucchini or cucumber for phytonutrient goodies.
 
Had you water fasted for 12-14 hours before the blood was taken for the cholesterol test?
 
Thanks for all your comments and support! I'm on a statin and have been on one since I was diagnosed with diabetes years ago. I had my dose increased about 4 months ago, I'm on 40mg Atorvastatin.

My bloods were taken in the morning after fasting.
 
I would see how a low carb high fat, or a keto type of diet goes. It's often very good, as I linked above. I would also want the doctor to look into why my trigs and HDL are still out of range. The LDL may not be accurate with those trig levels and high trigs indicate a higher percent of the sdLDL, the one I don't want.
https://nutritionandmetabolism.biomedcentral.com/articles/10.1186/s12986-019-0334-y

I would discuss and take the doctors advice on possibly adding or changing to Fenofibrate, niacin vitD

https://care.diabetesjournals.org/content/25/7/1198#:~:text=CONCLUSIONS—The atorvastatin-fenofibrate combination,more than each drug alone.

https://pubmed.ncbi.nlm.nih.gov/12360175/
 
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