Advice low BMI and high cholesterol / pre diabetics

Clawsal

Hi, I am looking for advice for my dad who is almost 60, has a low BMI (possibly underweight) and very high cholesterol.

He finally went for a check up a few months ago and has very high cholesterol, was put on 40mg statins for 3 months.

Statins lowered his cholesterol but he is now pre diabetic (with symptoms). The doctor made him stop the statins and they will reassess in 3 months.
Will the pre diabetes go away on its own?
Could he start again on a lower statins dosage?

What is he supposed to eat? No sugar no simple carbs no saturated fats AND he should absolutely not lose any weight.
The doctor was very unhelpful, called him a faux maigre (“fake skinny”) and won’t admit the pre diabetes comes from the statins... found it was a side effect on the internet.

Also telling my dad that he should gain a bit of weight but cut out white bread, sugar and cheese / cream... all that is fattening !

Clawsal

I think faux maigre = skinny fat actually. So he is skinny fat.

kommodevaran

I don't know anything about cholesterol, statins and diabetes, and whether avoiding saturated fat is a good idea, but I know this:
Underweight is classified as a BMI below 18.5.
No foods are fattening. If you eat more calories than you burn, over time, you get fat.
If your father needs to put on weight, he has to eat more calories than he burns.
Sugars are simple carbs, that leaves starch and fibre.
If saturated fat is out, that leaves unsaturated fats (poly+mono).
It's practically impossible to avoid sugar and saturated fat completely, and have a healthy diet.
Rigid food rules are often given instead of explaining what the patient should aim for, and why, so the patient can figure out the hows for himself, and actually succeed.
Your father might need the assistance of a dietician.

Clawsal

kommodevaran wrote: »

I don't know anything about cholesterol, statins and diabetes, and whether avoiding saturated fat is a good idea, but I know this:
Underweight is classified as a BMI below 18.5.
No foods are fattening. If you eat more calories than you burn, over time, you get fat.
If your father needs to put on weight, he has to eat more calories than he burns.
Sugars are simple carbs, that leaves starch and fibre.
If saturated fat is out, that leaves unsaturated fats (poly+mono).
It's practically impossible to avoid sugar and saturated fat completely, and have a healthy diet.
Rigid food rules are often given instead of explaining what the patient should aim for, and why, so the patient can figure out the hows for himself, and actually succeed.
Your father might need the assistance of a dietician.

kommodevaran wrote: »

I don't know anything about cholesterol, statins and diabetes, and whether avoiding saturated fat is a good idea, but I know this:
Underweight is classified as a BMI below 18.5.
No foods are fattening. If you eat more calories than you burn, over time, you get fat.
If your father needs to put on weight, he has to eat more calories than he burns.
Sugars are simple carbs, that leaves starch and fibre.
If saturated fat is out, that leaves unsaturated fats (poly+mono).
It's practically impossible to avoid sugar and saturated fat completely, and have a healthy diet.
Rigid food rules are often given instead of explaining what the patient should aim for, and why, so the patient can figure out the hows for himself, and actually succeed.
Your father might need the assistance of a dietician.

I know the BMI classification and that a calorie is a calorie thanks.

I am looking for practical advice.

kommodevaran

Clawsal wrote: »

kommodevaran wrote: »

I don't know anything about cholesterol, statins and diabetes, and whether avoiding saturated fat is a good idea, but I know this:
Underweight is classified as a BMI below 18.5.
No foods are fattening. If you eat more calories than you burn, over time, you get fat.
If your father needs to put on weight, he has to eat more calories than he burns.
Sugars are simple carbs, that leaves starch and fibre.
If saturated fat is out, that leaves unsaturated fats (poly+mono).
It's practically impossible to avoid sugar and saturated fat completely, and have a healthy diet.
Rigid food rules are often given instead of explaining what the patient should aim for, and why, so the patient can figure out the hows for himself, and actually succeed.
Your father might need the assistance of a dietician.

kommodevaran wrote: »

I don't know anything about cholesterol, statins and diabetes, and whether avoiding saturated fat is a good idea, but I know this:
Underweight is classified as a BMI below 18.5.
No foods are fattening. If you eat more calories than you burn, over time, you get fat.
If your father needs to put on weight, he has to eat more calories than he burns.
Sugars are simple carbs, that leaves starch and fibre.
If saturated fat is out, that leaves unsaturated fats (poly+mono).
It's practically impossible to avoid sugar and saturated fat completely, and have a healthy diet.
Rigid food rules are often given instead of explaining what the patient should aim for, and why, so the patient can figure out the hows for himself, and actually succeed.
Your father might need the assistance of a dietician.

I know the BMI classification and that a calorie is a calorie thanks.

I am looking for practical advice.

Here's practical advice: Get in touch with a dietician.

Clawsal

kommodevaran wrote: »

Clawsal wrote: »

kommodevaran wrote: »

I don't know anything about cholesterol, statins and diabetes, and whether avoiding saturated fat is a good idea, but I know this:
Underweight is classified as a BMI below 18.5.
No foods are fattening. If you eat more calories than you burn, over time, you get fat.
If your father needs to put on weight, he has to eat more calories than he burns.
Sugars are simple carbs, that leaves starch and fibre.
If saturated fat is out, that leaves unsaturated fats (poly+mono).
It's practically impossible to avoid sugar and saturated fat completely, and have a healthy diet.
Rigid food rules are often given instead of explaining what the patient should aim for, and why, so the patient can figure out the hows for himself, and actually succeed.
Your father might need the assistance of a dietician.

kommodevaran wrote: »

I don't know anything about cholesterol, statins and diabetes, and whether avoiding saturated fat is a good idea, but I know this:
Underweight is classified as a BMI below 18.5.
No foods are fattening. If you eat more calories than you burn, over time, you get fat.
If your father needs to put on weight, he has to eat more calories than he burns.
Sugars are simple carbs, that leaves starch and fibre.
If saturated fat is out, that leaves unsaturated fats (poly+mono).
It's practically impossible to avoid sugar and saturated fat completely, and have a healthy diet.
Rigid food rules are often given instead of explaining what the patient should aim for, and why, so the patient can figure out the hows for himself, and actually succeed.
Your father might need the assistance of a dietician.

I know the BMI classification and that a calorie is a calorie thanks.

I am looking for practical advice.

Here's practical advice: Get in touch with a dietician.

Or maybe some people have had the same experience and can offer some advice.

No way he is going to a dietician... it took years to get him to have a checkup.

kommodevaran

Clawsal wrote: »

kommodevaran wrote: »

Clawsal wrote: »

kommodevaran wrote: »

I don't know anything about cholesterol, statins and diabetes, and whether avoiding saturated fat is a good idea, but I know this:
Underweight is classified as a BMI below 18.5.
No foods are fattening. If you eat more calories than you burn, over time, you get fat.
If your father needs to put on weight, he has to eat more calories than he burns.
Sugars are simple carbs, that leaves starch and fibre.
If saturated fat is out, that leaves unsaturated fats (poly+mono).
It's practically impossible to avoid sugar and saturated fat completely, and have a healthy diet.
Rigid food rules are often given instead of explaining what the patient should aim for, and why, so the patient can figure out the hows for himself, and actually succeed.
Your father might need the assistance of a dietician.

kommodevaran wrote: »

I don't know anything about cholesterol, statins and diabetes, and whether avoiding saturated fat is a good idea, but I know this:
Underweight is classified as a BMI below 18.5.
No foods are fattening. If you eat more calories than you burn, over time, you get fat.
If your father needs to put on weight, he has to eat more calories than he burns.
Sugars are simple carbs, that leaves starch and fibre.
If saturated fat is out, that leaves unsaturated fats (poly+mono).
It's practically impossible to avoid sugar and saturated fat completely, and have a healthy diet.
Rigid food rules are often given instead of explaining what the patient should aim for, and why, so the patient can figure out the hows for himself, and actually succeed.
Your father might need the assistance of a dietician.

I know the BMI classification and that a calorie is a calorie thanks.

I am looking for practical advice.

Here's practical advice: Get in touch with a dietician.

Or maybe some people have had the same experience and can offer some advice.

No way he is going to a dietician... it took years to get him to have a checkup.

Can you go on his behalf? Will he listen to you?

kimny72

Unfortunately, I think most people will feel it's irresponsible to give you advice on what he should eat, since we don't have all his medical info and are not medical professionals.

Your doctor gave bad advice, if for no other reason than because it wasn't clear and seems to contradict itself. Most doctors actually have very little training in diet and nutrition.

Typically high cholesterol and diabetes are reversed with weight loss, but your father can't do that. My first thought is he needs a second opinion and/or a registered dietitian.

Did the doctor give any clue of what might have caused an underweight man to have high cholesterol and pre-diabetes? Is there a genetic predilection involved? Was it his total cholesterol that was high? My total cholesterol is high, but it turns out my HDL is high and LDL is average so I was told not to worry about it.

Is he at all active? Do you know why he has become underweight? What is his current diet like? Did he used to be overweight? Does he drink or smoke? Is there a history of heart disease or diabetes in the family? I don't honestly expect or want you to answer these questions in a public forum, but these are the sorts of questions a medical professional would need to consider in order to determine what to recommend and if the cholesterol and pre-diabetes is even worth worrying about.

If he isn't active, increasing his exercise "might" be more important than anything in his diet. Also, no foods individually are fattening. It's about the totality of the diet, the calorie level, and the activity level that determine weight gain or loss and body composition. And it would be practically impossible to eat no sugar and no saturated fat.

I'm sorry if this really isn't helpful, and really sorry that the doctor just left you with a lot of confusion. I hope you can find some clarity. Perhaps check out the websites for the American Heart Association and the American Diabetes Association and go from there.

kimny72

Sorry, dupe post

nvmomketo

I developed prediabetes while a normal BMI, although I was near the top of the range. I suspect my steroid use (autoimmune issues) helped it show up faster, but my high carb diet was probably moving me in that direction anyways. I think eating a lot of glucose, from a lot of carbs, which causes the need for frequent high insulin, which can be a factor for developing IR. I suspect I have a low personal fat threshold. IMO

Anyways, when prediabetes is not caused by excess weight, losing weight is not a big help.

To control my BG, I adapted a low carb diet - I went to ketogenic (<30g carbs) levels and it brought my BG levels down to normal within days.

I follow the plan in Dr Bernstein's Diabetes Solution. It's a LCHF plan designed to reduce insulin and BG levels for diabetics. Worked beautifully.

Happily, higher fat diets, including saturated fat (which is the form our body prefers to store fat for future energy use), tend to improve cholesterol. HDL tends to go up, triglycerides tend to go down, and LDL becomes a larger less dense particle which is healthier. In some LDL will rise but since its size has changed it us not a bad thing - uneducated doctors may not be aware of that though.

Look into the books Cholesterol Clarity (easy read), Great Cholesterol Myth, and Cholesterol Con. Peter Attia md. has some good blogs on the topic. Dave Feldman has some fascinating n=1 experiments (replicated by dozens of people) that shows that cloesterol tends to drop after 3 days of a high fat, and higher calorie diet. Low fat tends to worsen cholesterol, and so does low calorie. Really interesting stuff.

https://m.youtube.com/watch?v=jZu52duIqno&amp;vl=en