Low Carb/Sugars for Low Cholesterol?

AmieJW44

Good morning everyone - Hope any of you on the East Coast like me are surviving Sandy!

I have familial hpyercholesterolmenia - meaning I have extremely high cholesterol but not because of what I eat, because of my genes. My weight is within the normal range and I've been dealing with this for two decades now, on and off meds. Typically my doctors have warned me of keeping cholesterol, fat, and particularly saturated fat out of diet, so I've followed an almost vegetarian diet. Recently though I started seeing a new doctor, and he told me because of the type of high cholesterol I have, what I take in won't really affect me but I should limit or completely remove unrefined/processed/starchy sugars - so not only sweets, but also pasta, bread, etc. The Paleo Diet seems to embody that philosophy, so I've decided to give it a try for a month, while also limiting the fat and cholesterol in the meats I'm suddenly consuming.

So I'm mostly curious if anyone else has been told to cut down on carbs/sugars in the interest of maintaining or lowering cholesterol, and what sort of diet plans have you had luck with? My doctor recommended dropping weight as well (wants me on the lower end of the spectrum) and my body fat percentage, so I'm hoping this diet change (along with my normal exercise) will help. Anyone have any advice on that also?

Thanks!
Amie

Timehope

Forgive me for a long response:

You have posed a very interesting question right on the forefront of the ongoing debate, where competent researchers seem ready to drop the gloves and go at it from opposite sides, each swearing their way is the right way. Like you, I am the average Joe caught in the middle wondering who is right. After a LOT of reading and my own experiences I am coming to the conclusion that both sides may be right, but for different metabolisms.

Anyway, like you I come from a family background of high cholesterol, and like you, I was rigorously semi-vegetarian for years. (Can "rigorous" and "semi" be used in the same phrase?) I mean I ate skinless chicken or salmon once or twice a week, but I rarely ate cheese, never butter, never candy or desserts, never red meat or pork, rarely eggs, rarely mayo. My idea of a hamburger was a whole wheat bun with all the condiments -- but no meat. I bought low-fat cookbooks and was hugely proud of getting through some days with a gram or less of dietary fat.

So why was my cholesterol always high? Mayo Clinic has an "Executive's Checkup" program (for people presumably too busy to see their doctors very often) but it is very comprehensive. A few years ago I had such a checkup and they prescribed me a statin on the spot. (They also said, "Cut down on dietary fat!" but when I told them what I ate they were stumped.) You didn't report what your blood tests showed but I will present mine as a case study. At the time of my checkup:

T. cholesterol 327, triglycerides 168, LDL 229, HDL 64.

On statin: 231, 103, 149, 63. (Far better, but not ideal. )

Here's the interesting part: after reading several books (for example Gary Taubes' "Why We Get Fat") I threw caution to the wind, began eating cheese, steaks, hamburger meat, even butter (the arch-enemy.) Lots of leafy vegetables but no sugar, breads, pastas, etc. Gallons of olive oil, plenty of olive oil mayo. By the way, I continued on the statin.

A few months later: 189, 53, 96, 80. (Absolutely ideal. )

For many people, I suspect, the standard low-fat model works beautifully. But for others, it doesn't: their bodies are quite happy to manufacture blood fats out of innocent-seeming carbohydrates and sugars.

Diane Kress, in "Metabolism Miracle," claims that the latter tendency is a genetic pre-disposition for a subset of the population (I don't recall if she says 45% or 55%). Some start at birth with this metabolism issue, others switch over because of stress, weight gain, aging etc. After that it's a lifelong struggle. She's really talking about the overall metabolic syndrome -- I don't know but perhaps you can have hyperlipidemia and NOT have metabolic syndrome. (I'd say that was true of my mother.) Metabolic syndrome involves hyperlipidemia, but has a lot of additional features: high blood pressure, belly fat, higher blood glucose, etc. It's keyed to a built-in intolerance of carbs which promotes a disturbed insulin system.

The low-carb approach has been shown to work with people with metabolic syndrome. Will it work for someone who does not have signs of metabolic syndrome, and only has hyperlipidemia? Dunno...

Anyway, in this very long and convoluted response to your great question, my advice would be: If a super low-fat diet has not worked for you in terms of getting your cholesterol down, by every means try super low-carb. If it is right for you, you should see the results in a few months.

I hope this is helpful...

Casedata

Diane Kress, in "Metabolism Miracle," claims that the latter tendency is a genetic pre-disposition for a subset of the population (I don't recall if she says 45% or 55%). Some start at birth with this metabolism issue, others switch over because of stress, weight gain, aging etc. After that it's a lifelong struggle. She's really talking about the overall metabolic syndrome -- I don't know but perhaps you can have hyperlipidemia and NOT have metabolic syndrome. (I'd say that was true of my mother.) Metabolic syndrome involves hyperlipidemia, but has a lot of additional features: high blood pressure, belly fat, higher blood glucose, etc. It's keyed to a built-in intolerance of carbs which promotes a disturbed insulin system.

The low-carb approach has been shown to work with people with metabolic syndrome. Will it work for someone who does not have signs of metabolic syndrome, and only has hyperlipidemia? Dunno...

My mother has been extremely thin all her life (5'7", 110 lbs) but has had cholesterol numbers up into the 300's. Her diet has always been packed full of sweets and carbs. For my self, I do not have as high of cholesterol as my mother, but I do suffer with very high triglycerides, and have taken TriCor for years. I just recently started on a lower carb diet. I don't go as low as most low carbers. I hover around 120g and limit my sugar to 18g. I don't know yet what this diet will do with my numbers but I do know I feel better, have more energy, which causes me to exercise more.

So it will be interesting to see what other people with hypercholesterolemia shares about their numbers by being on a low carb diet.

DMW914

I agree with XCcyclist, try the low carb approach. You may even want to exclude certain gluten like rice, corn & wheat as they cause inflammation in your guts that lead to a whole host of other health issues. Also a good probiotic (not Align or other phramacy versions as they don't have enough of the vatious strains of friendly bacteria that's been stripped from taking meds/steroids or antibiotics) from a natural food store can assist you too.

Bakkasan

Low carb is believed to be superior in lowering cholesterol and raising HDL. My post about being bored has a few links to published studies but this is the one you would want to look at. My last blood work was 126 down from over 300. I was dedicated LCHF and a lot of weight lifting. I took 2 months off, now I am back at it. I dropped almost 80, got about 40 left if I retain all of my muscle mass.

http://www.ncbi.nlm.nih.gov/pubmed/15051841

Postprandial lipemia was significantly reduced when the men consumed both diets compared with baseline, but the reduction was significantly greater after intake of the very low-carbohydrate diet. Mean and peak LDL particle size increased only after the very low-carbohydrate diet. The short-term hypoenergetic low-fat diet was more effective at lowering serum LDL-C, but the very low-carbohydrate diet was more effective at improving characteristics of the metabolic syndrome as shown by a decrease in fasting serum TAG, the TAG/HDL-C ratio, postprandial lipemia, serum glucose, an increase in LDL particle size, and also greater weight loss (P < 0.05).

cramernh

In less than 90 days, my total CHO went from 252, DOWN to 177. My A1c went from 11.2 DOWN to 5.2 - I had a dramatic increase of HDL, and equally in decrease of my LDL. My Triglycerides are down to 102.

This was accomplished with elimination of:
candy
junk food
potatoes
rice
corn
pasta
flour
breads
whole milk
soda

We eat 100% clean at home. All meals are made from scratch and using only fresh foods. You will never find a box of kraft mac & cheese or a lean pocket in my house ever!

So far, I have maintained my current readings for over a year and even improved more (current HDL is 84!). In a couple of weeks I am due for my next blood draw (last draw was June 2012) to see where I am prior to meeting with the Endocrinologist that I also work for...

Familial hypercholesterolemia can be corrected but it requires a total commitment of the person affected with it. They have to be willing to eliminate these types of foods if they want to wipe it off the radar... some of my patients with FH have tried to incorporate whole grains, but it proved to slow down the progress of improving their total CHO panel. Others who did the same thing that I did, showed dramatically fast improvement.

rhondatn

Very interesting conversation that I have been pondering myself for a while. Before I started the lc lifestyle had borderline high cholesterol and high triglyceride numbers. After going low carb these numbers went down to normal ranges. I just fell off the wagon for a bit, had a physical, with my results being borderline high cholesterol once again. She wanted to put me on a low cholesterol diet, but I'm going to do my own thing and low carb it once again (how many times does it take to learn?) and see what the numbers are come April 2013 with a repeat lab.

Timehope

Possibly the most important number that has not been discussed here is fasting blood glucose. That is really the signature of how your body is handling carbs.

According to MedOnline and "Metabolism Miracle" (by Diane Kress) if your fasting blood glucose is over 90 you have carbohydrate intolerance -- and insulin resistance. (MedOnline says frankly that over 89 your pancreas is possibly damaged already -- that was a shocker to me.)

Diabetes (when your pancreas burns out on insulin production for good) is universally recognized at 125 fasting blood glucose. But pre-diabetes (that is to say, diabetes in early stages) begins at 100. (Some say at 90 -- others at 110.)

The important thing is that before you get to the 125 threshold there is arguably the possibility you can slow, halt and even reverse the progression. A strict low-carb regimen appears to be one of the leading -- possibly the very best leading -- ways to do that.

cramernh

Possibly the most important number that has not been discussed here is fasting blood glucose. That is really the signature of how your body is handling carbs.

According to MedOnline and "Metabolism Miracle" (by Diane Kress) if your fasting blood glucose is over 90 you have carbohydrate intolerance -- and insulin resistance. (MedOnline says frankly that over 89 your pancreas is possibly damaged already -- that was a shocker to me.)

Diabetes (when your pancreas burns out on insulin production for good) is universally recognized at 125 fasting blood glucose. But pre-diabetes (that is to say, diabetes in early stages) begins at 100. (Some say at 90 -- others at 110.)

The important thing is that before you get to the 125 threshold there is arguably the possibility you can slow, halt and even reverse the progression. A strict low-carb regimen appears to be one of the leading -- possibly the very best leading -- ways to do that.

Normal blood sugar levels (1.American Diabetes Association (2011). Standards of medical care in diabetes - 2011. Diabetes Care, 34(Suppl 1): S11-S61) are as follows:

Minimum 8hr fasting - Medical standard is less than 100mg/dL
Postprandial readings - Medical standard is less than 140mg/dL. Depending on the patient's medical data, postprandial can also be considered within normal limits from 180mg/dL

You are considered normal between the ranges of 80-120 - that is the standard protocol of measurement prior to meal consumption. A reading of 130 is still considered within normal range as well.

You are still considered within normal range if your blood sugar is low at 60. In most healthy patients, sugar levels are even lower

Less than 50mg/dL: leads to generalizes weakness, hunger, progressive loss of mental function, heart palpitations, syncope, unconsciousness and ultimately you are now a very dangerous medical emergency.


Sugar was already addressed in my previous post - if you go back to read that post - it clearly addresses the typical/traditional foods associated with refined starches - starches being sugar.

But, food is not the only contributor to high blood sugar levels. There are mutually antagonistic metabolic hormones that do play a role as well:

Cortisol, catecholamines and glucagon all have the ability to raise sugar levels
On the flip side, insulin; an anabolic hormone, has the ability to lower

MedOnline and Metabolism Miracle are not true viable sources of this situation.


Cramernh
Low Carber Daily Forum
Moderator

AmieJW44

Everyone - thank you so much for your responses, and I'm sorry I myself have been so late in saying so! All of this information is incredibly encouraging and further solidifies my commitment to giving it a shot.

I don't know my exact numbers, but I know my overall cholesterol was around 600 when tested almost a month ago. My "good" cholesterol was always on the high side, but the bad was high also even though my triglycerides were always at normal levels. I've got normal to lower blood pressure, and have never been told I'm at risk for diabetes or anything else. This has always been frustrating because every time I go into the doctors office I get the lecture "You've gotta get that cholesterol down! Eat whole grains and more fiber, and stay away from fatty, cholesterol laden foods! No fast food! No cheese! Cut out the dairy!" And every time I tell them, "I do! I do!" yet nothing really changes but a few hundred points here and there (which isn't a lot when you've been as high as 900). I'm glad I have this doctor who's looking at my cholesterol differently and told me something new. I'm still on three different medications and the verdict will be out for another month when I get tested again, but I'm actually looking forward to it.

For now these are the foods I eat regularly:
- Lean meats (chicken breast, pork loin, turkey)
- Once a week red meat but still lean
- Fish (but not shellfish)
- Egg whites and turkey bacon
- Lots of veggies and pretty much all of them
- Limit my fruit, but still eat some when I need more carbs in my diet
- Just started adding legumes back into my diet (they're not on the Paleo Diet so I'm cheating a bit)
- Olive and other vegetable oils
- Every so often butter (maybe once a week)
- Some nuts on a limited basis (when I haven't hit my fat quota for the day)
- Sweet potatoes
- Sometimes sugar substitute, but not often


What I do not eat:
- Sweets (candy, chocolate, cookies, coffee drinks, etc.)
- Pasta and rice, even whole wheat and brown
- Bread, even whole wheat
- Potatoes (except for baked sweet potatoes)
- Dairy - with the exception of butter occasionally


I have also drastically limited my alcohol intake. Right now I'm not drinking at all, but I will probably move that up to one day a week (my cheat day) but want to see if it helps with the cholesterol numbers.

I should note that while the scale hasn't moved but about three pounds over the past month, I do notice a change in how my clothes fit and several people have remarked that I look like I've lost weight. I was hoping to lose about 10 pounds total, and get my body fat percentage down to between 18-22%. Currently I'm 37, 5'3, weigh 127 lbs and have 29% body fat.

Will keep you all posted!

TheVimFuego

Possibly the most important number that has not been discussed here is fasting blood glucose. That is really the signature of how your body is handling carbs.<snip>

Totally agree.

My thoughts on Cholesterol are that it's not a great marker for heart issues, whatever flavour of it you measure. Just my weird world though.

AmieJW44

I don't disagree with that skepticism. I get my heart checked regularly, and every time the doctors are astonished because of how good it looks but yet how high my cholesterol is. There haven't been conclusive studies that prove high cholesterol definitively leads to heart attacks, but that is the general theory. However, I've also been curious of studies on the type of high cholesterol I have. Sure, many people with high cholesterol are also overweight, out of shape, don't eat well, and don't exercise enough so of course they're going to have heart problems. But my high cholesterol is because of my body - it doesn't process what it makes - so wouldn't my body also know how to handle that? If I'm in shape (which I relatively am), shouldn't that be more important than a number?

I don't know... probably by the time today's newborns are our age, this high cholesterol thing will be as much of an old wives tale as cold and rain making you sick (viruses don't thrive in cold, damp places), reading in the dark will make you go blind (why wasn't everyone alive before electricity blind then?), or eating blood-rare meat gives you more nutrients that well-done meat (undercooked meat can actually make you sick). Until then, I'll listen to the doctors.

TheVimFuego

<snip>I don't know... probably by the time today's newborns are our age, this high cholesterol thing will be as much of an old wives tale as cold and rain making you sick (viruses don't thrive in cold, damp places), reading in the dark will make you go blind (why wasn't everyone alive before electricity blind then?), or eating blood-rare meat gives you more nutrients that well-done meat (undercooked meat can actually make you sick). Until then, I'll listen to the doctors.

I hear ya, who knows what to think in today's world? So many theories, so much vested interest in pushing drugs or whatever ... and so little undeniable 'fact' for that matter.

I mean we've been through 'high' cholesterol generally, then LDL vs HDL, then vLDL is the problem, then it's the ratio between them all that seemingly is significant.

Then there is the other view that the cholesterol is only there trying to fix the problem, and not cause it.

I'll confess to not knowing my numbers and will probably never will, I will proceed in ignorance and hope .... to be honest my liver will probably pack in before my heart

I think keeping the blood sugar in check isn't a bad goal generally and that's how I'm going to proceed ... eat whole, nutrient-dense, mostly unprocessed, food.

OK, minimally processed.

OK, some ice cream and a snack-sized Boost Bar a day but watch the rest like a hawk.

Ah, I don't know either ... Good luck on your journey