So here I am checking the mail when I come across a friendly-looking letter from my Doctor, seeing as I just had a VAP Cholesterol panel done, I think to myself: “oh nice, they decided to print me out a copy of the results.” What I found inside was an insult for many reasons, let me tell you why.
My cholesterol has never been high; throughout my life, it has always been around the following; it has never deviated more than 10 points in LDL.
|Blood Glucose||Over 600! | A1C > 15|
Which makes sense to some extent as I’ve eaten some form of a low-fat diet for the majority of my life. When I was diagnosed with diabetes, my trigs shot up to 400. Again predictable.
After becoming diabetic, my doctor suggested I keep an eye on cholesterol. I was under 200 total, which is good (according to him), but being diabetic, I am at a higher risk for heart disease. Ok fair enough, he recommended a low-fat diet. Seeing as I’ve done low-fat all my life, I promptly threw the paper away and set about doing it my own way.
I did a lot of research and switched to low carb. Not extremely low carb, around 80 grams per day. Brown rice, whole grains, oat bread, and Ezekiel bread (sprouted grains) were still staples in my diet. This, along with medication (Metformin), helped stabilize my blood sugar down from 600 to safe levels (100-160). My next four cholesterol tests are averaged below.
|Blood Glucose||140-150 | A1C 6.6|
Wow, look at that. Total is lower (meaningless but still under 200), HDL (the so-called good cholesterol) shot up 10 points, LDL dropped (so-called bad), and trigs went from 400 down to a new all-time low, and I lost weight! Wow, this is great. My doc must be happy, right?!
Not in the slightest. He frowned about my diet and the results and told me that he would be prescribing Statins as I didn’t get it even lower than he wanted.
That is when it hit me, are we seriously taking advice from doctors that go by one marker on one test? Wouldn’t it be better if we averaged tests out? They’re not even that accurate; if you were to take ten cholesterol tests in a row, you would get a different result every time. I resolved to do more research and work on it in my own way without the evil statin.
I learned how the standard lipid panel is completely worthless. Cholesterol is not bad. LDL and HDL aren’t even cholesterol; they are lipoproteins that carry cholesterol, protein, and fat. HDL primarily carry cholesterol back to the liver.
I learned that LDL is not “bad,” there are several types of LDL particles. In simple terms, the particle number matters more. That being said, the smallest densest particles are the most damaging in concentration.
The total LDL count does not measure this. Who cares what this number is if I have the large type of LDL particle, and my particle count is low? The one that passes harmlessly through the blood and never penetrates our arteries? Heart disease is all related to inflammation and plaque formation in our arteries. And a low carb diet reduces inflammation, lowers your small dense LDL particles AND PARTICLE COUNT!
This was when I decided to start a Ketogenic diet, otherwise known as the Induction Phase of Atkins. Prior to starting, I had my A1C measured again. Blood Glucose 115-138! | A1C 5.7
After starting a Keto Diet, I no longer wanted the standard lipid test. On my next visit (6 months later), I asked for a better test. My doctor knew nothing about NMR (superior) or VAP tests (Mostly calculated) and didn’t understand why I wanted them. As my insurance wouldn’t pay for NMR, I ended up with VAP, but to even get it ordered, I had to provide my doctor with CPT Lab codes on the tests. (Quest Diagnostics: VAP NMR | Labcorp NMR)
Now remember on a keto diet for six months, here are my latest numbers.
|Blood Glucose||< 115! | A1C 5.2|
Here we see a consistent drop in my numbers, LDL is down again to new record lows, a rise in HDL and trigs are down as well, and I’ve lost….
60 freaking pounds!
I did not go back to my doctor for the results as my lab has an app on my phone that delivers the results directly to me. Now back to the letter. Let’s just see what he says. “Names are removed to protect the ignorant.”
Dear John, Dr. ImNotListening has received your lab results and has stated the following. LDL-C cholesterol goal, which is mildly elevated at 102, Normal level is below 100. Enclosed is a low cholesterol diet that the doctor recommends that you continue to follow. Please schedule an appointment in 6 months. Thank you.
Notice a trend yet? It does not matter what I improve; it will never be good enough as they keep moving the goal post further and further away. Not only are they still recommending a low-fat diet AGAIN. Something that has NEVER worked for me. A high grain high carb diet AGAIN. What point of me being diabetic do they not get? You cant give a T2 diabetic this diet. My blood sugar would skyrocket once again when it’s finally and totally truly under control. I would be forced to take insulin to control it.
I think it’s time I find a new doctor, don’t you? But that might not fix this; the real problem is not just my doctor; it’s the guidelines being set by USDA ADA\NCEP and so on. Doctors don’t have the time to learn what’s new in medicine nor the will or power to deviate from these guidelines. Beyond that, the majority of doctors are not trained properly in nutrition, they were given a short primer on it and then moved on to medicine.
Here is the “low cholesterol” diet they’ve given me.
Fat & Cholesterol Restricted Diet :
- Milk/Dary 2-4 Servings per day
- Low Fat avoid anything above 4% fat
- Meat 5oz skinless, 4 eggs per week, avoid fried or fatty cuts
- Breads & Grains 6-11 Servings a day
- Limit high-fat baked goods
- Vegetables 3-5 servings per day, avoid buttered, creamed, fried, or sauced vegetables
- Fruits 4 servings per day
- Avoid coconuts, avocados, and olives
- Dessert Limit to control calories, avoid high-fat items
Purpose: The low fat/low cholesterol diets are designed to reduce serum lipids
for the treatment and prevention of coronary heart disease. It is
believed and recent studies support the idea that lowering the levels of
cholesterol in the blood will prevent the formation of fatty plaques
found in the thickening of the artery walls known as atherosclerosis
- Foods high in total fat, saturated fat, and cholesterol are controlled.
- Total cholesterol intake is restricted
- Foods high in complex carbohydrates and fiber such as fruits, vegetables, whole grain products, and legumes are emphasized.
Diet Therapy of Blood Cholesterol:
- Fat < 30% Saturated fat < 10%
- Carbohydrates 60%
- Protein 10-20%
- Cholesterol <300mg
Yeah, let me get right on that.