AIR DATE: August 29, 2013 at 7PM ET
FEATURED EXPERTS: Jimmy Moore & Dr. Eric Westman
FEATURED TOPIC: "Cholesterol Clarity Q&A"
With the much-anticipated release of the book Cholesterol Clarity: What The HDL Is Wrong With My Numbers? by Jimmy Moore and Dr. Eric Westman, both of the coauthors joined us on "Ask The Low-Carb Experts" this week for a Q&A session answering listener questions about this critically important new book about the subject of cholesterol. This book was written to fill a major void in the marketplace of an easy-to-understand manual on cholesterol, why it's not the evil substance we've been led to believe, what really matters the most on your cholesterol panel, and which levels are optimal if you are going to pay attention to cholesterol. Here's your exclusive chance to hear directly from both Jimmy and Dr. Westman answering listener questions about the book. That's what we've got for you in Episode 43 of "Ask The Low-Carb Experts" in this Cholesterol Clarity Q&A.
Get Cholesterol Clarity: What The HDL Is Wrong With My Numbers?
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Here are some of the questions we address in this episode:
I have read and enjoyed books by both of you and am very much looking forward to reading Cholesterol Clarity! I am a 53-year old diabetic female who had heart bypass surgery 6 months ago. There is a history of cardiovascular issues on both sides of my family. I've read that statins can have some rather serious side effects. What, if anything, can you say to me and my doctor to convince us that it would be safe for me to stop taking the 10mg Lipitor I am now taking?
So what's the deal with plant sterols? I see it for sale as a supplement to "lower your cholesterol" and I see people taking it. Is there any benefit to it? What about the harm in taking it? I follow a low-carb, high-fat lifestyle, so I get plenty of dietary cholesterol from animals.
I have a one word question: Eggs. I eat at least three eggs a day everyday for breakfast along with some cheese and bacon. I feel this kind of large low-carb breakfast really gets me through the day. However, I can't find any consensus about eggs. Are they good, good in moderation, bad long-term, or will eating 21 eggs a week kill me?
I've read that higher serum cholesterol could be a clue that something else is going on in the body—for example, tissue damage that needs repair, or a decreased ability for cholesterol to be delivered into cells. Could you please talk about the role of LDL in particular, and what an increased level might indicate about other health factors?
The homeostatic model for serum cholesterol appears to be well worked out for a standard high-carb diet. Do you think that the correct model is substantially different for a ketogenic low-carb, high-fat diet, and that this might be the reason for the large number of "hypercholesterolemic" responses on this diet? Might the small intestine, instead of liver, be the dominant source of endogenous cholesterol on this diet?
My question is about the effect of fructose, sugar alcohols, and alcoholic beverages on your triglycerides. Would the fact my triglycerides are crazy high at 260 while everything else is fine mean that I should limit these things in my diet?
I have been diagnosed with a number of health issues including diverticulitis and Type 2 diabetes. Since then, I have been doing Paleo and cut out all gluten, sugar and high carb foods in my diet. I discovered that going ketogenic was right for me. Before I went keto, I had blood work run with the following results:
Total cholesterol — 265
HDL — 64
LDL — 176
Triglycerides — 158
A1c — 5.8
The next time I had blood work done was 6 months later. I asked for a VAP test and, although my doc doesn't understand how to read this test, she ordered it for me on my insistence. I moved towards a higher-fat diet and lost 40 pounds over that time since my last cholesterol panel. Here are the numbers:
Total cholesterol — 313 (my doctor was pushing statins)
HDL — 108
LDL — 187
Triglycerides — 77
To tell you the truth, my doctor had no idea how to interpret the more advanced numbers on my VAP test and I don't understand it either. I didn't accept the idea that I needed to go on a statin drug but I am greatly concerned with this very high 300+ total cholesterol level. So how do I interpret these cholesterol tests and what should I be doing differently in my diet to work on any weakness in these results? What exactly should I be looking for to track my progress?
The only guidelines I repeatedly see for the ApoE genotype 3/4 and 4/4 people are this: exercise, avoid smoking, abstain from alcohol and cut your saturated fat intake. Do you agree with these recommendations, especially the mandate to cut down on saturated fat? If so, how do you advise you patients who are eating low-carb, high-fat to reconcile this mandate to basically limit or avoid saturated fat with all that we know about the life-saving benefits of eating this way? What do people with this ApoE genotype gain by avoiding saturated fat?
PATHOLOGIST DR. SMALL:
I’m 59 years old and went low-carb about a year ago and my HDL rose from 50 to 77 and my triglycerides dropped from 92 down to 38. My cardiologist was stunned and asked me how I got such an outstanding triglycerides/HDL ratio with an outstanding CRP level of .4 and an carotid artery scan that show I have the arteries of an 18-year old. But he was not impressed with my LDL being above 130, my ApoB rising to 102, and my LDL-P coming in at 1500. How do you prioritize the favorable readings against the somewhat unfavorable ones? Do Heart Calcium Scores from a CT scan really tell the tale of where you stand with actual disease taking place in your coronary arteries?
I'm wondering how I can raise my LDL cholesterol levels since they seem to be too low. I haven't tested recently, but my previous test showed my total cholesterol is 142, HDL is 78, LDL is 71, and triglycerides are 50. I've been working on correcting a leaky gut and eating a Paleo/GAPS diet for the past year. My energy is very low, I’m always tired and my hormone levels are all on the low end of normal. I'm wondering if my too-low cholesterol could be part of the problem and if so, what can I do to raise it? I am not taking any cholesterol-lowering medications.
I went to my doctor and he says I am in the "dangerously high LDL range" and I should stop eating my low-carb high-fat diet and reduce my egg consumption to no more than 3 per week. My last lab results were the following:
Total cholesterol – 254
LDL – 186
HDL – 52
Triglycerides – 82
Blood glucose – 79
Over the last three years, my triglycerides have decreased, HDL increased, LDL increased, blood sugar decreased and weight decreased. I used to take a statin drug, but I will never take it again. I realize I probably shouldn’t worry about it, but my doctor went crazy about my numbers. Is the increase in my LDL cholesterol something I can choose to ignore or should I modify my diet to reverse the upward trend?
Is it possible that the rise in either total cholesterol or LDL-P that some people report while on a ketogenic diet is due to the fat leaving the adipose tissue as they lose weight? Are there any studies that show if it persists or goes away once weight stabilizes? And if your HDL is higher than your triglycerides while your fasting blood glucose level is under 100, do you care what total cholesterol or LDL-P is assuming there is no familial hypercholesterolemia?