AS SERIOUS AS A HEART ATTACK!

I wanted to put up this post in case anyone was wondering how things are going with my "kinder, gentler" challenge.

I am taking a break right now from weighing, measuring and tracking because on May 15, 2016, my dear husband, Bill, had a heart attack.  We had no warning, and did not even know that he was at risk.  Plus, he has been eating a healthy low carb, optimal protein, healthy fat diet for over seven years.  What the heck?

I want to write out the sequence of events, and I am hoping that this blog post might prevent someone else from going through what we went through.  So let me start at the beginning:

In September 2015, Bill had sudden onset vomiting and chest and abdomen pain.  We rushed to the ER, where he had an EKG and was told that his heart was fine.  The doc in the ER said it was probably just a stomach bug or food poisoning.  We understood that the normal EKG meant that his heart was healthy.  It was not, but no one at the ER told us that a normal EKG does not equate to a normal heart.

Four weeks later, in October 2015, it happened again.  Another ER visit, another EKG, and another clean bill of heart health.  This time, the ER doc suggested that Bill see a gastroenterologist.  Bill decided not to.  The ER doc did not mention seeing a cardiologist, even though Bill presented with chest pain and vomiting.

It happened again four weeks later in November, then four weeks later in December, then four weeks later in January.  Three more ER visits, three more normal EKGs, three more docs telling us to see a doc for the stomach, but no mention of seeing a doc for the heart.  In January, Bill finally decided to see a specialist, and after a few tests, was told he had GERD (gastroesophageal reflux disease).  He was given a pill to take and he started taking them.

Bill had slowly been gaining a little weight, even though his diet had not changed, and when he gained even more after starting the GERD medicine, he decided to stop taking it.  He had not had a stomach issue for several weeks.  He stopped taking the pills, and had another vomiting episode on May 10.  We called his GI doc, and he said to just start taking the pills again and everything would be fine.

On May 14, he fell ill and told me that he was tired and felt like he had been hit by a truck.  No chest pains, but just all over muscle aches.  In the evening, he had a headache and all his bottom teeth hurt.  I decided that if he was still not feeling well after the weekend, I would take him to the doctor.

On May 15, I went to lift weights at the gym, but Bill decided to stay home.  He said he felt better, but was very tired.  At 3 pm, he started having chest pains and difficulty breathing.  HE DID NOT FEEL THE NEED TO TELL ME THIS!  He thought he was having some sort of muscle spasm.  He spent the night sitting up in a chair, unable to lie down.

On May 16, as I was headed out the door at 4:30 am, Bill stopped me and told me he was having chest and back pain and trouble breathing.  We immediately got in the car to take the 10 minute drive to the hospital.  Neither of us thought it was a heart attack, or I would have called 911.  We told them in the ER that he was having chest pains, and after an EKG, things got pretty dramatic.

Within a few minutes, we were told that Bill was having a heart attack and needed immediate surgery.  He never clutched his chest and passed out.  It did not seem like a heart attack.  But standing in an ER room and listening to "Code Blue, Room 9!" over the PA system is something I never want to live through again.  Watching several medical persons run into my husband's room and start working on him was so frightening!  For the second time in my life, I felt like I was part of a TV show, the first time being when my daughter was in the ER after her fatal car accident in 1997. After an angioplasty and two stents, he was taken to the ICU, where he spent three days.  We found out that he had three blocked arteries in his heart.  One was completely blocked and that's where the two stents were placed.  Another one was 85% blocked, but the doctor said we would wait seven to ten days to put in a stent there, because putting in a stent can sometimes cause a heart attack, and the doctor did not want him to have two heart attacks so close together.  The other artery was only around 30% blocked, so no need for treatment on that one.

The cardiologist told me that if I had gone to work that morning and left Bill at home, he would have been dead in an hour or so.  He said that Bill did not have a "close call".  He had "THE call".

On May 17, Bill had an echocardiogram done to see what damage was done to his heart during the 18 hours that he was having a heart attack but did not seek treatment.  We were surprised to learn that there was no damage to the heart.

On May 18 we left the hospital and went home.  Bill was told to do a lot of nothing, to lift nothing, and to take a three to four month leave from work at the golf course.

On May 20, we were back in the ER because Bill was still having trouble breathing.  When we came into the ER, the same doctor was there.  He told us that Bill no doubt had congestive heart failure, and that his heart enzymes during the attack were the highest he had seen.  But the cardiologist said he did not have congestive heart failure, because there was no damage to the heart.  He did decide, however, to go ahead and do the surgery to insert the other stent, as long as we were there.  The surgery went well, and Bill was released from the hospital again the next day.

On May 23, I took Bill in to see the cardiologist in his office because he still could not breathe.  He was examined by the nurse practitioner, who told him that because his heart had suffered no damage, it must be lung disease brought on by fifty years of smoking (he quit ten years ago), and Bill was referred to a pulmonary specialist.  We made the appointment, but could not be seen for a couple of weeks.

On May 25, we were back at the ER because Bill could not breathe and was having head, neck and shoulder pain and was going back and forth between chills and hot flashes with extreme sweating.  The ER doctor told us that Bill had congestive heart failure.  Tests showed fluid around his heart and fluid around and in his lungs.  After he was admitted, the cardiologist ordered another echocardiogram, and this time it showed that there was damage to the heart.  So now the cardiologist concurs with the ER doc and Bill has been formally diagnosed with congestive heart failure.

Bill was put on a pretty high dose of a diuretic, and started losing water weight right away.  He was checked out by the stomach doc and the lung doc and got a clean bill of health from both, so it's all about the heart at this point.

On May 27, Bill was released from the hospital and sent home again.  He has a followup appointment today with the cardiologist, and next week he starts cardiac rehab.  In the ten days following his release from the hospital, he lost over 13 pounds of fluid.  His breathing is normal.  He sleep apnea is gone.  His energy level is good, but he does get tired a little bit after walking around.  He is not working, but we do take short walks around the block and such.  His mood is much improved and he is back to his normal, cheerful self.

But, enough about Bill!  I'm sure you are wondering how I am doing.

During the twelve days that we were going in and out of the hospital, I was stress eating and not sleeping.  I stayed with Bill at the hospital, sleeping on a futon next to his bed, and ate three meals per day in the hospital cafeteria.  The food was surprisingly good, with lots of low carb options.  I did eat a few high carb things, like I had a cookie twice during that time, and I had fruit and yogurt.  I was no nervous that I felt the emotional need to eat every couple of hours, and I gained several pounds during that time.

Needless to say, my plan for getting down to 130 pounds flew out the window when Bill's heart attacked him.  It has been three weeks since then, and I am now ready, emotionally and physically, to start taking care of myself again.  I fasted two days ago, and I am fasting again today, and may fast tomorrow as well.  This morning, I weighed 140 pounds.  I'm going to try to get on the fast track to getting rid of the weight I gained since May 15 and go on from there to my goal.  I took a break from the gym to take care of Bill, but I have started back again and have been lifting weights and making progress.

THE BIG QUESTION:  WHY DID THIS HAPPEN?

According to everything I know to be true, Bill should not have heart disease.  He has been eating low carb for over seven years.  He quit smoking over ten years ago.  He is active.  What has happened does not seem right, and I need to get to the bottom of it, and also find out if I am at equal risk.

From what I have learned, the cause of heart disease is not high cholesterol, but systemic inflammation, as these articles explain.  All of Bill's inflammation markers are high.  Maybe mine are, too.  I don't know.  And if he, and possibly me, too, have serious inflammation, what is causing it?  Is it the feedlot beef that is high in Omega-6?  Has a sensitivity to eggs been developing?  Is too much dairy causing inflammation?  I have no idea, but I intend to find out and stop this thing in its tracks so that Bill can recover, live long, and prosper.

In the third week of July, Bill and I are traveling to see Dr. Jeffry Gerber in Denver.  I have been following him for a while, and his understanding of heart disease is on the cutting edge of current research.  Bill will be tested and evaluated, and so will I.  If you would like to get an idea of Dr. Gerber's views on the subject, check out this great youtube video.

When we left the hospital, we were given a set of instructions that included the recommendation to eat 7-10 servings of grains per day, along with starchy vegetables, very low fat, virtually no animal products contained saturated fat, and low salt.  Basically, they want Bill to become a vegan.  This will happen over my dead body.  I know too much to ever let that happen.

And, all the doctors we saw told Bill that he needs to go on a statin drug.  Statins cause so many side effect, including damage to the heart muscle, damage to other muscles and memory loss.  Statins are bad, and Bill refuses to take one.  I have heard Dr. Gerber say that he does prescribe statins, but not very often, so we are hoping that Bill will not have to take them.  I trust Dr. Gerber, and if even he says that Bill should be on a statin, we will have to seriously consider it.

We will be depending heavily on Dr. Gerber to bring us through this mystery and out the other side.

I'm not sure when I will post again.  I will give an update when I can, and I will definitely let my readers know the results of our testing with Dr. Gerber.

Thanks for reading!

ENJOY EATING SATURATED FATS - THEY'RE GOOD FOR YOU

ARE EGGS BAD FOR YOU?

SATURATED FATS ARE HEALTHY TO EAT - US WELLNESS MEATS

Finally, more evidence that points to what we already knew...

Dietary intakes of saturated fats are not linked to cardiovascular disease, so says a meta-analysis from across the world. 

The conclusion that dietary intake of saturated fat was not associated with an increase in coronary heart disease or cardiovascular disease was reported in the American Journal of Clinical Nutrition this past February, 2010.

This study accumulated data from almost 350,000 subjects in twenty-one different studies. The data from these study subjects showed the development of approximately 11,000 cases of Coronary Heart Disease (CHD) or stroke. However, there was no link established between the subject's saturated fat intake and the incidence of CHD, stroke, or Cardiovascular Disease (CVD), and this did not change when the researchers focused their research to consider age or sex, or the quality of the study. 

"Our meta-analysis showed that there is insufficient evidence from prospective epidemiologic studies to conclude that dietary saturated fat is associated with an increased risk of CHD, stroke, or CVD," wrote the researchers, led by Dr Ronald Krauss from the Children's Hospital Oakland Research Institute in California. 

"[However,] nutritional epidemiologic studies provide only one category of evidence for evaluating the relation of saturated fat intake to risk for CHD, stroke, and CVD. An overall assessment requires consideration of results of clinical trials as well as information regarding the effects of saturated fat on underlying disease mechanisms, as discussed elsewhere in this issue. Nonetheless, a summary evaluation of the epidemiologic evidence to date provides important information as to the basis for relating dietary saturated fat to CVD risk," the researchers said.

The study, funded by the US National Dairy Council, Unilever, and the National Institutes of Health, challenges the mainstream majority thinking that saturated fats are detrimental to heart health. 

The old "lipid hypothesis" tried to show a direct relationship between the amount of saturated fat and cholesterol in the diet and the incidence of coronary heart disease. This lipid hypothesis for heart disease received a huge amount of publicity and public favor, in spite of the fact that other studies showed this hypothesis to not be true many years ago. 

In the last 50 years, big food processing companies jumped on the bandwagon and pushed the lipid hypothesis even further into the mainstream. Oddly enough though, prior to the 1920's, coronary heart disease was very rare in America. Americans ate lots of lard, butter, beef and cheese, but heart attacks and strokes were uncommon.

While vegetable oils and hydrogenated fats were pushed as the "healthy choice" over saturated fats for the next forty years, the incidence of coronary heart disease actually increased dramatically, so much so that today, heart disease remains a primary cause of death in the U.S. With the advent of the revised food pyramid, grains and carbohydrates pushed those numbers up even higher. 

If heart disease had any connection to saturated fats in the diet, how could it be that the use of saturated fats has gone down, while the use of processed vegetable oils like margarine, shortening, and trans fats-as well as sugar and grain-based processed foods have increased dramatically? 

Clearly something has been amiss here. 

Oils like canola, corn, soybean, and sunflower have been pushed as the healthy substitutes over saturated fats. It is these oils, though, that contribute to inflammation in the body, and upset the ratio of Omega 3 fatty acids and Omega 6 fatty acids.

Diets high in vegetable oils -especially hydrogenated vegetable oils, cause a variety of health problems, including inflammation. This inflammation leads to an increased tendency to form blood clots, which leads to heart attacks and strokes, now at higher than ever levels in the U.S. 

Most of the fat in our bodies and in the food we eat comes in the form of triglycerides, which are made of three fatty-acid chains attached to a glycerol molecule. Elevated triglycerides in the blood are usually linked to a higher than average potential for heart disease, but triglycerides do not come directly from dietary fats. Triglycerides are made in the liver from sugars that have not been burned for energy. Excess sugars in the body are from starchy carbohydrates, particularly refined sugar and white flour. It appears that triglycerides and vegetable oils and excessive Omega 6 fatty acids are causing much of the problem.

So you see, saturated fats are not the villains they have been portrayed to be, nor are they the cause of today's diseases; in fact quite the opposite is true. 

Saturated fats play an important role in the body in several ways: 

• Saturated fatty acids make up at least 50% of the cell membranes. They give cell walls their necessary stiffness and integrity.

• Saturated fats are extremely important for bone health. For calcium to be effectively utilized in our bones at least 50% of dietary fats should be saturated--so skim milk will not help your bones.

• Saturated fats are vital to the liver and help protect it from toxins such as alcohol and other drugs. 
 
• Saturated fats strengthen the immune system. 

• They are needed for the proper utilization of other essential fatty acids - Omega 3 fatty acids are better retained in the tissues and utilized by the body when the diet is rich in saturated fats as well.

• The fat around the heart muscle is actually highly saturated. The heart draws on this reserve of fat in times of physical stress. 
 
• Saturated fats lower a substance in the blood called Lp(a), or Lipoprotein(a), that indicates a tendency towards heart disease. 

• Short- and medium-chain saturated fatty acids have important antimicrobial properties. They protect us against harmful microorganisms in the digestive tract. 

The scientific evidence is beginning to pile up and does not (and never did) support the assertion that saturated fats clog arteries and cause heart disease. 

So while saturated fats have not yet been exonerated in the mainstream public, the tide is beginning to turn. You as an educated consumer, and your own health advocate know the truth about saturated fats vs. the evils of vegetable oils and refined foods. Enjoy your grass fed steaks, butter, cheese and lard and know you are doing your body good.

References:
Mary G. Enig, PhD, and Sally Fallon, "The Skinny on Fats", Weston A. Price Foundation, Jan, 1999.
Stephen Daniells, "Saturated Fats Not Linked to Heart Disease: Meta Analysis", Food Navigator.com, February 2010.
P.W. Siri-Tarino, Q. Sun, F.B. Hu, R.M. Krauss, "Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease", American Journal of Clinical Nutrition, February 2010.

To visit US Wellness Meats, click here.

For another great article on the importance of eating saturated fat by the Weston A. Price Foundation, click here.

THE LIPITOR PARADOX - FUNNY AND SCARY AT THE SAME TIME

A REVERSAL ON CARBS - LOS ANGELES TIMES ARTICLE

Fat was once the devil. Now more nutritionists are pointing accusingly at sugar and refined grains.

Carb consumption has risen over the yeras. So have U.S. obesity levels. (Kirk McKoy, Los Angeles Times / December 20, 2010)

By Marni Jameson, 

Special to the Los AngelesTimes

Most people can count calories. Many have a clue about where fat lurks in their diets. However, fewer give carbohydrates much thought, or know why they should.

But a growing number of top nutritional scientists blame excessive carbohydrates — not fat — for America's ills. They say cutting carbohydrates is the key to reversing obesity, heart disease, Type 2 diabetes and hypertension.

"Fat is not the problem," says Dr. Walter Willett, chairman of the department of nutrition at the Harvard School of Public Health. "If Americans could eliminate sugary beverages, potatoes, white bread, pasta, white rice and sugary snacks, we would wipe out almost all the problems we have with weight and diabetes and other metabolic diseases."

It's a confusing message. For years we've been fed the line that eating fat would make us fat and lead to chronic illnesses. "Dietary fat used to be public enemy No. 1," says Dr. Edward Saltzman, associate professor of nutrition and medicine at Tufts University. "Now a growing and convincing body of science is pointing the finger at carbs, especially those containing refined flour and sugar."

Americans, on average, eat 250 to 300 grams of carbs a day, accounting for about 55% of their caloric intake. The most conservative recommendations say they should eat half that amount. Consumption of carbohydrates has increased over the years with the help of a 30-year-old, government-mandated message to cut fat.

And the nation's levels of obesity, Type 2 diabetes and heart disease have risen. "The country's big low-fat message backfired," says Dr. Frank Hu, professor of nutrition and epidemiology at the Harvard School of Public Health. "The overemphasis on reducing fat caused the consumption of carbohydrates and sugar in our diets to soar. That shift may be linked to the biggest health problems in America today."

To understand what's behind the upheaval takes some basic understanding of food and metabolism.

All carbohydrates (a category including sugars) convert to sugar in the blood, and the more refined the carbs are, the quicker the conversion goes. When you eat a glazed doughnut or a serving of mashed potatoes, it turns into blood sugar very quickly. To manage the blood sugar, the pancreas produces insulin, which moves sugar into cells, where it's stored as fuel in the form of glycogen.

If you have a perfectly healthy metabolism, the system works beautifully, says Dr. Stephen Phinney, a nutritional biochemist and an emeritus professor of UC Davis who has studied carbohydrates for 30 years. "However, over time, as our bodies get tired of processing high loads of carbs, which evolution didn't prepare us for … how the body responds to insulin can change," he says.

When cells become more resistant to those insulin instructions, the pancreas needs to make more insulin to push the same amount of glucose into cells. As people become insulin resistant, carbs become a bigger challenge for the body. When the pancreas gets exhausted and can't produce enough insulin to keep up with the glucose in the blood, diabetes develops.

The first sign of insulin resistance is a condition called metabolic syndrome — a red flag that diabetes, and possibly heart disease, is just around the corner. People are said to have the syndrome when they have three or more of the following: high blood triglycerides (more than 150 mg); high blood pressure (over 135/85); central obesity (a waist circumference in men of more than 40 inches and in women, more than 35 inches); low HDL cholesterol (under 40 in men, under 50 in women); or elevated fasting glucose.

About one-fourth of adults has three or more of these symptoms.

"Put these people on a low-carb diet and they'll not only lose weight, which always helps these conditions, but their blood levels will improve," Phinney says. In a 12-week study published in 2008, Phinney and his colleagues put 40 overweight or obese men and women with metabolic syndrome on a 1,500-calorie diet. Half went on a low-fat, high-carb diet. The others went on a low-carb, high-fat diet. The low-fat group consumed 12 grams of saturated fat a day out of a total of 40 grams of fat, while the low-carb group ate 36 grams of saturated fat a day — three times more — out of a total of 100 grams of fat.

Despite all the extra saturated fat the low-carb group was getting, at the end of the 12 weeks, levels of triglycerides (which are risk factors for heart disease) had dropped by 50% in this group. Levels of good HDL cholesterol increased by 15%.

In the low-fat, high-carb group, triglycerides dropped only 20% and there was no change in HDL.

The take-home message from this study and others like it is that — contrary to what many expect — dietary fat intake is not directly related to blood fat. Rather, the amount of carbohydrates in the diet appears to be a potent contributor.

"The good news," adds Willett, "is that based on what we know, almost everyone can avoid Type 2 diabetes. Avoiding unhealthy carbohydrates is an important part of that solution." For those who are newly diagnosed, he adds, a low-carb diet can take the load off the pancreas before it gets too damaged and improve the condition — reducing or averting the need for insulin or other diabetes meds.

Americans can also blame high-carb diets for why the population has gotten fatter over the last 30 years, says Phinney, who is co-author of "The New Atkins for a New You" (Simon & Schuster, 2010).

"Carbohydrates are a metabolic bully," Phinney says. "They cut in front of fat as a fuel source and insist on being burned first. What isn't burned gets stored as fat, and doesn't come out of storage as long as carbs are available. And in the average American diet, they always are."

Here's how Phinney explains it: When you cut carbs, your body first uses available glycogen as fuel. When that's gone, the body turns to fat and the pancreas gets a break. Blood sugar stabilizes, insulin levels drop, fat burns. That's why the diet works for diabetics and for weight loss.

When the body switches to burning fat instead of glycogen, it goes into a process called nutritional ketosis. If a person eats 50 or fewer grams of carbs, his body will go there, Phinney says. (Nutritional ketosis isn't to be confused with ketoacidosis, a dangerous condition that can occur in diabetics.)

Beyond the fat-burning effects of ketosis, people lose weight on low-carb diets because fat and protein increase satisfaction and reduce appetite. On the flip side, simple carbs cause an insulin surge, which triggers a blood sugar drop, which makes you hungry again.

"At my obesity clinic, my default diet for treating obesity, Type 2 diabetes and metabolic syndrome is a low-carb diet," says Dr. Eric Westman, director of the Lifestyle Medicine Clinic at Duke University Medical Center, and co-author of the new Atkins book. "If you take carbohydrates away, all these things get better."

Though the movement to cap carbs is growing, not all nutritional scientists have fully embraced it. Dr. Ronald Krauss, senior scientist at Children's Hospital Oakland Research Institute and founder and past chair of the American Heart Assn.'s Council on Nutrition, Physical Activity and Metabolism, says that while he fundamentally agrees with those advocating fewer dietary carbs, he doesn't like to demonize one food group.

That said, he adds, those who eat too many calories tend to overconsume carbohydrates, particularly refined carbohydrates and sugars. "It can be extremely valuable to limit carbohydrate intake and substitute protein and fat. I am glad to see so many people in the medical community getting on board. But in general I don't recommend extreme dietary measures for promoting health."

Joanne Slavin, professor of nutrition at the University of Minnesota and a member of the advisory committee for the 2010 Dietary Guidelines for Americans, is less inclined to support the movement. The committee, she says, "looked at carbohydrates and health outcomes and did not find a relationship between carbohydrate intake and increased disease risk."

Most Americans need to reduce calories and increase activity, Slavin adds. Cutting down on carbs as a calorie source is a good strategy, "but making a hit list of carbohydrate-containing foods is shortsighted and doomed to fail, similar to the low-fat rules that started in the 1980s."

As nutrition scientists try to find the ideal for the future, others look to history and evolution for answers. One way to put our diet in perspective is to imagine the face of a clock with 24 hours on it. Each hour represents 100,000 years that humans have been on the Earth.

On this clock, the advent of agriculture and refined grains would have appeared at about 11:54 p.m. (23 hours and 54 minutes into the day). Before that, humans were hunters and gatherers, eating animals and plants off the land. Agriculture allowed for the mass production of crops such as wheat and corn, and refineries transformed whole grains into refined flour and created processed sugar.

Some, like Phinney, would argue that we haven't evolved to adapt to a diet of refined foods and mass agriculture — and that maybe we shouldn't try.

To read the full article, click here.

WATCH "FAT HEAD" MOVIE IN ITS ENTIRETY RIGHT HERE!

ELEVATED CHOLESTEROL LEVELS: CAUSE FOR WORRY? ELLEN DAVIS

Ellen Davis - Healthy Eating Politics

 

From Ellen Davis of the website Healthy Eating Politics:  

Fact: Half of all heart related deaths occur in people who have normal cholesterol levels.

In the United States, we have been brainwashed into believing that consuming saturated fat and having elevated cholesterol are synonymous with death from heart disease. This is called the Diet-Heart Hypothesis.
Problem is it's not true. Considering the fact stated above, and all the studies which suggest that higher cholesterol levels are associated with lower rates of mortality from any cause, we should consider the idea that cholesterol may be a substance we want to encourage, not reduce.
In fact, cholesterol is essential to life, and it provides substantial benefit to body health:

• Every cell in your body requires cholesterol to maintain cell wall integrity. Your body cannot make new cells without cholesterol, and cholesterol is used by the body to repair cellular damage.
• Cholesterol is the building material from which your body makes bile for the digestion of fatty acids. Without bile, you could not digest the fats you eat. Since your brain is 60% fat by weight, this would have a tremendous effect on your well being.
• Cholesterol is the parent substance from which aldosterone and cortisol are made. Without these two hormones, you would die in a matter of days, as these hormones keep the amount of salt and sugar in your blood at the right levels.
• Cholesterol is also the parent for another hormone called calcitrol. Calcitrol is the active form of vitamin D within the body, and it is involved in more than 300 cellular processes. One of the most important is the regulation of calcium levels in our bones. Without calcitrol, calcium would pass right through the body, and our bones and teeth would dissolve. In addition, nerve transmissions would fail, as they depend on calcium. The result would be total paralysis as muscle groups would be unable to respond to nerve impulses. Your heart, which is a muscle, would be unable to contract.
• Cholesterol helps the body fight infections and indeed this may be its most important benefit. Current research has suggested that heart disease and atherosclerosis may be caused by infectious organisms and the resulting inflammation they cause. Higher levels of cholesterol protect the body from these inflammatory microorganisms.
• Cholesterol acts as a protective substance against stroke and cancer.
• Low cholesterol contributes to mood disorders, such as aggression, violence and depression. A team at the Yale University School of Medicine has theorized that cholesterol somehow regulates and influences brain neurochemistry.
• Your brain, which is the seat of your memories, your personality, your "you-ness" relies heavily on cholesterol. The brain uses about 20% of your total body cholesterol. If the brain doesn't have enough cholesterol, cognitive problems happen. Indeed, some people have reported experiencing loss of memory and even amnesia after taking drugs to lower cholesterol.
• A study in 2003 by Pfreiger revealed that the brain uses cholesterol to build the synaptic connections between its neurons. In fact, the brain has special cells called glial cells which are specifically adapted to make cholesterol for neuronal connections. Without cholesterol, there would be no brain function.
• A lack of cholesterol can cause dementia. Current research is revealing that lower cholesterol levels are related to the development of Alzheimer's disease. Henry Lorin has written an interesting book on this subject called Alzheimer's Solved: Condensed Edition.
• People with higher levels of cholesterol live the longest. There are multiple studies which support this fact. This is especially true for the elderly.
• Some people suffer from a genetic defect which is called Smith Lemli Opitz Syndrome in which the body doesn't make cholesterol. These people suffer from debilitating health problems including growth retardation, digestive issues, and other serious body damage since cholesterol is essential to these body processes.
• Cholesterol is so important to your body that it will make it if you don’t eat enough. This self regulation makes it very difficult to use a low fat diet alone to lower your cholesterol. The less cholesterol you eat, the more cholesterol your body makes. If you want to lower your cholesterol, reduce your carbohydrate intake. Carbohydrates turn into sugar or glucose in the body, and cholesterol is made from glucose. Any basic biochemistry text will confirm this fact.

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Elevated Cholesterol is Good

There are multiple studies which provide evidence that even high cholesterol levels above 300 mg/dl are not the dire health problem the government, drug companies and other nutritional experts would have you believe.
The real culprit in heart disease is the inflammation caused by elevated insulin and blood sugars brought on by eating highly refined carbs, and too many carbs in general.
The fact is that chronically high blood sugar and insulin are at the root of heart disease, as well as most autoimmune diseases. Dr. Ron Rosedale writes about this here. Cholesterol levels have never been linked definitively to heart disease in any study, and in fact many recent studies have declared no relationship exists.

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Notes on High Cholesterol and Drugs

If your cholesterol levels are elevated, and your doctor has mentioned drugs, please, please at least read the following resources, so you can make an informed decision. Doing so could save your health or even your life.

• Whole Health Source: List of Studies Which Do NOT support the Diet Heart Hypothesis
• Health Policy on Blood Cholesterol -Time to Change Directions paper published in Circulation 1992 86:3:1026-1029
• A Doctor Discusses the Dangers of Low Cholesterol
• The Statin Effects Study website
• THINCS: The International Network of Cholesterol Skeptics
• Spacedoc.net, a website by Duane Graveline, M.D.
• High Cholesterol helps build muscle mass.
• Medical Consumers website.
• Cholesterol and Health
• What's Cholesterol Got To Do With It? - article by Gary Taubes
• Dr. Drug Rep: article in New York Times magazine
• Spacedoc.net Forums: Read anecdotal evidence about the damage statins cause to individual health.
• The Great Cholesterol Con: The Truth About What Really Causes Heart Disease and How to Avoid It by Dr. Malcolm McKendrick
• The Great Cholesterol Con by Anthony Colpo
• Alzheimer's Solved: Condensed Edition by Henry Lorin, DMD.
• Fat and Cholesterol are Good for You by Uffe Ravnskov, MD PhD
• The Cholesterol Myths: Exposing the Fallacy That Saturated Fat and Cholesterol Cause Heart Disease by Uffe Ravnskov, MD PhD. This book is out of print, but you may be able to find copies on the web.
• Lack of Association Between Cholesterol and Coronary Heart Disease Mortality and Morbidity and All-Cause Mortality in Persons Older Than 70 Years A study published in the Journal of the American Medical Association

Large volumes of evidence support the fact that in addition to having no link to heart disease, borderline high cholesterol levels actually lower your risk of having a stroke or succumbing to an early death from cancer, digestive or respiratory diseases.
In addition, there are many documented cases of statin drugs causing serious injury and death to otherwise healthy people. Educate yourself!

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What to Say to Your Physician

Get your physician involved in a discussion about cholesterol levels and the study results which contradict the mainstream lipid hypothesis:

• Ask him or her to look at the studies which prove there is no relationship between high cholesterol blood levels and arteriosclerosis.
• Ask why many long term study reassessments like Framingham and MRFIT have shown that people with "elevated" cholesterol levels have the lowest rates of "all cause mortality", and that in fact, lower cholesterol levels are dangerous.
• Ask about natural treatments such as a low carb diet, Pantethine, and CoQ10 and L-Carnitine for increased heart health.
• Point out that current research models are suggesting that low cholesterol levels are associated with Alzheimer's Disease.

If you get the answer that this contradictory information is bunk, maybe you need a new physician.

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MY CYBER CHAT WITH TOM NAUGHTON OF THE MOVIE "FAT HEAD"

--> A couple of years ago, in response to watching the movie Super Size Me, I completely stopped eating at fast food restaurants and I've never looked back.  Tom Naughton's response to watching the movie was a little more extreme:  He set out to make his own documentary, exposing the obvious (to him) inaccuracies, inconsistencies and downright deceptions in that movie.

The result was Fat Head, a factual and comic look at Super Size Me, written by, produced by and starring Tom Naughton, a stand up comedian, sit down writer and first time film-maker.  Not only does Tom rip Super Size Me to shreds, but he also shines a very informative spotlight on the whole low carb nutritional movement.  I just got my copy a week ago, after watching all the teasers for the same on youtube, and I loved it.  However, because of the way I am "wired", I wanted to know more about what Tom thought on a few low carb confusions of mine.

I contacted Tom, asking if I could grill him a little, and he graciously told me to fire away.  In pretty short order, I got some very interesting and thought-provoking answers and observations from Tom, which helped me fine tune my own understanding of the way I have chosen to eat - high fat, moderate protein and low carb.

Following are some Q & A from Tom and me. 

Rebecca:  How is fat stored in the absence of insulin?  Most of the things I have read talk about how the over-release of insulin causes glucose to be stored as fat.  I have also read that protein that is not needed by the body is converted to glucose and stored as fat.  But what happens when a person eats overeats fat?  I asked that question of Gary Taubes in his recent interview with Jimmy Moore.  Gary answered by saying he has a problem with the word “overeat” and then he really didn’t answer the question.  He said that what is enough for one person might not be enough for another person.   

So I am trying to rephrase the question so that it is clear:  Say a person is eating a certain amount of fat, protein and carbs (very low carb), and they are maintaining their weight on these amounts of each macronutrient.  Then, they suddenly increase their fat intake only by a large amount.  Do they begin to gain weight?  And if so, why?  If fat storage is driven by insulin, and fat does not provoke an insulin response, then how does that fat get stored?  

I have heard some say that excess fat beyond what the body needs will just cause the body to raise the metabolism to burn it off.  I have heard some say that the body does not use the excess fat, but just excretes it.  I have heard some say that the excess fat is a “calorie bomb” and will be stored as fat, but they do not say by what biological mechanism this happens.  

Dr. Atkins said that we can eat as much fat as we want, because it will not cause insulin to be produced and there will be no way for the fat to be stored.  But then he says that if we eat way too much, it will cause weight gain.  How? 

Tom:  Unless you’re a type I diabetic, your body will always produce some insulin in response to food, and good thing too, or you’d waste away and die.  Carbohydrates generally provoke the greatest insulin response, but protein provokes an insulin response too.  I’m not aware of any experiments in which subjects lived on a diet of 100% fat, so I can’t say whether or not it’s possible to gain weight on fat alone, but we don’t eat fat alone; we eat fat with protein. 

So my guess is that while you’re less likely to store calories as fat if you’re eating nothing but fat and protein, it’s still possible to gain weight if you eat enough, because the protein could provoke an insulin response sufficient to store some fat.   

Rebecca:  What is the difference between “Calories In Calories Out” and “Creating a Calorie Deficit”?  I have heard many people talk about how 3500 calories equals a pound, and that to lose a pound per week, all you have to do is cut 500 calories from your daily food.  Or cut 250 calories per day and increase your activity by 250 calories each day for the same result. 

Many low carb people will say that this theory is wrong, because a calorie is not a calorie is not a calorie.  The body will react to 100 calories of high glycemic index carbs differently than it will react to 100 calories of butter.  I know that I, personally, will maintain my weight on 1100 calories of high carb, low fat food, and I will also maintain my weight on 1800 calories of low carb, high fat food.  So I do believe that there is a “metabolic advantage” to eating low carb and high fat.   

Also, many will say it is wrong because the body can adapt through homeostasis or thermogenesis, and keep the body from losing weight.  I heard this analogy recently:  It's kind of like the Borg on Star Trek, where a phaser weapon works against the alien Borg creatures once, but then they adapt, and soon the same phaser blast no longer does anything. 

I started a thread on the Atkins Forum called “My Body is Not a Piggy Bank!  (Do Calories Matter?)” and I posted information that I got off of Adam Kosloff's website Why Low Carb Diets Work.  On that website, Adam attempts (and does a great job, I think) of crystallizing Gary Taubes’ ­Good Calories Bad Calories into an easily read and understood form.  Gary told Adam that he thought it was good. 

If anyone can prove that homeostasis and/or thermogenesis are real,  it is me!  Without changing my activity, I have both gained and lost weight eating 1400 calories and 2000 calories and everything in between.  And all of this high fat, moderate protein and very low carb (never more than 40 total carbs and as low as 20 total carbs). 

Tom:  To lose weight, you still have to create a calorie deficit. The idea behind low-carb is that the fat cells are open for business, so if you create the need to tap them, you can. Otherwise, simply eating less can encourage your body to slow your metabolism.   

Calories In Calories Out assumes the number of calories you burn stays more or less constant. It ignores adaptive thermogenesis, the process by which your body can dramatically raise or lower your metabolism in response to the foods you eat, hormones, etc.  So according to the Calories In Calories out crowd, if you simply eat less, you’ll automatically lose weight matching the equation 3,500 calories = 1 pound of fat. However, if your fat cells aren’t open for business and you simply eat less, your body will respond to starvation at the cellular level by slowing your metabolism. That’s part of the reason so many diets fail, and also the reason some people who try to grit it out end up losing muscle instead of fat. Likewise, people who literally can’t seem to gain weight (my son, for one) have metabolisms that ramp up if they eat more. 

If your fat cells are open for business, your body can make up for a fuel shortage by burning body fat, so it won’t experience cellular starvation and won’t slow your metabolism. But any way you slice it, you need to give your body a reason to tap those fat cells. I’ve seen people accuse the low-carb doctors of either denying the need for a calorie deficit or just now admitting to it, but Drs. Eades & Eades wrote about the need to create a calorie deficit way back with their first Protein Power book, which was published in 1997.  

Research has shown that people who go on low-carb diets often end up eating less spontaneously. There’s a reason for that: once the fat cells are opened up, they supply a bigger share of your energy, so you don’t feel the need to eat as much. 

Rebecca:  It seems like you are saying that Calories In Calories Out does not work if the fat cells are “closed” but it does­ work if the fat cells are “open”.  Or maybe it works when the fat cells are “open” but you make sure not to drop your calories too low and cause the body to “shut” the fat cells again.

But doesn’t “creating a calorie deficit” also ignore adaptive thermogenesis?  If the fat cells are “open” does that turn off adaptive thermogenesis, or is it still possible? 

If I am understanding this correctly, the difference between Calories In Calories Out and Creating a Calorie Deficit is really only a matter of semantics.  You could basically say that if you are eating high carb and low fat, Calories In Calories Out will not work.  But if you are eating low carb and high fat, Calories In Calories Out will work.  Isn’t Creating a Calorie Deficit really the same thing as Calories In Calories Out, provided, of course, that you are acknowledging that all calories are not created equal? 

Just eating less and exercising more (Calories In Calories Out) will not make a person lose weight IF they are eating wrong.  But if they are eating right, eating less and exercising more will make them lose weight (Calorie Deficit).  Please help me to understand this better!   

Tom:  Well, it’s a big, complex subject, but I’ll try to make it as clear as possible.  The Calories In  Calories Out crowd believes that 1) Body fat is passive and 2) All calories count the same.  Therefore, they make goofy statements such as “If you just cut 100 calories per day from your diet, you’ll lose 10 pounds per year.”

They see the body as a bank which has a set number of daily expenses (your basal metabolism).  Every calorie consumed is a deposit, and every calorie burned through activity is a withdrawal.  So in their view, if your basal metabolism is 1500 calories and you burn an extra 500 calories through activity, eating more than 2000 calories will always cause weight gain, and eating fewer than 2000 calories will always cause weight loss. 

We know this is poppycock because people like my wife and son weigh exactly the same year in and year out.  They can’t possibly be consuming EXACTLY the right number of calories every year.  My son easily consumes more than a million calories in a year.  According to simple calorie math, if he over-ate by a mere 7,000 calories, he’d gain two pounds – yet that never happens.  So unless he’s eating exactly the right number of calories every year – with 99.3% accuracy – his body must be adjusting his metabolism up and down in response to his diet to maintain his weight. 

In fact, my son twice tried to gain weight by eating quite a bit more, but it didn’t work.  Other people have tried to starve themselves thin but couldn’t lose anything close to what the simple Calories In  Calories Out math says they should have lost. 

That’s what Taubes explained in his book. It’s important to understand that despite what some of his critics have said, Taubes does not believe calories can magically disappear or that the laws of thermodynamics don’t apply to the human body.  (We’re talking about a guy with a degree in physics, after all.)  In any system, the body included, the inputs and outputs must match.  However, Taubes believes that 1) Body fat is an active driver of your metabolism, 2) the amount of fat your body wants to maintain is determined by hormones, and 3) the body responds to different sources of calories in different ways. 

Body fat drives metabolism by providing you with a supply of fatty acids for fuel.  To keep your blood sugar level, your body needs to alternately store and retrieve fat – storing fat when blood sugar is high so the blood sugar will be consumed first and brought down to a safe level, retrieving fat as blood sugar drops so blood sugar isn’t over-consumed and pushed too low.  The amount of body fat you need for this system to work depends on how efficiently your fat cells can release fatty acids, which in turn is a function of several hormones.  Insulin, of course, is a prime mover in this system because high levels of insulin can slow down or block the release of fatty acids.  If your fat cells are slow to release fat, your body will work to make them bigger, because bigger fat cells can release more fatty acids, thus allowing you to keep your blood sugar stable. 

So if hormones are telling your body to maintain a certain level of body fat, it will fight your efforts to gain or lose.  It fights by adjusting your metabolism up or down.  So you cut 100 calories per day from you diet, just like the experts suggest, and nothing happens.  Why?  Because if hormones are telling your body to remain fat, your body will respond by making adjustment to the calories it expends. 

The Calories In  Calories Out crowd doesn’t account for those adjustments.  They also don’t account for the fact (despite plenty of clinical research) that the body tends to raise its metabolism in response to certain nutrients, such as proteins and medium-chain triglycerides – the fat found in coconut oil. 

Here’s an analogy:  To the Calories In  Calories Out crowd, the gas I put in my car is calories in, the gas my car burns while idling is basal metabolism, and the gas my car burns while moving is calories expended through activity.  In their minds, this equation never changes.  But of course, we all know you can buy a car that gets 35 mpg, and three years later it’s only getting 28 mpg.  That doesn’t violate the laws of thermodynamics, and it doesn’t mean the energy in no longer matches the energy out.  It means something has changed inside the car’s system and it’s no longer using the energy in exactly the same way.   

There is no getting around the fact that to burn away body fat, you need to create a need for your body to consume the fat – an energy deficit.  But merely cutting calories may not do the trick, because your body can adjust your metabolism down, thus reducing or eliminating the deficit.  That’s what Taubes was trying to explain:  The calories in can cause adjustments in the calories out.  If you don’t solve the hormonal issues first, shrinking your fat cells will simply produce a situation where your body can’t retrieve fatty acids quickly enough to feed your cells and keep your blood sugar level.  Then your body will fight like crazy to avoid shrinking the fat cells any more – again by slowing your metabolism. 

So for the calorie deficit to work in the long term, it must be combined with a hormonal environment that allows your body to efficiently retrieve fatty acids from your fat cells.  That’s where keeping your insulin levels low comes in. 

Rebecca:  If I am Creating a Calorie Deficit, why am I still 36% body fat, even though I eat high fat, moderate protein and very low carb? 

Even though it makes sense, in theory, that I need to “burn” more calories than I take in, I have not been able to make that theory a reality in my body.  It seems that every time I either increase or decrease fat and protein (carbs always staying very low in all cases), there is no rhyme or reason to why I either stay the same weight, or lose weight or gain weight.  

Remember my "Borg" analogy? Well, my body is the Borg, and it wants to weigh 143.4 pounds and Resistance is Futile!  When I decrease my intake of food in order to create a calorie deficit, it will sometimes give up a little fat, but then adapts and starts storing fat again, bringing me back to 143.4 pounds or more.  There was one time that I increased my food intake from 1600 calories to 2000 calories, and dropped several pounds in a week, but then my body adjusted my metabolism (I’m assuming) and all the weight came right back, with a little more just for good measure, to teach me a lesson. 

In your Jimmy Moore interview,Tom, you said that people can look up exactly what you ate and how it caused you to lose a certain amount of weight.  If you were to look at my food diary, you would see no rhyme or reason to the weight I have lost, gained or maintained relative to the food I happened to be eating at the time or the amount of exercise I was getting or not getting.   

I recently just gave up and ate 1800 calories per day for a few months without a change.  My weight stayed the same.  I then dropped down to 1400 calories, and did not lose weight.  I have been doing this now for two weeks, with no change in my weight.  But didn’t I create a calorie deficit?  And 1400 calories for a 5’3” woman is certainly not starving, I would think… 

How can a person (me!) create a calorie deficit when thermogenesis is at work, it seems, to keep my body at a certain weight?   What is the likelihood that a person has no control over their weight, and no matter what they eat or how much they exercise, they will not lose weight? 

Tom:  Okay, this is the answer nobody wants to hear, but here goes:  Short of starvation that would ruin your health, it may not be possible for you to be as thin as you would like to be.  As I explained above, your body needs to be able to store and retrieve fatty acids to keep your cells fed and your blood sugar level.  The amount of body fat required to do that job depends on how quickly and efficiently your fat cells release fatty acids.  Think of it this way:  if you’ve got weak batteries, you need more of them to produce the same charge.  So unless you can make your fat cells more efficient, your body is going to fight you tooth and nail to maintain your current level of body fat – because it NEEDS that body fat to avoid cellular starvation between meals, especially when you’re sleeping. 

You may be able to make your fat cells more efficient through changes in hormones – thyroid recovery, adrenal recovery, insulin sensitivity recovery, etc. – but if you’ve suffered irreversible damage to any of those, there’s a limit to how much body fat you can or should lose. 

I once managed to semi-starve myself down to 165 pounds, but the love handles and bit of belly fat in the front still didn’t go away.  I started burning up my own muscles instead.  My arms, legs and chest got skinnier, the belly didn’t.  At some point, my body refused to sacrifice the body fat it needed.  I just didn’t realize at the time that it did, in fact, need the fat.   

So I can only suggest looking into possible fixes for hormone problems, keeping your carbs low (which you apparently already do), and engaging in hard exercise to improve your insulin sensitivity a bit.  Beyond that, I believe the smartest thing to do is to accept that what matters is health, not body size.  As Dr. Mary Vernon said in a lecture I attended, “From a health standpoint, I don’t care how fat you are.  I care about what you’re burning for fuel.” 

Rebecca:  What do you think of the BodyBugg?  I have a friend who uses one, and he says it accurately tells him how many calories he is burning off each day so that he can create a 20% calorie deficit and lose weight consistently.  He eats high fat, moderate protein and low carb.  I feel that if I got one (out of desperation!), it would tell me that I am burning calories, but I still would not lose weight. 

Tom:  Never seen one.  Since the body will adjust your metabolism to keep you fat if you don’t solve the hormonal issues first, I don’t see the point of counting every calorie. 

Rebecca:  What other processes are at work in the body to store fat due to hormonal imbalances other than insulin? 

Estrogen dominance, low progesterone, low testosterone, low thyroid, high cortisol and low melatonin will all cause weight gain.  Why?  (By the way, I have all of these, and having my hormones balanced with natural, bio-identical hormone replacement has not helped me lose weight.)  Do people with these imbalances gain weight because the imbalances cause excess insulin to be produced?  And if that is so, and a person is eating very low carb, what the heck is the insulin driving into the fat cells?  Fat and protein? 

Tom:  I don’t believe they all work directly through raising insulin.  From what I’ve read, they all have an effect on how efficiently your body can release fatty acids for fuel.  Testosterone, for example, aids in lipolysis – the release and burning of fatty acids. Insulin, however, can block the actions of hormones that aid in lipolysis.  If you can’t release fatty acids quickly, your body doesn’t want to give up the body fat it needs.  

Rebecca:  It's disappointing to me that I am actually a success story in the new Atkins book, A New Atkins for a New You.   

Tom:  I take it you don’t feel successful at the moment?

Rebecca:  The answer to that is resounding NO!  I have done everything right.  I have exercised, I have lifted weights, I have eaten low carb, I have had my hormones naturally balanced with bio-identical hormone replacement.  I am one of the top three contributors on the Atkins Community Forum, where some of my articles are used in the forum “stickies” so that newcomers will see them.  I am profiled in The New Atkins For a New You.  I was interviewed by Jimmy Moore for his podcast this past September.  I have this health and nutrition blog. 

And sometimes I feel like a hypocrite.  I spend all my time telling everyone I know that low carb is the way that human beings were designed to eat, but eating this way is not causing me to lose more than just a few initial pounds of fat.  I started out at 46% body fat and now I am 36% or so, and I am stuck.  I did get down to around 33% over a year ago, but it has steadily been going back up since then.  

Tom:  I hear you.  I’d love to have arms with veins that pop and six-pack abs, like my son.  But it’ll never happen.  I stopped a life-long weight gain and reversed it to a significant degree, but I know I damaged my metabolism as a young man, and it will apparently only recover so far.  I have to focus on the fact that at age 52, I’m stronger than when I was at 25, I can walk for miles in hilly terrain without getting fatigued, I kick my wife’s behind in racquetball even though she’s 14 years younger, my blood pressure is low, my triglycerides are low, my HDL is high, and I’m the only one of my friends in my age bracket who isn’t taking some awful prescription drug. 

You are NOT a hypocrite, Rebecca.  You cannot compare yourself to people whose bodies are happy to be thin.  (If I compared myself to my wife and son all the time, I’d go bonkers.)  You can only compare who you are now with who you would’ve been if you hadn’t taken steps to improve your health.  So I don’t compare myself to my son.  The only person I compare myself to is the one I used to be.

Rebecca:  Can fat tissue be damaged beyond repair?  I have heard some say that the basic problem is that fat tissue function is damaged.  Do you think that there is a possibility that, in some cases, adipose tissue has been damaged beyond total repair?  Is there a chance, when there are no other possible issues at play, that a person cannot be capable of creating a calorie deficit in order to lose weight?  Gary Taubes said something to that effect in his recent interview with Jimmy Moore.  He said that, in some people, there will be excess fat that will not go away, no matter how well they eat. 

Tom:  I think Gary’s right, for the reasons I have already talked about here.

Rebecca:  So you think that a person can be fat and healthy?  In your Jimmy Moore interview, you talked about the difference between being overweight and being unhealthy, using members of your family and yourself as examples:  You are a little overweight and yet you have normal blood sugar, and others in your family are normal weight and yet have Type 2 Diabetes.  Do you believe that being overweight causes disease, or that disease ­leads to overweight?  My father’s doctor has always told him to avoid gaining weight in order to avoid Type 2 Diabetes.  His mother, my grandmother, was overweight most of her life and developed Type 2 Diabetes in her 60s.   

I think of myself, and realize that I have low triglycerides, good HDL and slightly high LDL, but normal blood sugar, and low inflammation markers, like C-Reactive Protein and Homocysteine,  and yet I am 36% body fat.  If I stay this fat, will that lead to developing Diabetes and Coronary Heart Disease, or can I stay fat and remain healthy, as long as I eat right (low carb) and exercise?  Should I only care about my health, and not try to lose weight, and if I do that, will this fat, healthy body of mine lead me down the road to ill health? 

Tom:  My father-in-law is lean, athletic, and a type 2 diabetic.  My maternal grandmother is on the skinny side, but also became a type 2 diabetic.  Clearly, body fat is not the cause of type 2 diabetes, or we wouldn’t see lean type 2 diabetics.  It’s far more likely that many people eat diets that both make them fat and create insulin resistance at the same time.  Others can eat the same diet and become insulin resistant without becoming fat.  

Having said that, there is some evidence that the fat that accumulates in your liver may accelerate insulin resistance through the production of inflammatory cytokines. 

Rebecca:  So basically, does staying slim keep you healthy, or does staying healthy keep you slim (chicken/egg)?   

Tom:  Proper diet can aid in keeping you both slim and healthy.  Losing weight may assist in keeping you healthy by removing inflammation-producing visceral fat from your liver. 

Rebecca:  Tom, why do people get fat?  I know that Gary has a book coming out about this, but I am interested to hear your take on it.  I have heard it said (maybe by Gary) that we don’t get fat because we sit on the couch and eat too much – we sit on the couch and eat too much because we are fat.   

In other words, we aren’t fat because we eat too much and don’t get enough exercise. We’re not just lazy gluttons.  It’s not just Calories In Calories Out.  There is actually something wrong in the adipose tissue that is driving us to eat (specifically carbs) and causing us to stay inactive and keeping our metabolism slow. 

I know that I did not change the way I was eating or exercising, but when I hit thirty, I just started gaining weight.  I now blame hormonal imbalances, of which I’m sure insulin was one.  I was also eating a high carb and high fat diet, except when I was trying to lose weight, and then it was high carb and low fat. 

What do you think? 

Tom:  Metabolic derangement happens first.  The result is weight gain and lethargy.  When Dr. Robert Lustig treated kids for cancer, they nearly all become fat and lazy soon after.  Realizing something hormonal must’ve happened, he tested them and ended up giving them a drug to suppress excess insulin production.  Bingo; they lost weight and became active again, without anyone harping on them to eat less and exercise more. 

Rebecca:  I've been doing a lot of reading lately about cholesterol, because my husband's is high.  Based on what I've been learning, I am beginning to wonder:  Does serum cholesterol even matter? 

Since starting low carb 20 months ago, my cholesterol has gone from around 200 to around 220.  I’m sure it would not surprise you to know that my doctor wants me on statins.  I refused.  I did agree to start supplementing with red rice yeast, but now I am wondering if I should even be trying to lower my LDL.  I have been reading a lot of things in books and on the internet that say that as long as triglycerides are low, and inflammation is low, you could have a high LDL and it doesn't matter.  Some doctors believe that, ten years into the future, cholesterol will not even be considered a marker for heart disease.  What do you think? 

Tom:  Don’t try to lower your LDL.  High LDL protects you against infections and cancer.  It’s only a problem if you’re producing small, dense LDL, which is unlikely if you have low triglycerides and high HDL.  Also, LDL isn’t usually measured; it’s calculated.  If you have low triglycerides (below 100), that calculation will nearly always overestimate how much LDL you have.  Your doctor probably doesn’t know this, but there’s never, ever been an association shown between high cholesterol and heart disease in women.  In senior citizens, those with high cholesterol have the longest average lifespans, primarily because they have a lower rate of cancer.

Rebecca:  Thanks, Tom!  I really appreciate you taking the time to answer my questions!   I know that we all hope that low carb wisdom will prevail - and hopefully in our lifetimes!

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