Thank you, Kathy! I do think I understand the gist of it all. I just want to know if I should take a statin, I don't think I have any risk factors other than being overweight for heart disease. I know I should be under 200 in the total cholesterol and under 100 in the LDL, but my ratio of total to HDL is not too bad. I have also read that eating saturated fats raises LDL (bad cholesterol) but it raises the "big fluffy" parts of LDL (the parts which supposedly "aren't bad", the small dense particles are.)
Cholesterol - 236
HDL - 56
LDL - 162
CH/HDL ratio - 4.23
Now I don't know if my LDL had large fluffy or small dense particles. I asked my doctor about a test to determine that, is there one? He is a little put off, I think, by my questioning on the statin issue. I certainly don't want to harm myself in any way by doing something stupid. Maybe there is a less invasive way to lower cholesterol. And, as we all know, correlation does not equal causation.
VLDL is a byproduct of glucose metabolism, specifically from fructose. Lots of insurance companies won't pay for the test, but I think it's important. My husband thinks that the VLDL test is less than 100$.
Your doctor should be very interested in treating *you* not just your numbers and he should be happy that you are really taking this seriously. I question his value as your primary care provider just from what you told me. My doctor encourages questions.
My husband came back. He will gather some links if you want, but essentially he says this:
That the efficacy of statins reducing mortality is small or nil in almost all studies. They *do* lower LDL, but how much VLDL vs "fluffy" LDL is unknown. He didn't come across a study that reduced mortality by any significant degree, especially as it increases your risk of liver failure, renal failure (by way of muscle breakdown which releases myoglobin, causing acute renal failure and can cause permanent insufficiency or failure), diabetes (! I didn't know that one) as well as neuropathy.
When statins are given to people who already have a low LDL, the mortality reduction (small) remains the same as when statins are given to those with a high LDL, so it's possible that the reduction in LDL isn't really what make statins (somewhat) useful. Lots of people are starting to think it's the anti inflammitory properties that made them useful.
He also said (I was wrong) that there is also a small increase in HDL's with statins.
There haven't been any good long term studies on fish oil, so he can't recommend just replacing the use of statins with fish oil, but you might try fish oil, niacin (start with a low dose and take it at night - flushing is a side effect) and soluble fiber, before you embark on statin therapy. Exercise is also huge.
I decided that instead of worrying about the fat and whether its too much or too little, I just think in terms of whole foods and good taste, kind of along the lines you hear with the French Paradox. I use as much fat as tastes great. But I don't try to pack on fat just because (which a lot people do). Sometimes that means I, gasp, have low fat food (not modified to be low fat, just naturally low fat), and sometimes it means something outrageously fatty, and usually something in between.
For me, that's kind of an intuitive approach. I don't want to go from obsessing over calories to obsessing over lots of other nutritional details. Or from being afraid of fat to being afraid of too little fat.
I read a book that was maybe a bit frou frou/new agey, but what I really like in it was the idea how we eat (with relaxation and pleasure) makes a big difference in how our body handles the food. That "fair" food, thorough enjoyed without stressing over it is more nutritious than "perfect" food you analyze within an inch of its life and worry you still didn't get it right.
The mind-body connection is a powerful thing. (FYI, the book is The Slow Down Diet, by Marc David).
Somehow, I have this idea that over time, my body will lead me to the right food and lifestyle if I let it. I think the paleo movement is much further from being objective than it claims to be. I see lots of people on paleo or low carb forums pick apart every detail of studies they don't agree with, and gloss over the weaknesses of the one that agree with them. So while I think there's much good going on in the movement, I don't feel like I have to be faithful to the one true diet because I don't think we know what it is yet.
I use as much fat as tastes great. But I don't try to pack on fat just because (which a lot people do). Sometimes that means I, gasp, have low fat food (not modified to be low fat, just naturally low fat), and sometimes it means something outrageously fatty, and usually something in between.
I really try to rely on informed common sense and that sounds about right to me. I find lard and most visible meat fat disgusting and can't have it. I made Mexican ribs this weekend and spent half an hour trying to peel every little bit of fat off of it. I can't stand the taste. But I love fatty fish and butter and I can't go more than a day without my herring and sardines. And eggs. Liver is something I try to do in moderation but I love it in all its fatness and I had leftover lunch of braised liver after last night's braised liver (with mushrooms) dinner.
Amen to this ... I don't feel like I have to be faithful to the one true diet because I don't think we know what it is yet.
Science makes new strides every day. Who knows what'll be next?
Hey, I had a lighbulb moment yesterday. By lunch time, I was growling stomach hungry but not weak and hypoglycemic feeling!
I agree, we're all an experiment of one... Like you Susan, I don't get that weak hypoglycemic feeling anymore either ... I really like this plan and am adjusting to what I feel is right and still losing weight :
I eat a lot of fat. No, really - a LOT. It is not uncommon for me to consume more grams of fat in a day than protein. When I had my cholesterol checked at a free health fair at work last month, my total cholesterol was 108. Yup, 108. My HDL is low, but my ratio is well within normal/healthy range. I wholeheartedly believe that the trick is to limit carb intake. I've found some studies that show that fat, even saturated, is basically only bad when combined with carbs. I don't have time right this second to go through them, but these are actually studies/articles I dug up when researching low-carb diets in general, so they are not all specific to fat, but still mostly relevant.
What a strange night for me. Around 10 I started obsessing about my need for a late night munchy. I ended up in a grocery store and nothing fit both my cravings and my diet. This was highly addictive behavior -- up and down the aisles, back and forth from one choice to another, a little stressed, maybe angry. Very reminiscent of the worst times kicking cigarettes. I ended up with a big bag of mixed nuts and large tub of plain yogurt. I did not find this satisfying and ate waaaay too many nuts. I gorged and got a headache. Maybe I was better of cheating with some ice cream or a bag of chips?
Julie, I love your rambling post and find myself in agreement with most of it. You, Susan and Ilene, sitting on or very near your goals probably have a little more capacity to see the struggles philosophically. You have established control of body with mind. I'm looking at losing almost 50% of my body weight and have not established any control yet. You have the feeling your body will lead you to the right foods. Mine would lead me to deep dish pizza, pints of good beer, donuts for breakfast, and a myriad of chocolate based products. You trust your body and I'm severely disciplining mine so that someday I can trust it. Oddly, it is the same reason I discipline my child.
I love looking at the research the paleos use to make their case, and I love the training they've given me to analyze rather than accept conclusions. Yep, we just don't have solid answers and conclusions are regularly open for discussion. I'm motivated by many things but one is finding an eating lifestyle that will make me lean. Associated with that motivation are the success stories within that life style. Low carb feels like the answer for me. Early in this thread I was critical of caveman re-enactment thinking. It's too faddish and too open to flaws and debates. I have found something interesting about "caveman thinking" helping me though. I ask myself all the time if "this food" was available to Grok. There's several ways to get the same result. Is this natural, real food, modern, processed, whatever. But for some reason considering Grok is helping me. Now I'm rambling, but I do that all the time.
Wow. There is just a ton to read there if you follow the links to the right of the Science Daily articles. Thanks. There's even a couple recommending high carb breakfasts and nixing low carb diets as bound to fail.
This is a fabulous interview (podcast) with Dr. Stephan Guyenet of Whole Health Source blog which I follow religiously.
He is being interviewed by Chris Kresser of the Healthy Skeptic blog on the topic of obesity. It's rather long, but well worth the listen if you're the least bit techie. http://thehealthyskeptic.org/
I think Stephan is one of the most "real" of the bloggers and one I trust because he is a scientist specializing in body fat regulation, but he also is not "wed" to any particular protocol. He just goes where the science takes him and sometimes changes his mind based on new evidence. (While this seems logical, it is upsetting to me how ideological some scientists are once they pick their path, they feel they can't deviate from it even in light of new evidence.)
PS - Lost another pound down to 209 and am now officially on the Onderland Express!!!
thanks CJ -- You know I'm also a big fan of Stephan's. In the comments to a thread I cannot find he was asked specifically what he ate. There was almost no dairy (homemade yogurt was it), very little grains only prepared in old world ways, and well over 50% of his calories come from fats, mostly saturated fats. He, Peter at Hyperlipid, and Dr. Harris at PaNu, are all very lean (like 5'11" and 160 pounds) and all get a majority of their calories from fats. They all share the trait you admire too. They let the science lead them, not preconceived ideologies -- which I agree some of the other paleostars do.
Lots of great information here, thanks everyone. These are just what I needed today, it has been a struggle this week trying to make good choices. I think the stress of our dog dying and the busy schedule we've had since this is my sons last week of school has just gotten the best of me. I have been mostly primal with a few exceptions of a handful of crackers and a slice of pizza. I think I need to tattoo my fingers or put a string on my finger reminding me that everytime I eat crap I will feel like my insides are fighting a war. Tomorrow I'm going to go back to counting calories and carbs so I can see where I may be slipping up so I can get my weightloss to continue. I really want to be a few inches smaller before my vacation in June and definitely 1 size smaller by our big vacation in July. I did take my kids to the pool yesterday for the first time this season and I will not do that again until I buy a new swim suit, the ones I had are huge and not flattering! So that was exciting, I really tried to make the old 1 work but I was tugging it up the whole time we were there.
Jill- awesome job! I sometimes tell my friends now I eat a lot of fat, when they compliment me, I love to see their faces!
There haven't been any good long term studies on fish oil, so he can't recommend just replacing the use of statins with fish oil, but you might try fish oil, niacin (start with a low dose and take it at night - flushing is a side effect) and soluble fiber, before you embark on statin therapy. Exercise is also huge.
Thank you for all the info, Kathy! I do take fish oil every day and I do exercise. I have thought about taking niacin and, in fact, purchased some of the time-released niacin in an effort to avoid the flushing.
But then I read somewhere (arghghgh, can't remember where) that niacin has some serious problems associated with it (not the skin flushing, but some kind of medical problem) and that scared me.
My dr. did tell me that there was an "alternative" medical group at the local hospital that treated issues like cholesterol ... and maybe I would want to talk to them. They are apparently more holistic in their approach, I'm just not sure my insurance will cover it. I'm going to check it out, though. Why I need an entirely different group of people to help me with this common problem is beyond me, however. The doctor must know that there are other ways to treat cholesterol other than statins.
When I had my cholesterol checked at a free health fair at work last month, my total cholesterol was 108. Yup, 108. My HDL is low, but my ratio is well within normal/healthy range.
108! Wow! I didn't even know it could GET that low!
Thank you for all the info, Kathy! I do take fish oil every day and I do exercise. I have thought about taking niacin and, in fact, purchased some of the time-released niacin in an effort to avoid the flushing.
But then I read somewhere (arghghgh, can't remember where) that niacin has some serious problems associated with it (not the skin flushing, but some kind of medical problem) and that scared me.
My dr. did tell me that there was an "alternative" medical group at the local hospital that treated issues like cholesterol ... and maybe I would want to talk to them. They are apparently more holistic in their approach, I'm just not sure my insurance will cover it. I'm going to check it out, though. Why I need an entirely different group of people to help me with this common problem is beyond me, however. The doctor must know that there are other ways to treat cholesterol other than statins.
Yeah, I don't know why your doc won't help you with that, but at least he told you about this group! I bet with a referral you can get insurance to at least pay in part. I think it's a great idea.
You guys are all so great! I loved coming here today and reading all of the contributions made. BibBob, you are like my sugar addiction twin, I think. I have done the exact same thing, frequently in my life. Haunting the grocery store, padding up and down the isles fretting and desperate for something to stop that nervousness. It feels like something is *wrong* and ice cream (my drug of choice) will definitely make it better. And it really does soothe that anxious feeling - for a while. The positive feedback loop created there, makes it so so hard to stop that habit. When the anxiety comes, sugary foods dance through my head. Ice cream, Donuts and Cake, Oh, My!
I haven't lost weight in at least a week. I am not giving up. I'll give myself a couple more weeks for maybe by body needs to adjust after the shock of losing ten pounds. I also feel flu'ish. I thought the low carb flu feeling was to happen more early on?
jilly thanks for the links and CJ thanks for the podcast!
koceank29 - I can't wait for people to start complimenting me on my weight loss because your post made me laugh and I want to see the looks on their faces, too when I tell them how much fat I'm consuming!
because I don't think we know what it is yet.
... I really like this plan and am adjusting to what I feel is right 
and still losing weight 
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