Drugs vs. Supplements II and a JimKKKins Moore Update!
Jimmy Moore was a relatively healthy, 230 lb man circa 2005-2006. Despite his repeated lies to the contrary, he didn't just see his weight creep up a pound or two per month for 15 lb increases per year in the intervening years. Still, whatever his path, he ended up back over 300 lbs in 2012 and went on his extreme nutritional ketosis fat fast diet. He is now teetering at the brink of his former 230 lb goal. Someone ought to remind him that he was a mere 3 pounds more than he weighs now in 2009, but he's clearly entered the pathological state where he believes his own lies. He's currently on hiatus from podcasting to co-write a book with Dr. Eric Westman (who I can only think has taken leave of his senses) on cholesterol. This would appear to be an effort on Jimmy's part to convince himself and others that his levels are peachy keen and perhaps even healthful.
At right is a table of Jimmy's lipids through the years. That table was compiled for this blog post. His January 2013 bloodwork:
Cholesterol Clarity?
TC: 419
TC: 419
LDL: 332
Those are not typos there. His LDL has now eclipsed his total cholesterol through mid 2009 and his numbers continue to head north despite losing weight. In January he weighed about 245, comparable to a panel done roughly 7 years ago when his cholesterol was a somewhat respectable TC 252, LDL 172. (This is apparently the type of story he's looking for for the upcoming book. Does Westman have a clue who he's writing with here? He should!) . Do Jimmy's "healthy high fat, moderate protein, low carb lifestyle" has resulted in a 66% increase in total cholesterol and a 93% increase in LDL, and since there's no reason to believe his lipid profile has improved any, he has seen a whopping 109% increase in TC and 79% increase in LDL since his cholesterol test in 2005, when he weighed 230's, exercised near daily with 45 min of "chronic cardio" and ate the normal Atkins diet (nega-paleo I might add).
Jimmy Moore is doing something that is NEGATIVELY affecting his metabolism. I'm all for there being serious flaws in the whole lipoprotein biomarkers, clogged arteries, dietary cholesterol, sat fat arena. But I want to hear one ... JUST ONE ... of these gurus, MDs, PhDs or whatever, who come on his show, egg him on (pun, no pun?, your choice) and give him credibility by proxy ... describe his lipid profile as indicative of good metabolic health. Just one. { cues crickets ... } Before going on here, I again want to call out Jeff Volek, Steve Phinney AND Eric Westman. These three are the authors of The New Atkins, and V&P wrote the two Art & Science books that have inspired Jimmy's NuttyK. All three of these have headed clinical trials involving dietary interventions, and as such, all three are aware of the ethical obligations. If they are so sure about this Nutty Ketosis being healthy and so forth, let's put that to a hypothetical test (why not a clinical one?). Let's "sign" Jimmy Moore up as a participant ... he's kept meticulous records. Here are the results for an anonymous subject: Before: Weight 300 lbs, TC 345, LDL 255 and after 8 months: Weight 245, TC 420, LDL 330. Would either or any of you researchers ethically continue this subject in your study? This is a serious question. In just about every LC study I've ever seen, lipids tend to improve or stay about the same with LC, but generally improve if significant weight loss is involved. Here our "subject" has lost 55 lbs (18% body weight, well exceeding the 5-10% threshold that we generally see metabolic improvements in) while seeing his TC increase over 20% and LDL increase almost 30%. This is practically unheard of, and I'm almost certain that were Jimmy Moore a subject in a clinical trial we would be reading about how one subject in the NuttyK group was discontinued due to extreme unfavorable changes in lipids.
Let me remind you that Jimmy Moore can be one of the most sanctimonious prickers out there when it comes to promoting his lifestyle. Those who eat carbs do not care about their health like he does. He is in this for more than weight loss, it's about health and treating your body right. Seriously? The large fluffy LDL he is so proud to sport is the kind seen in familial hypercholesterolemia ... but Jimmy doesn't have that. He didn't even have that scary high LDL when he weighed 400 lbs. Something else is going on here, and his 2005-6 profiles tell us it is not that he was not permanently broken by his beat down at the hands of Little Debbie. And now we see worsening still, despite losing the weight once again. In addition to the lipids that Dr. Dayspring described as "nightmarish", and that the docs working with Robb Wolf would most certainly see him on statins for if he were in Reno Law Enforcement (heaven forbid for the city of Reno), he also reported both oxalate crystals and protein in his urine in January.
Wait, but there's more. Jimmy's fasting blood glucose was drifting up into "prediabetic" range before NuttyK. I tend to think that is more from gaining weight and chronic high fat overnutrition, but when he started to lose weight rapidly it should have normalized on its own. In the past Jimmy's FBG's were good when reported during weight loss schemes. But this time, it did not. And so, Jimmy turned to Glycosolve by Leaner Living. If you haven't already watched this video, may I suggest doing so now? Glycosolve may be a natural supplement, but it is utterly dishonest and hypocritical for Jimmy Moore to continue to carry on a business relationship with Leaner Living when their MRP has a decidedly non-paleo ingredient list that even calls it what it is ... non-dairy coffee creamer! More on that here if you missed that too. This ain't paleo, primal, real food, whole food, WAPF, nuttyK, whatever label you want to associate with Jimmy Moore's business diet strategy du jour. Ahh, but this is for a potentially lifesaving supplement, so we shouldn't care? The circlejerkers don't :( In any case, LLVLC is now brought to you in part by Glycosolve, a formulation of largely berberine. Here's the ad.
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| Grimmy More loves Glycosolve Enter Coupon Code NUTTYKMAN |
Oops ... wrong ad ... LOL (no, the photoshop is not mine but I won't give cred and expose the creator to the wrath of Grog). Here it is. That's much better!?
** Update 10/21/13: I have struggled with the impression some may get from posts like this as regards Leaner Living. I have gotten to know the doctors behind this company and they are two of the better medical professionals providing honest and unbiased information and interacting on the internet. I have my own thoughts about doing business with Jimmy Moore, but those are eclipsed by the quality of these men to where I trust their judgment and reasons for doing so. I wanted to include this update because both in the video and posts like this, my criticism may seem harsh of the LL products when it is NOT intended to be. It is Jimmy Moore who represents to his readers that he personally vets the products he promotes, and he did promote the other products they offer, specifically their MRP. The ingredients of their MRP's do not meet Jimmy's personal nutritional edicts, and it was the hypocrisy of this on his end that I am addressing. [end update]
Why is someone eating virtually no carbohydrate (and what little he is ingesting is mostly lactose) having fasting blood glucose level issues anyway? Something is going on with the liver here and gluconeogenesis is not being properly suppressed. Has this always been the case? No. Not when Jimmy visited Dr. Westman back in 2008 for his non-existent reactive hypoglycemia.
But what got me on this kick and ties this whole blog post together was this latest in his update post:
Thanks to my continued use of the blood sugar-lowering supplement Glycosolve with berberine and banaba leaf, I saw outstanding AM blood sugar control averaging around 81 this month. When I wake up and see readings in the upper 70s/lower 80s, it’s such a good feeling because I know my body is a lot better off at these levels than if my blood sugar was in the 90s, 100s or much higher. I’m convinced that getting your fasting blood sugar down into the 80s on a consistent basis is going to do more for your health than just about anything else. It’s imperative that you know where you stand and take action to get to where you need to be. It’s made all the difference in the world to my health through the implementation of NK and the Glycosolve. If you struggle in your blood sugar control, I HIGHLY recommend this nutritional approach and supplementing to get to where you need to be.
Again, why has someone developed the level of impaired fasting glucose that Jimmy has? Seriously? Jimmy brags about not taking any medications, but that is only warranted bragging if you are sporting levels that would not otherwise cause your doctor to have a mild heart attack. This man is obsessed with blood glucose levels that were stunningly normal, while not seeking to do a darned thing to improve his lipid levels. We ALL know where you stand Jimmy. What really got me, however, was this from the comments.
I blogged previously on this issue here: Berberine -- Supplement or Pharmaceutical? Does it matter? Perhaps Jimmy had issues with metformin. Many do, at least initially. But it would be difficult to find a more commonly used drug with the track record like that metformin has. But Jimmy calling it a "drug" and berberine a "supplement" is pure semantics, when:
The biguanide class of antidiabetic drugs, which also includes the withdrawn agents phenformin and buformin, originates from the French lilac or goat's rue (Galega officinalis), a plant used in folk medicine for several centuries.
It's a distinction without a difference. Now as I noted in my other post on this issue, berberine is supposed to lower cholesterol levels too ... I wonder what Jimmy's would be without it? On the berberine v. metformin front, the only true positive I can think of at the moment for choosing the former is not needing a prescription. Everything else favors the latter because unlike supplements, evil drugs are:
- Of known efficacy
- Of known potency
- Of known bioavailability
- And of known metabolic fate (e.g. how they are broken down, utilized and/or excreted)
- Regulated and went through a rigorous approval process (even generic requires approval to demonstrate efficacy) that includes observed side effects and rates of incidence.
- As regards side effects, this is even more important weighing drugs that have been around for a while vs. "herbals". Once a drug goes into use, there is a process whereby adverse reactions are reported, by law, to the FDA. There is no such system in place for herbals, and it is only in cases like ephedra, where several deaths were linked to its use, that such potential dangers are identified.
Lastly, counter to some perceptions, "drugs" are actually cheaper than thee alternatives in many cases. Such is the case for metformin -- on many of those $4/month-type discount lists, whereas Glycosolve will run you 4X that or more (depends on which study dosage you intend to emulate). This is not to dis berberine in general or Glycosolve in particular, it is just the reality. There may be reasons other than the aforementioned bullet points to take berberine over metformin. With changes in our American health system, avoiding a formal diabetes or prediabetes diagnosis may be something to think about, as with life insurance rates as used to be discussed from time to time by diabetics on Jimmy's forum. Frankly, I'm surprised it has not been pharmaceuticalized. But if you're taking berberine, it would really be incorrect to declare yourself "medication free" and you should do your homework before taking it.
So to sum up, despite getting almost back to his "fighting weight" (not sensationally skinny!) Jimmy Moore now needs to take what is, for all intents and purposes, a drug to regulate his fasting glucose levels and presents with astronomical lipid levels he actively ignores. Further he is demonstrating issues with his kidneys with protein in his urine and oxalate crystals. This is not, despite claims to the contrary, a healthy man. And this is the improved version while many of the circlejerkers were defending his health despite his gain to the 300 lb mark. A ringing endorsement for livin la vida paleoloca if I ever heard one!
Comments
He's going to write a book on nutritional ketosis
"I’m scheduled to be on a panel about ketogenic diets at PaleoFX in a couple of weeks, giving my one-year update lecture on The Low-Carb Cruise in May and then presenting a poster about my NK experiment at the Ancestral Health Symposium in Atlanta, Georgia in August. Soon after that I’ll begin the writing process on the book after my cholesterol book is released about this whole nutritional ketosis thing to release in 2014. It’s busy stuff, but in a good way!"
He's now testing his triglycerides on a daily basis as well
"Before I share all of my usual numbers, I did an interesting test this cycle to see what was happening to my triglycerides on a daily basis for about three weeks in a row. I used the CardioChek Portable Blood Test System along with a box of 25 triglyceride testing strips to get a feel for what my day-to-day morning overnight fasted readings looked like. In one of my interviews for my upcoming book Cholesterol Clarity, the notion was put out there by one of the experts I talked to that triglycerides are a highly volatile number fluctuating by as much as 50-100 points a day and thus can’t be relied on as a key health marker. This statement went in direct contrast to what many other people I have talked to were saying–so I decided to put it to the test on myself."
He's thinking about doing another week long fast
"I’m really curious about trying something either in this next 30-day cycle or maybe in April after PaleoFX. I’d like to do a one-week TOTAL FAST with nothing but water kind of like I did a couple of years ago just to see what impact that would have on my blood sugar and blood ketone levels throughout the day. I’d measure those every hour on the hour for the entire seven days to document the results."
He's getting tested for familial hypercholesterolemia - FINALLY
"including a genetic test for determining if I have familial hypercholesterolemia that I sent off to a lab today, another heart scan on Thursday to see if there are any calcium deposits in my coronary arteries (the last one I had done in 2009 showed ZERO), another NMR Lipoprofile test in the next month or so to see what’s happening with my LDL particles and other tests that come my way. If this NK way of eating is harming me in some way, then I certainly want to do the tests to see that for myself."
If it comes back positive WHAT WILL HE DO?? Take a statin drug and go on a low fat plant based diet??
What happens if the NMR test comes back with an extremely elevated LDL-P number?? Didn't Dr Dayspring say that if his LDL-P remained over 1000 he (Dr Dayspring) would recommend that JM go on a statin drug?
homas Dayspring • 4 months ago −
Dr Lipid analysis: Using all the knowledge we possess today, all of the numbers that you are thrilled about have no meaning in the face of a 99th percentile LDL-P. You also should not say an LDL-C of 285 has no meaning. The cholesterol concentrations that often have no meaning are low levels (where an LDL-P is needed to evaluate risk). No one with an LDL-C of 285 with the exception of a Type III dyslipoproteinemia patient have a low apoB or LDL-P. If you have an LDL-C that high, particle testing is not needed. You need to significantly reduce the saturated fat in your diet and see what happens: repeat the NMR in 3 weeks and you will know if your nightmare LDL-P is sat fat related. I'll bet your LDL-P drops. If it does not, you need serious lipid-modulating medication. We have seen this paradoxical horrific rise in LDL-P in some people who are on ketotic diets.
LLVLCBlog Mod Thomas Dayspring • 4 months ago
Thanks for your input Dr. Dayspring. My comment about no meaning was that it didn't tell the whole story. So if I'm not supposed to consume saturated fat, then what sources of fat should I eat?
Charles Grashow • 4 months ago −
Jimmy - you said "My blood work from October 2005 showed my lipid profile as nearly ideal with HDL at 71, triglycerides at 57, VLDL at 11, LDL at 119, and total cholesterol at an acceptable 201. This was what my numbers looked like after livin’ la vida low-carb for about 22 months and I was proud to see them doing so well."
What have you changed since then and why don't you go back to what you were doing then??
LLVLCBlog Mod Charles Grashow • 4 months ago −
What was working then doesn't work for me now 7 yeas later. Thus, I adjust.
Charles Grashow LLVLCBlog • 4 months ago
Why did you change what was working then and why do you think it won't work now??
LLVLCBlog Mod Charles Grashow • 4 months ago −
Because what was working then stopped working or me. You adjust and make appropriate changes as I've done
ThatWriterChick kang • 4 months ago
25% of the population has at least one APOE 4 gene – the gene that has been linked to having a tougher time metabolizing fats, especially saturated fats, and Alzheimer's. If you've never had your APOE genetic profile tested, this may be observational evidence that you are a 3/4 or 4/4.
LLVLCBlog Mod ThatWriterChick • 4 months ago
I'm a 3/3.
melancholyaeon • 4 months ago
Why are they out of whack, Jimmy? Have you had the gene test? Let me ask you bluntly, if you can answer: are you APOE 4 or FH? If you are APOE 4 or FH, your numbers will always be weird, no matter what you do. My first guess would be that you are APOE 4, because FH is very rare.
LLVLCBlog Mod melancholyaeon • 4 months ago −
I'm APOE 3/3.
So - he can't have familial hypercholesterolemia - why would he need to get tested again?
http://paleohacks.com/questions/50789/why-does-ldl-skyrocket-when-doing-paleo-it-could-be-apoe#axzz2NY6bpyrX
Charles Grashow • 4 months ago
How can you not see how it looks to post your extremely alarming lipid results, mention that you're working with a doctor you trust who thinks said results indicate you are doing tremendous damage to yourself, and, IN THE SAME POST, talk about how you're writing a book to help people interpret their own lipid results?
Doesn't listening to Dr. Dayspring (which is a GOOD thing) and considering what he is saying as arguably valid disqualify you from writing such a book? How can someone not sure how to interpret their own results help others?
Now, it is possible you could go through this whole experience, learn a lot, and then, if you've clearly learned some good information that helped, end up writing a book about what you've learned. But that's not what you're doing. You've already signed to do the book and have a deadline, while you sit there confused by your own results. This is madness.
LLVLCBlog Mod Charles Grashow • 4 months ago −
Talk to my publisher. In the meantime, I'm interviewing the best and brightest people who know their stuff in this arena (Dr. Dayspring included, who I am visiting in VA next month). The reality is nobody knows what the importance of LDL-P and/or Apo B are for people on a ketogenic diet. Maybe I can help solve this mystery for the many others out there who are in this same situation that I am. I appreciate your concerns and your feedback, Charles.
As an aside, I knew my doctor was an idiot because I nearly halved my cholesterol in less than 6 months and she didn't even ask me how I did it. Just shrugged and said "I guess you don't need statins at this point."
"To teach"
Why do you ask?
Dr. Westman
Why is Robb Wolf associating with this goof-ball? There's evidence JM is a liar,huckster, and links to KKK Grand Wizards. I'm starting to think reasonable people are starting to feel sorry for him. This is some sad stuff.
With FH, I find the whole, "oh, well, it doesn't matter," to be very counter productive and even misleading.
I ditched the daily use of butter for cooking, used EVOO instead, and cut back on cream and dairy fat and, boom, TC was down 50 points in a few months. It's no mystery in my case, and I did know from a DNA test that I'm in the category of folks who superabsorb fat. High fat is not my friend. I wish I could eat high fat--I love me fat. But, there it is. I do moderte fat now. Low fat sucks butt, and I'd rather be obese than eat low fat, but moderate fat is not bad. :D
Now, to lose what my lazy butt regained....which is dazzlingly hard at 53 with Hashimoto's, I can tell ya.
Here's a clue:
http://nigeepoo.blogspot.co.nz/2012/04/how-eating-sugar-starch-can-lower-your.html
HDL at 71, triglycerides at 57, VLDL at 11, LDL at 119, and total cholesterol at an acceptable 201
Jimmy Moore blood work from Januaru 2013
HDL at 75, triglycerides at 60, VLDL at 12, LDL at 332 and total cholesterol at 419
NMR Test results October 2012
LDL-P was 3451(should be under 1000) and small LDL-P was 221
APO B was 238 (should be under 80)
SO - after 8 years of livin la vida low carb his LDL almost tripled, his total cholesterol more than doubled, his LDL-P is more than 3x the ideal level and his APO B is almost 3x the ideal level.
BUT - there's NOTHING to worry about??
He has an easy out:
"I'll be worse on any other diet."
I bet he really believes it too
These people are positively giddy over some 1% increase in diabetes rate in some epidemiological study on sugar yet ignore huge prospective studies demonstrating considerable risks associated with good old fashioned LDL-C. I tend to think it's not the particles themselves but the underlying pathology that is the problem. My personal thoughts on the subject, nothing more. I agree with the Dayspring line that when LDL gets over 300, the particle number and size are pretty irrelevant because the number (the biomarker most closely associated with CVD) is going to be over the top. Jimmy brushes that off.
http://www.policechiefmagazine.org/magazine/index.cfm?fuseaction=display&article_id=2822&issue_id=122012
Case 1 Lost 12 lbs and went from LDL-P around 2231 to 1026 (LDL-C 117 to 61), trigs from 362 to 117 -- TAKING A STATIN in conjunction with paleo which Robb described to me in Twitter as very general guidelines (but the program is low carb, how low I do not know).
Case 2 Lost 40 lbs LDL-P from 1393 to 1096 (LDL-C 106 to 83), trigs from 270 to 38 -- using more pharmaceuticals (unspecified) vs. Case 1
Since we're talking some 80-odd officers, I presume these are some best cases but how does one promote the idiocy of Jimmy Moore and be involved in this, and believe in the basics of paleo which -- I'm sorry, but if that doesn't exclude dairy along with grains is a total farce.
According to a recent post on either his blog or FB, Jimmy is interviewing Robb Wolf for his book. Huh? What will Robb say? Who knows. But he probably helped him get a Victory Belt contract ... sigh :(
Yeah, in most studies the LDL for the low carbers goes down a bit or up a bit but not much either way. The diet in these studies is never high fat in absolutes, which is what matters. When you have an MD like Attia bragging on consuming almost 500 g of fat a day, there's something very wrong there! (Though this guy works out 2-3 hours per day). My own levels go up and down a bit pretty predictably with my weight. I think your doc was right to be concerned with it going up as it did for you, and I think any reputable doctor should too.
What is going on with Westman? I mean he never struck me as a zealot ... maybe Volek rubbed off on him while they were writing TNA. Don't know. But how can he write a book with this guy about this subject?
Dayspring's comments were pretty damning. I'm SHOCKED he published them!
Thanks for sharing your thoughts on the matter.
We all lack clairvoyance on this topic.
This is why my scepticism is within a very conservative range that confers with the idea that we still don't fully understand the subject. I don't think a moderately high LDL count is the end of the world, but with the current preponderance of evidence, I'd rather not risk having more. In my spare time, I invest, and to me, LDL--good or bad--is like risky portfolios; I'd rather not have too much of it, and last time I checked, I didn't. Fortunately, I have really high HDL, really low LDL, low trigs and what I consider good low total cholesterol around that mark that vegans and vegetarians are ridiculed over. Now who knows, maybe my reading is actually the real BAD figure that future research and knowledge will reveal as problematic. Perhaps it's my age. I'm certainly not dying of cancer. . . yet.
However, as it stands, oxidised LDL is not good, so I'd rather have less of the LDL lingering around to get oxidised. This doesn't mean that a highish total cholesterol by conventional standards is a bona fide problem. But it still doesn't mean that I'm going to go for the 'more is better' mentality.
All this n=1 and pin pricking and peeing on strips and counting carbs has not helped him a single iota. There's no doubt in my mind he'd see improved health on a moderate diet. A moderate protein, moderate fat, moderate carb, moderate calorie diet. His unshakable dogmatic insistence that low carb is the only way may well be the way to an early grave.
Then explain/rationalize these numbers
NMR Test results October 2012
LDL-P was 3451(should be under 1000) and small LDL-P was 221
APO B was 238 (should be under 80)
Remember what Dr Dauspring told him
"Dr Lipid analysis: Using all the knowledge we possess today, all of the numbers that you are thrilled about have no meaning in the face of a 99th percentile LDL-P. You also should not say an LDL-C of 285 has no meaning. The cholesterol concentrations that often have no meaning are low levels (where an LDL-P is needed to evaluate risk). No one with an LDL-C of 285 with the exception of a Type III dyslipoproteinemia patient have a low apoB or LDL-P. If you have an LDL-C that high, particle testing is not needed. You need to significantly reduce the saturated fat in your diet and see what happens: repeat the NMR in 3 weeks and you will know if your nightmare LDL-P is sat fat related. I'll bet your LDL-P drops. If it does not, you need serious lipid-modulating medication. We have seen this paradoxical horrific rise in LDL-P in some people who are on ketotic diets."
4/14/12: “Nevada Outlook” with Monica Jaye, Host
Participants:
Dr. James Greenwald, Medical Director of SpecialtyHealth, Inc.
Tamara Lopes, Division Chief for the City of Reno Fire Department
Robb Wolf, Best Selling Author of “The Paleo Diet”
Topics:
1. SpecialtyHealth’s Wellness and Prevention Program for City of Reno Police and Firefighters
2. Insulin Resistance as our nation's #1 health problem
3. The Paleo Diet
4. Research and Education by nationally known speakers
Dr. Mary C. Vernon may have tried to take too much off the top. Kansas federal prosecutors have charged the physician and co-author of Atkins Diabetes Revolution with five counts of tax evasion and one count of making a false statement to a bank in order to obtain a loan.
In a release Wednesday, prosecutors announced the indictment against the doctor, who practices in Lawrence and Shawnee. Vernon is a national figure often called upon by news agencies to discuss obesity, diabetes and low-carbohydrate diets.
The Atkins craze was apparently quite beneficial to Vernon. She co-authored an Atkins book in 2004, a year after the accidental death of Dr. Robert Atkins. Between 2003 and 2008, she earned approximately $778,686 for consulting services provided to American Nutritionals Inc., a business founded by the late doctor.
According to the indictment, Vernon was also the subject of an investigation by the Internal Revenue Service. The IRS seized and levied its way to collecting close to $2 million from her between 1999 and 2007 in order to cover taxes, interest and penalties that she allegedly failed to pay between 1991 and 2005.
In addition, Kansas federal prosecutors allege that Vernon provided UNB Bank with false copies of her 2006 and 2007 tax returns as part of a loan application in September of 2009 for a home refinance in Lawrence. Prosecutors maintain that she never filed tax returns in those years.
The indictment covers Vernon's alleged actions from 2003 to 2010 in Douglas County. If convicted, she faces up to five years in prison and a fine of $250,000 on each count of tax evasion, and 30 years and a fine of up to $1 million for the false-statement charge.
I wonder if this can be the explanation of what we see with the results of Jimmy.
I am no fan of the High Fat Diet and think this is dangerous route.
http://chriskresser.com/episode-16-chris-masterjohn-on-cholesterol-heart-disease-part-2
http://chriskresser.com/chris-masterjohn-on-cholesterol-and-heart-disease-part-3
"in my opinion, if someone is losing weight and they’re losing it at a healthy pace in a sustainable way and they see fluctuations in their blood lipids, in my personal opinion, they should wait until their weight has been stable for three to six months before trying to interpret it. In other words, if blood lipids go up while you’re losing weight, concentrate on losing the weight and normalizing your metabolism. Then once your weight has been stable, start looking at blood lipids and so on."
"Chris Masterjohn: Yeah, absolutely that’s the kind of variation you can expect for biological reasons. I’m citing these values on variation by the way, from studies where they used the same method at the same lab from these people. Where they analyzed the samples in duplicate showing that the actual variation due to the lab assay was very small, like 1-2%, and that most of this variation is biological. In order to conclude that it’s even changed outside of your normal variation when everything’s staying the same, those are the large kind of values that you need. Now the second thing you need, the one exception to this by the way, would be if you had an average while you were on one diet and you had measured it 3 or 4 or 5 or 6 times, and then you do the same on a new diet, then you have a sense of your own variation so you can compare them. But in the absence of that, you just measured a couple times, once on an old diet once on a new diet, you need really large changes to conclude something’s different. Now the second thing is, I often get these questions from people who say I went on this diet and my triglycerides went through the roof, my this or that went through the roof. And I say, one of the first questions I’ll ask these people is, did your weight change. And quite often they say oh yeah that’s true. And here’s the thing, there’s really no good research I’ve seen so far about the effects of weight loss, fasting, and caloric reduction, on blood lipids. There are a lot of fairly poorly designed studies, and I’ve reviewed a lot of them, and they’re at wild conflict with one another. But this is what I’ve basically concluded as tentative working hypothesis, if you are obese or overweight and you normalize your weight and normalize all your metabolic parameters, you should expect in the long term, after your weight has stabilized, your blood lipids to mostly improve according to the conventional paradigm of risk factors."
So this would be my advice first make sure that the difference is large enough to say it’s actually increased. Second, if you’ve been losing weight don’t even look at your blood lipids until your weight is stable. If you’re obese and overweight, normalize your metabolism, normalize your weight, normalize your body fat, wait til it’s stable for a few months and then test your blood lipids. And if it’s triglycerides make sure it’s fasting, make sure it’s been the same length of time since your last meal and those things. Only then should we even begin to say okay there is an increase or there is a decrease that’s meaningful."
The question I have is this - if you truly believe that LDL-C and TC DO NOT MATTER - how high will his lipids have to go before concern is shown?
Cate says:
June 18, 2012 at 12:03 pm
Dr Davis,
I’ve cut my carbs to less than 50 gms a day over the last 6 months and eliminated all wheat. I’ve lost 50 lbs and am now down to 140 lbs which is a good weight for me (5’8″). I’m pretty sure I’m in a state of constant nutritional ketosis.
My doctor just called and is totally freaked out because my numbers are total Cholesterol 365, HDL 48, Ratio 7.6 and LDL 292. I’m not worried because I’ve never felt better. Is there a test that I can ask my doctor to have done that will portray what my real risk factors are?
Reply
Dr. Davis says:
June 18, 2012 at 10:22 pm
Yes, Cate.
I would consider:
1) Lipoprotein analysis, e.g., NMR Lipoprofile, HDL lipoprotein analysis (from HDL Labs), Berkeley HeartLabs lipoprotein testing, or VAP. However, it is doubtful that your doctor will have the expertise to interpret. You might consider a functional medicine doc.
2) A heart scan to yield a coronary calcium score. The thing to worry about is coronary atherosclerosis, not cholesterol values. See my Heart Scan Blog where I’ve been discussing these issues for several years.
He also says later on
"When HDL and triglycerides are this favorable, it usually means that calculated LDL overexaggerates true LDL. Note that the LDL particle number of 1756 equates to a “true” LDL of 175 mg/dl–still a bit high. You want to know what proportion are small LDL particles–this is the real issue. This is driven by carbohydrates, especially in people with Lp(a)."
So JM's "true" LDL is 345 mg/dL - would Dr Davis say this is a bit high??
"The Lp(a) is a very important issue. My first choice to reduce expression of this genetically-determined factor: High-dose fish oil. I use 6000 mg per day of EPA + DHA from fish oil, divided into two doses. Please also see the many conversations on the Track Your Plaque website about his complex pattern."
http://www.marksdailyapple.com/why-did-my-cholesterol-go-up-after-going-primal/#axzz2NdosR8Lq
Besides - Dr William "Wheat Belly" Davis advocates an LDL level of 60
http://www.wellsphere.com/heart-health-article/the-track-your-plaque-rule-of-60/321307
The Track Your Plaque recommended targets for conventional lipids (i.e., LDL, HDL, triglycerides) are LDL 60 mg/dl, HDL 60 mg/dl, and triglycerides 60 mg/dl: 60-60-60.
Not only is this set of values easy to remember—60-60-60—but is grounded in science and the results of clinical trials.
LDL 60 mg/dl
The LDL target is based on experiences such as that of the Reversal Trial, the PROVE-IT Trial, and the Asteroid Trial, all of which showed that LDL cholesterol values in the range of 60 mg/dl dramatically enhance the likelihood of stopping plaque growth or achieving regression, reducing risk of heart attack more than more lenient LDL targets
http://www.healthcentral.com/heart-disease/c/1435/48470/ldl-naturally?ic=506048
http://www.healthcentral.com/heart-disease/c/1435/47556/hdl-naturally
http://www.healthcentral.com/heart-disease/c/1435/47040/triglycerides
So - both Dr's Dayspring AND Davis would more than likely tell JM to drastically alter his diet and more than likely start him on low dose statins - which have been shown to reduce arterial plaque
He relates on his website that he made himself sickly because of his "zeal for vegetarianism", then next he goes 180 degrees in the opposite direction:
"Thus, it has become my mission to promote the truth about cholesterol, the unsung hero of brain and body." (2005)
http://www.cholesterol-and-health.com/Vegetarianism.html
Another advocate (or should I say, "zealot"), which is the opposite of being objective.
a paper co-authored by Loren Cordain - the father of "paleo"
http://content.onlinejacc.org/article.aspx?articleid=1135650&issueno=11
James H O'Keefe, Jr, MD; Loren Cordain, PhD; William H Harris, PhD; Richard M Moe, MD, PhD; Robert Vogel, MD
Optimal low-density lipoprotein is 50 to 70 mg/dl
Lower is better and physiologically normal
"We live in a world very different from that for which we are genetically adapted. Profound changes in our environment began with the introduction of agriculture and animal husbandry 10,000 years ago, too recent on an evolutionary time scale for the human genome to adjust. As a result of this ever-worsening discordance between our ancient genetically determined biology and the nutritional, cultural, and activity patterns in modern populations, many of the so-called diseases of civilization, including atherosclerosis, have emerged. Evidence from hunter-gatherer populations while they were still following their indigenous lifestyles showed no evidence for atherosclerosis, even in individuals living into the seventh and eighth decades of life (15- 16). These populations had total cholesterol levels of 100 to 150 mg/dl with estimated LDL cholesterol levels of about 50 to 75 mg/dl. The LDL levels of healthy neonates are even today in the 30 to 70 mg/dl range. Healthy, wild, adult primates show LDL levels of approximately 40 to 80 mg/dl (17). In fact, modern humans are the only adult mammals, excluding some domesticated animals, with a mean LDL level over 80 mg/dl and a total cholesterol over 160 mg/dl (15- 16) (Figure 1). Thus, although an LDL level of 50 to 70 mg/dl seems excessively low by modern American standards, it is precisely the normal range for individuals living the lifestyle and eating the diet for which we are genetically adapted."
SO - by co-authoring this paper Cordain is agreeing that "although an LDL level of 50 to 70 mg/dl seems excessively low by modern American standards, it is precisely the normal range for individuals living the lifestyle and eating the diet for which we are genetically adapted."
SO - how does one get to a LDL-C level of 50-70 mg/dL on a HFVLC diet??
Inquiring minds want to know.
I'd spent a short time at PaleoHacks years ago, in no small part because of threads like "Are we meat-eating hippies?" That's how a movement is made.
Needless to say, the crowd mostly agreed with the ludicrous claim.
Is it possible to get LDL that low any other way?
Also, to be fair, a sensibly done vegan diet of whole foods and starches with adequate supplementation (quality forms of B12, D3, K2 and choline), could also be effective. However, one must acknowledge those micronutrient pitfalls of the diet and make up for them rather than assume that it is some purity magic spell that'll solve everything. None of that romanticised nonsense.
LDL Cholesterol vs. LDL Particle Number, LDL-P and ApoB Measurements
Uploaded on Jul 29, 2011
Dr. Thomas Dayspring explains the relative utility of the traditional LDL cholestrol measurement versus measures of LDL particle number, LDL-p and apoB. Health Diagnostic Laboratory, Inc. measures this information with advanced testing.
livinlowcarbman
@rnikoley
Outstanding interview on
@jonathanbailor podcast. Love the new
direction and philosophy you are taking.
It mimics my approach.
Nikoley linking to KKK Grand Wizards now?
JM co-oping Nikoley now? "mimics my approach"
infers, that Moore had the idea first…what ever the idea is...
Hey, come on …. it's funny… you can't make these
characters and their ideas/actions up unless you're
maybe Leonard Elmore.
LDL-C: 98.6 (so easy to remember that one)
HDL-C: 50.4 (I thought about daily 2oz alcohol to get that higher, but on reflection it doesn't seem necessary to get higher)
Trigs: 55
TC: 160
I was enamored back then of a soup made of potatoes and cream (though I haven't thought of a catchy name for that recipe yet). I see nothing wrong with French bread, angel hair pasta or Momofuku ramen (all processed!), so I was surprised my trigs weren't higher - having previously read all the alarmism.
I think that metabolic disorders occur mainly because of overflow of calories. Get 1" of rain in a half hour, and that's destructive flash flooding. Get 1" in a day and that's not only harmless, it's beneficial. This necessarily assumes no pathology, of course. Of note, Dayspring always does say that most of what he talks about is for the IR people. Being IR does lower the bar a lot on how little (by way of carbs) creates the overflow.
Now, separate out the 2/3s that have been overeating, and what are you left with? That's the residual risk that doesn't get discussed much. Well, inflammation gets discussed somewhat. And everybody knows that those processed industrial seed oils (with their O6) are very pro-inflammatory. Except these subjects hadn't heard about that:
"Dietary intakes of alpha-linolenic and linoleic acids are inversely associated with serum C-reactive protein levels among Japanese men."
http://www.ncbi.nlm.nih.gov/pubmed/19628101
"Among specific PUFA, only alpha-linolenic acid and linoleic acid showed clear inverse relationships...", not the vaunted and overprescribed DHA and EPA.
Maybe IL=6 et al. would be different, I don't know.
When I had the high numbers, my LDL was 316. Now LDL is 134. My regular doctor says my numbers are normal, but the cardiologist wants the LDL way below 100 (I think something like 70), and wants me to double the Atorvastatin dosage. Haven't decided if I want to, though.
I think he would fail a glucose tolerance test if he took one today.
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