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 | Saturday, April 4, 2009 at 22:08:59 mst
Comment ID: #1
Name: Richard Wills
E-mail: rkwills(at)mac.com
I'm curious -- what has improved in your bloodwork? Have you by any chance had the NMR LipoProfile that Dr. Davis (the Heart Scan Doc at http://heartscanblog.blogspot.com) recommends?
Conventional cholesterol testing is not very useful or predictive of future heart attack risk, but as Davis shows, lipoprotein testing, like the NMR LipoProfile, is very useful because it identifies the number of particles of small LDL cholesterol, which is the really bad stuff. My small LDL cholesterol went way down (from a particle number of 1000 to 300, which is near normal) and my good HDL cholesterol went way up (from 40 to 59) when I eliminated grains and started eating more meat, roughly following Cordain's Paleo Diet. Normal small LDL cholesterol is 0-210 for Davis, but 0-600 for conventional docs (when they do it, which is almost never).
I also take niacin and lots of fish oil and vitamin D, but no statins.
My mildly abnormal EBT heart scan (a test that shows coronary plaque burden) has improved on this regimen, I've gradually lost 25 pounds -- and I'm no longer hungry all the time! |
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| Sunday, April 5, 2009 at 1:24:38 mst
Comment ID: #2
Name: Sean Kimpton
I am currently reading GCBC. It is extremely good.
Here is a short (edited) you tube clip of Taubes presenting his case;
http://www.youtube.com/watch?v=MGkpZ4Ax-00
Sean. |
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| Sunday, April 5, 2009 at 7:03:05 mst
Comment ID: #3
Name: Diana Hsieh
E-mail: diana(at)dianahsieh.com
URL: http://www.dianahsieh.com/blog
Richard -- My triglycerides are way down (from 109 to 55) and my HDL is up a bit (from 79 to 99). My LDL went down and then up, but based on the reading that I've done, that's a totally junk number anyway. [To explain for others: (1) Because your standard LDL value calculated rather than measured, it tends to be very inaccurate. And (2) LDL can be large and fluffy (that's good) or small and dense (that's bad).)] Based on my triglyceride level (plus my diet), I'm reasonably certain that my LDL is all of the large and fluffy kind, but I've not yet gotten the particle size test. I'm going to do that next time I see my doctor -- and then I'll blog my results, of course!
Also, my fasting blood glucose used to be about a very high 95. I've not gotten that test from my doctor again, but my own home tests show that it's now in the mid-70s. |
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| Sunday, April 5, 2009 at 9:00:57 mst
Comment ID: #4
Name: Richard Wills
E-mail: rkwills(at)mac.com
You can bypass your doc for blood testing by going through DirectLabs at http://www.directlabs.com. Just register and order “NMP LipoProfile” for $99. You’ll be sent a lab requisition by email, which you then take to any LabCorp lab nationwide (see https://www.labcorp.com). The results will be emailed to you a few days later. DirectLabs has a great variety of blood tests and they do a great job. (I can't say the same for LabSafe, whose customer service is so-so and they won't report results by email)
You do have to pay for the test out of pocket, but I think it's worth it. If you go through your doctor, first you have to wait 1-2 months for an appointment, then wait an hour in the waiting room because the doc is running late. Then once you've been ushered in for a rushed 10 minute audience with his majesty the doctor (who calls you by your first name but expects you to call him Dr. Jones), you have to try to talk him into getting a test he's unknowledgeable about or thinks is unnecessary -- like the NMR LipoProfile or a vitamin D level -- and he may well refuse to order it. If he does agree to order it, you often have to go back to him to get the results. So you have to make another appointment, wait some more in the waiting room and get another rushed 10 minute audience. Even worse, if it's a test he usually doesn't order, he may give you bad advice on what the test results mean and what to do about them (like telling you to start a statin, which are way, way overprescribed).
Getting your own bloodwork (from DirectLabs, Grassroots Health for vitamin D levels or http://www.zrtlab.com for other fingerstick at-home tests) is a clean, self-directed, capitalist way to get bloodwork. I have no connection with these organizations, but as a physician, I'm appalled by the hassles and insanities of our dysfunctional, paternalistic, over-regulated, insurance-based medical system and welcome any options that allow the individual to direct his own testing when he chooses to.
Davis comments on this issue at:
http://heartscanblog.blogspot.com/2008/10/self-directed-testing.htm
and
http://heartscanblog.blogspot.com/2009/03/self-directed-health-at-h ... |
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| Sunday, April 5, 2009 at 9:04:44 mst
Comment ID: #5
Name: Richard Wills
E-mail: rkwills(at)mac.com
Typo -- I meant to write "NMR LipoProfile" not NMP in my first sentence. |
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| Sunday, April 5, 2009 at 9:36:12 mst
Comment ID: #6
Name: Monica Hughes
E-mail: monicabeth10(at)gmail.com
URL: http://fa-rm.org
Great comment, Richard.
I'm curious if you have any opinion, or would like to share your opinion, on the "CardioCheck" apparatus available at Wal Mart? It measures "total cholesterol", HDL, and triglycerides. Do you think this would be a useful tool for monitoring HDL and triglycerides? Is this handheld machine accurate? A round of test strips and the machine only cost $130. Although it doesn't give particle size of LDL, I wonder if this type of tool might be a good general proxy of health for those of us who can't afford $400 right now for NMR Lipoprofile (the latter is obviously superior).
My main concern is whether the values for HDL or triglycerides that one would get from from Cardiocheck are actually reasonably accurate. I'd be curious to see how my HDL changes as I increase vitamin D intake. Dr. Davis suggests that increasing vitamin D will improve HDL levels, so I'd like a reasonably accurate and cheap way to monitor it. |
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| Sunday, April 5, 2009 at 9:38:50 mst
Comment ID: #7
Name: Monica Hughes
E-mail: monicabeth10(at)gmail.com
URL: http://fa-rm.org
Whoa -- NMR Lipoprofile iss only $99!? I thought is was more like $399.... !! |
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| Sunday, April 5, 2009 at 10:50:42 mst
Comment ID: #8
Name: Tod
Richard,
Thanks for mentioning that online lab. I have been trying the paleo diet for awhile, thanks to Diana's posts, and I want to verify whether eating a dozen eggs a week really has no meaningful effect on cholesterol levels, among other things (Vitamin D is another one). I have had to actually convince my doctor to order the tests for me, and then the results were returned to me on a paper marked "all in normal ranges." It took a half hour to get the actual numbers from his office! I want to establish a baseline and a history! They seem to think that because I lack an MD after my name, I wouldn't want to know what is happening in my body with any granularity other than "okay" or "not okay."
Tod |
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| Sunday, April 5, 2009 at 11:34:42 mst
Comment ID: #9
Name: Richard Wills
E-mail: rkwills(at)mac.com
Monica -- Yes, the NMR LipoProfile is only $99, which is quite a bargain. And thanks for reminding me about the CardioChek. I had heard about it and meant to research it, but didn't till just now.
***********
Davis had this to say about it on his Track Your Plaque Forum:
Posted: 2/1/2009
We start with our experience with the CardioChek home cholesterol device, since home cholesterol testing is a question that has arisen on the Forum on a number of occasions. It's also a great strategy to be able to do your own testing, something we wish to cultivate substantially in the coming months. (More on that in future.)
First of all, the CardioChek is a hand-held device that measures total cholesterol, HDL cholesterol, and triglycerides. (There is also a "professional" device called CardioChek PA that performs more tests, but the device costs over $700.) It requires a finger prick to obtain a drop of blood for testing.
This is a really neat concept: a device that can be used by just about anybody that yields immediate results. Nothing needs to be mailed to a laboratory, no wait for results. It also yields more than just a total cholesterol. All other home test kits we could find tested only total cholesterol and the sample had to be mailed to the laboratory.
However, having used the device several times, some comments:
1) The company is not very good about telling you that each test--total cholesterol, HDL, and triglycerides--require a separate fingerstick and a separate test strip. It means that, for every panel of total cholesterol, HDL, and triglycerides, 3 fingersticks have to be performed and 3 test strips used.
2) The first couple of tests will be cumbersome. Even my nurses had a bit of difficulty following the instructions, though they were quite clear and concise. (They do provide a helpful online video.)
3) LDL will need to be calculated, just as your laboratory does. (LDL = total cholesterol - HDL - triglycerides/5).
How about costs? The device can be obtained for as little as $79 at Walmart and Amazon.com. The tests strips come in separate boxes, purchased separately. A set of 3 total cholesterol test strips costs between $12 and $15; similar prices for HDL and triglycerides. Thus, each run of total cholesterol, HDL, and triglycerides will cost you about $12-15 (3 test strips), provided there are no fumbles (which are somewhat common, particularly at first.)
Availability is a bit of a difficulty. The CardioChek website lists CVS, Walgreen's, and Walmart as retailers, along with several online distributors that I've never heard of. I bought our device at CVS for $99, test strips for $14.95. However, after stopping at 5 different CVS locations, 3 Walgreen's, and one Walmart, none carried triglyceride test strips, which therefore have to purchased online. Also, none of the Walgreen's or Walmart even carried the device itself, despite the website's claims.
I suppose if you are wealthy, purchasing the professional CardioChek PA is an option, though we did not test this device.
With regards to accuracy, our first few panels on employees yielded credible numbers that compared favorably with the values we obtained on our professional in-office device (Cholestech), with one exception. (One HDL differed substantially.)
I will keep everyone updated as our experience with the device grows.
Dr. Davis
***********
Another poster had this experience:
Posted: 2/7/2009
I bought a CardioChek home cholesterol analyser in November 2008, and have used it about a dozen times since then. I found the values that it gave comparable with values that I've had from results from my doctor's lab reports, and with values that I've had from sending off samples to an online lab service over the last couple of years.
The first time I used it, I repeated a sample of my HDL, and found it identical, so I haven't done any further tests for reproducibility since then.
The most interesting aspect has been the correlation of the results with changes in my life.
My HDL results at weekly intervals were 61, 61, 60, 54, 56, 63.
I then went on holiday to India for 2 weeks, eating mostly rice and dahl (lentils and chickpeas), with eggs for breakfast and avoiding wheat. No exercise. When I returned my HDL was 32, rising to 43 and 54 in the subsequent 2 weeks.
I've just returned from a 1 week downhill skiing holiday, skiing about 5 hours a day, and my HDL is now 58.
My total cholesterol seems to roughly track my HDL: 241, 242, 205, 219, 238, 255
On return from India 183, 201, 212
On return from skiing 229
I initially tracked my TG for the first 4 weeks and found it to be 84, 71, 72, 71. I haven't done it since then, since it requires fasting for 14 hours, and the strips are harder to find than the other two.
I'll continue tracking my levels, but at more widely spaced intervals, until I've got a feel for the kind of variations that occur.
***********
Bottom line: It's not perfect but it sounds like a reasonable way to follow your progress and to motivate you to stay on track. I may buy one. |
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| Tuesday, April 7, 2009 at 13:28:58 mst
Comment ID: #10
Name: Ariel A.
E-mail: ariel_aviatik(at)yahoo.com
Diana Hsieh wrote:
"If all else fails, I can easily skip a meal or two or three because my body can easily draw on its fat reserves rather than crashing without fresh input of carbs."
My understanding is that your body first draws on _muscle_ reserves, after about nine hours or so. So going without food for so long is generally not a good idea. Intermittent fasting, I dunno. If you're lifting weights all the time I suppose you would rebuild muscle mass.
Parenthetically I'd like to thank Ms. Hsieh for all of the valuable nutrition links, which have been real food for thought. Especially valuable is the perspective on modern vegetable oils, and the case for routine CT heart scans ("track your plaque.") I'm also halfway thru Taubes. Altho I'm not completely sold yet on all of this, I started modifying my diet about nine years ago in response to Taubes, and have had real benefits.
My only real quibble was the rudeness displayed by a couple of respondents the last time I made comments here. |
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| Wednesday, April 8, 2009 at 8:52:42 mst
Comment ID: #11
Name: Monica Hughes
E-mail: monicabeth10(at)gmail.com
URL: http://fa-rm.org
"My understanding is that your body first draws on _muscle_ reserves, after about nine hours or so."
It uses both. Technically, plenty of your cells can use fat alone by breaking the fatty acids down and feeding acetyl groups directly into the Kreb's cycle. Only some of your cells need to do glycolysis forward (and thus, gluconeogenesis from amino acids). And all amino acids are not essential. Your body can make the majority.
Personally, I've found IF extremely beneficial in restoring my insulin sensitivity. In fact, I've never felt better. Here is a pic of someone else who fasts intermittently and has a paleo-ish diet:
http://theorytopractice.wordpress.com/2008/11/10/this-is-what-44-an ...
Obviously this guy lifts weights, and probably during a fast as other Art DeVany/EvFit types do. I don't look like this but I've been monitoring my body fat percentage as I lose. The amount of lean muscle loss on this type of program is surprisingly low. Think about why this type of result might be possible, hormonally speaking. I can't agree that it's not a good idea to go a long time without food. All of our paleolithic ancestors did this out of necessity. The workout (hunt) directly preceded feeding, probably by a couple of hours, and the "workouts" would have been relatively few per week preceded by probably at least a 24 hour fast. We aren't forced to do this to survive anymore (of that I'm glad, but it doesn't prove anything), and so many modern people do the exact opposite: "carbo-loading" followed by hours of cardio. The results in terms of body comp. are obvious.
While I am skeptical that all carbohydrate is problematic and I believe we need to do the trials called for at the end of Taubes' book, I'm much more convinced that weight and body comp are hormonally regulated. You can shoot people up with growth hormone and they will gain muscle without any other changes dietarily speaking. How can that be? WEll, that's the same signal you send to your body when you fast. Fasting induces the production of growth hormone. |
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| Thursday, April 9, 2009 at 9:14:35 mst
Comment ID: #12
Name: Raj
E-mail: objectiveman(at)gmail.com
URL: http://objectiveman.blogspot.com
One of the first blogs I started reading was Noodlefood a few months ago. Besides learning a lot about Objectivism I have picked up a lot about eating right. I started avoiding eating processed foods and especially white bread, started having more animal fats. I have reduced my triglycerides by 30%, reduced my VLDL by 8 points. I just finished Good Calories.. and have cut back sugar by 90%, increased my protein intake. I hope to improve my Lipid profile by a huge margin.
My sincere thanks to Diana and rest of the the Noodlefoodler's. |
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| Thursday, April 9, 2009 at 13:45:13 mst
Comment ID: #13
Name: Ariel A.
E-mail: ariel_aviatik(at)yahoo.com
Thanks for the detailed info, Monica. |
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| Friday, April 10, 2009 at 13:27:31 mst
Comment ID: #14
Name: Lucy
E-mail: ljf62(at)columbia.edu
Thanks to Diana for the book review and to the others who left comments here. I am looking forward to reading Taubes' book. I've been doing the South Beach diet for a few months; it has a lot of similarity (so it seems) to the dietary philosophy of GCBC in terms of the avoidance of processed carbohydrates and sugars. However, the SBD book is rather light and superficial on the science and explanations; over half the book is devoted to recipes and meal plans, whereas I'd like to have a better understanding of the physiological principles involved.
There are a few things from the SBD approach that I wonder about, too. For example, it prohibits all dairy products in "phase one." Based on some other books I'd read, I decided to ignore this prohibition, and I have half-and-half and yogurt every single day. I'll be interested to read Taubes' take on milk sugars, which I suppose is the basis for the opposition to dairy in the SBD. Also, all fruit is prohibited in phase one. I followed this guideline, in fact, the only fruit I've had since January were some orange slices on an oriental salad. But having grown up with the mantra "eat your fruits and vegetables," this prohibition seems counter-intuitive. Don't the vitamins and minerals and anti-oxidents and whatnot count for something? I have a black raspberry patch out back, and I'd like to be able to eat berries without guilt come June and July. I'd also be curious if anyone wants to weigh in on artificial sweeteners: I've been using splenda simply so I can continue to drink coffee.
Perhaps my biggest problem with the SBD approach is that it advises only staying on phase one for two weeks, or at most a few weeks longer than that. In phase two, they recommend reintroducing fruits, fiber-y cereals, whole grain pasta, rice, pitas, bread, bagels (!) etc. "in moderation." (Phase three is even more lenient.) When I tried to do that during my last attempt, it undid all my previous efforts and was so demoralizing. I suppose I'm similar to Diana in having had a "pathological relationship to sugar." Sugar and refined carbs were my one addiction, and I simply can't have them on a regular basis, not even a little bit of "whole grain" whatever every day. This time, I'm approaching the near-elimination of those carbs as a permanent lifestyle change, and I take it that that is in line with the ideas in Taubes' book.
What's amazing to me, though, is that once I removed those carbs from my diet, the craving for them disappeared. Considering I was worried that I had a *psychological* problem because of an inability to control this carb/sugar addiction, that change is just tremendous. My only regret is that I didn't learn about this approach to eating years ago. It also makes me very angry when I think about all those years I was trying to follow that stupid government food pyramid that was pushed as proper nutrition.
Thanks again for the interesting and informative posts. |
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| Friday, April 10, 2009 at 19:41:11 mst
Comment ID: #15
Name: Diana Hsieh
E-mail: diana(at)dianahsieh.com
URL: http://www.dianahsieh.com/blog
Lucy -- I know how you feel about those sugar cravings! Too well, in fact. South Beach sounds like it starts reasonably well, then just gradually moves a person back to the standard American diet of low-fat and whole grains. That's just dumb.
Regarding fruit, I've found it to be fine in relatively small quantities -- particularly berries of various kinds, which only have a small amount of sugar in them. In contrast, grapes, pineapple, apples, mangoes, and the like are pretty well-loaded with sugar, so I eat those very sparingly. (They do seem very sweet to me now.)
This fruit sugar table might be of use:
http://www.thepaleodiet.com/nutritional_tools/fruits_table.html
In part, your fruit consumption should depend on (1) whether you're trying to lose weight or not and (2) how well you tolerate it. You sound pretty sensitive to sugars, so you might not ever want to gorge on pineapple. However, you'll probably do just fine to eat a good quantity of those raspberries this summer. They have nearly 10g of sugar per 100g of fruit, but I suspect that 100g of raspberries is quite good volume of fruit in comparison to 100g of pineapple.
You can find more data at the USDA database:
http://www.nal.usda.gov/fnic/foodcomp/search/ |
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| Sunday, April 12, 2009 at 18:35:43 mst
Comment ID: #16
Name: Lucy
E-mail: ljf62(at)columbia.edu
Hi, Diana,
Thanks for your note. The links were also helpful; I'm going to print out some of that data so I can keep it in mind. I bought Gary Taubes' book over the weekend, and so far it's terrific. I love his rigorous, scientific approach.
I just measured a cup of frozen blueberries (last season's leftovers) and it weighed about 100 grams. That is actually a decent amount of berries for a dessert or snack. I suppose I won't be making jam anymore, though - I think the ratio for making a batch is about 7 cups berries to 5 cups white cane sugar. Yikes. Who knew what a nightmare those innocuous-looking PBJ sandwiches were?
I think I'll avoid the sugary fruit for the most part going forward. We don't get fresh pineapple in PA anyway, so perhaps I'll hold off on that until I get a chance to visit Hawaii! More difficult might be apples, which we get in abundance in the late summer and fall, but so far it's been surprisingly easy to say "no" to sugary foods once I got them out of my system (literally, I suppose).
And I agree with you that moving back into the standard grains and starches diet is dumb; it's a particularly dumb suggestion considering that the author of SBD is a cardiologist, and if he recognized both what dietary missteps caused the problems in the first place and that those eating habits were affecting much more than just weight (i.e., causing type-II diabetes and cardiovascular problems)....well, why recommend ever going back to those habits? (Particularly for people who've already shown themselves to be susceptible to carb addiction!)
Best,
Lucy |
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