Wednesday, March 19, 2008

My Wife Christine: The Perfect Example Of Why Low-Carb Isn't Just About Weight Loss

How can this beautiful face be anything but healthy?

When most people talk about the low-carb lifestyle, the subject usually centers around weight loss. And naturally so! After all, books like Dr. Atkins' New Diet Revolution, which totally changed my life forever for the better in 2004 when I lost a total of 180 pounds that year, are marketed as "diet" books. And bookstore shelves are absolutely LOADED with author after author touting this plan and that plan to help you lose the blubber.

But when we talk about "diet" in the full context of what that word really means, we're not just referring to weight loss. The simplest definition of a "diet" in my mind refers to "the way you eat." That's it! So, for people on any of the various low-carb diets like Atkins, Protein Power, South Beach, or The Zone, for example, the focus is on the mechanism that happens inside the body when you reduce your carbohydrate intake. And that is what produces the ever-elusive weight loss.

Yes, eating low-carb does indeed result in some rather spectacular weight loss. But the thing that amazed me more than anything about livin' la vida low-carb when I first started on it were the massive improvements in my health. I was taking prescription medications for high cholesterol, high blood pressure, and breathing problems. Within nine months of my low-carb way of eating, I no longer needed those prescription drugs. And I've never taken another pill from a pharmacist since.

People e-mail me all the time wanting to know why they haven't lost weight on low-carb because the scale hasn't moved as fast as they were hoping. My response back to them is usually to remind them that at least they are losing weight and that their first and foremost priority when livin' la vida low-carb is NOT weight loss, but rather it should be their health. This is perhaps the most overlooked aspect of the low-carb life that is simply ignored by people who don't think it's necessarily something they need for their life.

Take, for example, a normal weight person. Most people would look at that individual and conclude that a low-carb diet is unnecessary for them because they're not overweight or obese and, thus, are healthy, right? Welllllll, not necessarily. And the same goes for an overweight or obese person. Just because they are carrying around a few extra pounds doesn't automatically mean they are unhealthy. Of course, the extra weight can lead to health issues in the long run, but it's not a perfect indicator of current health problems.

With that said, I wanted to share with you some rather startling results from a recent physical that my dear wife Christine had at her doctor. She started on a reduced-carb dietary approach about a year ago after her triglycerides had risen to a slightly-elevated 250. Her HDL was over 50 at the time and her LDL was over 140. Of course, the doctor was very concerned about this and wanted to put her on Lipitor, but her husband (that's me!) advised against it. That's why we tried low-carb for her.

In just a few short months, Christine dropped 35 pounds and was feeling a lot better by quitting sugary sodas and eating less carbohydrates than she was. Keep in mind that she has a much higher carb tolerance than I do. I have to keep my carbs below 50g daily or I gain weight whereas Christine can eat around 150g before weight starts to creep up on her. It's the difference in our metabolism and I'm cool with it (although watching her get away with eating more carbs is a bit frustrating...but I get over it!).

Since she got her weight back down by livin' la vida low-carb, Christine has allowed a few bad habits to creep back into her diet again--eating French fries (one of her favorite foods!) when we eat out, having breaded meats, eating sandwiches with the bun, and eating her favoritest candy in the whole widey-widey world--M&M's! Yes, old habits are hard to break, but as long as her weight was in check there wasn't a reason to panic.

Or was there.

Today we got the results of her blood work and one number stuck out like a sore thumb among all the others--HER TRIGLYCERIDES!!! While Christine's HDL rose slightly to 58 and her LDL plummeted to 94 without the use of that statin drug her doctor wanted to put her on, her triglycerides actually ROSE to 293. HOLY COW!!! Needless to say, she was quite upset by this and couldn't understand why her cholesterol improved, but her triglycerides didn't. And here's the crux of why I decided to write this blog post.

Christine is the perfect example of why low-carb isn't just about weight loss. Despite all her best efforts to reduce her sugar and carbohydrate intake from the levels she used to eat and the weight loss success she experienced as a result of doing that, her health in the form of her triglycerides did not see a benefit. Sure, her lipid profile was a positive, but what happened with her triglycerides?

It's perplexing that Christine's HDL would go up, LDL would go down, but triglycerides would simultaneously rise. Dr. Mary C. Vernon has said that a rise in HDL above 50 and a reduction in triglycerides below 100 is a sure-fire way of knowing if someone is truly following a low-carb diet or not. If not, then you can tell if someone is eating something they shouldn't.

And the studies are clear: a high-carb diet lowers HDL and raises triglycerides and your HDL/triglyceride ratio is a better indicator of heart health risks than total cholesterol and LDL. University of Connecticut researcher Dr. Jeff Volek found in one of his studies that triglycerides are cut in half when following a very high-fat (85 percent), low-carb program.

Christine is looking at an anomaly of sorts. On the one hand, her cholesterol numbers are fabulous and keep her from ever having to consider the "s" word to lower them (not that she would!). But on the other hand, now her doctor wants to put her on a risky prescription drug called Lovaza to bring her triglycerides down. Christine got a big bag full of samples for her to try (HOO BOY!) and I am always curious to read the fine print about these wonder drugs.

Check out these disclaimers for Lovaza:

Before you take LOVAZA you should take these steps to control your very high triglyceride levels: modify your diet (YA THINK?!), lose weight if you are overweight, increase exercise and reduce alcohol use. Treatment with LOVAZA has not been shown to prevent heart attacks or strokes (EEEEEK! Then why would you want to take this drug in the first place?!). Burping, infection, flu-like symptoms, upset stomach, a change in your sense of taste, back pain and skin rash are LOVAZA’s most common side effects, but there are others.

Oh, is that all? Sheeez! Reading off all these potential side effects of medications designed to help improve your health is enough to make me nauseous (do they make a pill for THAT?!). As someone who has suffered with the negative side effects of statin drugs, if I can find a way to "modify" my diet to lower my triglycerides, then I will. And that's what we're gonna try with Christine instead of Lovaza.

Starting right now, she is on a strict low-carb diet. No more French fries, breaded chicken sandwiches, or M&Ms until we can get the triglycerides down (and hopefully after that, too!). It's not a weight loss's a HEALTH thing! And Christine now realizes that her lack of weight gain gave her a false sense of comfort with the way she was eating. How many others are walking around out there thinking they're okay when very clearly they are not? That's the question we should be asking about rather than what diet is good for weight loss.

Christine will go meet with a dietitian on Friday afternoon and I'll be sitting in the room with her during this conversation. We're bracing for the low-fat lecture, but I was encouraged to see on her chart that a 1600-2000 calorie diet consisting of low-glycemic foods with 35 percent fat was recommended alongside a moderate exercise routine. Considering her fasting insulin levels were also slightly elevated, this may be a plan for success. I'll be anxious to hear straight from the horse's mouth on Friday what she thinks about Christine's condition and hopefully it won't have anything to do with taking prescriptions of any kind.

We'll be meeting some of the best and brightest minds in the world of low-carb research next month in Phoenix, Arizona for a Nutrition & Metabolism symposium, so you bet we'll be asking them for their opinion about what Christine should do henceforth. But I open the floor to you my readers to share your comments about this and any personal or professional experience with what Christine is going through. I'm just surprised her cholesterol improved so much and her triglycerides did not. Any thoughts?

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Blogger Sarah said...

If Christine is still eating a higher level of carbs, including the dreaded SUGAR (M&M's) she just may be more Insulin sensitive (based on a higher fasting level) than either of you suspect. I would be willing to bet that if she's not counting carbs, she's probably consuming a higher level than she realizes. Combine that with a higher fat diet (I assume since you both eat much of the same food at home) and it's not surprising that her triglycerides would increase. If it were me in her place (and it used to be) I would knock back those carbs, tune out the dietitian and avoid the drugs until I'd had several months of true low carbohydrate living. If her triglycerides drop as I suspect they will, then I'd tell the doctor exactly what I'd done.

Best of luck to Christine.

3/20/2008 1:59 AM  
Blogger Kevin M. said...

This is a top ten post, because it shows in black and white the real effect that carbs have in the body. If medics won't do this real-life research and reporting, then we must. Yes, low carb is about far more than just weight - that is still the biggest misconception about it.

It will be good to hear some professional feedback about the cholesterol numbers, but it just goes to show that the professionals have very little or no understanding of what these numbers mean.

As for eating habits, I would not be so afraid of occasional breaded chicken or sandwiches, as their impact is minimal, but this result reveals that fries and especially M+M's can literally be deadly foods.

And please, flush those pills, and flush any other questionable advice a doctor gives you! People must learn to think for themselves and start questioning standard medical advice. Doctors are not infallible or all-knowing, though they like us to think they are. Don't be intimidated by the great medical sham, it's your health.

3/20/2008 2:06 AM  
Blogger Peter said...

It might be worth temporarily cutting out the M&M's and other foods with refined flour and sugar just to see if that affects the triglicerides or doesn't. If it doesn't,she might try increasing the M&M's, etc. to see if that's really a factor. These experiments might have less side effects than the drugs and yield more information. It's easy for me to say "just cut out your favorite foods", just don't say it to me.

3/20/2008 7:39 AM  
Blogger chrisdat said...

Jimmy, Read Dr. Sears - either Omega Rx Zone, or The Anti-Inflammation Zone on high dose fish oils. Correlates perfectly with Gary Taubes (Good Calories, Bad Calories) which I'm reading for the 2nd time.
After my husband and I lost weight on low-carb my LDL and triglycerides remained high. My husband's triglycerides also were high (over 250). With 6 months on high dose fish oils I was able to reduce my tri's to 50, and my husbands to 93. My LDL remains high but my HDL is 67 (like you said HDL/Tri ratio is most important).
Silent inflammation is the problem. You'll love the Sears books - pure science like Taubes.

BTW - I'm with you on super low-carb, it's a requirement for me. But my husband can tolerate a lot more. I think I'm around 50 like you, and he's 150 or so. Oh well, it's worth it for our health!!!

3/20/2008 8:00 AM  
Blogger JD said...

Well according to Dr. Mirkin, Christine should try taking fish oil and cutting out refined carbs.

3/20/2008 8:28 AM  
Blogger Carl said...

Hello Jimmy,

This is absolutely true! I am now living la Vida low carb on the Atkins diet. I have hit a plateau and have not lost weight for a month. This doesn't bother me. My primary reason for low carbing is control of my diabetes and health. Losing weight although definitely a goal is not most important. Another reason is I don't want to pay co pays for all the prescriptions my doctor had me on. If these medications do anything at all it is very little. I also don't want to suffer their side effects. So far this year I have saved $500 in co pays! I was taking Avapro, Byetta, Zetia and Glocovance. My blood sugar, cholesterol and blood pressure control is much better now with just diet and exercise. I was not healthy taking these prescriptions and was getting worse. When I first found I had diabetes my triglycerides were in the thousands. So high that the LDL and HDL could not be read. After losing 60 pounds on Atkins my triglycerides were 36!

3/20/2008 8:35 AM  
Blogger blog nerd said...

Did they do a repeat test? And exactly how long did she fast before the test? False results are common on these tests.

You are right to be puzzled about the results. They are odd, to say the least.

3/20/2008 9:03 AM  
Blogger Cheryl said...

I'm not surprised by Christine's lab results. Simply because someone is within their normal weight range does not mean they are eatting healthy.

Look at the legacy of marathon runners who have dropped dead from heart attacks, only for an autopsy to find they had coronary artery disease (CAD) or blockages. It would be a challenge to try to convince me that all that "carb loading" they do for running does not have an impact on their heart. I find it ironic that the medical community has not connected the dots. Most marathoner "sudden deaths" are blamed on family history of CAD or "anomalies". Get a grip marathoners, it's the simple carbs that are killing you.

Good for you Christine giving up the simple carbs. Just proof that you don't have to run a marathon to be healthy :)

3/20/2008 12:34 PM  
Blogger Susan said...

I think the sugar and white flour (breaded meats) are to blame. Cut those out and retest. The fish oil is a good recommendation also.
I just wanted to counter another comment that said to "flush those pills" away. It's preferred that you throw them away in your garbage as flushing them allows the medication to eventually seep into the general water supply. Filtering doesn't remove the pharmaceuticals and most of the large cities in the US have been tested and found to have traces of drugs (of all kinds) - ugh!

3/20/2008 2:28 PM  
Blogger carolinakayaker said...

I have had great success low-carbing and using Lovaza as a daily supplement regimen. I take 4grams with a multi-vitamin every day with no side-effects. My triglycerides dropped to 70 (after 2 months)and I still have 50 lbs. to lose. Once I hit goal weight I may stop the Lovaza and see what happens. Just a good way for me to get Omega 3's.

3/20/2008 3:00 PM  
Blogger Jimmy Moore said...

Great comments so far everyone! Christine is NOT taking the pills and will instead opt for following a genuinely low-carb diet to see the impact it will make on her triglycerides. This was a good lesson for her to see that simply lowering your carbs may not be enough. You have to get them to a certain level before the impact is seen in your health.

She's eating low-carb meals and knows what that entails since she's watched me do it for the past four years. We also started her on my liquid fish oil supplements today which I've been BEGGING her to take for a long time. Now she is.

No more M&Ms, French fries, breaded meats, or sandwiches with the bun for her. It's all livin' la vida low-carb from here, baby! Wish us well at the dietitian's office tomorrow. Pray I don't blow a gasket if she pushes her low-fat garbage! Christine and I have already discussed that regardless of what she says, we're putting her on strict low-carb for the next four months to see what the impact will be. We already know it's gonna be REALLY good! :D

And we're not "flushing" the pills. We'll dispose of them properly for those of you who are worried.

3/20/2008 3:06 PM  
Blogger Tuulia said...

Thank you for this post. You're describing my exact thoughts - it is about eating and being and staying healthy rather than merely weight-loss. To me, low-carb diet is not diet in the traditional sense, but a life-style with so many benefits, I would never ever even think of going back. I still have a lot to learn (and a lot of pounds to lose) but I already feel so much better I don't even think of going back to eating so many carbs. Dieting before was all about cutting some treats for a while and then going back to them after the weight loss. No wonder I never really lost any weight as it came back.

Sorry I don't have any ideas about what your wife should do. This is all very new to me, and I wanted to thank you for your wonderful blog and posting the idea that's been simmering in my head for so long.

3/20/2008 3:06 PM  
Blogger HunBun said...

Does Christine join you in any form of exercise? That was always the other part of the lecture I used to get about my trigs, that they respond very well to exercise (plus ya just feel better over all!) sure couldn't hurt! The lowest I was ever able to get my trigs was in the high 200's (1400+ unmedicated) on 600mg of Lopid twice a day and 1500mg of TR niacin every night. Within a few weeks of going LC the number was under 200 for the first time ever and has gotten and stayed below 100 for the last 2 years or so and I am off both meds.

3/20/2008 3:08 PM  
Blogger R'chy said...

Great! don't want them in our drinking water! ;-)

3/20/2008 3:46 PM  
Blogger Lisa32989 said...

Why are you wasting your money on the dietitian, if you already know what you're gonna do? Do what you know, retest in 6-8 weeks and then, if necessary, go to the dietitian (bet you won't need it!)

Start making oopsie rolls to take when eating "out". Christine can still have her sandwiches :) I just had a big-ol, sloppy burger with chili and queso for lunch, all on oopsie rolls.

You can always have low carb pseudo fries @ home & there are definitely low carb breadings, including pork rinds (ya just have to get busy in the kitchen). I've been chocolate-free since 96 (due to migraines) so I don't have an M&M substitute, but I bet they're out there!

Keep the pills. You can give 'em back to the Doc for some "sucker" who won't make lifestyle changes.

3/20/2008 3:50 PM  
Blogger Jimmy Moore said...

More GREAT comments everyone! I love it when a serious discussion ensues from a post like this and I KNEW this one would make it happen. :D

Christine is NOT exercising right now with me and definitely not at the level that I am with my cardio and resistance training. But I'm trying to get her on at least a moderate exercise routine to help.

As for the dietitian, it's a free service as part of the physical Christine paid for. So we're doing it partly because it is no charge and partly because we're interested in what she has to say. Stay tuned!

Now, about those oopsie rolls! You gotta share the recipe for that! E-mail it to me with pics and I'll feature it in a blog post. By the way, I do use substitutes for the fried stuff and chocolate, but Christine still likes the real thing. I guess she'll get used to them now.

THANKS again for the comments everyone!

3/20/2008 5:50 PM  
Blogger Lisa32989 said...

I can't take credit for the oopsies. They're cleochatra's creation. Just a bit of a twist on Revolution Rolls.

3/20/2008 5:55 PM  
Blogger lovinglife said...

I can't stress enough the need to have Christine's tests re-done. Mistakes are made every day.

You're getting a lot of great advice here. One of the mistakes especially people who are non-diabetic is that we think as long as we are not gaining weight that we are eating in the good range of low carb. If you are not counting your carbs every day, if at 5:00 p.m. you can't tell me off the top of your head how many carbs you had that day, you are not doing a low carb or a controlled carb lifestyle. The worse part of that is that you are kidding yourself.

Eating low carb usually means that you are taking in a lot of fat. That's great except when you combine that fat intake with excess carbs (and excess carbs can mean 90 grams in one day if 90 grams are too many for you).

It's easy to do. I fall off the train sometimes and say hey, I am not a diabetic like my husband. A few extra carbs a day are not going to hurt me. Except that a few extra a day become many extra in a week, etc. The weight starts to come back on AND your health suffers because you are not eating properly.

The best part of what's happening to Christine is that she is aware and that she has an awesome and interested husband who loves her and will help her get on the right track.

I was just thinking that if someone were to be told that they were allergic to a particular type of food, they would stay away from that food with a passion. Yet, with all the knowledge that we have about carbs, knowing these things are soooo detrimental to our health, we just cave at times and indulge. That's okay to do once or twice but you've got to put on the brakes after that first slip up or you are going to go down the wrong road.

Good luck, Christine. You're doing the right thing by staying off the drugs.

3/20/2008 6:10 PM  
Blogger Kenney said...

I don't want to lose sight that carbs are important though. They are our energy. But we should lower carbs to adjust to the amount of energy (calories) you are burning that day.

You should always eat enough carbs to cover what you're energy expenditure that day, BUT you don't need anymore. At least that's what your trend should be. This is definitely an issue of health not just weight loss. I love this post.


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3/20/2008 6:12 PM  
Blogger mrfritznyc said...

another idea if Christine is up for it: Intermittant Fasting. IF is not for everyone, but I am pretty sure it would drop her triglycerides. And get this, she could still indulge in those carby treats now and then. According to Dr. Eades, something like M&Ms would drive up your trig, of course, but fasting 19 or so hours would bring them right back down.

3/20/2008 6:25 PM  
Blogger Jimmy Moore said...

GREAT SUGGESTION, Mr. Fritz! Christine may do well with intermittent fasting since she doesn't eat for hours at a time some days. I couldn't do it as you well know, but I'll suggest it for Christine.

3/20/2008 7:07 PM  
Blogger Jimmy Moore said...

Kenny, I appreciate your comments, but there is no such thing as an essential carbohydrate. Your body NEEDS fat and your body NEEDS a moderate amount of protein, but you can go through an entire day without eating even moderate amounts of carbs and still have plenty of energy because of a process called gluconeogenesis where the body makes its own carbs from the protein you consume.

The whole calories in, calories out mentality is not the entire story as we learned so eloquently in Gary Taubes' book Good Calories, Bad Calories which I highly urge you to check out. THANKS for your kind comments about my post and I appreciate your contribution to the discussion. :)

3/20/2008 7:15 PM  
Blogger Lynn said...

Hi Jimmy

I realy don't think it's the fact that Christine is eating 150 carbs a day at all. I think it is the type of carbs she consumes. I eat between 60-80 carbs daily but those carbs come from veg, dairy, 85% cocoa dark chocolate and a very small amount of oats. Most of my carbs come from veggies.

I don't tolerate fruit at all but I bet if Christine had her carbs come from veg,fruit and dairy she would be fine. If she does go VLC she might also end up underweight since she maintains easily on an intake of 150g daily. Just some thoughts :)

Sending her the luck of the Irish from the other side of the Atlantic.


3/20/2008 8:10 PM  
Blogger Tom Bunnell (TB)--TB said...

Carbohydrate addiction is what it is. -- Every single one of us is a carbohydrate addict. -- You take any 50,000 people, you got 50,000 carbohydrate addicts. -- Every single one of us needs to break this addiction. Carbohydrate addiction is ruining each and everyone of ours psychial and mental health. -- It doesn't matter if your fat or skinny, it's carbohydrate addiction. -- Nobody can believe or understand this simple truth! It's impossible that that's what it is! But it is!

3/20/2008 8:12 PM  
Blogger Jimmy Moore said...

Lynn, I agree, and this is precisely what Christine and I were talking about at supper tonight. The quality of her carbohydrate choices have been so poor that we simply need her to choose better ones. Nuts, seeds, cheese, veggies, fruits and the like will dominate her carb choices. We're confident this will do the trick on her triglycerides and I'm glad she is serious about wanting to do this for the sake of her health. The next stop for her would have been diabetes or a heart attack.

3/20/2008 8:56 PM  
Blogger Amy Dungan (a.k.a Sparky's Girl) said...

I can't add to the great comments here since it's pretty well been covered. I do want to wish Christine the best of health! Good luck to her on her new lower-carb plan!

3/20/2008 10:45 PM  
Blogger Rachel said...

HI, Jimmy. The whole cholesterol thing is so confusing to me...I never quite know what to believe! I've had doctors here in Asia try to interpret my numbers, but I seem to be a confusing case. What does it mean if I have very LOW triglycerides? (so low that the doctors seem concerned?) Last time I was tested, my triglycerides were 44. But my total cholesterol was 232! My HDL was 97 and my LCL was 175. I know you're not a doctor, but you seem to really know your I okay? I try to eat a LC much as possible! But I think the very low triglycerides is because I've been an avid athlete for over 10 years now.

Anyway...thanks for sharing about Christine's situation. I hope I can continue learning more about cholesterol and diet through her experience.

3/21/2008 6:07 AM  
Blogger Jimmy Moore said...

Rachel, your numbers are better than mine! Your HDL/triglyceride ratio is outstanding, so keep doing what you're doing. :D

3/21/2008 9:57 AM  
Blogger Paul Bain Jr said...

You are the most honest man I know. Nothing gets swept under the rug with you. I aplaud you in this day and age you are a rare person Jimmy.

3/23/2008 3:12 AM  
Blogger Low Carb Band-It said...

Jimmy - have you gone and read EXACTLY what LOVAZA is? It's super duper high levels of Omega3s - that's all (well a few inert ingredients). The reason for the warnings - super duper high levels of Omega3s will cause those symptoms as well. Do a bit more digging "if" she needs some extra help.

Also, if she can't get it down with diet alone (and from what I've read a few can't) - have you considered her taking Red Yeast Rice? Do some reading on that as well.

3/23/2008 6:06 PM  

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