I'm a VLC T2 diabetic. I'm (probably) lucky in that I have a pretty good lipid profile: Trigs: 87.7 mg/dl LDL: 85.0 mg/dl HDL: 34.8 mg/dl Total: 139.2 mg/dl Total/HDL = 3.6 (well, at least as far as a standard lipid profile tells you anything about anything).
However, I encounter a lot of metabolically deranged T2s with very high cholesterol numbers, who are conflicted about following a low-carb/high-fat diet, because they are scared that eating more fat would damage their already poor cholesterol numbers. This is a significant obstacle to many adopting a low-carb diet that would almost instantly reverse their diabetes.
Up until recently I've loved dishing out this quote from Dr Richard Feinman: "Dietary carbohydrate restriction is the single most effective method (except for total starvation) of reducing triglycerides, and is as effective as any intervention, including most drugs, at increasing HDL and reducing the number of small-dense LDL particles. Beyond lipid markers, carbohydrate restriction improves all of the features of metabolic syndrome."
The message here is that, even if it doesn't reduce your LDL-C, a low-carb diet will probably improve the quality of your LDL particles. Big fluffy LDL good, small dense LDL bad.
However, after reading through Peter Attia's brilliant "Straight Dope on Cholesterol" series, and listening to Chris Kresser the other night on the Robb Wolf podcast, it seems that the size of LDL particles is pretty irrelevant, and we should be worrying about the number of particles instead.
I understand concordance and discordance, but is there any data that describes what low-carbing does to your particle number?
asked byborofergie (11488)
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on October 11, 2012
at 12:53 PM
Some info to consider ...
CETP will pull triglycerides out of VLDL to LDL and HDL
The mechanism behind why triglycerides go up, HDL goes down
On a low-carb diet, triglycerides go down and HDL increases
What raises triglycerides? It???s the carbohydrates!
LDL cholesterol can look fine but LDL particle count is ???lethal???
But you won???t be fine because they???re loaded with triglycerides
Doctors need to be telling patients to ???cut the damn carbs???
Ignore cholesterol and check your triglycerides first
The total cholesterol limit of 200 is ???ancient history???
HDL and triglycerides should both be 50
136,000 people with heart disease were included in this
55% had an LDL cholesterol under 100
18% had an LDL cholesterol under 70
- Might your cholesterol values be too low and compromise immunity?
Serum cholesterol ??? LDL and HDL ??? help defend against infections. As long as you have these infection-fighting lipids in your blood, infections can???t kill you.
Infections destroy LDL and HDL, and the more severe the infection, the lower blood cholesterol goes. By the time the infection is severe enough to kill you, TC is very low. So countries with high infectious burden have both low TC and high infectious mortality.
- Perfect Health Diet ideal cholesterol profile :
Ideal profile: Total cholesterol, 200-240 mg/dl; HDL, >60 mg/dl; trigs, <80 mg/dl. LDL can cover a broad range consistent with health, but LDL numbers that are healthy in some people can be unhealthy in others, so I don???t see it as having a well-defined ???normal??? range, but generally speaking 80 to 160 mg/dl can be consistent with good health.