Blood Lipids

After my father died, I felt a driving need to get a hold of my health.  Since both my parents were hypertensive and diabetic and had cancer, I sensed an impending doom being overweight.  So I embarked on the quest to lean down.  I don't say 'lose weight' because it is possible to be normal or even under-weight but still have a high percentage of body fat.  In the weight-lifting world, this is known as 'skinny fat'.  In the medical world, this is known as 'normal weight obesity'.  See this link for more information on the condition: http://advanced-fitness-concepts.com/articles/1010TM.pdf  Skinny fat people as well as conventionally obese and overweight people may experience insulin resistance or prediabetes.  BMI-wise, I was technically 'overweight' on the cusp of 'obese'.  Not a healthy place to live. 


Enter the low carb lifestyle change, which truly worked to lose bodyfat (check out previous posts).  But enter criticism & concern from others who hold on to the 'eating fat makes you fat & unhealthy' dogma.  There was a sincere concern from family members about cholesterol and heart health since low carb eating is also high fat.  To allay concerns, I got a physical done complete with bloodwork.  I had results from my last physical in 2007 with which to compare.  Keep in mind that four years ago I ate a typical "healthy" diet: whole grains many times daily (oatmeal or whole grain cereal at breakfast, whole wheat bread for sandwiches at lunch, brown rice with dinner); low fat or fat free snacks (baked, low-fat crackers/chips, raisins, fruit); fat-free/ reduced fat dairy (skim milk in coffee & cereal, reduced fat cheeses, heart healthy spread instead of butter).


Note on VLDL & LDL levels: VLDL & LDL are not directly measured but rather calculated based on your triglyceride level.  See the following link for an explanation: http://www.livestrong.com/article/30831-calculate-ldl-cholesterol/  Step 3 in the link is your VLDL number, although it does not state that on the webpage (VLDL = triglyceride/5).




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	2007	2011	healthy range
total cholesterol	175	195	100-199 mg/dL
triglycerides	94	42	0-149 mg/dL
HDL cholesterol	53	87	>39 mg/dL
VLDL cholesterol (calculated)	19	8	5-40 mg/dL
LDL cholesterol (calculated)	103	100	0-99 mg/dL

As you can see, on the low carbohydrate high fat diet, my triglycerides dropped more than 50% to less than 1/3 of the maximum healthy range.  Keep in mind that triglycerides and good cholesterol (HDL) are greater predictors of future coronary events (ie heart attacks) than are total cholesterol.  You want triglycerides low & HDL high.  In my case total cholesterol increased because my HDL increased to a level more than double the recommended minimum value, which again is what you want.  VLDL & LDL (aka bad cholesterol) both dropped for me in response to the low carbohydrate high fat diet change.  Here is a useful link for understanding blood lipids: http://www.everydayhealth.com/heart-health/high-triglycerides-versus-bad-cholesterol.aspx  But to really get the science & politics of blood lipids, I recommend reading Gary Taubes' Good Calories, Bad Calories.


Here's something 'fun' that could also be very enlightening.  It's a heart attack risk calculator from the American Heart Association:  https://www.heart.org/gglRisk/locale/en_US/index.html?gtype=health

So to sum up:  we have been lead to believe that eating fat turns into 'bad fat' (triglycerides, LDL, & VLDL) in the blood which then clogs arteries.  Contrary to that, most recent science shows that eating carbohydrates increases triglycerides ('bad fat') and eating smaller amounts of carbohydrate along with increased percentage of calories from fats boosts your good cholesterol (HDL) while lowering your 'bad fat'.

At this point, being the wife of an attorney, I feel compelled to say that I DO NOT work as a medical professional, and my writing should NOT be construed as medical advice.  Consult your regular health care provider before making any changes to your diet, exercise regime, or medication regime. !!!

Recipe #5 - Roasted Haricots Verts

Beans - before & after



Haricots verts - that's green beans, y'all!  This is the easiest side dish recipe you will ever make.  I promise.  You can actually roast any kind of non-starchy veg with fantastic results - artichoke hearts, asparagus, zucchini, summer squash, turnips, etc.  Just watch your veg & adjust the time to make sure that it doesn't burn.  Fresh veg roasts faster; frozen veg takes longer.   Turnips are actually an AWESOME substitute for potatoes (yes, I'm that old that I learned to spell it T-O-E-S).  This preparation is SOOOO good with cauliflower; it becomes a close facsimile of deep fried Mediterranean/Middle Eastern cauliflower which is so addictive and with a lot less effort/mess.  Not so great with broccoli, though.  Don't know why.  It just seems to burn up rather than caramelize.

Ingredients:

• non-starchy veg, frozen or fresh
• olive oil
• sea salt

1)  preheat oven to 400F
2)  fill 8"x13" baking dish with frozen haricots verts to the rim (young green beans, which are more tender - tenderer??? - than the grown-up version, but they'll do, too)
3)  drizzle olive oil & spinkle with sea salt to your taste
4)  toss the beans to distribute oil & salt (I use my hands)
5)  bake in the oven until beans are soft & toasted on some edges, tossing once after ~15 minutes, i.e. half way cooked (this time use tongs, please)

Recipe #4 - Pimento Cheese Spread

Pimento Cheese Spread - A Thing of Beauty

I've just about gone broke buying Whole Foods pimento cheese spread.  It's so good!  Hence the necessity to make it myself.  Enter Paula Deen's recipe, which I tweaked to replicate that WF flavor.  I enjoy it piled half an inch thick on a slice of Wasa Crisp'n Light 7 Grain Crackerbread (3.7 net carbs per cracker).  It sort of scratches that Cheetos itch...sort of.  J   Why do I have a Cheetos itch if I'm eating low carb, do you ask?  My husband says that I cheat too much because cravings go away after 'induction'.  I say it's a woman thing - don't go there!  Purists could easily enjoy it on celery or slices of cucumber.

Ingredients

• 1 - 3 oz package cream cheese, room temperature
• 2 cups grated sharp cheddar
• 1 ½  cups grated Monterrey Jack or other white cheese (white cheddar, mozzarella, pepper jack, etc)
• ¼  cup mayonnaise
• sour cream to taste/ desired smoothness
• ½  teaspoon garlic powder
• ¼ tsp salt or to taste
• 1 tsp dried dill
• 2/3 – 4 oz jar of diced pimentos including juice
• ¼ - ½  finely minced white or red onion
• Black pepper to taste

Directions

Combine cream cheese, ¼ cup mayo, onions, pimentos, & spices in a large bowl until smooth.   Add grated cheeses plus sour cream to your taste or until you get your desired smoothness for the spread.  I end up using about ¼ cup sour cream total.  Chill at least one hour to allow the flavors to marry, if you can wait that long! 

http://www.foodnetwork.com/recipes/paula-deen/bobbys-pimento-cheese-recipe/index.html

Drew Carey's Story - Curing Type 2 Diabetes




Clip from OK Weekly 8/16/2010

 

So, to be clear, Drew Carey is not a personal friend.  ;-)  All the same, I applaud his efforts to decrease body fat via a carbohydrate-controlled lifestyle and thereby increase his insulin sensitivity!  His efforts have in fact been so successful that he no longer requires insulin injections to control his blood sugar levels.  http://www.people.com/people/article/0,,20406175,00.html?hpt=T2

It is a very controversial statement in the medical community to claim that Type 2 diabetes can be 'cured.'  Some argue that Type 2 diabetes is similar to drug addiction in that once an addict, always an addict even if one is not actively doing drugs, i.e. once a diabetic, always a diabetic even if you no longer require insulin.  But it sure must feel like a cure once you've been living that diabetic lifestyle with all the angst & danger that wildly fluctuating bloodsugar levels and risk for other concomittant diseases bring.  Being able to live & eat freely without constant finger sticks to check blood sugar levels & insulin injections to lower one's bloodsugar must feel like emancipation.

http://www.cnn.com/2011/HEALTH/01/28/reverse.diabetes/index.html

The above article from CNN this year (2011) shows that the possibility of curing Type 2 diabetes is starting to be realized by the medical establishment decades after Dr. Robert Atkin's controversial assertions about a reduced carbohydrate lifestyle were first espoused.  Dr Atkin's assertions took courage considering that they were absolutely contrary to the impetus of medical opinion & policies of that time, i.e. that low fat high carb diets promote better health. http://books.google.com/books?id=c7RkxQsgisQC&printsec=frontcover&source=gbs_ge_summary_r&cad=0#v=onepage&q&f=true   I'd like to quote an exerpt from the CNN article: 

"He cut out significant amounts of sugar and carbs in his diet, really changed how he ate," says McBride. "He's increased fiber, increased protein, cut back on alcohol, which is really sugar."  But McBride notes Legg needs to be tenacious.  "I told him, encouraged as I was, and proud and pleased [but] he's got to keep up those lifestyle habits for things to stay in the right direction," McBride said. "Without exercise, without diet and without weight control, the diabetes will come back. It's something he will need to manage his whole life."  That's something Legg says he would rather do than live as a diabetic.

There is in fact a bariatric physician (MD who treats obesity), Dr. Mary Vernon, who has treated her patients with low carbohydrate diets for years after observing that conventional diets were not successful in promoting permanent weight loss in many of her patients.  And for many patients, she has seen Type 2 diabetes reversed in the process. 

• Video link: http://www.thelivinlowcarbshow.com/shownotes/1500/dr-mary-vernon-327/  
• Video link: http://www.dlife.com/dlifetv/video/dr.-mary-vernon
•  http://lowcarbdiets.about.com/od/prediabetesanddiabetes/a/vernoninterview.htm 
• Dr Vernon is coauthor of Atkins Diabetes Revolution: http://books.google.com/books?id=c7RkxQsgisQC&printsec=frontcover&dq=atkins+diabetes&hl=en&ei=NJE7TrKnJ6qAsgK07bEs&sa=X&oi=book_result&ct=result&resnum=1&sqi=2&ved=0CEQQ6AEwAA#v=onepage&q&f=false

Some people fear that low carbohydrate diets are unhealthy for the heart.  Contrary to that fear, 'Two of the most consistent results when a person first reduces carbohydrates are a dramatic drop in triglycerides, and an increase in HDL ("good") cholesterol. These changes are so dependable that Dr. Vernon calls them the "hallmark of carbohydrate restriction"' (see the 3rd link in the preceding paragraph).  There are also many urban legends surrounding carb restricted lifestyles and the death of Dr. Robert Atkins.  They are patently untrue:

• 
  http://lowcarbdiets.about.com/od/lowcarb101/a/lowcarbmyths.htm
• http://lowcarbdiets.about.com/od/atkinsdiet/a/dratkinsdeath.htm

For Type 2 diabetics, decreasing carbohydrate intake may not only reverse their diabetes but may also reverse comorbidities (additional diseases/disorders related to Type 2 diabetes).  Just this year, quite a stir was created by a study which showed that kidney failure in Type 2 diabetics could be reversed by reducing carbohydrate intake and drastically increasing fat intake, i.e. eating a ketogenic diet - see my previous posting entitled 'My Mom's Story'.  Here are two articles on ketogenic diet's ability to correct kidney failure in Type 2 diabetics:

• http://articles.latimes.com/2011/apr/21/news/la-heb-ketogenic-diet-diabetes-kidneys-20110421
• http://www.plosone.org/article/info:doi/10.1371/journal.pone.0018604

If you do have Type 2 diabetes and you want to try reducing your carbohydrate intake, consult your doctor about your intentions and his/her recommendations.  The medications that you currently take, be they insulin or other blood sugar modulating meds or blood pressure meds, could lead to dangerous conditions like hypoglycemia (extreme low blood sugar that can result in coma & death) or hypotension (extreme low blood pressure which can result in shock or traumatic injury during a faint & death).  The problem is that these medications are correcting for high levels of blood sugar or blood pressure which may have normalized since implementing the new diet.  So procede with caution & check out this article for more information: http://lowcarbdiets.about.com/od/lowcarb101/a/medications.htm

If you are not yet diabetic and have a family history of Type 2 diabetes or are overweight (waist circumference >40" for males & >35" for females), consider that you may be able to avoid ever becoming diabetic by making simple changes to your presumeably carbohydrate enriched diet.  I recommend TNT Diet & The New Atkins For A New You because these diets not only promote carbohydrate intake reduction but also fat intake increase, which diets like Southbeach & the Zone do not.

• Link to TNT:  http://books.google.com/books?id=NPThUn6T0kIC&printsec=frontcover&dq=tnt+diet&hl=en&ei=fYs7Tor_J6qlsAKd1a00&sa=X&oi=book_result&ct=result&resnum=1&sqi=2&ved=0CDwQ6AEwAA#v=onepage&q&f=false
• Link to Atkins: http://books.google.com/books?id=TuoFvFXf3NYC&printsec=frontcover&dq=new+atkins&hl=en&src=bmrr&ei=Fow7TrKLOsajsQLw-LQ9&sa=X&oi=book_result&ct=result&resnum=1&ved=0CDQQ6AEwAA#v=onepage&q&f=false
• Link to info on Metabolic Syndrome, AKA Syndrome X & Insulin Resistance: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004546/
• Link to the 'pathway to diabetes': http://lowcarbdiets.about.com/od/prediabetesanddiabetes/a/whatisdiabetes.htm  

A Friend's Story - Infertility and PCOS

My Friend Before (33% body fat) & After (25% body fat)

Imagine yourself in this scenario...You are a newlywed woman in your mid 20's.  You have been diagnosed with Polycystic Ovary Syndrome (PCOS) which causes you to lose your period thereby threatening your hopes of ever conceiving a child naturally.  Imagine the sadness of having finally married your high school sweetheart but believing that you two may never be able to have children.  Imagine too that you are also at a high risk of developing cardiovascular problems at an early age as a consequence of PCOS.  Not only may you lose the chance of ever having children but you may be separated from your life's love at a tragically young age.

This is the situation my friend found herself in.  To hear her tell the story, she verbalized that she was resigned to the cards that she had been dealt regarding infertility.  But to see her, there was a blueness that belied the acceptance.  Shortly after her honeymoon, she decided to lose weight via conventional means.  It was an eight month struggle but she eventually lost 15 lbs.  After going on the TNT Diet, she lost a further 15 lbs in ONE MONTH!  Spontaneously, her period returned and has appeared regularly for the past handful of months since reaching her present weight.  Her MD tells her that her PCOS may be reversing itself as her hormones are regulating themselves.  Here is her story in her own words:

This low carb diet helped me lose weight but not only that, it
reversed my PCO syndrome. My hormone levels regulated itself after
losing 8% (33% to 25%) body fat! I am no longer in risk for high
cholesterol and triglyceride, praise God! The first week I lost 6 lbs
due to shedding water weight. In total I lost 15 lbs in 1 month (145
lbs to 130 lbs) and have kept it off since January! I just maintain
low carb dieting with 2 days per week of allowing healthy carbs such
as brown rice and whole wheat bread instead of white and sugar filled
items. It's all about making healthy choices but in order to do so we
have to learn all the hidden names for sugar and cut that out of our
diets. If you have a sweet tooth like me, don't worry! There are many
alternative recipes on the internet including in this low-carb blog!

PCOS is a condition where the ovaries form lots of fluid filled cysts instead of the one egg filled follicle shortly before a menstrual period.  The woman with PCOS has higher than normal levels of insulin (too much insulin causes the ovaries to produce more testosterone than normal) and testosterone (male hormones which prevent ovulation when elevated).  This abnormal hormonal milieu often results in the lack of egg production and therefore the inability to get pregnant.  Women with PCOS may also have high triglycerides, LDL (bad cholesterol), & blood pressure leading to an enhanced risk of heart attack.  There is also a greater chance of getting endometrial cancer because of an overgrowth of the uterine lining in response to decreased progesterone levels.  The following links discuss normal ovulation and PCOS in detail, respectively.  http://en.wikipedia.org/wiki/Ovulation   http://www.womenshealth.gov/faq/polycystic-ovary-syndrome.cfm

If you have PCOS, there is indeed hope for reversing your condition.  http://www.fertilitychicago.org/2569/how-does-a-low-carb-diet-help-to-reverse-pcos/  A 2005 pilot study from Duke University showed that a low carbohydrate ketogenic diet lowered free testosterone levels, leutenizing hormone to follicular stimulating hormone ratio (LH/FSH), and insulin levels while also reducing percent body fat in obese women with PCOS.  Two of the study participants who completed the 24 week course even conceived after previous infertility.  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1334192/pdf/1743-7075-2-35.pdf 

A 2006 study from the University of Alabama demonstrated that women with PCOS can decrease their insulin concentrations, both fasting and post-eating, by following a reduced carbohydrate diet.  The hope is that the reduction in insulin will allow for improvements in the hormonal/fertility area as demonstrated in the study cited above.  http://www.ncbi.nlm.nih.gov/pubmed/16500338

In 2009, the Harvard School of Public Health found that even in normal women without PCOS, high carbohydrate intake and high glycemic load foods are associated with infertility which results from the lack of ovulations.  http://www.ncbi.nlm.nih.gov/pubmed/17882137

I will let this other 2006 study from the University of Alabama speak for itself.  I quote from the Results section: "the PCOS group consumed significantly more white bread (7.9 +/- 4.4 vs. 5.5 +/- 2.9 servings over 4 days) and tended to consume more fried potatoes than did the control group (1.0 +/- 1.5 vs. 0.4 +/- 0.7 servings over 4 days). The PCOS group had a significantly greater fasting insulin concentration (22.5 +/- 14.9 vs. 15.1 +/- 8.3 muIU/mL) and a significantly lower glucose-to-insulin ratio (4.7 +/- 2.1 vs. 7.6 +/- 5.2) than the control group."  http://www.ncbi.nlm.nih.gov/pubmed/16762348

Acanthosis Nigricans (darkened skin folds)

Acanthosis nigricans (AN) may sound like the scientific name for an exotic South American bird, but it is a common sign of insulin resistance that people outside of the medical field may not recognize.  AN is a darkening of the skin commonly observed around the neck and in the armpits.  The following links are very educational but be warned that there are some graphic photographs of skin lesions.
http://dermatology.cdlib.org/DOJvol6num1/original/acanthosis/katz.html
http://emedicine.medscape.com/article/1102488-overview#showall

AN is significant not because of the rare malignant state but because it is a common sign of insulin resistance.  Why is that important?   In non-diabetics, insulin resistance/ hyperinsulinemia is an independent predictor of atherosclerotic buildup in the aorta, i.e. blockage that could lead to heart attack or stroke or peripheral vascular disease.  http://www.atherosclerosis-journal.com/article/S0021-9150(05)00580-0/abstract  The implication is that without being a diabetic, who are know to have an increased risk of heart disease, frequently eating refined carbohydrates may be clogging your arteries.  And we all know that is bad news.

The first time I became aware of this condition was during a discussion with a friend several years ago.  She was complaining about the darkening of the skin on the back of her neck and in her armpits, which led her to avoid sleeveless clothing and to wear her hair long to cover the embarassing marks.  This friend also revealed to me that it is a very frequent condition seen in pregnant women back in her Asian homeland.  She also remarked that she was surprised that I did not develop it when I was pregnant with my son because this darkening was strongly believed to indicate a pregnancy carrying a male child.  She in fact attributed her skin darkening to having bourne two sons, and she tried every conceivable skin lightening or exfoliating product to remedy it.  It makes me just shudder to think about all the women experiencing this skin darkening during pregnancy back in my friend's homeland, who may be suffering from gestational diabetes unbeknownst to them and its health implications for them and their children.  Another topic for another day!  http://care.diabetesjournals.org/content/31/5/e30.full.pdf+html

But it is not just ladies in a faraway land who suffer this condition.  AN is today used as a screening test for  children in the state of Texas to identify early those children who may have obesity related insulin resistance or Type 2 diabetes but who do not receive regular medical care.  http://www.infocusonline.org/acanthosis.pdf

AN can be misleading since it is not itchy or painful but merely unsightly.  My hope is that this discussion may prompt you to visit your doctor if you suffer from this condition so that you can start on the task of reversing this stealth killer - insulin resistance.

Recipe #3: Pasta Serendipity

Pasta Serendipity

This dish was the result of happy happenstance, hence the name, "Serendipity."  While preparing dinner, I was actually fighting some massive cheese curls cravings (the kids just got some for the lunch bags).  There were just some random bits of this & that in the fridge when suddenly I got a brainwave along the lines of fettuccini alfredo and spaghetti carbonara.  Using leftover Dreamfields spaghetti (see my previous posting on products that our family loves), I came up with this recipe.  Not so exact, kind of like a recipe you might find in your great grandmother's little recipe notebook.

Ingredients:

• 1 package Dreamfields spaghetti prepared per label
• 1 package bacon
• 1-16 oz package of baby spinach
• 3 cloves minced garlic (1 heaping teaspoon if using prepared garlic from a jar)
• 1/4 cup shredded mozzarella or 1 slice provolone per serving
• grated Parmesan or Romano cheese, 1 tbsp per serving
• full fat cream, 2-3 tbsp per serving

Procedure:

1. wash spinach & drain in a colander
2. prepare bacon to desired crispness & reserve rendered bacon fat
3. saute spinach & garlic in the bacon fat over medium-high heat until spinach is wilted
4. place the following on a microwaveable plate in layers: single serving of spaghetti; 3/4 cup wilted spinach; mozzarella/provolone cheese; drizzled cream; sprinkled Parmesan/Romano cheese
5. cover with a paper towel & microwave on high to melt cheese
6. sprinkle with 1-2 slices of crumbled bacon

YUM-E!!!

NOTE: the bacon fat is plenty salty, so you don't need to salt your spinach.  Also, if you choose to use turkey bacon, you should add 2-3 tbsp olive oil to the pan before wilting the spinach.