The 8-Week Cholesterol Cur<\/em>e, a book about eating giant oat bran muffins daily and taking sustained-release niacin was in the writing and destined to be a mega bestseller.\u00a0 The fear of fat was settling in on America.<\/p>\nAnd here I was starting to put patients on low-carb, high-fat diets to help them lose weight.<\/p>\n
Back then I had bought into the lipid hypothesis and truly believed excess cholesterol did indeed lead to heart disease.\u00a0 As a consequence, I was a little squeamish about putting people who might actually be at risk for heart disease on the diet.\u00a0 I had read the biochemistry texts, and I knew that insulin stimulated HMG Co-A reductase, the rate limiting enzyme in the cholesterol synthesis pathway;\u00a0 and I also knew that glucagon (insulin\u0092s counter regulatory hormone) inhibited that same enzyme.\u00a0 So, in theory, lowering insulin and increasing glucagon with diet should work to treat elevated cholesterol.\u00a0 But, knowing those things theoretically didn\u0092t really give me a whole lot of solace when it came to taking care of real flesh and blood patients who were entrusting their well being to me. (The picture at the top left of this post is one of the handouts I used in my early practice to demonstrate the many effects of too much insulin.)<\/p>\n
Stupidly, when I started on the diet myself, I didn\u0092t check my own labs, so I didn\u0092t really know what happened to me.\u00a0 The patients that I did put on the diet were typically women who were premenopausal (a group who rarely develop heart disease), so I didn\u0092t worry about them.\u00a0 I checked everyone\u0092s labwork, but no one\u0092s was really out of whack lipid-wise at the start of the diet, so I didn\u0092t have a lot to go on data-wise.\u00a0 The few who did have minimally elevated cholesterol tended to lower it over the first six weeks (I rechecked everyone at six weeks), so I figured the theoretical underpinnings of the diet were okay.\u00a0 But I was still uneasy.<\/p>\n
I had visions of myself in the witness box with a sneering plaintiff\u0092s attorney saying to me:\u00a0 So, Dr. Eades, are you telling the members of this jury that you put the deceased – whom you knew to have high cholesterol – on a diet filled with RED MEAT! IS THAT WHAT YOU\u0092RE TELLING THIS JURY, SIR? YOU, SIR, CAUSED THIS MAN\u0092S FATAL HEART ATTACK, DID YOU NOT?<\/p>\n
But more than being worried about this scenario, I didn\u0092t want to do anything harmful to anyone.\u00a0 I knew it would be difficult to live with myself if I thought I had killed someone or caused a heart attack out of pure negligence.<\/p>\n
You\u0092ve got to remember that at this time there was no one in his\/her right mind recommending a low-carb diet.\u00a0 There was Atkins, of course, but he had been totally discredited in the eyes of the medical profession by that time.\u00a0 It wasn\u0092t until over 20 years later in 2004 that he and the low-carb diet got even minimally rehabilitated.\u00a0 I was very uneasy to say the least.<\/p>\n
Then four patients came into my clinic, one almost right after the other, who changed my life.\u00a0 In my actual practice, I\u0092m kind of old school and always refer to my patients as Mr, Miss or Mrs. But for purposes of this post, I\u0092m going to refer to them by a bogus first name just to make it easier to keep track.<\/p>\n
The first of the four patients we\u0092ll call Angie.\u00a0 She was referred to me by MD, who was working at a different clinic than I at the time.\u00a0 Angie came into see MD for nausea and vague abdominal pains, symptoms that, along with tenderness in her upper right abdomen, led MD to suspect gall bladder disease.\u00a0 Angie was a 32 year old woman who was mildly overweight and had vague abdominal pain, but no other remarkable findings.\u00a0 MD drew blood on her and sent her for a gall bladder ultra sound.\u00a0 The ultra sound came back negative, but her blood work was a doozy.\u00a0\u00a0 Her total cholesterol was over 300 and her triglycerides were about 1900.\u00a0 MD called me and said \u0093Have I ever got the patient for you.\u0094\u00a0 This was what I had been waiting for.\u00a0 A patient who was female and pre-menopausal with terrible lipids.\u00a0 I figured I could treat such a patient without any risk of her developing heart disease over the short term, and I planned to recheck lipids way sooner than the normal six weeks.\u00a0 Since her lipids were so out of the ordinary for one so young, I asked MD to repeat them, fasting, have the results sent to me and to send Angie to see me after her repeat labs had come back.<\/p>\n
When I got her labs, I knew the first reading wasn\u0092t an error.\u00a0 In fact, they were a little worse than when MD checked them the first time.<\/p>\n
Total cholesterol: 374 mg\/dl (all values in mg\/dl)
\nLDL: ?
\nHDL: 28
\nTriglycerides (TG) 2080<\/p>\n
(There was no value for LDL because LDL is a calculated number and can\u0092t be calculated when the triglycerides are over 400 mg\/dl.)<\/p>\n
Upon examination I found a pleasant mildly overweight young woman who had no real physical signs except for mild tenderness in the right upper quadrant of her abdomen when I really pushed on it.\u00a0 She had no family history of heart disease and she didn\u0092t smoke – both pieces of information that made me feel better about what I was about to do.<\/p>\n
(Not only were her lipids a mess, Angie\u0092s liver enzymes were way abnormal as well.\u00a0 I now know that she had non-alcoholic fatty liver disorder, but we (the medical profession) didn\u0092t really recognize that as a common disease back then.\u00a0 I\u0092m sure her liver was inflamed to some degree, which explained the mild pain she was experiencing.)<\/p>\n
I gave her a fairly rigid version of what became the Protein Power diet.\u00a0 I explained exactly what she should eat and what she shouldn\u0092t and sent her on her way with my home phone number and my beeper number (this was before the days of cell phones). I told her to call me if she had even the slightest problem and to return to the office in three weeks for a recheck no matter what. And I gnawed my nails.\u00a0 I had the staff call her after a few days to see if she was doing okay.\u00a0 She reported that she was fine.<\/p>\n
I got no emergency calls from her and in three weeks she returned.\u00a0 Her right upper quadrant pain had vanished as had her nausea.\u00a0 She reported that she had never felt better.\u00a0 She had even lost nine pounds (which was a fair amount for her since she wasn\u0092t that overweight to begin with).\u00a0\u00a0 I rechecked her labs and waited anxiously for them to come back from the lab the next day.\u00a0 When they did, I was stunned.<\/p>\n
Total cholesterol: 292
\nLDL: 192
\nHDL 70
\nTG: 149<\/p>\n
I had hoped for a change for the better, but I hadn\u0092t in my wildest dreams expected this kind of change.\u00a0 I kind of figured that her triglycerides and cholesterol would come down slowly over several months, not that they would drop like rocks in only three weeks.<\/p>\n
The second of my life-changing patients was a casual friend of mine who came to see me about a week after my experience with Angie.\u00a0 He was a 55 year old guy we\u0092ll call Lynn who worked in advertising.\u00a0 I had gotten to know him when his company created some brochures for our clinic.\u00a0 He came to see me for an insurance physical.<\/p>\n
He arrived, we chatted, and then I looked him over.\u00a0 I poked and prodded and listened at all the appropriate places.\u00a0 He seemed fine. He was a thinnish white male who was just starting to develop a little (and I mean little) paunch.\u00a0 I would never have even noticed it had he not been sitting there with his shirt off.<\/p>\n
Talk turned to my own weight loss, and he asked me if I could put him on a diet to help him lose his little pot belly.\u00a0 I said \u0091Sure,\u0092 and told him about my meat, cheese, salad and green vegetable diet.\u00a0 I told him that I had lost my weight eating a ton of steak and had continued to do so.\u00a0 He was thrilled because he loved steak and had been avoiding it because of everything he had been reading about red meat and heart disease.\u00a0 I had our nurse draw his blood for the lab part of his physical and sent him on his way.<\/p>\n
The next day I was going through all the results from the bloodwork that had been drawn the day before when I came upon his.\u00a0 I nearly dropped my teeth.<\/p>\n
Total cholesterol: 312
\nLDL: ?
\nHDL: ?
\nTG: 1515<\/p>\n
(There was a note on the lab sheet that said they were unable to determine the HDL because the serum was too lipemic (cloudy with fat)?!?!)<\/p>\n
I thought, Whoa!, a 32 year old premenopausal woman is one thing, but a 55 year old male right in the middle of major-heart-disease-risk age is something else.\u00a0 And here I had put this guy with totally disrupted lipids on a red-meat diet, which, according to current medical thinking, would almost guarantee to make the situation worse.\u00a0 I put in an immediate call to his office and was told he had left that morning for vacation for two weeks.\u00a0 (Why he had neglected to even mention this trip when we talked for 30 minutes the day before baffled me completely.) I asked for the number wherever he was.\u00a0 His secretary told me that he was on a Caribbean Island and couldn\u0092t be contacted.\u00a0 I told her that if he called in to have him call me immediately.<\/p>\n
My fears were somewhat assuaged because I figured, hey, the guy is on vacation, he\u0092s not going to diet anyway.\u00a0 Why should I worry?<\/p>\n
He called me the day he got back and before I could get a word in told me \u0093Hey, your diet works great.\u00a0 I lost five pounds while I was on vacation.\u0094\u00a0 As it turned out, he was on a Caribbean Island, but it was a resort of some sort.\u00a0 As part of his deal, all the food was provided.\u00a0 He had chowed down on steak just about every day.<\/p>\n
I was mortified.\u00a0 I told him about his labs and told him to get into the clinic the next morning to have his blood rechecked.\u00a0 He came in.\u00a0 Here are his labs taken 15 days after his first ones.<\/p>\n
Total cholesterol: 195
\nLDL: 124
\nHDL: 26
\nTG: 201<\/p>\n
I was really stunned this time.\u00a0 How could these values change this much in just 15 days?<\/p>\n
He wanted to stay on the diet, so I told him to go for it. But I kept an eye on him.<\/p>\n
Not long after this experience I had a very nice lady, named Jesse, who was the mother of a friend of mine come to see me.\u00a0 She had had labwork done somewhere else and her cholesterol had come back as 735 mg\/dl.\u00a0 Her doctor had put her on a cholesterol-lowering medicine, but she was still distressed because she had a friend who remarked to her, \u0093I didn\u0092t know you could even be alive with a cholesterol that high.\u0094\u00a0 I examined her and found her to be a very mildly overweight 72 year old lady with no signs of anything out of the ordinary.\u00a0 I rechecked her blood.<\/p>\n
Total cholesterol: 424
\nLDL: ?
\nHDL: ?
\nTG: 1828<\/p>\n
Along with these lipid labs, her fasting blood sugar came back at 154 mg\/dl.\u00a0 So, not only did she have major lipid abnormalities, she had blood sugar that was in the diabetic range.<\/p>\n
I gave her instructions on the diet and told her to stay on her cholesterol-lowering meds until we checked her again in three weeks.<\/p>\n
Three weeks later:<\/p>\n
Total cholesterol: 186
\nLDL: 118
\nHDL: 27
\nTG: 201<\/p>\n
I was surprised this time, but not stunned.\u00a0 Along with these mega improvements in her lipids, Jesse\u0092s fasting blood sugar was 90.<\/p>\n
I told her she could go ahead and discontinue her cholesterol-lowering medications because her cholesterol was normal.\u00a0 She looked at me kind of funny and said, \u0093I stopped them when I started the diet.\u00a0 That\u0092s what I thought you said to do.\u0094<\/p>\n
The last of my four patients came along about two weeks after Jesse.\u00a0 This woman, we\u0092ll call Betsy, was famous in Little Rock.\u00a0 Actually, she wasn\u0092t the famous one – her husband was – but she got plenty of notoriety herself.\u00a0 And just in case you\u0092re wondering, it wasn\u0092t Hillary.<\/p>\n
She came to see me because she had picked up a little excess weight and wanted to get it off.\u00a0 I went through my normal workup and found Betsy to be a moderately overweight woman with no other physical signs of ill health.<\/p>\n
Her labs told another story.<\/p>\n
Total cholesterol: 416
\nLDL: ?
\nHDL: ?
\nTG: 2992<\/p>\n
(Like Jesse\u0092s and Angie\u0092s labs, Betsy\u0092s didn\u0092t show HDL because the serum was too lipemic.)<\/p>\n
After three weeks on the program, Betsy lost 11 pounds and came through with the following labs:<\/p>\n
Total cholesterol: 177
\nLDL: 122
\nHDL: 36
\nTG: 94<\/p>\n
By then, I was kind of getting used to these seemingly miraculous lipid improvements, so I was no longer stunned.\u00a0 But it did confirm that I was on the right track.<\/p>\n
After my experiences with these four patients, all of whom came to see me over about a three month period, I became convinced that my theorizing about the potent effects of reducing insulin was based in reality.\u00a0 Over the ensuing years, I saw many, many more patients with disturbed lipid metabolism whom I successfully treated with low-carb, high-fat diets, but these four, coming as close together as they did in the early days of my feeling my way along in my low-carb career, gave me the conviction to press on.<\/p>\n
I am eternally grateful to them.<\/p>\n
\n
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In the early 1980s MD and I were laboring away in anonymity in our clinics in Little Rock, Arkansas.\u00a0 By that time I had gone through my thin-to fat-to thin again metamorphosis, and I was starting to treat patients for obesity.\u00a0 My own transformation had been fairly striking, a fact not lost on many of […]<\/p>\n","protected":false},"author":108,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7],"tags":[],"class_list":["post-168474","post","type-post","status-publish","format-standard","hentry","category-news"],"_links":{"self":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts\/168474","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/users\/108"}],"replies":[{"embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/comments?post=168474"}],"version-history":[{"count":0,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts\/168474\/revisions"}],"wp:attachment":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/media?parent=168474"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/categories?post=168474"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/tags?post=168474"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
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In the early 1980s MD and I were laboring away in anonymity in our clinics in Little Rock, Arkansas.\u00a0 By that time I had gone through my thin-to fat-to thin again metamorphosis, and I was starting to treat patients for obesity.\u00a0 My own transformation had been fairly striking, a fact not lost on many of my overweight patients, a number of whom were seeking my professional advice on treating their own weight problems.\u00a0 I was still doing a fair amount of general primary care medicine, but more and more of my time was being diverted to helping people lose weight.<\/p>\n