Dec 22 2008

Healthy As an Ox

Jason wrote a very good article on being fat and losing weight, so that brings up something I’ve been meaning to talk about for a while.

I’m continuing to low-carb, but I haven’t been very strict about it lately.  I haven’t had any more carb pig-outs like I wrote about the other day, but it’s remarkably easy for too many carbs to slip into your diet when you aren’t careful.  Some low-carb cheesecake here, some breaded fried chicken there, some sweet potatoes over here on the side, and suddenly I’m often close to double my daily limit of 30 grams of carbohydrate a day—even though I’m sticking to foods that can be okay on a low-carb diet if the portions are small enough and you count everything.  Not surprisingly, my weight loss has stalled.

So I’ve started a food journal again.  FitDay.com is very handy for this, since it has most common foods in its database already, so you don’t have to look them up in a book one by one.  I’m really only interested in the carbs, but it will track fat and protein and other nutrients too, and it’s free.  Knowing that I’m already at 23g of carb for the day at suppertime helps, since it tells me what I can afford to eat and what I can’t.

Also, for various reasons, I just got blood work done, including a lipid profile.  This is the test they use to scare people into taking statins and other supposed anti-cholesterol drugs.  Now, keep in mind that I’m doing everything wrong, according to the medical/nutritional establishment.  I eat lots of red meat and lots of fat, especially saturated fat.  Lots of full-fat cream and cheese, almost no fruit, few vegetables, no grain, and not much fiber.  I don’t watch my calories, and in fact worry more about getting too few than too many.  Here’s my macro-nutrient breakdown for a typical day:

My Food Intake

My Food Intake

I also don’t exercise much, especially this time of year; and when I do exercise, it tends to be high-intensity strength-training stuff like lifting hay bales or hedge posts, not the aerobic “cardio” stuff that’s supposed to be good for your heart.  On top of all that, I put lots of salt on everything, and even drink salt water (for my adrenals, but that’s another post).  According to all the government health agencies and the people who design school diets, anyone you’d read in Newsweek or see on Oprah, and almost anyone you’ll find in a hospital, my cholesterol should be horrible.  They’d probably say it’s a wonder I’m still alive.

Well, here are my lipid numbers and a few other interesting ones from the test.  The first number is mine; the second numbers are the ranges the lab considers normal and healthy.

Total Cholesterol:      190     100-199
Triglycerides:           75       0-149
HDL Cholesterol:         47         39+
LDL Cholesterol Calc:   128        0-99
VLDL Cholesterol Calc:   15        5-40
Sodium:                 135     135-145
Chloride:                98      97-108
Iron:                    78      40-155
Glucose (blood sugar):   91       65-99

So, the only number there that’s outside their range is LDL, and I’ll explain why that doesn’t worry me in a minute.  Looking at the rest: my total cholesterol is excellent, right smack dab in the middle of the healthy range of 160-220.  That 100-199 recommendation is stupid and reflects an obsession with heart disease.  It’s true that there’s a correlation between cholesterol over 220 and heart disease (mostly just in men, though).  But it’s also true that in people with cholesterol under 160, other health risks increase: strokes, suicide, even being the victim of murder.  (I don’t think anyone’s determined why people with very low cholesterol get murdered more often than others; maybe they just won’t stop bragging about it and their friends get fed up.)  So the cholesterol range that correlates with the fewest deaths in general is 160-220, and I’m right in the middle of it.  I’d like to avoid all death, not just heart attacks, so that works for me.

That HDL is quite good, especially since exercise is supposed to increase HDL, and I can’t credit that.  My LDL/HDL ratio, which even mainstream experts are starting to admit is more important than the raw numbers, is excellent at 2.7.  I think their range on triglycerides is too high and should stop at 100, but either way, my number for that is excellent too.

And look at that sodium number!  I walk around all day drinking salt water, and if my sodium were any lower, the lab would have put LOW in bold print next to it.  Ditto chloride, the other element in salt that never gets any attention.  Don’t ever let people tell you salt is bad for you.  Even if sodium is bad for you, that doesn’t mean salt is, any more than drinking water makes you flammable because it’s made of hydrogen and oxygen.  I always knew salt was okay, but it’s nice to see this proof.

My iron is okay, but almost a little low, considering I eat a lot of red meat and don’t donate blood.  Another case where “you are what you eat” is a lot of nonsense.  My blood sugar was right in the top half of the healthy range, even though I low-carb and hadn’t eaten in twelve hours before they took blood for this.  Like I said in a post the other day, low-carb eating does not cause low blood sugar; the body retrieves glycogen from storage or converts protein to maintain the right amount.

So, what about that 128 LDL?  Well, first I need to back up a little and explain how they come up with these numbers.  See where LDL and VLDL both say “Calc”?  That’s short for “calculated,” which means they don’t measure those directly; they estimate them based on the other numbers.  The tests for total cholesterol, HDL, and triglycerides are fairly cheap.  The tests for LDL and VLDL are more expensive, so unless you order them specifically, the lab will simply calculate them.  They calculate VLDL by dividing triglycerides by 5.  That’s because VLDL is manufactured in the liver to carry triglycerides around, so they assume a certain ratio between the two: more triglycerides need more VLDL to carry them around.  Unfortunately, that ratio varies from person to person and diet to diet, so it could be as much as 40% off.  That means my VLDL could actually be anywhere from 9-21.

Then they calculate LDL by subtracting HDL and estimated VLDL from the total cholesterol.  In my case, 190-47-15=128.  Since that 15 could be 9-21, my LDL could vary from 122-134.  As an estimate based on an estimate, its accuracy leaves something to be desired.

But there’s a bigger problem with LDL: there are two main kinds.  (There are also at least five kinds of HDL, but since they’re all thought to be beneficial, we don’t distinguish between them much.)  There are light, fluffy, type-A LDLs and smaller, denser, type-B ones.  We worry about LDL because when it gets damaged, it forms plaque in the heart and arteries.  But the type-B LDL gets damaged far more than the fluffy type-A, so it matters which kind you make more of.  Unfortunately, distinguishing the two requires another expensive test, so it doesn’t get done often either.

Since all these measurements are based on volume, they don’t tell you how many actual LDLs you have floating around in your blood stream. If someone tells you they have a truckload of sports balls, you can’t figure how many that is unless you know whether they mean baseballs or basketballs.  Likewise, a certain volume of the bad, smaller type-B LDL will have a lot more of them running around wreaking havoc than the same volume of the lighter, type-A LDL.  Fortunately, a low-carb diet that includes plenty of healthy fats will tend to produce more of the light, fluffy LDL.  That 128 might be lower if I ate like the USDA recommends and produced more of the heavy, type-B LDL, but my health would be worse.

Ever since I started low-carbing and bucking the mainstream wisdom on diet, I’ve been curious what my numbers would be.  I was about 99% sure I was doing the right thing, but it’s nice to have scientific proof from my own body.

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