I see diabetic eye disease (diabetic retinopathy) nearly every day in my practice as a board certified optometrist in a large group practice. About a year and a half ago I examined four lean men about my age who were recently diagnosed with adult onset diabetes (type 2 DM or T2DM). Most diabetics I see are obese, but these men were skinny like me. My body mass index is about 22.
These encounters with newly diagnosed lean-adult diabetics led me to examine my diet which was heavy with “healthy” whole grains as shown on the USDA Food Pyramid. My breakfasts were usually “heart-healthy” oat meal or Cheerios with milk, two slices of whole wheat bread and Smart Balance spread or a plain bagel with low fat cream cheese, and black coffee. I was doing the right thing eating things that were healthy for my heart. My lunches and dinners weren’t much different -- healthy! I thought.
Then I realized the tremendous carbohydrate load I was ingesting each day might put me at risk for decreased health, perhaps toward being a lean adult-onset diabetic like the four patients mentioned earlier.
My interest in ketogenic eating evolved from the application toward reversing diabetes to it’s powerful anti-inflammatory power, as inflammation seems to be the source of many of the diseases of civilization (hypertension, heart disease, diabetes and Alzheimer’s disease which is now considered type 3 diabetes).
I started a strict ketogenic diet two days before Thanksgiving 2017 and have been 99% faithful since, straying from the diet rarely and mildly only when away from home and with little food choices. My carbohydrate intake is <25 gms/day, sometimes much lower and my fat intake is high as tracked with a free app Lifesum. A typical breakfast is ~ 1000+ calories, 95% fat, 5% protein (2 eggs and cheddar cheese fried in 2-3 tablespoons of olive oil/butter/bacon fat combination and 2 thick slices of bacon, black coffee.
I told my primary care physician about my ketogenic diet during a physical exam in August – he said nothing pro or con. The blood work results below include lipid panels done prior to keto, during keto, and my experiment with 1800 milligrams of Cholestoff daily while on keto.
The “Std Diet” is how I ate without regards to anything. The dates "Std diet" (pre-keto), 8/2018, 9/2018, and 11/2018 are blood draws and analysis dates.
Std Diet Keto 8/2018 Keto 9/2018 Keto + Cholestoff 11/2018 “Desired value”
Chol 190 291 287 234 <200
HDL 76 80 83 84 >40
LDL 105 195 189 135 --
Trigly 43 64 53 61 <150
Chol/HDL 2.5 3.6 3.5 2.8 <5.0
The ketogenic diet (low carbohydrate, moderate protein, high fat):
Increased my cholesterol from 190 to 291, a 53% increase. Bad.
Increased my LDL from 105 to 195, an 86% increase. Bad.
Increased my triglycerides from 43 to 64, a 49% increase. Bad. But still <150. Good!
Increased my HDL from 76 to 83, an 10% increase. Good.
Decreased my weight by 15 pounds. Not desirable in my case. I was skinny already.
The addition of 1800 mg of Cholestoff daily for 5 weeks until the 11/2018 blood analysis did lower my cholesterol from 287 to 234, an 18% drop. And it lowered my LDL from 189 to 135, a decrease of 29% without any side affects.
I ordered the lab work of 9/2018 and 11/2018 myself online via directlabs.com. You can too, without your physicians’ approval – the lab will send the results directly to you.
One analysis I had done that I did not include in this report is the Quest Cardio IQ analysis of my lipoprotein subfractions, that is, the LDL particle number and sizes. The sizes of these cholesterol particles is perhaps a more important cardiovascular health biomarker versus the LDL.
My Lipoprotein (a) (Lp, little “a”) is extremely optimal @ 15 nmol/L, and this biomarker is also now believed to be highly important in cardiovascular health assessment. I’m happy with that.
So, these cholesterol numbers would likely make most physicians and cardiologists start me on statins, but my HDL, triglycerides, Lp(a), and weight are normal. And I'm not sedentary -- I do high intensity interval exercising. I think there's a reassessment of what is “normal” cholesterol levels for eaters of lots of carbohydrates and what’s considered “normal” for those in ketosis and who are lean. For now, my doctor’s just watching, and I’m enjoying the fat.
Dag
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