I have tried to be consistent with Low carbohydrate High Fat diet or Atkins type diet for 8 years. Most of the time I was in nutritional ketosis documented at 0.5 or greater by serum checks.
I have read Eat Rich Live Long published in Feb 2018.
I agree that early diagnosis of insulin resistance needs to be made with 2 hour post prandial glucose and insulin level. I think this might make major inroads in preventing the next obesity pandemic by getting people on LCHF diet early in their life.
However I have two major problems with the advice of Eat Rich Live Long on:
1- How to Maintain Weight loss
2-How to treat high CAC score and high LDLc or LDLp or ApoB or non-HDL cholesterol.
See my review of Eat Rich Live Long link.
Despite being on LCHF my HgbA1c remains at 7.7. Losing 75 lbs in 2006 did not cure my DM2 problem. What has kept me from progressive cardiovascular disease is my great lipid reductions from:
Atorvastatin (lipitor) 10 mg
Endur-acin (over-the-counter Niacin) 1,000 mg.
My results from inexpensive standard lipid panel 4-3-18
FASTING
Total Cholesterol 144
HDLc 58
nonHDLc 78 (most important risk parameter on standard lipid panel)
LDLc 66 (standard for trials but not accurate w high TG discordance)
Triglycerides 64
Remnants 13 (greater than 35 is risk factor )
Hgb A1c 7.7 (not on insulin, on metformin, invokana and victoza)
Bioelectrical 4 point Impedance Scale
Wt. 206.8 pounds,
Body Fat 25.6%,
Fat Free mass 74.5%
Body H2O 55.5%
Muscle Mass 38.8 pounds
BMI 28.6
Waist 41.5 inches
Visceral fat 15
Liposcience Advanced Lipid testing 3-23-18
Non-fasting
Total Cholesterol 144
HDLc 60
non-HDLc 84 (goal less than 80)
LDLc 66
Triglycerides 92
Remnants 18 (TC minus HDLc minus LDLc)
HDLp 39.4 (problem with TC/HDLc ratios is no discernment between large/small HDLp)
small LDLp 312 (normal)(<750 b="" this="">not important if LDLp less than 750)
LDLp 661 <750 font="" nbsp="">(the best predictor CVD)
LDL size 20.2 (normal)
VLDL size 51 (high) (non-fasting)
LP-IR score 45 (normal) (not sure what to make of this I have DM2)
Fasting AM serum ketones:
3/29 0.3
3-30 1.6
3-31 0.7
4-1 0.8
4-2 0.6
Up to Date take away message.
1-The most important inexpensive risk factor is non-HDL cholesterol.
2- The best and most accurate risk factor is with advanced testing for particles.
Either LDLp or ApoB
3- Getting triglycerides down with LCHF, Lovaza (fish oil) and niacin is very important as well, especially for insulin resistant patients.
4- LCHF diet and nutritional ketosis will not be sufficient treatment in many cases, especially if CAC is greater than 100.
Statins, Zetia and Endur-acin (niacin) in low doses together can get particles down very low and even reverse plaque. Low doses have less side effects.
5- To reverse plaque on CAC or CIMT get:
non-HDL cholesterol less than 80 or
LDLp less than 750 or
ApoB less than 80
and
Triglycerides less than 100
To see several years of my CAC scores and CIMT with evidence of reversal of plaque go to my CAC and CIMT scores link
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