The disastrous results of a low-fat diet

4. November 2009 William Davis (16)
Rob was never that committed to following the program in the first place.

I met Rob because of a modest heart scan score and consultation for a cholesterol abnormality. Rob had been cycled through all the statin agents by his primary care physician, all of which resulted in terrible muscle aches that he found intolerable.

I started out, as usual, characterizing his cholesterol abnormality with lipoprotein testing (NMR):

LDL particle number 1489 nmol/L
LDL cholesterol (Friedewald calculation) 143 mg/dl
Small LDL 52% of total LDL
HDL 50 mg/dl
Triglycerides 82 mg/dl

(LDL particle number is the emerging gold standard for LDL quantification, superior to calculated or Friedewald LDL cholesterol for prediction of cardiovascular events.)

Rob is a busy guy. After only a couple of brief visits, life and work got in the way and Rob let his attentions drift away from heart health. Since the information I provided made little impact on his thinking, he reverted to the low-fat diet his primary care doctor had originally prescribed and that he read about in magazines and food packages. He also ran out of the basic supplements I had advised, including fish oil and vitamin D, and just never restarted them.

A couple of years passed and Rob decided that just poking around on his own might not cut it. So he came back to the office. We repeated his NMR lipoprotein analysis:

LDL particle number 2699 nmol/L
LDL cholesterol (Friedewald calculation) 229 mg/dl
Small LDL 81% of total LDL
HDL 53 mg/dl
Triglycerides 78 mg/dl


Two years of a low-fat diet had caused Rob's LDL particle number to skyrocket by 81%, nearly all due to an explosion of small LDL. Recall that small LDL is more susceptible to oxidation, more inflammation-provoking, more adhesive--the form of LDL particles most likely to cause heart disease.

Also, note that, despite the enormous increase in small LDL, HDL and triglycerides remained favorable. This counters the popular rule-of-thumb offered by some that small LDL is not present when HDL is "normal."

Low-fat diets as commonly practiced are enormously destructive. In Rob's case, a low-fat diet caused both calculated Friedewald LDL as well as LDL particle number to increase dramatically. In many other people, low-fat diets increase calculated Friedewald LDL modestly or not at all, but cause the more accurate LDL particle number to increase significantly, all due to small LDL.

I'm happy to say that, once Rob witnessed how far wrong he could go on the wrong program, he's back on Track. (Sorry, pun intended.) He has resumed his supplements and eliminated the food triggers of small LDL--wheat, cornstarch, and sugars.
Tags :

Comments (16) -

  • Jim Purdy

    11/4/2009 3:06:47 PM |

    Wheat, cornstarch, and sugars ... all have been out of my diet for a while now.

    I really appreciate the information and advice in your blog.

  • Nancy LC

    11/4/2009 6:02:11 PM |

    Dr. Davis,

    There's a belief in the low carb community that if triglycerides are low that LDL tends to be the large, buoyant sort that isn't problematic.  But this fellow's triglycerides are fairly low and clearly he has an issue.  What do you think?  Can one depend on having the harmless sort of LDL if you've cut out the grains and sugars?

  • 8bitpixel

    11/4/2009 9:09:41 PM |

    When can we expect an update on his numbers?

  • LPaForLife

    11/4/2009 9:54:12 PM |

    A low fat high carb diet reduced my HDL big time and didn't effect my total LDL much. This seems quite different from these results. I thought low fat usually reduces HDL. Am I wrong?

  • Jeff

    11/4/2009 10:05:49 PM |

    What are the sources of cornstarch? I can't think of anything that has cornstarch in it except, well, cornstarch.

  • Dr. William Davis

    11/4/2009 11:48:36 PM |

    Hi, Nancy--

    No, you cannot.

    Humans are a hodgepodge of varying genetic tendencies. While elimination of these small LDL triggering foods reduces small LDL, it doesn't always eliminate them, especially in the genetically predisposed.

  • Joe D

    11/5/2009 1:41:55 AM |

    I don't want to waste your time, but in case you don't know: I (and maybe others) received this email today. It was marked as "SPAM" but I opened it anyway since it had your name on it. If you didn't authorize it maybe you should mention it in your blog. Thanks. Joe.

    From: Dr. Davis - PharmaNutrients (email addressed followed) hilary at pharmanutrients.com
    Subject: Dr. Davis recommends Cardio for optimal heart health
    Date: November 4, 2009 8:02:02 AM MST

    http://www.pharmanutrients.com/cardio-landing-a

  • AMK

    11/5/2009 6:55:57 AM |

    Supplements can be of great help in getting rid of free radicals  to our body.  A good source of vitamins and antioxidants to suffice what we lack from food intake.

  • Dave Brown

    11/5/2009 11:08:15 AM |

    Hello Dr.,

    So if after eliminating wheat, cornstarch and sugars the lipoprotein test still show a high percentage of small LDL particles (probably due to genetics) - What could be done next?

  • Dr. William Davis

    11/5/2009 4:08:37 PM |

    In my view, once wheat has been eliminated, it should stay that way. I've seen too many people explode in weight and lipid abnormalities with resumption of wheat. I liken it to stopping alcohol in an alcoholic--once "dry," I would not recommend a drink or two.

  • Dr. William Davis

    11/5/2009 4:09:34 PM |

    Hi, Dave--

    The reduction of small LDL after dietary changes are made is among the most difficult patterns of all the address. This is discussed in great detail in several reports and forums on www.trackyourplaque.com.

  • Bonnie

    11/5/2009 6:14:25 PM |

    I've been reading your blog for about a year.  I am fitness professional at a healthy weight, but have had issues with genetic moderately high cholesterol (including Lp(a)). High HDL, low Triglycerides, high end of normal LDL (mixed A/B size) AND several high liver enzymes for some unexplained reason (possibly NAFLD?).

    I finally eliminated wheat from my diet (95% of the time) about 8 months ago.  My recent blood work came back and the most profound change was that ALL of my LDL particles are now in the Large range, AND nearly all of my liver enzymes are within normal range for the first time!  An unexpected surprise!

    Could it be that my liver doesn't like wheat??  Go figure!  

    I am now a believer Smile

    Thanks for your educational blog!

    Bonnie

  • Dr. William Davis

    11/6/2009 1:18:00 PM |

    Hi, Bonnie--

    That's great!


    Nigel--

    Yes, it applies to females, as well.

  • Anonymous

    11/11/2009 8:22:00 PM |

    How do we know that these results aren't more about the "dangerous" foods than the times they were eaten? If this experiment had been done with a few slices of turkey and a big salad and a glass of milk, would the results have been the same?

  • ultrasonic liposuction guide

    1/27/2011 5:40:26 AM |

    Well, I don't believe that high carbohydrate diets are causing ADD, but I do feel that some ADDers may be especially sensitive to high insulin levels generated by the modern low fat diet.

Add comment

Loading
Explosive plaque growth

Explosive plaque growth

10. December 2007 William Davis (3)
Every once in a while, we will see someone experience more-than-expected rate of coronary plaque growth, a sudden jump in heart scan scores. I'm talking about increases in score of 50%, even 100%, sometimes despite favorable lipid and lipoprotein patterns.

It's not always easy to pin this phenomenon down, since we often detect it after a year or more on a repeat heart scan. It would be wonderfully insightful to perform heart scans more frequently and track plaque growth more precisely, but of course, radiation exposure is the most important limiting factor, as is cost.

So this list is, admittedly, speculative. It is based on observation, on presumptive associations between events and heart scan scores. But, judging from what we do confidently know about coronary atherosclerotic plaque, I think these observations make physiologic sense.

These are the sorts of increases in heart scan score that can scare the heck out of you, silent yet explosive growth of coronary atherosclerotic plaque that can grow with no warning whatsoever.



Image courtesy Wikipedia and the United States Geological Survey.









Factors which I have observed to possibly be responsible for explosive plaque growth include:

--Overwhelming tragedy such as death of a loved one, financial ruin, divorce. One of my early and catastrophic failures was a young man in his early 40s who, in the space of just a few months, suffered the loss of his mother, a brother, and his mother-in-law, while working a high-stress job. His heart scan score doubled from around 100 to 200 in one year, despite perfect lipoproteins. He had a heart attack shortly after the second score, despite a normal stress test just months earlier. (Pessimism is tragedy's weak cousin, but one that still holds power to corrupt our otherwise best efforts at plaque reversal.)

--Substantial weight gain. In the early years of the Track Your Plaque program, before it was even called "Track Your Plaque," I witnessed a man more than double his score from 1100 to 2400 in 18 months just by allowing himself to gain 40 lbs. (I don't know what became of him. His life apparently suffered other disasters, as well, and we lost track of him.)

--Poorly-controlled diabetes. High blood sugars out of control have yielded explosive growth.

--Kidney disease--However, I am uncertain of how much this overlaps with a deficiency of vitamin D's active form, 1,25-OH-vitamin D3, the form that is often deficient in people with dysfunctional kidneys.

--An inflammatory disease that is out of control, e.g., rheumatoid arthritis.

--This is very speculative, but I've witnessed explosive growth after vaccine administration that yielded strange viral-like symptoms. In this one instance, the man was getting heart scans (on his own) every three to six months and described a severe illness following a vaccine administered in preparation for travel out of the U.S.

--Unrecognized low thyroid function--i.e., hypothyroidism. This is easily corrected with thyroid hormone replacement.


These factors can also be relative and they can be overcome. Look at our current Track Your Plaque reversal record-holder: a 53-year old woman who dropped her heart scan score an amazing 63% despite the loss of a loved one during the 15 months of her program. Despite an overwhelming tragedy, she overcame the potential adverse effects and set a record, probably a record for the entire world.
Tags :

Comments (3) -

  • chcikadeenorth

    12/11/2007 2:54:00 PM |

    thank you, very timely and informative, explains allot of my increase as well.But I am working to become a Low Plague Poster Baby Boomer.

  • Anonymous

    12/11/2007 11:25:00 PM |

    For someone that has explosive plaque, how would you try to treat?  Would lowering matrix metalloproteinase by prescribing doxycycline be an appropriate next step?

  • Dr. Davis

    12/12/2007 3:17:00 AM |

    First, consider correction of the cause.

    Unfortunately, a cause is not always identifiable, at least one you can do something about. Yes, anti-inflammatory strategies against MMP might be useful. Otherwise, there is, with present knowledge, no specific therapy for, say, grief.

Add comment

Loading