Very high triglyceride numbers (what does it mean, what can be done)?

Discussion in 'Health and medical' started by Myo Cardium, Dec 16, 2003.

  1. Myo Cardium

    Myo Cardium Guest

    Buddy of mine (mid-30's, male, recent ex-smoker, 6ft, 195 lbs) has come back with triglyceride
    numbers between 400 and 700 (yes he was fasting and has had these tests repeated several times).
    This was for a cholesterol test - apparently with triglyceride levels that high the HDL and LDL
    numbers are not trust-worthy?

    Anyways, he's on a diet of reduced (or no) sugar, cola, juices, red meat, and with a daily dose of
    flax seed for a few months before another test. No symptoms of diabetes that I'm aware of. He's
    vauguely aware that his brother also may have either high cholseterol or triglycerides. Sister,
    mother test ok. Father died in his 50's (heart disease of some sort).

    Anyways, I was wondering what other tests would be worth-while (say, thyroid?).

    Say that because of this diet his triglyceride levels test normal and so do the cholsterol levels.
    If this happens, and if he goes back to his normal diet, then presumably his triglyceride levels
    will go back up. If they do, is it a given that his cholsterol will also shoot up?

    OR, if the only consequence of an uncontrolled diet is high tryglycerides (but normal cholsterol)
    then is that a bad thing? Are there any medications that can reduce tryglceride levels?

    Please post any responses. Thanx.
     
    Tags:


  2. Julie Bove

    Julie Bove Guest

    "Myo Cardium" <[email protected]> wrote in message
    news:[email protected]...
    >
    > Buddy of mine (mid-30's, male, recent ex-smoker, 6ft, 195 lbs) has come back with triglyceride
    > numbers between 400 and 700 (yes he was fasting and has had these tests repeated several times).
    > This was for a cholesterol test - apparently with triglyceride levels that high the HDL and LDL
    > numbers are not trust-worthy?
    >
    > Anyways, he's on a diet of reduced (or no) sugar, cola, juices, red meat, and with a daily dose of
    > flax seed for a few months before another test. No symptoms of diabetes that I'm aware of. He's
    > vauguely aware that his brother also may have either high cholseterol or triglycerides. Sister,
    > mother test ok. Father died in his 50's (heart disease of some sort).
    >
    > Anyways, I was wondering what other tests would be worth-while (say, thyroid?).
    >
    > Say that because of this diet his triglyceride levels test normal and so do the cholsterol levels.
    > If this happens, and if he goes back to his normal diet, then presumably his triglyceride levels
    > will go back up. If they do, is it a given that his cholsterol will also shoot up?
    >
    > OR, if the only consequence of an uncontrolled diet is high tryglycerides (but normal cholsterol)
    > then is that a bad thing? Are there any medications that can reduce tryglceride levels?
    >
    > Please post any responses. Thanx.

    High triglycerides can be caused by eating too many carbs, particularly of the refined variety. It's
    not just sugar, but white flour and other things. He will need to modify his diet and continue for
    the rest of his life on such a diet. Otherwise, the problem will return. There are meds for high
    triglycerides, but I don't know the particulars of them.

    --
    Type 2 http://users.bestweb.net/~jbove/
     
  3. Oldal4865

    Oldal4865 Guest

    Myo Cardium wrote in message <[email protected]>...
    >
    >Buddy of mine (mid-30's, male, recent ex-smoker, 6ft, 195 lbs) has come back with triglyceride
    >numbers between 400 and 700 (yes he was fasting and has had these tests repeated several times).
    >This was for a cholesterol test - apparently with triglyceride levels that high the HDL and LDL
    >numbers are not trust-worthy?
    >
    >Anyways, he's on a diet of reduced (or no) sugar, cola, juices, red meat, and with a daily dose of
    >flax seed for a few months before another test. No symptoms of diabetes that I'm aware of. He's
    >vauguely aware that his brother also may have either high cholseterol or triglycerides. Sister,
    >mother test ok. Father died in his 50's (heart disease of some sort).
    >
    >Anyways, I was wondering what other tests would be worth-while (say, thyroid?).
    >
    >Say that because of this diet his triglyceride levels test normal and so do the cholsterol levels.
    >If this happens, and if he goes back to his normal diet, then presumably his triglyceride levels
    >will go back up. If they do, is it a given that his cholsterol will also shoot up?
    >
    >OR, if the only consequence of an uncontrolled diet is high tryglycerides (but normal cholsterol)
    >then is that a bad thing? Are there any medications that can reduce tryglceride levels?
    >
    >Please post any responses. Thanx.

    ". . . .No symptoms of diabetes that I am aware of. . ."

    Well, he has at least one symptom of diabetes, high triglycerides.

    He also displays a suspicious circumstance, a blood relative who died young from a heart attack.
    Dying young from a heart attack can be the first-noticed-symptom of developing Type 2 diabetes, a
    disease which "runs in the family".

    Type 2 diabetes is caused by a genetic condition. The genetic condition causes high Insulin
    Resistance which attacks the body for an average of 10 years before any easily detected symptoms
    such as high blood sugar emerge. However, it does cause high triglycerides levels which is usually
    regarded as a marker for Type 2 diabetes.

    A test which reveals high Insulin Resistance is a simultaneous measurement of fasting blood sugar
    and fasting insulin in the blood.

    Most folks have a fasting insulin level somewhere around 5 milliUnits per mL. Non-Insulin Resistant
    folks are characterized by a HOMA index less than about 30 (most of them are below 20),

    HOMA index = fasting blood sugar x fasting insulin/22.5

    (that's using U.S. measurements, blood sugar in mg/dL, fasting insulin in milliUnits/mL)

    It would be really useful to measure his blood sugar at 2 hours after a **high carb** meal. (If he
    has any diabetic friends, the diabetic friend should have a home blood testing meter.) Any blood
    sugar much over 100 mg/dL at 2 hours after eating a high carb meal is getting suspicious, any blood
    sugar much over 140 mg/dL mg/dL is a definite marker of developing Type 2 diabetes.

    However, that kind of blood sugar test isn't that descriptive for folks eating low carb unless they
    are already full-blown diabetic.

    Some over the counter self-treatments for high triglycerides are:

    a. one gram of fish oil 3 - 5 times a day. For triglycerides that high, 5 times a day is better.

    b. Flax seed ( note, he's not looking for the Flax Oil!. It's the outer casing of the seed
    he wants!)

    c. Time-release, (over the counter) niacin. 500 mg, taken twice a day.

    There are at least two prescription meds. Statins and Lopid work.

    http://www.reducetriglycerides.com/Bstdtreatment.htm

    Metformin is an anti-Insulin Resistance med which would help reduce any high Insulin Resistance.

    Good thing he's concerned. His father's early death and those lousy triglycerides indicate things
    don't go well genetically in his family. Best to get right after the problem when he's young.

    If they detect high Insulin Resistance, the lifestyle change which he needs is:

    d. Lose fat lb, especially around the abdomen
    e. Gain muscle lb
    f. Exercise vigorously every day. Daily is very important.
    g. Ration his daily carbohydrate, eat slowly digesting carbohydrate, split the daily carb over
    several small meals.

    Regards
    Old Al
     
  4. Matti Narkia

    Matti Narkia Guest

    Tue, 18 Nov 2003 00:12:10 -0500 in article
    <[email protected]> "Julie Bove" <[email protected]>
    wrote:

    >"Myo Cardium" <[email protected]> wrote in message news:[email protected]...
    >>
    >> Buddy of mine (mid-30's, male, recent ex-smoker, 6ft, 195 lbs) has come back with triglyceride
    >> numbers between 400 and 700 (yes he was fasting and has had these tests repeated several times).
    >> This was for a cholesterol test - apparently with triglyceride levels that high the HDL and LDL
    >> numbers are not trust-worthy?
    >>
    >> Anyways, he's on a diet of reduced (or no) sugar, cola, juices, red meat, and with a daily dose
    >> of flax seed for a few months before another test. No symptoms of diabetes that I'm aware of.
    >> He's vauguely aware that his brother also may have either high cholseterol or triglycerides.
    >> Sister, mother test ok. Father died in his 50's (heart disease of some sort).
    >>
    >> Anyways, I was wondering what other tests would be worth-while (say, thyroid?).
    >>
    >> Say that because of this diet his triglyceride levels test normal and so do the cholsterol
    >> levels. If this happens, and if he goes back to his normal diet, then presumably his triglyceride
    >> levels will go back up. If they do, is it a given that his cholsterol will also shoot up?
    >>
    >> OR, if the only consequence of an uncontrolled diet is high tryglycerides (but normal cholsterol)
    >> then is that a bad thing? Are there any medications that can reduce tryglceride levels?
    >>
    >> Please post any responses. Thanx.
    >
    >High triglycerides can be caused by eating too many carbs, particularly of the refined variety.
    >It's not just sugar, but white flour and other things. He will need to modify his diet and continue
    >for the rest of his life on such a diet. Otherwise, the problem will return. There are meds for
    >high triglycerides, but I don't know the particulars of them.

    Exactly. Low carb diet may help. Reduction in carbs means increase in fat or/and protein. The
    increased fat should IMHO consists mainly of monounsaturated and omega-3 fatty acids. In fact, fish
    oil has also been shown to reduce triglyceride levels, see

    Chan DC, Watts GF, Mori TA, Barrett PH, Redgrave TG, Beilin LJ. Randomized controlled trial of the
    effect of n-3 fatty acid supplementation on the metabolism of apolipoprotein B-100 and chylomicron
    remnants in men with visceral obesity. Am J Clin Nutr. 2003 Feb;77(2):300-7. PMID: 12540386 [PubMed
    - indexed for MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_u-
    ids=12540386&dopt=Abstract>

    Jonkers IJ, Smelt AH, Ledeboer M, Hollum ME, Biemond I, Kuipers F, Stellaard F, Boverhof R, Meinders
    AE, Lamers CH, Masclee AA. Gall bladder dysmotility: a risk factor for gall stone formation in
    hypertriglyceridaemia and reversal on triglyceride lowering therapy by bezafibrate and fish oil.
    Gut. 2003 Jan;52(1):109-15. PMID: 12477770 [PubMed - indexed for MEDLINE] <http://www.ncbi.nlm.nih.-
    gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12477770&dopt=Abstract>

    Durrington PN, Bhatnagar D, Mackness MI, Morgan J, Julier K, Khan MA, France M. An omega-3
    polyunsaturated fatty acid concentrate administered for one year decreased triglycerides in
    simvastatin treated patients with coronary heart disease and persisting hypertriglyceridaemia.
    Heart. 2001 May;85(5):544-8. PMID: 11303007 [PubMed - indexed for MEDLINE] <http://www.ncbi.nlm.nih-
    .gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11303007&dopt=Abstract>

    Stark KD, Park EJ, Maines VA, Holub BJ. Effect of a fish-oil concentrate on serum lipids in
    postmenopausal women receiving and not receiving hormone replacement therapy in a placebo-
    controlled, double-blind trial. Am J Clin Nutr. 2000 Aug;72(2):389-94. PMID: 10919932 [PubMed -
    indexed for MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uid-
    s=10919932&dopt=Abstract>

    Harris WS. Nonpharmacologic treatment of hypertriglyceridemia: focus on fish oils. Clin Cardiol.
    1999 Jun;22(6 Suppl):II40-3. Review. PMID: 10376196 [PubMed - indexed for MEDLINE] <http://www.ncbi-
    .nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10376196&dopt=Abstract>

    Marckmann P, Bladbjerg EM, Jespersen J. Dietary fish oil (4 g daily) and cardiovascular risk markers
    in healthy men. Arterioscler Thromb Vasc Biol. 1997 Dec;17(12):3384-91. PMID: 9437183 [PubMed -
    indexed for MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uid-
    s=9437183&dopt=Abstract>

    Roche HM, Gibney MJ. Postprandial triacylglycerolaemia: the effect of low-fat dietary treatment with
    and without fish oil supplementation. Eur J Clin Nutr. 1996 Sep;50(9):617-24. PMID: 8880041 [PubMed
    - indexed for MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_u-
    ids=8880041&dopt=Abstract>

    Mori TA, Vandongen R, Beilin LJ, Burke V, Morris J, Ritchie J. Effects of varying dietary fat, fish,
    and fish oils on blood lipids in a randomized controlled trial in men at risk of heart disease. Am J
    Clin Nutr. 1994 May;59(5):1060-8. PMID: 8172092 [PubMed - indexed for MEDLINE] <http://www.ncbi.nlm-
    .nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8172092&dopt=Abstract>

    Tato F, Keller C, Wolfram G. Effects of fish oil concentrate on lipoproteins and apolipoproteins in
    familial combined hyperlipidemia. Clin Investig. 1993 Apr;71(4):314-8. PMID: 8471818 [PubMed -
    indexed for MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uid-
    s=8471818&dopt=Abstract>

    Zakaria B, Bertsch S. [Low-dose omega-3 fatty acids as lipid lowering agents in the practice. A
    field study of ambulatory patients in general practice] Fortschr Med. 1992 Apr 10;110(10):178-82.
    German. PMID: 1577358 [PubMed - indexed for MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi-
    ?cmd=Retrieve&db=PubMed&list_uids=1577358&dopt=Abstract>

    Bairati I, Roy L, Meyer F. Effects of a fish oil supplement on blood pressure and serum lipids in
    patients treated for coronary artery disease. Can J Cardiol. 1992 Jan-Feb;8(1):41-6. PMID: 1617510
    [PubMed - indexed for MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMe-
    d&list_uids=1617510&dopt=Abstract>

    Burr ML. Fish food, fish oil and cardiovascular disease. Clin Exp Hypertens A. 1992;14(1-2):181-92.
    Review. PMID: 1541036 [PubMed - indexed for MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi-
    ?cmd=Retrieve&db=PubMed&list_uids=1541036&dopt=Abstract>

    Deslypere JP. Influence of supplementation with N-3 fatty acids on different coronary risk factors
    in men--a placebo controlled study. Verh K Acad Geneeskd Belg. 1992;54(3):189-216. PMID: 1413984
    [PubMed - indexed for MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMe-
    d&list_uids=1413984&dopt=Abstract>

    Harris WS, Windsor SL, Dujovne CA. Effects of four doses of n-3 fatty acids given to hyperlipidemic
    patients for six months. J Am Coll Nutr. 1991 Jun;10(3):220-7. PMID: 1832701 [PubMed - indexed for
    MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1832701&do-
    pt=Abstract>

    Terres W, Beil U, Reimann B, Tiede S, Bleifeld W. [Low-dose fish oil in primary
    hypertriglyceridemia. A randomized placebo-controlled study] Z Kardiol. 1991 Jan;80(1):20-4. German.
    PMID: 2035283 [PubMed - indexed for MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Ret-
    rieve&db=PubMed&list_uids=2035283&dopt=Abstract>

    DeLany JP, Vivian VM, Snook JT, Anderson PA. Effects of fish oil on serum lipids in men during a
    controlled feeding trial. Am J Clin Nutr. 1990 Sep;52(3):477-85. PMID: 2203252 [PubMed - indexed for
    MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2203252&do-
    pt=Abstract>

    Bohn KA, Friisk CF, Boe OW, Hysing J. [Effect on the lipid profile of diet supplemented with fish
    oil concentrate] Tidsskr Nor Laegeforen. 1990 May 20;110(13):1693-6. Norwegian. PMID: 2195704
    [PubMed - indexed for MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMe-
    d&list_uids=2195704&dopt=Abstract>

    Radack KL, Deck CC, Huster GA. n-3 fatty acid effects on lipids, lipoproteins, and apolipoproteins
    at very low doses: results of a randomized controlled trial in hypertriglyceridemic subjects. Am J
    Clin Nutr. 1990 Apr;51(4):599-605. PMID: 2181859 [PubMed - indexed for MEDLINE] <http://www.ncbi.nl-
    m.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2181859&dopt=Abstract>

    Bhathena SJ, Ali AA, Haudenschild C, Latham P, Ranich T, Mohamed AI, Hansen CT, Velasquez MT.
    Dietary Flaxseed Meal is More Protective Than Soy Protein Concentrate Against Hypertriglyceridemia
    and Steatosis of the Liver in an Animal Model of Obesity. J Am Coll Nutr. 2003 Apr;22(2):157-64.
    PMID: 12672712 [PubMed - in process] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db-
    =PubMed&list_uids=12672712&dopt=Abstract
     
  5. Oldal4865

    Oldal4865 Guest

    oldal4865 wrote in message ...
    >
    >Myo Cardium wrote in message <[email protected]>...
    >>
    >>Buddy of mine (mid-30's, male, recent ex-smoker, 6ft, 195 lbs) has come back with triglyceride
    >>numbers between 400 and 700 . . .(snip). . .

    >>OR, if the only consequence of an uncontrolled diet is high tryglycerides (but normal cholsterol)
    >>then is that a bad thing? Are there any medications that can reduce tryglceride levels?
    >>
    >>Please post any responses. Thanx.
    >
    >
    >
    > ". . . .No symptoms of diabetes that I am aware of. . ."
    >
    > Well, he has at least one symptom of diabetes, high triglycerides.
    >
    >. . .(snip). .> Some over the counter self-treatments for high triglycerides are:
    >
    > a. one gram of fish oil 3 - 5 times a day. For triglycerides that high, 5 times a day is
    > better.
    >
    > b. Flax seed ( note, he's not looking for the Flax Oil!. It's the outer casing of the seed he
    > wants!)
    >
    > c. Time-release, (over the counter) niacin. 500 mg, taken twice a day.
    >
    >There are at least two prescription meds. Statins and Lopid work.
    >
    > http://www.reducetriglycerides.com/Bstdtreatment.htm
    >
    >Metformin is an anti-Insulin Resistance med which would help reduce any
    high
    >Insulin Resistance.
    >
    >Good thing he's concerned. His father's early death and those lousy triglycerides indicate things
    >don't go well genetically in his family. Best to get right after the problem when he's young.
    >
    >If they detect high Insulin Resistance, the lifestyle change which he needs is:
    >
    > a. Lose fat lb, especially around the abdomen
    > b. Gain muscle lb
    > c. Exercise vigorously every day. Daily is very important.
    > d. Ration his daily carbohydrate, eat slowly digesting carbohydrate, split the daily carb
    > over several small meals.
    >
    > Regards
    > Old Al
    >
    >

    Oops! Little bit of a brain f*rt there. . .lots of "hows" , no "whys" or "who says so"

    1. McGowan, Mary P. M.D. "50 Ways to Lower Your Cholesterol" says so (she's a cardiologist)

    2. The cardiologist who advises my diabetic support group says so.

    3. I say so (hey, I tried it and it worked)

    4. Sadly, the big "WHY"

    WHY would you want to do this stuff?

    To avoid early heart attack!

    High triglycerides are a killer!

    Regards
    Old Al

    Regard
     
  6. Myo Cardium

    Myo Cardium Guest

    Will high triglyceride levels eventually lead to insulin resistance and hence will result in Type
    2 diabetes?

    I mean, could anyone develop type 2 this way if for some reason their metabolism keeps blood
    triglyceride levels high?

    Getting back to my buddy, he is by no means over-weight and it's not like he's constantly eating
    junk food. Should he get a home glucose tester?

    Is diabetes the worst - or most likely - outcome of persistent high tryglyceride levels vs coronary
    artery occlusion?

    Are triglycerides the same as (bad) cholesterol? I mean, can you have high triglcerides and still
    have the desired levels of HDL and LDL??? If so, then is coronary artery health tied independently
    to triglyceride levels - or cholesterol?

    Basically what I'm trying to determine is that if he continues to eat his regular diet (ok, maybe
    some omega-3 stuff and flax thrown in), then can he take cholesterol-lowering drugs to get his LDL
    and HDL to a desirable level and then his only problem is an elevated triglyceride level which will
    pre-dispose him to type-2 diabetes?
     
  7. Stuart

    Stuart Guest

    High tryglycerides are not a cause but a symptom of the metabolic processes involved in developing
    type 2 diabetes. My history is not unlike that of your friend. My fther died of a heart attack at
    53, I developed high blood pressure and high triglycerides in my mid-30s. Despite the fact that I
    was not overweight, was very active physically, and ate a reasonably healthy diet by the standards
    of the American Heart Association, I had a poor HDL to LDL ratio.

    I was put on Lopid, Questran, and told to eat a low fat diet. My doctor considered me her model
    patient because of my compliance with the recommended diet. I was diagnosed with diabetes at 52. I
    had moved and changed doctors in the intervening years. My new doctor suggested I try the low carb
    diet described in the Protein Power Life Plan by Michael and Mary Eades. I have been on the low carb
    for 3 1/2 years. My blood sugar is normal (HgbA1C low 5s), my HDL to LDL ratio is good, my
    triglycerides run around 100.

    Your friend has a chance to make a real difference in his long term health. Al is right about the
    fact that he should have his fasting insulin level checked. I believe the four essential
    measurements are HgbA1C, fasting insulin, C reactive protein, and homocysteine.

    Having read lots and lots of research papers I'm convinced that impaired glucose processing is the
    primary cause of heart disease. A significant secondary factor is B vitamin deficiency.

    I eat a low carb diet with less than 40 grams of carbs a day. I eat lots of low carb geen
    vegetables: leaf lettuce, broccoli, asparagus. Plenty of mono saturated fats, avocados and olive
    oil. I take 3 tablespoonfuls of cod liver oil each day. Cod liver oil brought my triglycerides down
    more than Lopid ever did.

    There is a lot of hysterical opposition to low carb diets. It seems to come mostly from people who
    have never tried it. Beside the book I mentioned earlier I think Barry Sears of the Zone diet has
    some good ideas.

    Leaving this problem go until diabetes develops or a heart attack happens is not a good approach.
    People who suffer the metabolic impairment that causes diabetes benefit by coming to grips with the
    problem sooner rather than later.

    Wishing good health,

    Stuart


    In article <[email protected]>, Myo Cardium <[email protected]> wrote:

    > Will high triglyceride levels eventually lead to insulin resistance and hence will result in Type
    > 2 diabetes?
    >
    > I mean, could anyone develop type 2 this way if for some reason their metabolism keeps blood
    > triglyceride levels high?
    >
    > Getting back to my buddy, he is by no means over-weight and it's not like he's constantly eating
    > junk food. Should he get a home glucose tester?
    >
    > Is diabetes the worst - or most likely - outcome of persistent high tryglyceride levels vs
    > coronary artery occlusion?
    >
    > Are triglycerides the same as (bad) cholesterol? I mean, can you have high triglcerides and still
    > have the desired levels of HDL and LDL??? If so, then is coronary artery health tied independently
    > to triglyceride levels - or cholesterol?
    >
    > Basically what I'm trying to determine is that if he continues to eat his regular diet (ok, maybe
    > some omega-3 stuff and flax thrown in), then can he take cholesterol-lowering drugs to get his LDL
    > and HDL to a desirable level and then his only problem is an elevated triglyceride level which
    > will pre-dispose him to type-2 diabetes?
     
  8. Myo Cardium <[email protected]> wrote in message news:<[email protected]>...
    > Will high triglyceride levels eventually lead to insulin resistance and hence will result in Type
    > 2 diabetes?

    He may be at higher risk for it especially if there are other findings to suggest metabolic
    syndrome (MetS).

    > I mean, could anyone develop type 2 this way if for some reason their metabolism keeps blood
    > triglyceride levels high?

    See above.

    > Getting back to my buddy, he is by no means over-weight and it's not like he's constantly eating
    > junk food. Should he get a home glucose tester?

    A male whose height is 6ft ideally should weigh 160 lbs. Being that he is 195 lbs in your original
    post, he might be overweight. He could be carrying the fat around his organs (visceral adiposity) so
    that he does not look overweight. What is his weight circumference?

    > Is diabetes the worst - or most likely - outcome of persistent high tryglyceride levels vs
    > coronary artery occlusion?

    If your friend has MetS, the high triglycerides increases risk of occlusive coronary disease (heart
    attacks) and cerebrovascular disease (strokes).

    > Are triglycerides the same as (bad) cholesterol?

    No.

    > I mean, can you have high triglcerides and still have the desired levels of HDL and LDL???

    Yes. However, with MetS, HDL is usually also low.

    > If so, then is coronary artery health tied independently to triglyceride levels - or cholesterol?

    See above.

    > Basically what I'm trying to determine is that if he continues to eat his regular diet (ok, maybe
    > some omega-3 stuff and flax thrown in), then can he take cholesterol-lowering drugs to get his LDL
    > and HDL to a desirable level and then his only problem is an elevated triglyceride level which
    > will pre-dispose him to type-2 diabetes?

    See above.

    Humbly,

    Andrew

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    http://www.heartmdphd.com/
     
  9. Oldal4865

    Oldal4865 Guest

    Myo Cardium wrote in message <[email protected]>...
    >Will high triglyceride levels eventually lead to insulin resistance and hence will result in Type 2
    >diabetes?
    >
    >I mean, could anyone develop type 2 this way if for some reason their metabolism keeps blood
    >triglyceride levels high?
    >
    >Getting back to my buddy, he is by no means over-weight and it's not like he's constantly eating
    >junk food. Should he get a home glucose tester?
    >
    >Is diabetes the worst - or most likely - outcome of persistent high tryglyceride levels vs coronary
    >artery occlusion?
    >
    >Are triglycerides the same as (bad) cholesterol? I mean, can you have high triglcerides and still
    >have the desired levels of HDL and LDL??? If so, then is coronary artery health tied independently
    >to triglyceride levels - or cholesterol?
    >
    >Basically what I'm trying to determine is that if he continues to eat his regular diet (ok, maybe
    >some omega-3 stuff and flax thrown in), then can he take cholesterol-lowering drugs to get his LDL
    >and HDL to a desirable level and then his only problem is an elevated triglyceride level which will
    >pre-dispose him to type-2 diabetes?

    You've got the cart before the horse. When discussing Insulin Resistance and Type 2 diabetes, high
    triglycerides are a "result" not a "cause".

    Insulin Resistance is a common cause (not the only cause) of high triglycerides.

    However, Coronary Artery health is totally enmeshed in the overall subject,
    i.e.:

    1. High triglycerides damage arteries

    2. High insulin levels which accompany Insulin Resistance damage arteries.

    3. High LDL which **tends** to follow Insulin Resistance and diabetes damages arteries.

    4. High blood sugars which accompany the diabetes which often results from long term Insulin
    Resistance damages arteries.

    5. High blood pressure which accompanies Insulin Resistance-damaged arteries also, by itself,
    "encourages" premature heart attack. (I don't know how that one works, btw)

    One fact which I don't know how to fit into the above answer: a high triglycerides to HDL ratio is
    very dangerous. A high ratio, above 3.0 means that certain lipids (LDL I think) are small sized, and
    therefore very dangerous. The small-sized ones are more prone to depositing in the arteries,
    oxidizing, and "sticking forever".

    Triglycerides are not the same as cholesterol. The principal components of a Lipid Panel are "Total
    Cholesterol, High Density Lipids (HDL), Low Density Lipid (LDL), Very Low Density Lipid (VLDL) and
    Triglycerides. I'm not qualified to give a lecture on them, I just know which are the bad ones (LDL,
    VLDL, triglycerides) and what I should do to minimize them.

    One can hope to fight the coronary artery damage by attacking the symptoms of high Insulin
    Resistance. The anti-high triglycerides meds (flax, niacin, fish oil) combined with the anti-
    cholesterol statins help. However, high levels of circulating insulin which accompany high Insulin
    Resistance will cause sufficient damage to cause premature heart attack all by themselves.

    It is in his best interest to find out if he has high Insulin Resistance and if he has it, attack
    it with the diet/exercise/fat loss/muscle gain tricks. If nobody will write the lab orders to test
    for high Insulin Resistance, then he ought to embrace the lifestyle changes anyway. The penalties
    are too severe to take chances.

    It makes perfect sense to use all the weapons simultaneously: anti-triglycerides meds, anti-
    cholesterol meds, and metformin anti-Insulin Resistance meds. However, few docs will treat high
    Insulin Resistance by itself. They tend to want to see something wrong with the glucose
    metabolism (diabetes or pre-diabetes) before prescribing the anti-Insulin Resistance meds
    metformin, Actos or Avandia.

    Insulin Resistance and Type 2 diabetes are genetic problems. Looking at a person's body and eating
    habits is not enough though abdominal fat is a strong indicator. Some men have problems when they go
    from 300 to 350 lb; some when they go from 160 to 180 lb.

    Of course, diabetes and Insulin Resistance aren't the only causes of high triglycerides:

    http://www.cholesterol-and-triglycerides.com/html/causes-and-effects.php3

    http://www.all-about-lowering-cholesterol.com/causes-of-high-triglycerides.h tml

    but they are a marker for High Insulin Resistance and Diabetes. When you bring up such topics on
    Diabetes Newsgroups, you tend to get a lot of diabetes/Insulin Resistance answers cause that's all
    must of know about the subject.

    Keep on digging. Good luck.

    Regards
    Old Al
     
  10. Alan

    Alan Guest

    On 18 Nov 2003 12:01:51 -0800, [email protected] (Dr. Andrew B.
    Chung, Mu-D/PhD) wrote:

    >Dr. Andrew B. Chung, MD/PhD Board-Certified Troll http://www.heartm-un.com/

    Duh!

    I did it again! I read all this before checking the sig. I have to remember to check the headings on
    threads like this for cross-postings.

    DFTT

    Cheers Alan, T2, Oz dx May 2002, diet and not enough exercise.
    --
    Everything in Moderation - Except Laughter.
     
  11. oldal4865 wrote:

    > oldal4865 wrote in message ...
    > >
    > >Myo Cardium wrote in message <[email protected]>...
    > >>
    > >>Buddy of mine (mid-30's, male, recent ex-smoker, 6ft, 195 lbs) has come back with triglyceride
    > >>numbers between 400 and 700 . . .(snip). . .
    >
    > >>OR, if the only consequence of an uncontrolled diet is high tryglycerides (but normal
    > >>cholsterol) then is that a bad thing? Are there any medications that can reduce tryglceride
    > >>levels?
    > >>
    > >>Please post any responses. Thanx.
    > >
    > >
    > >
    > > ". . . .No symptoms of diabetes that I am aware of. . ."
    > >
    > > Well, he has at least one symptom of diabetes, high triglycerides.
    > >
    > >. . .(snip). .> Some over the counter self-treatments for high triglycerides are:
    > >
    > > a. one gram of fish oil 3 - 5 times a day. For triglycerides that high, 5 times a day is
    > > better.
    > >
    > > b. Flax seed ( note, he's not looking for the Flax Oil!. It's the outer casing of the seed he
    > > wants!)
    > >
    > > c. Time-release, (over the counter) niacin. 500 mg, taken twice a day.
    > >
    > >There are at least two prescription meds. Statins and Lopid work.
    > >
    > > http://www.reducetriglycerides.com/Bstdtreatment.htm
    > >
    > >Metformin is an anti-Insulin Resistance med which would help reduce any
    > high
    > >Insulin Resistance.
    > >
    > >Good thing he's concerned. His father's early death and those lousy triglycerides indicate things
    > >don't go well genetically in his family. Best to get right after the problem when he's young.
    > >
    > >If they detect high Insulin Resistance, the lifestyle change which he needs is:
    > >
    > > a. Lose fat lb, especially around the abdomen
    > > b. Gain muscle lb
    > > c. Exercise vigorously every day. Daily is very important.
    > > d. Ration his daily carbohydrate, eat slowly digesting carbohydrate, split the daily carb
    > > over several small meals.
    > >
    > > Regards
    > > Old Al
    > >
    > >
    >
    > Oops! Little bit of a brain f*rt there. . .lots of "hows" , no "whys" or "who says so"
    >
    > 1. McGowan, Mary P. M.D. "50 Ways to Lower Your Cholesterol" says so (she's a cardiologist)
    >
    > 2. The cardiologist who advises my diabetic support group says so.
    >
    > 3. I say so (hey, I tried it and it worked)
    >
    > 4. Sadly, the big "WHY"
    >
    > WHY would you want to do this stuff?
    >
    > To avoid early heart attack!
    >
    > High triglycerides are a killer!
    >

    Specifically in the context of MetS. The 2PD approach is an safe way to permanently lose fat weight
    (central adiposity) in this context, ime.

    Use the pubmed links at HeartMDPhD.com if you want to look up the studies that establish
    triglycerides as a CAD risk factors in folks with MetS.

    Humbly,

    Andrew

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    http://www.heartmdphd.com/
     
  12. Jim Horne

    Jim Horne Guest

    "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote in message
    news:[email protected]...

    <snip>

    : The 2PD approach is an safe way to permanently lose fat weight (central adiposity) in this
    : context, ime.
    :

    speaking of diets:

    Four Popular Diets Equally Effective for Weight Loss

    Nov. 10, 2003 (Orlando) - In a randomized study comparing four popular diets over the course of a
    year, all diets demonstrated efficacy for weight loss and reduction of Framingham risk scores, but
    only the Atkins, Weight Watchers, and Zone diets achieved statistically significant reductions in
    Framingham scores, according to results presented here at the American Heart Association (AHA)
    Scientific Sessions.

    "Losing 20 pounds corresponded to about a 30% reduction in heart risk score," said Michael L.
    Dansinger, MD, assistant professor of medicine at Tufts University, New England Medical Center, in
    Boston, Massachusetts. Although he explained that at this point "it isn't clear if a 30% reduction
    in risk score is the same as a 30% reduction in heart attacks." Dr. Dansinger presented his results
    at an AHA press conference.

    (requires MedScape account)

    http://www.medscape.com/viewarticle/464193

    Oh and please remind me just how many research studies has the 2PD been subjected to? and where can
    one find the published data?
     
  13. Stuart wrote:

    > High tryglycerides are not a cause but a symptom of the metabolic processes involved in developing
    > type 2 diabetes. My history is not unlike that of your friend. My fther died of a heart attack at
    > 53, I developed high blood pressure and high triglycerides in my mid-30s. Despite the fact that I
    > was not overweight, was very active physically, and ate a reasonably healthy diet by the standards
    > of the American Heart Association, I had a poor HDL to LDL ratio.
    >

    Were you at "ideal" body weight (BMI=20)?

    >
    > I was put on Lopid, Questran, and told to eat a low fat diet. My doctor considered me her model
    > patient because of my compliance with the recommended diet. I was diagnosed with diabetes at 52. I
    > had moved and changed doctors in the intervening years. My new doctor suggested I try the low carb
    > diet described in the Protein Power Life Plan by Michael and Mary Eades. I have been on the low
    > carb for 3 1/2 years. My blood sugar is normal (HgbA1C low 5s), my HDL to LDL ratio is good, my
    > triglycerides run around 100.
    >
    > Your friend has a chance to make a real difference in his long term health. Al is right about the
    > fact that he should have his fasting insulin level checked. I believe the four essential
    > measurements are HgbA1C, fasting insulin, C reactive protein, and homocysteine.
    >

    HgbA1C probably obviates the utility of fasting insulin. C reactive protein (CRP) should be hsCRP.
    Homocysteine should be checked when someone shifts to a high protein diet. Kidney function and uric
    acid levels should probably also be monitored if one opts to go high protein. Ime, the 2PD approach
    is simpler given these considerations.

    >
    > Having read lots and lots of research papers I'm convinced that impaired glucose processing is the
    > primary cause of heart disease. A significant secondary factor is B vitamin deficiency.
    >
    > I eat a low carb diet with less than 40 grams of carbs a day. I eat lots of low carb geen
    > vegetables: leaf lettuce, broccoli, asparagus. Plenty of mono saturated fats, avocados and olive
    > oil. I take 3 tablespoonfuls of cod liver oil each day. Cod liver oil brought my triglycerides
    > down more than Lopid ever did.
    >
    > There is a lot of hysterical opposition to low carb diets. It seems to come mostly from people who
    > have never tried it.

    The opposition comes from concerns that "unbalanced" diets would lead to more cancer, heart disease,
    and renal disease. These concerns arise not from "not trying the low carb diets" but from scientific
    considerations.

    > Beside the book I mentioned earlier I think Barry Sears of the Zone diet has some good ideas.
    >
    > Leaving this problem go until diabetes develops or a heart attack happens is not a good approach.

    There are "safer" ways to lose weight, however.

    > People who suffer the metabolic impairment that causes diabetes benefit by coming to grips with
    > the problem sooner rather than later.
    >

    That they do.

    >
    > Wishing good health,
    >
    > Stuart

    Thank you for your comments.

    Humbly,

    Andrew

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    http://www.heartmdphd.com/
     
  14. oldal4865 wrote:

    > Myo Cardium wrote in message <[email protected]>...
    > >Will high triglyceride levels eventually lead to insulin resistance and hence will result in Type
    > >2 diabetes?
    > >
    > >I mean, could anyone develop type 2 this way if for some reason their metabolism keeps blood
    > >triglyceride levels high?
    > >
    > >Getting back to my buddy, he is by no means over-weight and it's not like he's constantly eating
    > >junk food. Should he get a home glucose tester?
    > >
    > >Is diabetes the worst - or most likely - outcome of persistent high tryglyceride levels vs
    > >coronary artery occlusion?
    > >
    > >Are triglycerides the same as (bad) cholesterol? I mean, can you have high triglcerides and still
    > >have the desired levels of HDL and LDL??? If so, then is coronary artery health tied
    > >independently to triglyceride levels - or cholesterol?
    > >
    > >Basically what I'm trying to determine is that if he continues to eat his regular diet (ok, maybe
    > >some omega-3 stuff and flax thrown in), then can he take cholesterol-lowering drugs to get his
    > >LDL and HDL to a desirable level and then his only problem is an elevated triglyceride level
    > >which will pre-dispose him to type-2 diabetes?
    >
    > You've got the cart before the horse. When discussing Insulin Resistance and Type 2 diabetes,
    > high triglycerides are a "result" not a "cause".
    >
    > Insulin Resistance is a common cause (not the only cause) of high triglycerides.
    >
    > However, Coronary Artery health is totally enmeshed in the overall subject,
    > i.e.:
    >
    > 1. High triglycerides damage arteries
    >
    > 2. High insulin levels which accompany Insulin Resistance damage arteries.
    >
    > 3. High LDL which **tends** to follow Insulin Resistance and diabetes damages arteries.
    >
    > 4. High blood sugars which accompany the diabetes which often results from long term Insulin
    > Resistance damages arteries.
    >
    > 5. High blood pressure which accompanies Insulin Resistance-damaged arteries also, by itself,
    > "encourages" premature heart attack. (I don't know how that one works, btw)
    >
    > One fact which I don't know how to fit into the above answer: a high triglycerides to HDL ratio is
    > very dangerous. A high ratio, above 3.0 means that certain lipids (LDL I think) are small sized,
    > and therefore very dangerous. The small-sized ones are more prone to depositing in the arteries,
    > oxidizing, and "sticking forever".
    >
    > Triglycerides are not the same as cholesterol. The principal components of a Lipid Panel are
    > "Total Cholesterol, High Density Lipids (HDL), Low Density Lipid (LDL), Very Low Density Lipid
    > (VLDL) and Triglycerides. I'm not qualified to give a lecture on them, I just know which are the
    > bad ones (LDL, VLDL, triglycerides) and what I should do to minimize them.
    >
    > One can hope to fight the coronary artery damage by attacking the symptoms of high Insulin
    > Resistance. The anti-high triglycerides meds (flax, niacin, fish oil) combined with the anti-
    > cholesterol statins help. However, high levels of circulating insulin which accompany high Insulin
    > Resistance will cause sufficient damage to cause premature heart attack all by themselves.
    >
    > It is in his best interest to find out if he has high Insulin Resistance and if he has it, attack
    > it with the diet/exercise/fat loss/muscle gain tricks. If nobody will write the lab orders to
    > test for high Insulin Resistance, then he ought to embrace the lifestyle changes anyway. The
    > penalties are too severe to take chances.
    >
    > It makes perfect sense to use all the weapons simultaneously: anti-triglycerides meds, anti-
    > cholesterol meds, and metformin anti-Insulin Resistance meds. However, few docs will treat high
    > Insulin Resistance by itself. They tend to want to see something wrong with the glucose metabolism
    > (diabetes or pre-diabetes) before prescribing the anti-Insulin Resistance meds metformin, Actos or
    > Avandia.
    >
    > Insulin Resistance and Type 2 diabetes are genetic problems. Looking at a person's body and eating
    > habits is not enough though abdominal fat is a strong indicator. Some men have problems when they
    > go from 300 to 350 lb; some when they go from 160 to 180 lb.
    >

    Fwiw, I have never seen anyone at "ideal" body weight (BMI=20) develop Type 2 diabetes.

    Humbly,

    Andrew

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    http://www.heartmdphd.com/
     
  15. "Jim Horne" <[email protected]> wrote in message news:<[email protected]>...
    > "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote in message
    > news:[email protected]...
    >
    > <snip>
    >
    > : The 2PD approach is an safe way to permanently lose fat weight (central adiposity) in this
    > : context, ime.
    > :
    >
    > speaking of diets:
    >
    > Four Popular Diets Equally Effective for Weight Loss
    >
    > Nov. 10, 2003 (Orlando) - In a randomized study comparing four popular diets over the course of a
    > year, all diets demonstrated efficacy for weight loss and reduction of Framingham risk scores, but
    > only the Atkins, Weight Watchers, and Zone diets achieved statistically significant reductions in
    > Framingham scores, according to results presented here at the American Heart Association (AHA)
    > Scientific Sessions.
    >
    > "Losing 20 pounds corresponded to about a 30% reduction in heart risk score," said Michael L.
    > Dansinger, MD, assistant professor of medicine at Tufts University, New England Medical Center, in
    > Boston, Massachusetts. Although he explained that at this point "it isn't clear if a 30% reduction
    > in risk score is the same as a 30% reduction in heart attacks." Dr. Dansinger presented his
    > results at an AHA press conference.
    >
    >
    > (requires MedScape account)
    >
    >
    > http://www.medscape.com/viewarticle/464193
    >
    >
    > Oh and please remind me just how many research studies has the 2PD been subjected to? and where
    > can one find the published data?

    As many as the "commercial" diets mentioned in your citation at their inception.

    The 2PD approach is as obvious a concept as the "wheel."

    Was there ever a study to show the wheel works?

    Think about it.

    God's humble bond-servant,

    Andrew

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    http://www.heartmdphd.com
     
  16. Alan <[email protected]> wrote in message
    news:<[email protected]>... <fabricated material snipped>

    I'm sure the original poster appreciated your contribution.

    FYI Note: I am aware that I am responding to a cross-posted message. Because the author of the
    message to which I am responding did not request that the header be trimmed, I have not trimmed it.
    If you are upset about reading this message, a few suggestions:

    (1) Yell at Alan
    (2) Report Alan to his ISP for violating their TOS with his fabricated post.
    (3) Killfile this thread.
    (4) Killfile me.
    (5) Read about free speech.

    This discussion(s) is related to the 2 pound diet approach (2PD) which is described completely at:

    http://www.heartmdphd.com/wtloss.asp

    Though Dr. Chung invented this approach, he did not initiate this Usenet discussion(s). His
    participation in this discussion(s) has been voluntary and has been conducted in the spirit of
    community service. His motivation has been entirely altruistic and has arisen from his religious
    beliefs as a Christian. Jesus freely gave of Himself to better the health of folks He touched:

    http://www.heartmdphd.com/healer.asp

    From the outset, it has been clear that there are those who are vehemently opposed to the 2 pound
    diet approach. They have debated
    Dr. Chung on every perceived weakness of the 2 pound diet approach and have lost the argument
    soundly at every point:

    http://www.heartmdphd.com/wtlossfaqs.asp

    These debates are archived on Google in their entirety within this and other discussion threads.

    However, instead of conceding gracefully that they've lost the argument(s), certain parties have
    redirected their hatred of the 2 pound diet approach toward its author. The rationale appears to be
    "if you can not discredit the message then try to discredit the messenger."

    Initially, these folks accused the messenger of "trolling." A "troll" is someone who posts under the
    cloak of anonymity messages with no redeeming discussion value and with the sole purpose of starting
    "flame" wars.

    These hateful folks lost credibility with this accusation when the following observations were made:

    (1) Dr. Chung has not been posting anonymously.
    (2) The 2PD has been on-topic for the Usenet discussion groups hosting the discussion(s).
    (a) Those who are failing low-carbing can dovetail LC with the 2PD to achieve near-
    ideal weight.
    (b) Obese diabetics improve their blood glucose control when their weight becomes near-ideal.
    (c) For (b) see: http://tinyurl.com/levc
    (3) Dr. Chung did not start the discussion(s).
    (4) The 2 pound diet approach is 100% free (no profit motive).
    (5) Dr. Chung's credentials are real and easily verified on-line (including jpegs of the actual
    diplomas).

    Full of hatred, frustration, and desperation, certain individuals have tried to attack Dr.
    Chung's credentials knowing full well that they were attempting to libel him. One notable example
    is Mr. Pastorio:

    http://www.heartmdphd.com/libel.asp

    When the full light was cast on Mr. Pastorio's libelous statements, the hateful folks hiding in the
    darkness of anonymity only hissed louder in support of their fallen hero.

    Fortunately, those who have been following this discussion(s) either actively or as lurkers can
    easily dismiss the hisses, for what they are, using the on-line third-party resources at:

    http://www.heartmdphd.com/profile.asp

    where Dr. Chung's credentials can be verified many times over and libelous claims that credentials
    were bought are easily and summarily debunked.

    Moreover, readers need only make the following observations concerning the anon posters who continue
    to hiss (ie JC Der Koenig and Mack):

    (6) They are anonymous and thus they expect to have no credibility (or accountability).
    (7) They are by their Usenet history courtesy of Google, unsavory characters.
    (8) They have not added anything to the discussion(s) except to deliver one-sided insults.
    (9) They complain about alleged cross-posts from Dr. Chung by cross-posting.
    (10) They do not complain about cross-posts from folks who attack the 2PD or its author.

    and conclude that these anon posters deserve only their kill file.

    It is my hope that the above brings new readers of this thread up to speed.

    It will remain my pleasure to participate here on Usenet above the din of hissing from the
    peanut gallery.

    Sincerely,

    Andrew

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    http://www.heartmdphd.com
     
  17. Stuart

    Stuart Guest

    Andrew,

    I suspect you are right that BMI=20 is a successful formula. There might be exceptions among high
    risk populations like native americans. I spent my adult life up to my late thirties at BMI=20. I
    have no medical records going back to that period in my life so I don't know what my numbers looked
    like. I was running 1600 miles a year and was in superb areobic condition.

    My first existing records are from about a year after I switched from running to bicycling. I was
    still getting more excercise than most Americans but my triglycerides were above 250. Within 5 years
    I also had high blood pressure and 8 years after that I was diabetic. I do have some native American
    ancestory. My BMI=25 at the present time and I am working my way back down toward my running weight.

    You and I both know how rare adults are in America who are non-smokers who have a BMI of 20.

    I have a technical/scientific background and now that I've spent three years reading medical
    research papers I'm shocked at the poor level of experimental design in many of the
    published studies.

    Many of the attacks on low carb diets are less based on science than on dietary religious zeal. I
    will stand by the low carb diet as an excellent way to achieve glycemic control. The health claims
    for a low fat diet are no better grounded in science and yet are subject to far less criticism.

    Regards,

    Stuart

    In article <[email protected]>, Dr. Andrew B. Chung,
    MD/PhD <[email protected]> wrote:

    > oldal4865 wrote:
    >
    > > Myo Cardium wrote in message <[email protected]>...
    > > >Will high triglyceride levels eventually lead to insulin resistance and hence will result in
    > > >Type 2 diabetes?
    > > >
    > > >I mean, could anyone develop type 2 this way if for some reason their metabolism keeps blood
    > > >triglyceride levels high?
    > > >
    > > >Getting back to my buddy, he is by no means over-weight and it's not like he's constantly
    > > >eating junk food. Should he get a home glucose tester?
    > > >
    > > >Is diabetes the worst - or most likely - outcome of persistent high tryglyceride levels vs
    > > >coronary artery occlusion?
    > > >
    > > >Are triglycerides the same as (bad) cholesterol? I mean, can you have high triglcerides and
    > > >still have the desired levels of HDL and LDL??? If so, then is coronary artery health tied
    > > >independently to triglyceride levels - or cholesterol?
    > > >
    > > >Basically what I'm trying to determine is that if he continues to eat his regular diet (ok,
    > > >maybe some omega-3 stuff and flax thrown in), then can he take cholesterol-lowering drugs to
    > > >get his LDL and HDL to a desirable level and then his only problem is an elevated triglyceride
    > > >level which will pre-dispose him to type-2 diabetes?
    > >
    > > You've got the cart before the horse. When discussing Insulin Resistance and Type 2 diabetes,
    > > high triglycerides are a "result" not a "cause".
    > >
    > > Insulin Resistance is a common cause (not the only cause) of high triglycerides.
    > >
    > > However, Coronary Artery health is totally enmeshed in the overall subject,
    > > i.e.:
    > >
    > > 1. High triglycerides damage arteries
    > >
    > > 2. High insulin levels which accompany Insulin Resistance damage arteries.
    > >
    > > 3. High LDL which **tends** to follow Insulin Resistance and diabetes damages arteries.
    > >
    > > 4. High blood sugars which accompany the diabetes which often results from long term Insulin
    > > Resistance damages arteries.
    > >
    > > 5. High blood pressure which accompanies Insulin Resistance-damaged arteries also, by itself,
    > > "encourages" premature heart attack. (I don't know how that one works, btw)
    > >
    > > One fact which I don't know how to fit into the above answer: a high triglycerides to HDL ratio
    > > is very dangerous. A high ratio, above 3.0 means that certain lipids (LDL I think) are small
    > > sized, and therefore very dangerous. The small-sized ones are more prone to depositing in the
    > > arteries, oxidizing, and "sticking forever".
    > >
    > > Triglycerides are not the same as cholesterol. The principal components of a Lipid Panel are
    > > "Total Cholesterol, High Density Lipids (HDL), Low Density Lipid (LDL), Very Low Density Lipid
    > > (VLDL) and Triglycerides. I'm not qualified to give a lecture on them, I just know which are the
    > > bad ones (LDL, VLDL, triglycerides) and what I should do to minimize them.
    > >
    > > One can hope to fight the coronary artery damage by attacking the symptoms of high Insulin
    > > Resistance. The anti-high triglycerides meds (flax, niacin, fish oil) combined with the anti-
    > > cholesterol statins help. However, high levels of circulating insulin which accompany high
    > > Insulin Resistance will cause sufficient damage to cause premature heart attack all by
    > > themselves.
    > >
    > > It is in his best interest to find out if he has high Insulin Resistance and if he has it,
    > > attack it with the diet/exercise/fat loss/muscle gain tricks. If nobody will write the lab
    > > orders to test for high Insulin Resistance, then he ought to embrace the lifestyle changes
    > > anyway. The penalties are too severe to take chances.
    > >
    > > It makes perfect sense to use all the weapons simultaneously: anti-triglycerides meds, anti-
    > > cholesterol meds, and metformin anti-Insulin Resistance meds. However, few docs will treat high
    > > Insulin Resistance by itself. They tend to want to see something wrong with the glucose
    > > metabolism (diabetes or pre-diabetes) before prescribing the anti-Insulin Resistance meds
    > > metformin, Actos or Avandia.
    > >
    > > Insulin Resistance and Type 2 diabetes are genetic problems. Looking at a person's body and
    > > eating habits is not enough though abdominal fat is a strong indicator. Some men have problems
    > > when they go from 300 to 350 lb; some when they go from 160 to 180 lb.
    > >
    >
    > Fwiw, I have never seen anyone at "ideal" body weight (BMI=20) develop Type 2 diabetes.
    >
    > Humbly,
    >
    > Andrew
    >
    > --
    > Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/
     
  18. Mack

    Mack Guest

    On 18 Nov 2003 19:19:38 -0800, [email protected] (Dr. Andrew
    B. Chunk, MD/PhD) wrote:
     
  19. Stuart <[email protected]> wrote in message news:<191120031958428784%[email protected]>...
    > Andrew,
    >
    > I suspect you are right that BMI=20 is a successful formula.

    It is really not a question of right or wrong. Nor is it a formula. It remains my experience that
    lean folks (BMI=20 or less) don't develope type 2 diabetes.

    > There might be exceptions among high risk populations like native americans.

    I can only speak from experience.

    > I spent my adult life up to my late thirties at BMI=20. I have no medical records going back to
    > that period in my life so I don't know what my numbers looked like. I was running 1600 miles a
    > year and was in superb areobic condition.
    >
    > My first existing records are from about a year after I switched from running to bicycling. I was
    > still getting more excercise than most Americans but my triglycerides were above 250.

    What was your BMI?

    > Within 5 years I also had high blood pressure and 8 years after that I was diabetic. I do have
    > some native American ancestory. My BMI=25 at the present time and I am working my way back down
    > toward my running weight.
    >
    > You and I both know how rare adults are in America who are non-smokers who have a BMI of 20.

    The 2PD approach is changing that in my neck of the woods.

    > I have a technical/scientific background and now that I've spent three years reading medical
    > research papers I'm shocked at the poor level of experimental design in many of the published
    > studies.

    Poor experimental design happens in all fields.

    > Many of the attacks on low carb diets are less based on science than on dietary religious zeal. I
    > will stand by the low carb diet as an excellent way to achieve glycemic control.

    Permanent weight loss is a better way of achieving glycemic control.

    > The health claims for a low fat diet are no better grounded in science and yet are subject to far
    > less criticism.

    Low fat diets are actually better grounded in basic science research. Look up "atherogenic diet"
    on pubmed.

    > Regards,
    >
    > Stuart
    >

    Thank you for your comments, Stuart.

    Humbly,

    Andrew

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    http://www.heartmdphd.com
     
  20. Mack wrote:

    > On 18 Nov 2003 19:19:38 -0800, [email protected] (Dr. Andrew
    > B. Chunk, MD/PhD) wrote:

    Having trouble spelling, Mack?

    Humbly,

    Andrew

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    http://www.heartmdphd.com/
     
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