Free the Animal

Triglycerides: 93.5% Reduction in Three Weeks - 3,100 to 202

So there you have it: the punchline, right there in the title.

But who did it, and how? That would be none other than Dr. William Davis, cardiologist. So then, what sort of medical procedure did he perform? What sorts of pharmaceuticals did he prescribe? To what level did he admonish his patient, Daniel, to cut the arterycloggingsaturatedfat and to eat lots more servings of hearthealthywholegrians?

Of course, anyone who actually reads and thinks for themselves -- rather than swallowing the cloistered expert-&-authority-protectionism of conventional "wisdom" -- should know, he did none of those things; which, given the other successes he's blogged about -- some of which I've highlighted here -- exposes most if not all of the "lipid establishment" (i.e., cloistered expert-&-authority-protection racket) as con men: most physicians in that role, all the drug companies, and our beloved (not!) FDA.

Got it? Good, so let's move on.

Since most of you who should know, know, what then, dear supplicant to cloistered expert-&-authority-protection rackets, did Dr. Davis do? I'm glad you asked! It's actually simple: step one is that he "prescribed" 3,600 mg of over-the-counter omega-3 fatty acids per day, i.e., plain ol' fish oil caps. Depending on concentration, that could be anywhere from 5 to 10 1g caps per day, guesstimating. After 10 days, Trigs had dropped from 3,100 to 1,100. Step two was to continue on the OTC fish oil and eliminate wheat, corn starch, and sugar from the diet (in other words: less hearthealthywholegrains, more arterycloggingsaturatedfat). This took him from 1,100 to 202 in another 10 days.

Daniel, a sufferer of what's known as familial hypertriglyceridemia, now has lower Trigs than whole bunches of people walking about without such a genetic disorder. For those who don't know, triglycerides are fat circulating in your blood. The more hearthealthwholegrains and sugar you eat, the higher will be your triglyceride levels. The more arterycloggingsaturatedfat you eat, the less will be your levels. Almost all paleo and low-carb eaters have levels less than 100, and most of us hang out in a range of 40-60. I believe the average in the US is around 150 or so, and climbing (all while the cloistered expert-&-authority-protection racket claps and cheers over irrelevant, non-associated lower LDL levels). Lots of people are walking around at 400 and higher. But, hey, they lowered their LDL by eating lots of hearthealthywholegrains, and thus helping out Big Agra, who, in gracious turn, helps the cloistered expert-&-authority-protection racket. It's all quite cozy, incestuous...and insanely profitable.

High triglycerides are bad, very bad, and in my opinion, far worse than "elevated" serum cholesterol (lipoproteins). High triglycerides are well associated with death from heart disease, while half of those who die from heart disease have low cholesterol and half have high cholesterol.

Well, that about sums up the story (but not the rant), so the rest is devoted to Dr. Davis himself, who tells the brief story here and here.

I am continually surprised at the number of people with high triglycerides who are still treated with a fibrate drug, like Tricor, or a statin drug, when fish oil -- widely available, essentially free of side-effects, with a proven cardiovascular risk-reducing track record --should clearly be the first choice by a long stretch.

Could Dr. Davis be referring to his own colleagues in the medical profession -- most, probably?

Uh, yep:

Unfortunately, most of my colleagues, if they even think to use omega-3s, choose to use the prescription form, Lovaza. Indeed, several representatives from AstraZeneca, the pharmaceutical outfit now distributing this miserably overpriced product, frequently barge their way into my office poking fun at our use of nutritional supplements instead of the prescription Lovaza. "But insurance covers it in most cases!" they plead. "And your patients will know that they're getting the real product, not some fake. And they'll have to take fewer capsules!"

Dr. Davis has previously blogged about the Lovaza rip off; punchline: $3,600 per year vs. $150 per year (all while so many in America clamor to have everyone pay for everyone else's "health" care...).

He says further:

I never use Lovaza to reduce triglycerides, even in familial hypertriglyceridemia -- the FDA-approved indication for Lovaza -- and have not yet seen any failures, only successes.

Good for Daniel, and good for the heroic Dr. Davis, who gives a great prognosis.

He's got just a little further to go to achieve the biologically ideal level of less than 60 mg/dl. You can see that it is not really that difficult--provided someone didn't load you down with nonsense about "cutting your fat," or statin or fibrate drugs.

And guess what, on a related topic? I just heard from a very well respected health blogger in email that a guy who'd contacted him about fatty liver disease got his enzymes back to normal in a single month. This, after 9 whole years of a fatty liver. What advice did this health blogger give him? Drop the sugar, vegetable oils, and take fish oil.

Let's be clear who the enemies are in all this: many of Dr. Davis' colleagues, all pharmaceutical companies, the FDA, and the whores in the mainstream media who can't wait to bend over for each and every one of the foregoing as often as they possibly can.

You didn't hear that here first, but you'll hear it often.

What A "Sterling" Transformation!

Well, I do not believe I've ever seen such a profound change, by which I mean a virtual reprogramming of this guy's genes.

This was reported to Mark Sisson, and I'll just let the pictures speak for themselves, as well as motivate you to go read Sterling's amazing story over at Mark's Daily Apple.

Now, any doubt left that The Primal Blueprint is the new go-to resource for all things primal and paleo?

Mom Rings In: "Amazing Results"

I last reported on my mom (68, type 2) getting off insulin injections in March. The benefits of the paleo lifestyle continue to stack up, now seeming to ease arthritis pain, as well as nerve damage in the feet from going undiagnosed as a type 2 for so long.

~~~

I don't know if it is removing grains, sugars, vegetable oils, etc. from my diet, or the supplements I am now taking, or a combination, but I am getting amazing results that I didn't even think about at the time I started.  Even though I take medication for rheumatoid arthritis I still had some pain.  I tried and succeeded in keeping the Methotrexate at a low dosage because of the damage it can cause to the liver.  I was willing to live with some pain and did not allow it to alter my lifestyle.  I always had some pain in my lower legs and feet, my knees, my hips, my shoulders and neck, and my hands, especially my thumbs.  I had additional pain in my feet caused from nerve damage from diabetes.  Several of my toes were actually frozen. I couldn't move them except with my hand.  They always hurt.

Well, I still have nerve damage in my feet but there is little pain, just kind of a feeling like some of the toes are tingly.  I do not have complete movement back yet, but a measurable improvement, especially on my left foot.  I can actually separate all the toes without using my hand, just by wanting to.  My right foot is improving but at a slower rate.  It was the worst of the two so that is understandable.  I don't have pain  in the rest of my body.

I should be able to get off the oral diabetic meds within the next couple of months.  After that I will try to get rid of the meds for arthritis.  It is scary, because if it doesn't work it is 3 months of total and complete hell.  But I am going to try it.  I want to be on the supplements and the paleo program for a while longer before I do.

Thank you, thank you, thank you.

~~~

Well, what can I say? 

Nothing Like a Picture - Reader Transformation

Tim Ranitsch, featured in this former post, send me a couple of photos. On the left is his much larger self at 225 and on the right, at 170. While he lost most of his weight doing a standard dieting approach, he reports feeling much better and more natural on the paleo path the last nine months.

It never ceases to amaze me how getting down to a normal weight transforms a person's face. Great job, Tim, even if you used conventional dieting (starvation and food obsession) to get there. Now you're in a great place for life.

Reader Feedback - Doctors and Cholesterol

First up, an email from Robert, who'll become a medical doctor in under a week. He must be completely thrilled, eh?

~~~

Just wanted to say hello. I’ve been a regular reader for several months now and thought I should take a moment to introduce myself. My name is Robert and I will be an MD in about six days. I’ll be starting an internal medicine residency in Reno, NV in July. I am both excited and nervous about starting, nervous largely because my patience with “modern” medicine is in rapid decline and I have three years of attending physicians to deal with. Yes, Richard, all of the doctors I have worked with personally approach health and nutrition in as mindless a manner as you think and often rant about.

~~~

I know, Robert, and isn't it the damnedest thing? Here you spend all that time, money and effort -- all the while enduring an enormous burden in terms of mental and physical stress and fatigue -- and it would certainly be an appropriate reward to be held in the sort of superman high esteem doctors have traditionally and often deservedly been held.

But I think it's safe to say that owing to the Internet, with its legions of people like me who deal in facts, logic and principles -- and not so much in titles, degrees and positions -- that we're in a situation where the gig is up. Doctors have largely squandered the goodwill they've earned over a century of hard, dedicated, lifesaving work. Thankfully, there are a growing number of docs like your very-soon-to-be self who have come to see the light. It's going to be an uphill battle for a long time.

For instance, Tim, another reader, sent me his lipid panel for comment. Though I don't expect you to comment, Robert, I have an idea that you would interpret it far differently from Tim's doctor. So, as frustrating as it is, this is a step in the right direction. There's that.

~~~

February, 2008, 225 lbs, years on the Standard American Diet:

Total 173
Trig 109
HDL 60
LDL (calc) 91
VLDL 22
Ratio 2.9

July, 2008, 160 lbs, through calorie counting, semi starvation, yet semi-low carb:

Total 145
Trig 38
HDL 69
LDL (calc) 68
VLDL 8
Ratio 2.1

Been going Paleo(!) since Sept 08, intermittent fasting, 3 days a week lifting hard efforts, sprints, eating tons of meat! Actually heading down the road for 90 days of meat only (2+ weeks in right now) so I did another panel:

May 1, 2009, 170 lbs, more muscle!

Total 226
Trig 34
HDL 82
LDL (calc) 137
VLDL 7
Ratio 2.8

Should I be concerned of the rise in Total and LDL?  From what I've read on your blog, Dr. Eades, and other sources, I don't think so.  I am more fearful of the 145 total number (cancer! etc) than the 226!  But my doctor is of the opposite opinion.

~~~

His doctor is of the opposite opinion, but why? Has the doctor been reading Eades, Davis, Sears, Briffa, or the many others out there and concluded that they are wrong? I doubt it. Tim's doctor is probably what I now refer to as a "regurgitator," i.e., as applied to the medical profession: someone who is trained to expertly diagnose and treat in accordance with conventional "wisdom," right or wrong. My non-medical opinion is that we ought to be cheering his great success in improving his health in a way that reflects every well done study and observation of this sort of thing I've seen.

For example, his C-reactive protein was .3 (a "BTW" in another part of his email), where "normal" is < 3 mg/l. This is a strong marker for inflammation -- the very thing that small, dense LDL acts upon to cause heart disease. Also, the ratios they have given Tim are of Total/HDL, which remain steady, as his HDL went from 60 to 82 (all the while you hear great cheering amongst the ignorant masses when someone goes from 45-50 and credits oatmeal or Cheerios). Normal for that ratio is 4-6, because grain and sugar eaters have such miserably low HDL. Ideal is 2-3. Mine was 2.1, so was my wife's, thereabouts, so there's three data points on that for Paleo: IDEAL.

The more important ratio by far, in my opinion, is Trigs/HDL. This is one of the biggest associations with cardiovascular disease (CVD). Again, grain and sugar eaters have abysmally low HDL (the thing that carries oxidized LDL out of your arteries and back to the liver for recycling) combined with elevated triglycerides, which is dissolved fat in the blood. Yes, ironic, isn't it? You want low levels of circulating fat in your blood? Replace grain and sugar with fat in your diet and the very first thing that will happen is that your Trigs (fat in your blood) drop precipitously. Guaranteed.

Tim went from a decent level of 109 ("normal" is considered < 150, but that's only because it's based on normal for grain and sugar eaters) to a whopping low of 34. Of course, he did it by replacing crap in his diet (grain and sugar) with real food like animals and their fat. 

Now, in case you're suspicious about the veracity of this Trig/HDL ratio being of prime importance, there's a lot out there. How about this, a 1990 (!) interview with then director of the massive, long-term Framingham Heart Study, Dr. William Castelli.

"There's a subgroup of people who have an HDL under 40 and triglycerides over 150," he explains. "These people have galloping proression of their cholesterol deposits, which will eventually lead to heart disease, and the average physician is not picking it up."

You can read the whole interview.

So, what did Tim's Trig/HDL ratio do while progressing from SAD to Paleo? It went from 1.8, which is on the very low side of ideal (< 2), to .4, which is on the screaming bleeding high side of ideal. Mine is also .4, so is my wife's, thereabouts, so three more data points for ya. Tim achieves a 4.5 magnitude improvement on his Trig/HDL ratio.

I wonder what Cheerios would have done for him.

But that's not all. His LDL is calculated, and rather than rehashing the pitfalls of calculated LDL, I'll just refer you to my 2-part series: What Do You Think You Know About LDL Cholesterol? (part 1; part 2). For another reference, here's how LDL ought to be measured: NMR LippoProfile.

But what can we glean from the information provided? Well, it turns out that the Trig/HDL ratio is a reasonable marker for LDL particle size. Remember, and you can find out more here, but small & dense LDL particles are the real danger. Guess what else? grains and sugar give you a profile where most of your LDL is small and dense, while a high fat (natural, i.e., animal) diet gives you LDL that's large and fluffy, which is inversely associated with CVD, so far as I can tell.

Ratio of Triglycerides to HDL Cholesterol Is an Indicator of LDL Particle Size in Patients With Type 2 Diabetes and Normal HDL Cholesterol Levels

RESULTS — Clinical characteristics, pharmacological therapies, lifestyle, and prevalence of diabetes-related complications were similar in both patient groups. LDL size correlated negatively with plasma triglycerides (TGs) (R2= 0.52) and positively with HDL cholesterol (R2=0.14). However, an inverse correlation between the TG–to–HDL cholesterol molar ratio and LDL size was even stronger (R2= 0.59). The ratio was >1.33 in 90% of the patients with small LDL particles (95% CI 79.3–100) and 16.5% of those with larger LDL particles. A cutoff point of 1.33 for the TG–to–HDL cholesterol ratio distinguishes between patients having small LDL values better than TG cutoff of 1.70 and 1.45 mmol/l.

Let's unpack this, and by the way, while this may look incomprehensible to many of you, do know that a couple of years ago it would have been to me too. I can only encourage you to persevere. You can develop an ability to pretty well understand this stuff. Yes, consult a doctor (hopefully one like new-doc Robert), but go in knowing and understanding what you're talking about. If a doctor is ever offended by your accumulated knowledge and insistence on questions and clear explanations, you need to find a new one.

• LDL size correlated negatively with plasma triglycerides: higher Trigs = smaller LDL particles (bad)
• ...and positively with HDL cholesterol: lower HDL = smaller LDL particles (bad)
• However, an inverse correlation between the TG–to–HDL cholesterol molar ratio and LDL size was even stronger: the ratio is even more important, i.e., the higher the ratio, the smaller (badder) the LDL particles. Stunningly striking: 90% of those with small dense LDL (bad bad bad) had a Trig/HDL ratio greater than 1.33.

So, what's an average Trig/HDL ratio? I don't have time to look up averages and verify sources, but let's just assume an "on the edge" level for both Trigs (150) and HDL (40). 

That's a whopping ratio of 3.75, well above that 1.33 "cutoff"!!! So, if you present to your medical professional with better-than-"normal" triglycerides of 149 and HDLs of 41, he's going to give you a big high 5, and tell you you're on the right track. He's probably not going to even measure your C-reactive protein to determine inflammation markers, nor your Lipoprotein(a), or even homocysteine. And Tim? Before his transformation? Even with a very moderate Trig level by "normal" standards, he had a ratio of 1.8, well over that 1.33 "cutoff" between likely (with 90% confidence) small dense LDL and large fluffy. And now, at .4? Fergettaboutit. He's going to have an NMR per a subsequent email, but I can already tell you what it's going to show.

[Late edit: Note that as commenter below, GoEd, has correctly pointed out, that 1.33 ratio is based on European units for Trigs and cholesterol, i.e., mmol/l instead of mg/dl. That would all be fine and good, but Trigs and cholesterol convert differently. Dumb mistake, as I've made these conversions a number of times. So, at any rate, the ratio for Trigs and cholesterol based upon mg/dl is about 3.0, not 1.33. So, still, our example of a "normal, excellent" profile at a ratio of 3.75 is still well above the cutoff, albeit not quite as dramatically as I first implied.]

Though it is probably achievable to have a a small percentage of small LDL on a standard diet, I'm far more certain that it's going to be far easier accomplishing it on a paleo-like diet.

By the way, my lipid panels over the last year are here and here, my last with HDLs of 133. Yes: 133.

Afterthought: Tim has VLDL measurements, and the only thing I know is that lower is better. However, I've no idea how they are measured, how reliable they are as a marker, or any relevant studies. If an astute reader can educate me and the rest of us, please do so -- with my sincere gratitude.

A Great Email (FTA tops Zone; Medical Professionals)

As I muddle around, trying to get back in sync from the long weekend -- of which I took every advantage -- here's an email from Eileen that came in last Friday that I was really pleased to receive.

~~~

I just wanted to let you know that you are certainly changing (saving?) lives with your blog.  I forget how I found Free The Animal, but it was shortly after I started my New Year's resolution to drop the 20 lbs I'd gained in the past 18 months.  I had the idea that I was going to Zone because it had helped me lose weight in the past, although I remember quitting because it was a hassle to weigh and measure every bite of food (and quite frankly, I was starving on 12 blocks/day).  Anyway, finding your blog coincided nicely with my Zone procrastination so I decided to follow your recommendations instead.  January 1st, I weighed 145 lbs and a week ago, 125 lbs.  The best part of that is that much of the weight lost was this big spare tire of fat around my waist and no starving.

Also thanks to you/your blog, I began to supplement Vit D heavily. I should mention here that I'm an RN, and since it was cold & flu season the topic came up with some of my coworkers regarding Vitamin D supplementation.  One of the older nurses was telling the younger girls how important it was to take "the recommended 400 IU per day".  If I didn't read your blog, I wouldn't have known that 400 IU isn't likely to do much for people with D deficiency.  I kept taking 6000 IU (and kept my mouth shut - can't argue with some of those old battleaxes and win).  D Action sent my test results in April and my level is 76.

My annual "physical" is coming up in a few weeks, and I am curious to see if my physician will check my cholesterol.  Last year my HDL was a pathetic 38. I'm hoping that after 5 months of healthy eating, there is an improvement.

So thank you, Richard.  Because of your drive to educate the rest of us, you have helped me make truly positive changes in my life and health.  Keep up the great work!

~~~

Pretty amazing, eh? The Zone, a working life amongst medical professionals, and all it really takes is some decent common sense to eat real food, plenty of natural fat, and the rest takes care of itself.

Hearty congratulations to Eileen.

New Lipid Panel

Well I went and ordered up some blood work the other day and results began coming in today. While my past Lipid Panel was blogged right here, this is the new one.

The past one shows a total serum cholesterol of almost the same (219), while I had an HDL of 106 and a calculated LDL of 104. You know what I think of calculated LDL. Well, this isn't a NMR LipoProfile or a VAP. It's the best I can get from Kaiser and it purports to be a direct measurement of LDL (though not a particle count). However, if accurate, I would expect my particle count to be 660-669 nmol/L, which would be considered optimal in terms of particle number (< 1000). Size is something we can only guess on, but my HDLs make it clear that I'm pretty high in fat consumption and that's highly associated with mostly large fluffy LDL and little to no small dense LDL.

It's interesting to note that if you look at Patrik's NMR LipoProfile and assume my LDL Direct to be accurate (for now -- I am still going to do an NMR as well), then calculated LDL overstated our actual LDL by about 50% (45% for him, 56% for me). This is consistent with Dr. Davis' experience. For grain, high-carb, low-fat dieters, calculated LDL usually understates actual LDL particle number (most of the particles small and dense as well) while for Paleo-like, no grain, high-fat, low-carb dieters, calculated LDL usually overstates actual LDL particle number (the vast majority of particles being large and fluffy). Moreover, I predict that as more of these Paleo NMRs come in and get published, we're going to find the understated LDL for the grain eaters is going to be a larger percentage on average than the overstated LDLs for the Paleos.

I didn't have Trigs measured. They were 47 before and I'm quite certain they are still under 50 (and probably closer to 40, now, as I'm lower carb than before and have been on it longer. Let's assume the same 47 for ratio calculation. Here's the ratios from before:

• Total/HDL = 2.07 (average is 4-6 and ideal is 2-3; I'm on the extreme end of ideal)
• HDL/LDL = 1.02 (average is .3-.4 and ideal is above .4; again extreme end of ideal)
• Triglyceride/HDL = 0.44 (optimal is less than 2, so again, extreme end of ideal)

And now:

• Total/HDL = 1.68 (19% improvement; I'm now off the scale)
• HDL/LDL = 2.02 (98% improvement; again off the scale)
• Triglyceride/HDL = 0.35 (20% improvement; off the scale)

Want to know my "secret?" Click right here. 

I may have some additional test results to report on later, after they come in.

Reader Real Results

I'm perilously behind in many small posting projects, and that includes a number of things my great readers have emailed over to me. Trust me: I see everything. Hell, I even have a very complimentary email from Dr. William Davis of Track Your Plaque heroism and fame, as yet unanswered, and that's woefully embarrassing. But I'll get to everything, sooner or later. Man, it has been one busy week.

But, first things first. With all adoration and respect to all readers and supporters of this blogging effort, not to mention the mutual support and help out to those who need it most, this reader is just a bit special to me.

Email from mom, who turns 68 one month from today.

~~~

Just about a year ago I went to a new doctor at Kaiser. He seemed different than other doctors I had. He had read my file and was familiar with my history. He said I was the most controlled diabetic he had ever had for a patient. He told me that if I would lose about 15 pounds he would work with me to get off insulin. Another 15 after that and he believed I could get off oral medication and control the diabetes with diet alone.

Well, I tell you, it has been a slow and difficult journey. When you are taking insulin it is so difficult to lose weight. Added to that, I was not totally convinced that low carb was completely ok. I didn't see the need to follow your program completely. I thought moderation was the answer. As I lost weight I slowly decreased the amount of insulin I was taking, but it was still slow, with many ups and downs.

I am now within seven pounds of the first goal the doctor set for me. My insulin was down from 12 N insulin (slow acting) and 4 R insulin (fast acting) in the morning and 16 N insulin and 5 R insulin at night to no R insulin at all and 5 N insulin in the morning an 6 N insulin at night. I thought, "what is 7 pounds, what difference could that make?" So 5 days ago I stopped taking insulin. I also started following your recommendation totally. My blood sugar levels are non diabetic, ranging from 84 to 98. I am taking the supplements you suggested and am totally off grains and all the other things you say are unhealthy for us. I have been off sugars and vegetable oils for a long time.

I think our trip to Puerto Vallarta was the turning point. I could really see the difference in Dad, plus being with you every day, discussing this with you, and feeling the results myself did it for me. I am feeling great. Next week I will go in for blood test and about a week after that I will see my doctor. He said at the beginning of this that when I got off insulin he would change my oral medications till I could get off them. I want that to happen as soon as possible. By the way, in the first 4 days, I lost two pounds, the most I have lost in that amount of time in years and years. I don't think it was water either because I have been continually dieting for years and even changing diets has not resulted in a big water loss in years.

~~~

"By the way, in the first 4 days, I lost two pounds, the most I have lost in that amount of time in years and years." Couldn't have a thing to do with the decreased amount of insulin. "A calorie is a calorie." That one's for the theoreticians over practicians, out there.

Well that's wonderful news, eh? Could not be happier or more satisfied. A big part of why I do what I do here is keeping my wonderful parents in good health. Thankfully, they don't follow physician advice blindly. While I wouldn't want them to follow my advice blindly, either, they do know that I have the respect of many respected MD's and other highly educated people in the health field, and they know that I care tremendously.

Mom mentioned dad. Well, he does look great, and at 71, has regained a youthful outlook and activity level. He was out in the sun, the pool, even the ocean every day in Puerto Vallarta. He still has about 30 pounds to go (about 30 lost so far), but he's on his way. He just emailed this morning to say that he just completed his first 30-hr fast, felt great, and couldn't even finish his break-fast steak. He's done a number of 24-hr fasts, so, just as expected, this was a cinch for him.

And, he's becoming quite the efficient fat burner. See, there was some concern in the last couple of weeks, as he began having random, even fasted blood glucose levels of 120-130 and even slightly above, but never over 140, which is the real danger zone. While his A1C remains a reasonable 5.1, randomness was causing worry. My intuitive (i.e., non-medical) thinking was that he's in vastly uncharted territory for modern medicine. How often do doctors deal with high random glucose readings for a patient who has been very low carb for months (paleo style), has dropped 30 pounds, and fasts regularly? Based on my own experimentation with taking my (24-hr) fasting BG from 85 to 115, not by eating sugar, but by going to the gym and hitting the weights hard for 30 minutes, reasoned that the blood glucose can only be coming from body fat mobilization and that his body is fine with the level. In fact, it seems an ideal situation for me. His body is allowing his BG to remain slightly elevated rather than secreting insulin to drive it back into tissues (as fat, of course).

So, I posted an inquiry on Art's private blog, and Dr. Doug McGuff (a reader of this blog; and who just published Body by Science) was kind enough to provide some very useful and interesting information:

WRT your dad’s slightly high glucose reading, I might have a few possible explainations.

1) Was he truly fasted? If he cheated with a little black coffe, the caffeine could have activated phosphorylase and cleaved some glycogen which was released into the blood.

2) His returning insulin sensitivity may have set him up for a variant of the “Somogi phenomenon”. The Somogi phenomenon can occur in diabetics who take too high of a dose of their evening insulin. During the wee hours of the morning hypoglycemia kicks in triggering epenephrine-induced glycogen cleavage which produces an elevation of their AM glucose. With your dad, his improving insulin sensitivity allows him to fully stock his glycogen stores. During his overnight fast, his insulin now works with a vengence, his blood sugar drops enough to trigger glyogenolysis from his glycogen stores, and voila! A transient supranormal rise in blood sugar. A tip off would be if his pillow case or pajamas were a little sweaty upon wakening. The same epinephrine that cleaves glycogen will activate the sweat glands. You may have experienced the same thing when you first started paleo, or when you first tried intermittent fasting. This is just part of the transition from being a sugar-burner to a fat-burner, and IMO is no big deal. Fasting insulin is a much better metric to follow.

Yep. It seems obvious to me, and some may disagree, but if fasting insulin levels are low in the face of an elevated BG that's less than 140 (150 is when tissue damage stats to occur), then that tells me that your body is simply seeing no reason to spike insulin. It's doing just fine. Leave it alone. Moreover, if BG is "elevated" thusly and insulin remains low, then that blood sugar is going to fuel your body's work, which equates to weight loss. To lose body fat, you must first mobilize body fat, which your body then converts to useable energy (glucose), and then uses it.

NMR LipoProfile

A while back I blogged a two-parter on LDL Cholesterol (Part 1 / Part 2). Part 1 deals with how unreliable standard blood tests are for determining your real risk. In part 2, I highlighted real world examples from the offices of doctor William Davis.

And now, I'm going to show you a real world example from a reader and (obviously) fellow high-fat Paleo eater. Click here to access Patrik's NMR LipoProfile (Nmrlipo PDF) He kindly gave permission to share it with you.

The fist thing to notice is that his LDL cholesterol -- calculated, just like the one you get -- is a whopping 204. Bet that'd make you worry, eh? However, his actual particle number for LDL is 1417, corresponding to a measured LDL of 141, a full 63 points lower. So the cholesterol tests like the ones you get -- the ones on which basis doctor prescribes statins to millions -- is a full 45% overstated in this case. However, it should be noted that if you eat a lot of carbohydrates, grains in particular, it's far more likely that your measured LDL is far higher than your calculated one. In essence: same problem, opposite error.

But here's the really big deal: he has ZERO small dense LDL particles, the only ones that matter. Had he taken conventional medical advice, he'd be on statins and probably other stuff, and yet he has absolutely no risk in terms of the huge association with small dense LDL and heart disease. Read more about this on the LioPanel website:

Why cholesterol may not be enough

Why your LDL particle number is important

How can I get the NMR LipoProfile test?

Understanding your test results

Meet Theresa : Age 57

Oh, and we ought to also mention that he's got a respectable HDL of 63, as well as killer Trigs at 40 (lower than mine, at 47). Good job, Patrik. Congratulations.

Do You Need to Gain Weight? Try Paleo

For the most part, because it's the chief problem most face by far, people come and follow this and other blogs in order to lose weight (fat), recompose their bodies (lean to fat ratio), and to maintain.

But for a (lucky?) few, that's not the problem. Rather, they are skinny and can't seem to add muscle mass. For that, here's Nathan's story.

~~~

Two years ago, I tipped the scales at just over 130lbs. I'm 5'10" and living in Southern California, that didn't make for me feeling especially great about myself when hanging out at the beach. Don't get me wrong, I was not horribly depressed with the way I looked or anything, I just knew I could be better. I have always been the skinny guy, was sick of it and wanted some shape. I started hitting the gym 4x/week and following the "standard" bodybuilding diet of eating as much as I could, with very little effort to make sure it was quality food. Last summer, I was at a solid 150 and quite pleased with myself. On Oct. 1 I crashed my motorcycle and that quickly led into the holiday season, so I went for three months without going to the gym. In the meantime, I had been reading your site and began taking steps toward a paleo-style diet.

Immediately after Christmas, I started in on the paleo diet in earnest. On Jan. 5 I started hitting the gym again, still 4x/week, this time with a modified paleo diet and the difference has been amazing. Before, when doing a tough leg workout I used to get nauseous and/or lightheaded nearly every time from the strain. Neither has happened once since starting up again in January and I've been hitting it harder than before. I only rest 30 to 45 seconds between my sets except for when I switch exercises, when I grab a drink of water and then immediately start back up. My workouts went from an average of 60-75 minutes to 30-40 minutes and are much more intense. I have also been hitting the major muscle groups harder, as you suggest, to help stimulate the release of GH.

I was gaining lean mass previously, but was also gaining a bit of fat along with it. That is no longer the case. I checked my weight after the first week of lifting, 150 dead on. I am not looking to get huge, 170 or so should be good for me depending on how I look and feel. I have not checked weight since after that first week and won't until my birthday in April, but I have seen some great progress in six short weeks, much more than I saw in twice the time with my previous diet. Three of my shirts, which fit perfectly at the New Year, are now too small and I have yet to lose any definition in my abs, which is my only gauge for whether or not I'm gaining fat.

I just wanted to relate that this lifestyle will not only work for those who wish to lose weight, but for those who want to gain weight as well. It is a far cry from the "standard" bodybuilding diet of constant eating, but I have found it to be much more effective... not to mention easier to stick to. All the constant eating takes up lots of time. Instead I am eating good food when I'm hungry, feeling great and seeing great results.

Thank you for all the great information. People I talk to still think I'm slightly crazy but there is no denying the way I feel and the results I see.

~~~

Thanks for the great story, Nathan; and congratulations to you for listening to your body and making that your primary guide. It never surprises me. That's because this blog is about the principles of evolutionary biology. That is our guiding light. It should be no surprise that when living in accordance with sound principles delivers the goods every time.

Results from Others

The other evening I ran into a couple of friends of mine, Kevin & Joseph, and was glad to see a big improvement in both of them. Kevin had contacted me a few month back, had been reading my blog, and expressed frustration at trying for so many years to lose "a measly 15 pounds." We met for breakfast, I gave him a few insights, he picked up The Paleo Diet and went to it.

A few weeks back, he emailed to say that he's cut 10 pounds already. What I didn't know is that his partner, Joseph, was apparently following the prescriptions as well.

Well, let me tell you: they both looked great, and Joseph's face, in particular, was markedly leaner and thiner -- and shined with health and vitality. His progress, so far? 17 pounds. I asked Joseph how he felt, and he said something quite relevant: "I feel like a normal person, again." I wish the both of them much continued success in their new life way.

Now, keep Joseph's insightful comment in mind as I quote an email from Aaron:

First of all, I just wanted to write thanking you for the work you're doing on your blog. I forget exactly how I originally became a reader; probably it was something Billy Beck had linked, back in the Honesty Log days. But your posts about Paleo eating, IF, etc. really convinced me. I've recently switched to a low-carb, high-fat diet, with intermittent fasts and occasional intense workouts and I'm amazed: it just works.

If anybody had told me 18 months ago that I could skip meals without even noticing, I would have laughed---I needed to eat every 4 hours. If anybody had told me I could go 30 hours without eating---not just once, but several times a month---I would have thought they were insane. Yet now I do it all the time. So, again, thank you for the information and the inspiration.

I recently read Gary Taubes's book, Good Calories, Bad Calories. Even though I was already in the choir, so to speak, his evidence is so overwhelming that I'm amazed at how people can still insist on "low-fat, whole grains." Churchill's quote about "stumbling over the truth" comes to mind. I did not know the history of the McGovern report. In fact, I had not considered the political dimension of the thing at all, and I suppose no ideology has a monopoly on the "it failed, so do it again, only harder!" mindset. But still, it fits my prejudices to blame this on the Left-Statists. :)

As a contrast to Taubes, I give you my in-laws: the anti-Taubes. My father-in-law is a retired pharmacist, and my mother-in-law a retired nurse. They subscribe to the latest health bulletins from God knows where. Everything in their kitchen is "low-fat, whole-grain." They use Country Crock instead of butter. Even their ice cream is "Lite."

And they eat ALL. THE. TIME.

Now, my father-in-law works out just about every day, and he looks fit. He's a runner, and he's a pretty fast runner for being nearly 70. But he measures his raisin bran to make sure he's getting exactly One Cup, and of course it's got skim milk on it. My mother-in-law nibbles all day long: crackers, fig newtons, etc. (but all Low Fat!). She does not look fit as fit, but she has bad knees and can't work out as much.

They are convinced, of course, that eating all that animal fat is really bad for me. They think I'll fall off the wagon eventually, too. I don't know why I would---I kind of enjoy not being hungry all the time. That and not being 20lbs overweight like I used to be.

"They eat ALL. THE. TIME." That's not normal, folks. Congratulations to Aaron.

My Progress

I'm going to give you a brief update on your host's progress. Since my last photo update in September, you'll certainly be happy to know that I'm chugging along.

It was quite some time ago when I was reading some stuff by Clarence Bass (make sure you see his photo at 70-years-old), where he said, "Lose fat slowly." I'm not even certain of his reasoning, but I tend to defer to guys that old (like Art), so credible in appearance. So, I've never worried about it. I typically drop ten pounds or so, hang out for 2-3 months, up & down, with every weight peak just a bit lower than the last, and then it kicks off again.

You see, with Paleo / EvFit / Primal, you just never ought to have a worry. You're are applying sound, logical, 4-million-year-tested principles to your very own life. The source of my passion and what drives this blog: it has been well over a year since I even had a shadow of a doubt that this worked: unequivocally. And I'm not just talking weight; I'm talking fat loss, muscle gain, hugely increased energy, better blood markers: the whole enchilada to employ a bad metaphor. It works, and it works for everyone, every time, across the board.

It's how you were designed to eat. But, you're always welcome to eat inferior.

So, since that last update, at around 190, I went from there to 195, to 187 at the lowest, and bounced back-&-forth continuously, all the time getting stronger and stronger in the gym. I'm really impressed with the amount of muscle I've gained in my legs, and am now up to typically doing 3 sets of 10 inclined leg presses each at about 450, followed by a burn off at around 300, 15-20 reps. Where I could not do a single dead hang pull-up a year ago, I can now do 4-5 before I have to start kipping it up to the bar, then I can do lots more.

So, I hit my lowest weight since around 1994 the other day: 183.

I'm headed to Puerto Vallarta on Saturday. Believe it or not, I plan to lose fat during my vacation. Hunger for me, now, is almost non-existent. You saw that photo melange from the camping trip. I lost weight there, too.

I'll see if I can get out some pics of me en vacanceses. With tan in hand.

Jay's Rapid Progress

In case you didn't see the comment.

If there is one thing that will bring your body fat down, it is IF. I shot down from 19% to just over 10% in a very short time(third week of August to about a week and a half into September). I was gonna post pics on here for evidence. It was insane. The fasts were 18-20 hrs at most around twice a week.

The goal of workouts is to maintain lean mass and gain some. Work on big muscles: chest, legs, shoulders and whatever accessory smaller muscles you feel help your lifts. Do compound movements: benches, squats, deadlits.

I do 3 days of lifting, a Tabatha sprint protocol and plyos in the other two days. I also have one leisure day to do light lifting or sprint work as well. So to sum up, One full day off for sure, 2 big lift days, and the other just to get the heart going and physical activity.

Then while reading Richard's site, I was sort of plateauing in the 10% range, but wanted to shred even more and so I fasted 24 hours two days a week. I also worked out first thing in the morning after a extended overnight fast.

I am today at 6-1 165 lbs, 7% body fat. So in the course of let's say.....5 months that's a drop from 20-7%.

Marisa's Comment and Bratty Kids

This comment came through on an older post from November on evolutionary nutrition. Let me quote Marisa.

Hi! I stumbled upon this "paleo" eating quite by accident. I have a gluten/casein allergy that has wreaked havoc on my health, and has induced autistic symptoms in one of my children. Since removing it from our diet, my eczema has abated, and my child's ability to cross-pattern appeared for the first time, along with her toe-walking (symptom of neurological damage) being a thing of the past ... except when we get wheat contamination, and then she walks around like a ballerina again. (along with the diarrhea, aggression, and general malaise)

We experiemented with the whole GFCF (gluten-free/casein-free) world of other grains, but literally spent a fortune. In the hopes of reeling in the finances, I dropped all the "fun" foods, and stuck to non-allergenic foods that were readily available to us: grass-fed, organic beef, pork, chicken, vegetables, nuts, organic oils (EVOO, coconut and palm mostly), coconut milk, and some fruits (thank god for Whole Foods). Because of our leaky guts I shied away from legumes (mold). Well, there you have it: the paleo diet. As we progressed along this line, I was astonished at my kids' recovery: they were happier, less tantrum-y, their skin (which had always been dry) became dewy soft, their chapped lips were a thing of the past too.

This is purely anecdotal, but I have noticed a tremendous difference in the behavior of children in rough correlation to the things I see them eating. Kids eating lots of cereal, mac & cheese, cookies, boxed juices, sodas, candy and so forth often behave as awful brats.

On the other hand, my wife has some relatives with two young children that are perhaps the best behaved I have ever witnessed in my life. The mother is a fish-eating vegetarian, I never observe much junk in their house, and though not Paleo, it's always real food served up around there.

Coincidence? Well, one of the things that Weston Price often remarked about during his world travels to study people living on traditional, non-industrial diets was the good behavior of the children, and that he never saw any sort of harsh discipline or corporal punishment involved.

Then, there's this from Stephan some months ago. Go see how closely the increased use of industrial vegetable oils tracks with homicide

Vegetable Oil and Homicide

One of the major dietary changes that has accompanied the downward slide of American health is the replacement of animal fats with industrially processed vegetable oils. Soybean oil, corn oil, cottonseed oil and other industrial creations have replaced milk and meat fat in our diet, while total fat consumption has remained relatively constant. The result is that we're eating a lot more polyunsaturated fat than we were just 30 years ago, most of it linoleic acid (omega-6). Corn oil may taste so bad it inspires you to violence, but its insidiousness goes beyond the flavor.

Stephan also has a follow up post well worth a read (The Omega Ratio), as in addition to the epidemiological correlations, he lists a number of intervention studies suggesting that improving the omega 3/6 ratio ameliorates some behavioral problems.

- EPA supplementation (a long-chain n-3 fatty acid) reduced aggression and depression in a group of women with borderline personality disorder.

- DHA supplementation improved aggression in young Thai students.

- n-3 supplementation improved symptoms of bipolar disorder.

- EPA supplementation improved symptoms of unipolar depression.

- n-3 supplementation improved perinatal depression.

- n-3 supplementation improved symptoms of major depression.

- DHA and EPA supplementation reduced suicidal behaviors and improved markers of well-being in patients with recurrent self-harm.

- n-3 supplementation decreased anger and anxiety in substance abusers.

So, are your kids brats, and you think that's just the way it is? How about stop with the poison (flour, sugar, processed vegetable oils and all the crap made from some combination of them)? feed 'em all the meat, natural fat, vegetables, fruits and nuts they want, only that, and just see what happens.

Paleo Tales of Success

I find that many people don't really grasp the essence of the Paleo (and Paleo-like) way. They approach it like they approach other diets, focus on what you can't have, and eventually go on in their endless quest for some silver bullet.

To my mind, the Paleo way is about two things, primarily.

1) To obtain not just sufficient or even good nutrition from food, but to obtain optimal nutrition from food. So, with respect to that piece of bread, pile of rice, dessert -- or any of the other things we don't eat -- we're eating, in its place, an additional piece of meat, fish, more vegies, fruit, or what have you. Over a week, or even a day, were you to compare your nutrient intake to any other average diet, you would blow it out of the water. Big time. It's not even close.

2) Hunger normalization. The problem with this one is that most people have no idea that their hunger it totally berserk. They consider the idea of fasting, for instance, and it's horrifying. Yet, people on the Paleo way embrace fasting naturally. Why? Because hunger is a hugely different experience for someone on the Paleo path.

Here's three testimonials that touch on one or both of these crucial elements.

Diana Hsieh emailed me back in Septamber to thank me for the blog. She'd been following it for some months, used the information, and benefited. And now look.

So after years of following various iterations of the low-fat, chubby face diet, look. She's taken a good 20 years off her appearance. You can read her whole story here.

I'm really thrilled with my weight loss. I've been battling my slowly-growing layer of fat since 2004. For four long years, I exercised daily: I did the standard regimen of 40 to 60 minutes of cardio. I attempted to eat "healthier," mostly meaning less fat, less calories. I was often ravenously hungry; I often felt deprived; I desperately craved sugar. Worst of all, despite some occasional success, my weight continued to creep upwards. I felt like I had no control.

And I'll bet Diana's former diet was about as healthy in terms of nutrition you can get on a low-fat regime. Her husband, Paul, is a physician and Diana is months away from obtaining her PhD in Philosophy. They live on a farm. I doubt she was eating junk food all day. Notice how she used to look pretty much like an average American, nowadays. Now, as with all Paleo people who've been on the diet a while, she looks lean and healthy. Far above average.

Now, of course, I love when someone documents success like that and it turns out I had a role in it. At first, it seemed unbelievable that people would actually take me seriously enough to try some of these methods, but you know what? I guess that sometimes people can recognize genuine when they see it. Dr. Dan of At Darwin's Table has only been blogging a short while, and like me, much of it is about his own path in losing weight and gaining health through optimal nutrition from food. Yet he already has an amazing reader success story and I'd highly encourage everyone to read that.

Confessions of a Carb Addict

I really, really used to think I had an eating disorder. Here I was at 30 years old - 108 kilo on a 5′2″ inch frame (that’s 238 pounds and 158 centimetres respectively) and massively unhappy with my body, my appearance and dieting like a fiend. I didn’t try the proverbial “everything” to lose weight, but I tried a great number of things, the Gillian McKeith “You Are What You Eat” diet, Weight Watchers, Intuitive Eating, food combining, vegetarianism, I even took part in a special addiction workshop because I was convinced I was addicted to food. [...]

...I was never, ever full. Never. EVER. [...]

...That of course meant I had blown the diet and so all food became fair game, but then no matter how much I ate I WAS NEVER FULL! NEVER. EVER. FULL! [...]

I don’t remember how I found Dr Dan’s blog, but because of him I read Loren Cordain’s book, tried it out for about one month, cutting out dairy and grain and have never looked back since. I’ve lost about 4 kilo after about 6 weeks of practice and - although I can’t claim the Paleo way has saved my life, it has most definitely saved my sanity. All those feelings of fear, desperation, anger, and madness have disappeared. I’m calm for the first time in my adult life. I’m eating well and slowly but surely letting my disordered patterns go. I’m not totally free yet, I’m scared about the amount of food I can put away, I mean, dude. I can EAT. But I keep reminding myself that my body is playing catch-up and I am healing my body, NOT hurting it. My knees and hips have stopped hurting and you know what? I’m hungry right now but…it’s cool. This is the first time in my whole life that I have not felt like climbing the walls when I’ve been hungry. This is a different kind of hunger, it’s not sickening or acidic - this is a different way of living my life because after an eternity, I AM CALM.

Get it? She's getting optimal nutrition, losing weight, getting control of hunger, getting healthier. That's just a bit of her story excerpted. Go read the whole amazing thing.

And now, Keith Norris, already a well-established Paleo eater and experienced exerciser finds that last bit of success in intermittent fasting (with photos). I have blogged extensively about fasting myself, and can attest that Keith has it right on, and also with some of his own unique takes on the methodology. There's too much to do a good job of excerpting, so just go take a look at his photos and read his story.