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What to Do if You Have High Cholesterol Levels

Posted Jan 15 2013 8:21am

What do you do if your cholesterol doesn’t improve on a low-carb diet? What do you do if it gets worse? Many low carbers will tell you that you don’t really have to worry about high numbers. But is that true?

Low-Carb Bacon and Eggs BreakfastLow-Carb Bacon and Eggs Breakfast

  • Should you just ignore your high cholesterol tests?
  • What does Dr. Atkins say about elevated cholesterol levels?

For many of us, ignoring our cholesterol tests is no longer possible because health insurance companies are beginning to tie health insurance rates, as well as eligibility of insurability, to your cholesterol levels, smoking habits, and other health markers. In my own situation, we have to take a yearly physical that includes cholesterol tests, and input that information at Cigna’s website. If we choose not to do that, at the present time, our insurance rates will increase by 20 percent. If you smoke, they will add an additional 10.

Although this was the first year that participating in Cigna’s Health Survey was mandatory by my husband’s company, Cigna takes those figures, compares them to previous data, and gives you recommended goals that meet “their” standards. The movement in this country towards socialized medicine isn’t likely to allow low-carb dieters to continue ignoring their cholesterol numbers forever.

Standards are bound to get tighter as we move forward into Obama Care, so thinking about the health implications of what’s going on right now is important for long-term health, as well as weight-loss success. Despite current thought, Dr. Atkins never took the viewpoint that I hear so often within the low-carb community. In fact, most people’s attitudes and rationalizations about elevated cholesterol levels are downright frightening because many newcomers are listening to the distorted, twisted advice.


Although Dr. Atkins is best known for bringing very low-carb diets and graduated low-carb diets into the spotlight, his life’s work also included nutritional research and vita-nutrient therapy. As a cardiologist, he didn’t simply slough off elevated levels of blood fats in an effort to defend his diet blindly, but clearly stated that “cholesterol and triglycerides are one of the most widespread causes of heart attacks, strokes, and clogging of the arteries in general.”

What he reminded us of was that high cholesterol levels themselves are not disease. They are blood lipid abnormalities that serve as “predictive factors for a hardening of the arteries.” If you treat the symptoms without figuring out what’s causing the elevated cholesterol, there’s no guarantee that you will stop or even regress the disease process.

But Dr. Atkins also believed that by bringing your cholesterol numbers in line with the current medical view,  you can at least keep yourself off of statins and help avoid their awful side effects. In addition, “high triglycerides and low HDL levels are the two lipid abnormalities that are clearly and unequivocally linked both to insulin resistance and to the intake of carbohydrates.”

Apparently, LDL cholesterol is not.

Those with insulin resistance need to avoid excess carbohydrates at even moderate levels, because your body’s chemistry “turns the carbohydrates into triglycerides.” Triglycerides often interfere with the production of HDL, the good cholesterol that helps transport LDL molecules to the liver to be recycled or eliminated from the body. “The Atkins Center experience [was] that people whose triglyceride levels are more than double their HDL levels (in mg/ml) do better on carbohydrate restriction.” But that doesn’t hold true for everyone.    

“Some people get the best results by restricting saturated fats, while others do better if they eliminate all sugar from their diet and reduce consumption of carbohydrates. You must learn which works best for you.”

No two individuals will react the same way to dietary and nutritional changes. However, Dr. Atkins also believed that elevated cholesterol was a symptom of “dysnutrition,” and that if you “correct the dysnutrition, you will control your blood cholesterol.”


It’s overly simplistic to say a low-carb diet will automatically improve cholesterol levels. That depends on how you implement what you learn. “Occasionally, a major elevation in blood cholesterol does occur in patients on a low-carbohydrate diet.” But occasionally was Dr. Atkins findings pre-1981. Today, a typical low-carb diet doesn’t even fit Dr. Atkins profile of what a low-carb diet for lowering cholesterol should look like.

 Although he has always stated that avoiding eggs and saturated fats are a last resort, his sample menus as late as 2002 had dieters eating ham, ground turkey, round steak, salmon, and mozzarella cheese. His cornbread recipe even contained real, whole-grain cornmeal along with a soy-based bake mix, and that was specifically for his ongoing weight-loss phase. So we’ve traveled pretty far out in left field from what Dr. Atkins believed.

When Atkins speaks of using a low-carb diet to control your cholesterol levels, he means that you need “to avoid sugar in all of its forms, even fruit and fruit juices, and you should keep your intake of starches to a minimum.” That’s because “diets low in total carbohydrates and alcohol usually lower triglycerides dramatically.”

According to Dr. Atkins, simple sugars elevate triglycerides more dramatically than complex, unrefined carbohydrates. While medical professionals don’t always agree on which is worse, triglycerides or total cholesterol, Atkins believed that “both contribute equally to heart disease potential.”

Dr. Atkins cholesterol recommendations require strict attention to the ingredient lists on the products and spices you buy, and avoiding any product that contains:
  • alcohol
  • sugar
  • corn syrup
  • honey
  • fructose
  • dextrin
  • high-fructose corn syrup
  • maltodextrin
  • or any of the sugar alcohols

That eliminates almost all sugar substitutes and puts you on a regimen that mostly consists of whole foods. It also means you should eliminate all products that contain any amount of starches or flour. While that sounds like a no-brainer, store-brand cream cheese, most brands of mayonnaise, bacon, sausage, extracts made with an alcohol base, and many other typical low-carb foods would not fit that profile.

In addition, the amount of carbohydrates you eat per day needs to be fine-tuned to fit your blood cholesterol levels, rather than just for weight loss.   


For many people, a strict low-carb diet may still not be enough. While triglycerides can drop dramatically and HDL increase with a standard low-carb diet , LDL cholesterol levels can be far more stubborn. Although cutting down on saturated fat is the typical treatment for elevated LDL cholesterol levels, Dr. Atkins always preferred to take a nutritional approach to the problem first. Supplements such as:
  • niacin
  • pantethine
  • inositol
  • chromium
  • Vitamin C
  • essential fatty acids
  • fiber supplements
  • lecithin granules
  • garlic

were always included in his treatment program for elevated cholesterol levels. His view on health was never low-carb tunnel vision. Even from the beginning, it was completely nutritionally based.


Most medical recommendations lean toward substituting saturated fats with polyunsaturated or monounsaturated oils. While scientific tests have shown the positive results on cholesterol levels when making such changes, Dr. Atkins cautions that an increase in polyunsaturated oils increases your need for Vitamin E

In addition, He also used to insist that vegetables oils be cold-pressed, rather than chemically extracted. That insistence was softened a bit to “best” in 2002, but his reasons are still valid. Supermarket oils are treated with “gasoline, benzene, carbon disulfide, and/or lye.” They’re also overheated and treated with antioxidants and corn-based defoamers.


According to Dr. Atkins, another thing to look at if you have elevated cholesterol levels is your thyroid. In his professional opinion, elevated cholesterol can be a symptom of a sluggish thyroid. However, he never relied on thyroid tests to check thyroid function. He preferred to use your basal body temperature because what he was interested in was how your thyroid was functioning, not the amount of thyroid that was circulating in your blood.

For a sluggish thyroid, Dr. Atkins often used kelp supplements “because kelp contains iodine, the element upon which thyroid function depends.” However, most cases of thyroid deficiency are not due to iodine deficiency, although a fear of salt does seem to be common among low carbers. You can see that in the number of people who continue to believe that the Atkins Flu is inevitable.

Even so, Dr. Atkins saw nothing wrong with giving kelp a try, claiming it was a “relatively safe nutritional technique for cholesterol lowering” when thyroid was suspect. In fact, in Dr. Atkins clinical experience, metabolic resistance to weight loss in obese individuals was almost always due to thyroid deficiency.

When iodine isn’t the issue, natural or synthetic thyroid hormone may be necessary, but there seems to be as much misinformation among medical authorities regarding thyroid function as there is about cholesterol. Most general doctors will go by whatever the lab they use suggests, so if you suspect you might have thyroid issues, it might be best to seek out a thyroid specialist instead of a general or family practitioner.


Sources:

Atkins, Robert C., M.D., Dr. Atkins’ Diet Revolution: The famous Vogue superdiet explained in full, Bantam Books, New York, 1972.

Atkins, Robert C., M.D., Dr. Atkins’ Nutrition Breakthrough: How to Treat Your Medical Condition Without Drugs, Bantam Books, New York, 1981.

Atkins, Robert C., M.D., Dr. Atkins’ Vita-Nutrient Solution: Nature’s Answer to Drugs, Simon & Schuster, New York, 1998.

Atkins, Robert C., M.D., Dr. Atkins’ New Diet Revolution (expanded edition), M. Evans and Company Inc., New York, 2002 (originally published 1992).
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