Diet advice please! Low carb vs whole... - British Heart Fou...

British Heart Foundation

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Diet advice please! Low carb vs wholegrain carbs...

bazhorn profile image
8 Replies

Good morning folks.

HA 3 months ago. Stented.

Was previously a sugar and carb addict.

Gave up sugar immediately after HA.

After reading concerns about sugar and carbs and their effect on arterial health I went very low carb for the last 2 months.

There was an increase in saturated fats along with the low carb diet (couldn't have done it otherwise).

I was losing weight at an average of 0.5 kg per week. I felt it was the easiest and most effective weight loss strategy I'd ever experienced.

I then stopped atorvastatin for 2 weeks due to an incompatibility for the antibiotic I was prescribed (GP's advice).

I then kept away from the statin until the blood test. The blood test was delayed so much I ended up off statins for about a month. I felt great.

However the blood cholesterol/lipid results came back recently and they were high, with talk about it being potentially familial. Cholesterol 6.9 and lipo protein 1300. (Been referred to the lipid clinic).

(This test ended up being just under 2 months after the low carb, higher fat diet and after 1 month of no statin.)

Came back to statins as a result, trying simvastatin now as I suspected atorvastatin was making me feel like a zombie.

I went back on wholegrain carbs (not too much), and cut the saturated fat, just having olive oil and proactiv spread.

Now I'm gaining weight!

I don't know whether to go back on low carb (with the saturated fats but not too much) and lose weight, or go back on the more traditional approach with wholegrain carbs and zero saturated fat and consequent weight gain....

Would the statin be enough? Does the medication help so much it's beneficial effect would render the low carb/whole carbs issue a relatively minor one?

P.S. I've never been able to exercise my weight down. I've however been doing very well with my cardiac-physio-prescribed exercise regime the last 3 months.

8 Replies
Chappychap profile image
Chappychap

Diet is such a deeply personal decision it's difficult to recommend anything, the diet that's best for you is one that fits with your circumstances such that you can stick with it for years rather than weeks!

What I would say is that if your GP suspects that your high cholesterol is familial, then perhaps you could request a DNA test to confirm the diagnosis? As far as I know Familial Hypercholesterolaemia is the only heart related condition where the NHS will run genetic tests.

That's a shame, the chief scientific advisor to the BHF (who sponsor this forum) argues that gene testing is the next horizon for heart disease . In the specific context of heart disease and diet for example, a test for the Apo/E gene would tell you if you were in the 20% of the population that really needs an ultra low fat and low alcohol diet in order to stay safe. Again, I believe the BHF is currently researching Apo/E genetic effects, probably too late for any of us to benefit but hopefully good news for our children.

Good luck!

I went low carb a few months after my HA and am now 10 or so months into it. All my health markers are improving except cholesterol. However I was still losing weight at quite a rapid pace when I had my last blood test, which is known to cause a temporal rise in cholesterol (up to 9 3!)

I also had a stent due to plaque build up in an artery. This plaque build up can only happen if there is underlying inflammation. Aside from the high carb content, grains contain inflammatory proteins, and none more so than wheat. I intend to stick to a diet low in inflammatory foods and that necessarily is a low carbohydrate diet.

In a standard lipids panel (in the UK), the only values that are actually directly measured are HDL and triglycerides. A focus on upping HDL and lowering triglycerides will serve you well. The LDL is a computed value and tells you very little about sdLDL which is believed to be the harmful component. It is possible to have a large number for LDL but still have an adequately low sdLDL. It is also found that as your HDL/Trig ratio increases, your sdLDL level goes down. For these reasons I have no concerns about my LDL or total cholesterol readings.

With regards to Familial Hypercholesterolemia, it is an inherited genetic condition. You either have it from birth or you don't. I've had a nurse and a doctor suggest I have FH, but I also have pre heart attack cholesterol numbers which are lower than the threshold for FH to be considered.

I can't tell you what's best for you medication wise, but I do believe a healthy diet includes meat, organ meats, fish, lots of veg, eggs, dairy (if you are not intolerant), nuts, some seasonal fruit.

Avoid all grains, vegetable seed oils, potatoes and other high starch vegetables, limit legumes. Little or no processed food, no ultra processed food.

I hope this helps. This is working for me (or not if you accept the mainstream obsession with cholesterol numbers as being correct).

JennyRx profile image
JennyRx

The lipid clinic will test for FH it can’t be guessed at. I was tested and it came back negative - hurray - but they found I had very high lipoprotein (a) another genetic factor - my figure is very high and this puts me a high risk of HA and strokes. I do low carb and try and keep my sat fats down too. It’s not easy. I was proper low carb before but I try to cut out saturated fats now. Although I love cheese. Exercise is about health. About keeping muscles strong including your heart. To help take yourself into older age living well as well as aging well. But most of us wouldn’t be able to exercise anywhere enough to weight loss. But never stop walking. It always does you good.

bazhorn profile image
bazhorn in reply to JennyRx

Yes I'm keen to get to the lipid clinic asap to check that out! Yes I'm still persevering with the exercise (and increasing it too) as it makes me feel good rather than weight loss per se.

JennyRx profile image
JennyRx in reply to bazhorn

All they can do at the lipid clinic for lp(a) is get LDL down below 1.8, get BMI below 25 (or in my case as I’m part Indian below 22 which I’m struggling with) no smoking and low saturated fat diet. I take ezetimibe, aspirin, amlodipine, losartan and having a break from statins to see if that’s what’s causing my peripheral neuropathy or whether that’s left over from chemo. If it is I shall be put on a new cholesterol drug. But I also struggle with pre diabetes as that’s genetic too and I’m on endocrine blockers for cancer which drives up cholesterol and blood sugars. So it’s all getting a bit tricksy so I eat low carb low sat fat, walk, run, Pilates, go to work and await the treatment for lp(a) which is in phase 3 trial atm And enjoy life, family and friends. X

Just to muddy the waters further….studies have shown that there is a proportion of people for whom a low carb diet directly increases cholesterol, but particularly LDL. I have/had high cholesterol, and went on a statin in Jan. I had to stop it in May due to a deranged liver that we couldn’t get to grips with, but when they checked my cholesterol at that point, my total cholesterol was down from 6.9 to 5.4, and all of my other numbers were finally in the right relationship to each other for the first time in two years. For the last 6 years, I’ve been following a low, wholegrain carb, high protein diet alongside exercise to shift ten stone. I’ve been maintaining my weight for the last three, but there is a bit of me now wondering if some of the increase - my lifestyle couldn’t be any cleaner - is actually the result of the low carbs. I’m not talking about FH, but I had assumed a genetic component in the family to developing CVD given the history, but realise now it could be a bit of both. My mother had an NSTEMI at 64, my dad has arteriosclerosis, both grandfathers dropped down dead with heart attacks before the age of 50, one grandmother had a stroke, the other needed a pacemaker in her 50s and was on anticoagulants etc. for the last 30 years of her life.

Also worth pointing out that statins offer benefit beyond just lowering cholesterol. With my horrendous family history, I’m hoping to be able to go back on one in the next few weeks.

bazhorn profile image
bazhorn in reply to

That's really interesting about the proportion of people for whom LC ups the LDL level - I wonder if that could be tested for? I must admit I was really surprised at my results. Yes I've got a similar family history too, so I may have a bit of both as well.

PecanSandie profile image
PecanSandie

What worked for me is keeping a food diary. I used myfitnesspal but there are others. Make a record of everything you eat and weigh yourself once a day. Weight loss happens over time. If you lose your target amount weight too quickly you will probably gain it back. I stopped eating beef and pork and try to avoid saturated fats. I use olive oil almost exclusively. Also, remember just because you are eating healthy doesn't mean it's "all you can eat". Even healthy food has to be portioned out and eaten in moderation. Exercise is important (30 minutes a day walking at least 5 days a week was my choice of exercise). It took me about three years to lose 30 pounds but those pounds have stayed off and that was almost 10 years ago.

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