I just scanned these comments and saw the one a while back about Dawn Phenomenon. I recalled reading about this on Peter’s Hyperlipid site – was surprised how long ago I read it. Here it is:

http://high-fat-nutrition.blogspot.com/2008/05/physiological-insulin-resistance-2-dawn.html

There may be more on his site but I did not search diligently.

Best Regards,

Philip Thackray

My latest version is closer to Dr. Bernstein’s diet. I shoot for 70% fat and 10% carbs. I’m down another five pounds iin the six weeks of following it. My performance varies, of course. Lots of temptations in the world.

I approach cholesterol from the “quality” perspective, and it seems larger, fluffier lipoproteins are of much higher quality than small, dense varieties. I’ve learned that these VLDL packages are created in the liver from mostly, if not all, sugars. Nearly all fructose passes through this gate to become a saturated fat packed for delivery in these things. After their trips to cells and they return to the liver, they then become LDL particles. Exogenous fats, btw, are packed in the intestines in chylomicrons. These suckers never see the LDL pathways. I then look at the Friedwald. It’s a vlolume measurement. If particles are bigger, the value grows, and vice versa. So it seems logical that we’ve misinterpreted these friedwald results. Yes consuming sugars reduces LDL values – the LDL sizes are smaller. Yes fats increase LDL values – the LDL sizes are bigger. But, this can only be true if results corroborate failings of LDL as an indicator of heart risk. In 2009 UCLA released results showing 3/4 of all heart attack victims had normal LDL values. Dr. Krauss’ 2010 meta analysis of cohort studies shows no correlation of saturated fat consumption and heart disease. I’ve alse looked intensely for the evidence supporting cholesterol and saturated fat as causes of heart disease. I find zero level one evidence. None! Even the NHLBI in their definition of atehrosclerosis admits they do not know what causes it.

I ask my opthalmologist to check for atherosclerosis during my all too frequent eye exams. He sees none. And I’ve had zero signs of retinopathy in tehse past four years after a vitrectomy followed by bleeding in 2006. Not a valued attribution by any menas. Vitrectomies and sugar control have wonderful results, generally. But really, after three and a half years of high SF consumption, shouldn’t I see at least some atherosclerosis in my eyes? Shouldn’t my aerobic performance be degrading isntead of improving? Shouldn’t my energy levels be falling instead of rising? My 60% fat brain can find zero reason to avoid saturated fats and plenty to maximize them.

Have a great day!

Saturated fats do tend to raise total cholesterol, both LDL (bad) and HDL (good). The percentage increase is usually higher for LDL than for HDL.

For U.S. readers: cholesterol of 9 mmol/l equals 348 mg/dl (very high). Before I get too exercised about a cholesterol level, I like to see it confirmed by a repeat test within the next month or two.

-Steve

Best of luck to you.

-Steve

Sweet potatoes have a certain health halo about them. Compared to regular white baking potatoes, they seem to have about twice the vitamin C and much more vitamin A. Otherwise I’ve seen lots of confusing and conflicting comparisons of the two on the Internet, including the issues of glycemic index and load. Some of the confusion stems from ignoring the potato skin in the analysis. For a diabetic concerned about blood sugar effects of potatoes, self-monitoring of blood glucose is the answer. Not with every serving, but until a pattern is clear.

[I’m experimenting with sweet potatoes because they are such a useful food for diabetics).

I think that the ‘Mediterranean’ angle is a template to build on as there are many cuisines in the Mediterranean.– it may determine the primary foodstuffs but it’s not the whole shebang. Giving up bread was the hardest challenge for me and despite my continued use of sour dough breads which have a lower GI impact for some time, I finally gave that up to.

One slice of bread: 15-20 grams of carbohydrate.

My rule of thumb when adopting the diet was that I’d try not to put in my mouth any substance over approx 15 grams of carbohydrate per serve. So for a time I allowed myself that 15 gram leeway for one item per meal.: esp as it related to rice or bread.

So I’m more or less maintained –with medication– in the 5.8-6.8 mmol range but with continuing blood pressure issues I’d like to surmount and my weight loss has plateaued.

Not a bad result….

The KMD diet is a bit roughage light unless you add that extra to make up for the whole grain shortfall. (Sweet potatoes are useful there. Oven roasted at high temps: much better than french fries.).

Over time my rice substitute became ….grated cauliflower! It was my means to continue to risotto; and pumpkin has become a diet staple. Chayotes are useful…but these vegetables are not Mediterranean standards so you need to consider your eating options outside the box.

Nonetheless, Spanish cuisine — and recipes — I found very KMD friendly. The Spanish tend to separate the grains from the rest of the meal — except for paellas.South American foods are different, though, because of the corn and beans.

My olive oil intake has gone up along with my consumption of olives. I buy Kalamata olives now in 6 km pales! But then I’ve always eaten Mediterranean influenced diet and am a keen cook.

There are some work arounds that can enable you to consume the edge foods like bread such as adding a strong acid — like vinegar or yogurt — to marry your consumption of higher GI foods .(This is why sour dough is preferable to normally yeasted breads: its’ acidic). But in my experience, nothing moderates the impact standard dried legumes have on my blood sugar –although my work around is to eat peanuts which are also a legume but with a much lower GI.

(So imagine: strawberries dipped in no sugar dark chocolate and rolled in crushed peanuts then chilled and served semi frozen)

I can’t give you medical advice without a 45-minute office visit which would include a physical exam and lab work. Nevertheless, I can make a few general comments about what some of my personal patients have done to good effect in this situation. Those with more excess fat weight to lose tend to do better by sticking with the Ketogenic Mediterranean Diet (KMD) for a while longer, perhaps one or two months. Those who are getting tired of the relatively high fish intake have substituted eggs, cheese, meat, or poultry. Or the other types of seafood you like, such as shrimp, crab, oysters, mussels, etc.

As you eventually transition toward a more traditional Mediterranean diet, go easy on the concentrated sugars and refined starches. E.g., try whole grain pastas and breads instead of the more refined products. If weight management deteriorates, you may need to count calories and not exceed your safe limit, or go back to reduced total carbs.

Good idea also to check out my page above called “Low-Carb Mediterranean Diet.”

You may have already changed your metabolism enough that you could switch to the traditional Mediterranean diet immediately without adverse effects on weight and blood sugar. Every case is different. If it were me, I’d sure keep exercising.

Best wishes,
-Steve