I am diabetic with a history of heart attack and CABG. I was slowly drifting into really unhealthy numbers so in 2019, we decided to close our restaurant, and I started a weight loss journey. The first year I lost less than 10#. I got on trulicity and over the next two years, I lost another 20 pounds. But my triglycerides remained stubbornly high. I finally got a referral to a lipidologist who tested by Apo B and I was in the high-risk range.
But his diet recommendations were going to be impossible for me to achieve. I could not give up that much joy to extend what would then be a life of much-reduced happiness. His was a 15% diet and that was NOT going to happen.
So I spent a month diving into what the evidence was. I found a YouTube channel {Nutrition Made Simple} by Dr Gil Carvhalo. He presents studies and breaks them down, showing their strengths and weaknesses and tried to put them in perspective of other studies. His number one piece of advice is the best diet is one you can stick with. Based on a lot of research, reading at least the executive summaries and conclusions sections of a heck of a lot of papers, and consulting with my endocrinologist and a nutritionist, I had a plan. My atorvastatin was raised to a maximal dose as was my trulicity.
December 2022 and January 2023, I restructured my diet with the goal of reducing high triglycerides and high ApoB. I eliminated all refined carbs from my diet replacing them with whole grains and polysunsaturated and monounsaturated fats, and upping fats from fish. I cut my red meat consumption by about half but my total animal protein intake was higher. And I eliminated all processed meats {My total bacon sausage intake was maybe 2 servings in 90 days down from 3/4 servings a week! After 90 days of this here is what happened|
Triglycerides >500 to ~260 {yikes! to much better but still of concern}
Apo B from 110 {high cardiovascular risk} to 66 {normal risk}
a1C from 7.1 to 5.7
Lost 20#
At that point, we started adding things back to our eating…
eggs {maybe 3 a week, some weeks more, some none. I eat them when I want them}
dairy. some low fat and some full fat. Over half is yogurt, the rest cheese and ice cream, and a tiny bit of milk/cream in cooking
ice cream, specifically {4 oz portions 2 or 3 times a week.}
All of these additions are backed up w/lot of evidence in studies and meta-analyses.
I adopted regular resistance and core training. After 6 months of eating eggs, dairy, and ice cream, but keeping my saturated fats from red meats low, here is what happened:
Triglycerides mid 200s to low 200s
ApoB remained essentially the same
Lost 10 more pounds
a1C constant at 5.7
So very consistent with the data and results Dr Carvahlo and so many others promote, nut gets lost in the social media health world.
Caveats apply:
My partner joined me in our dietary changes. She lost 25# in the 9 months. Her support has been essential.
These are only my results, not a scientific study. This is an anecdote and only 1 data point.
Drugs and weight loss drove a lot of the first round of improvements. But so did the diet, as it was part of the increased rate of weight loss. With the exercise I now do, the 10# loss in the second period understates the benefit as I now have more muscle mass and less fat in my body composition.
Other diet plans might have worked just as well. But this diet, based on the so-called Mediterranean diet, is the most natural one for me to go to. I took a lot of stuff I ate in smaller amounts and made them into the majority of my diet. And I kept treats {stuff eaten daily like nuts and dark chocolate} indulgences {every couple of weeks} in my plan. And I just say eff it and have a pizza or a trip to a steak house or butcher {maybe once every two months}
Why the saturated fats I choose to eat? Because there are loads of studies showing these fats reduce the risk of coronary events, help a1c, etc. Other fats do not have that kind of support in the data. I have my opinions on keto or carnivore diets, but that is for a different discussion.
Here is the link to Dr Carvalho’s YouTube channel. I use this as food for thought, not specific medical advice. Everything I learn here I bring to my medical team and make a plan off of that.
