I don’t think I’ve ever considered myself fat. I’ve always been active. I mean I ran track and played basketball in high school. And since then, I’ve done some sort of walking, biking, jogging, or weight-lifting on a daily basis. Plus where I live in Colorado, hiking and snowboarding are almost a requirement.
My diet’s always skewed towards what most would consider healthy. Plenty of whole grains, fruit, veggies, some meat, but pretty light on the fat – predominantly chicken breasts, lean turkey, and fish. I’d grab fast food or healthy casual (Chipotle, Qdoba, etc.) maybe 4 times a week. But other meals were cooked from scratch at home (thanks to my wife).
Why it all began
My fondness for butter (and fat in general) started in August of 2016 with a routine visit to the doctor. I should say routine for some people, but not for me, and probably not for most men between 20 and 50. I was going in for my first physical since college, maybe even since high school. I really don’t remember.
So why go now? I’ve never had any serious health concerns. I’m fairly active, I’m not overweight, I eat fairly healthy most of the time.
Well, a month prior, my dad went in for open heart surgery. He had an aortic aneurysm – a bulge in a weak spot of his body’s main artery. He was lucky they caught it before it burst. Most people don’t survive the bursts.
Anyway, he got through it just fine. But, it got me thinking about my own health. Am I at risk for something like this? Am I walking around with some ticking time-bomb of an issue waiting to go off at any moment?
Off to see Dr. G
Now, if you haven’t been to a doctor in a while, it’s hard pick one. You can find a few online reviews, but most of them aren’t very helpful. Especially if you have no idea what you’re looking for. So, I defaulted to the same general practitioner my dad was seeing at the time – we’ll call him Dr. G.
The visit itself was pretty uneventful. But the lab work later that week turned out to be fun! The morning of the test, the lab tech calls my name and she hands me a cup.
Me: “Wait…what am I supposed to do with this?”
Lab Tech: “That’s for your urine test.”
Great. Somehow when Dr. G was mentioning blood work, the words “urine test” failed to reach my ears. Nothing like a pop-pee quiz in the morning! I had already been fasting and I hadn’t been drinking much. In fact, I had just peed while i was killing time in the lab waiting room. So, the lab tech introduced me to my new best friend – the drinking fountain.
After some brief chugging-like-there’s-no-tomorrow, I got back into the lab and forked over the fluids.
I have a cholesterol fever and the prescription is…
A couple days later, I got a call from my local Walgreens that went something like this:
Pharmacist: “Mr. Eat Your Cheerios?” (most people can’t pronounce my last name right out of the gate) “Your prescription is ready to be picked up.”
Me: “Uhhh…okay. For what?”
Pharmacist: “For Lipitor” (actually, I don’t remember if it was Lipitor or some other statin)
Me: “Oookay. Thanks.”
It turns out our friend Dr. G got my lab results back, noticed my cholesterol was high, and was nice enough to save me some time and hassle by submitting a drug order directly to Walgreens without consulting me first. Super easy for me, right?! All I had to do was drive a couple blocks, pick up my new drugs and carry on with the rest of my normal adult life.
But, I’m not normal. By nature, I’m a scientist. I question. I dig. I ponder. Even if something is generally accepted as true, I still want to know why.
So instead of going to the pharmacy, I vented to my wife. I don’t remember exactly what I said, but my complaining probably included plenty of frustration over the audacity of this medical professional to assume I don’t want to discuss different treatment options and that I’ll just blindly accept whatever drug he decides to dispense my way.
My next move was to call Dr. G. Our conversation went something like this:
Dr. G: “Well your total cholesterol is high and your LDL is high. I’ve diagnosed you with Pure Hypercholesterolemia. Since your otherwise pretty healthy, I believe your high cholesterol is due to genetics.”
Me: “I don’t know any of my family’s cholesterol numbers, so I guess that could be the case. But, what about my HDL and Triglycerides? They seem pretty good, right?”
Dr. G: “Well, some studies are showing that too much HDL might be bad for us.”
He went on to explain how i should take the statin he prescribed and come back for follow up blood work in a couple months.
Confrontation is not my strong suit. So, instead of responding with something like, “I don’t know what kind of Banana Republic operation you’re trying to run here!” I kindly wished him a good day and hung up the phone.
Besides, I had a lot of research ahead of me.
Here are my numbers
Nothing too crazy here. My LDL and total cholesterol are high, my blood pressure is borderline, but still good. The rest of the numbers are actually decent.
I started by scouring the web for everything I could find on cholesterol and statins. Most of what I found was pretty consistent with the American Heart Association and what we typically see in the media:
High cholesterol leads to heart disease and stroke…HDL is good…LDL is bad…eat less fat and your numbers will improve.
After lot’s of ho-hum data, I eventually ran across some resources that had a completely fresh take on cholesterol, cardiovascular disease, and fat:
- The Great Cholesterol Myth by Jonny Bowden, Ph.D. and Stephen Sinatra M.D.
- Wheat Belly by William Davis, M.D.
- Grain Brain by David Perlmutter, M.D.
- Eating Academy the personal blog of Peter Attia, M.D.
Coincidentally, my wife had already started reading a couple other books along the same lines including Why We get Fat by Gary Taubes.
“Fat is good” and other mind blowing discoveries:
- Eating fat doesn’t make us fat. But, carbs do. More specifically, it’s the insulin spikes induced by carbs that make us fat.
- Saturated fat is good for you. In fact, in many ways it’s better for you than carbs.
- High Cholesterol as a whole, does not cause cardiovascular disease. I’ve learned that fasting glucose levels, triglycerides, and especially HBA1C are better predictors of heart disease than cholesterol.
- Most doctors (including our friend Dr. G) don’t measure cholesterol correctly. They measure LDL count when they should be measuring the size of the LDL particles. Big and fluffy is good, small and dense is bad. Thankfully, you can estimate your particle size by looking at the ratio of triglycerides to HDL.
- Cholesterol is good. As long as it’s not the small dense LDL type. Cholesterol is responsible for transporting hormones and nutrients throughout the body.
- Statins can have unhealthy side-effects. Statins can disrupt our body’s natural process of dealing with inflammation, which can in some cases lead to cholesterol that is too low.
Back to the Doctor
Armed with more more info, I decided to get a second opinion. I tried to focus on doctors that mentioned an interest in metabolic disease or diabetes in their bios, since my reading was starting to convincing me of a high correlation between heart disease and diabetes.
The new doctor I chose (we’ll call him Dr. H) looked at my prior test results and gave me some great news. When taking into account all of my other risk factors for cardiovascular disease (age, waist size, no family history of heart disease, good HDL and triglyceride levels), I wasn’t even close to needing a statin!
So all is well, right?
Yes, but I think I can do better
Motivated by my new found counter-intuitive research, I wanted to try something crazy. I was going to completely flip the food pyramid upside down. For the next 12 months I would cut my carb intake (especially sugar, fruit, and bread), up my fat intake, and veggie-up a little more. Would I see I difference in my next blood test? I think so.
Technically, this is an upside down version of the outdated government food pyramid from 1992. The latest guide is actually a plate and sadly, they eliminated the fats section all together.