I have lost some more weight, another 10 pounds since I started. But I was also interested in the effect it would have on cholesterol and triglycerides. I hoped that it would lower my triglycerides, raise my HDL cholesterol and not raise my LDL cholesterol too much. Fortunately, I had my lipid profile done last December so I could compare. Here were the numbers then (the normal range is within brackets[]):

Triglyceride (mg/dl): 112 [40-160]
Cholesterol (mg/dl): 153 [<200]
HDL (mg/dl): 31 [29-67]
LDL (mg/dl): 100 [<130]
TC/HDL ratio: 4.94 [<5]

Not a terrible profile by conventional standards. Everything is within normal ranges. Still, HDL is a little low and the ratio is just within normal range. And even though the triglycerides aren’t bad, there is plenty of room to push that lower.

So after three months of meat, eggs, cheese, veggies and nuts, what is my lipid profile now?

Well, first off, something in there is a red flag with my doctor, who wants to set up an appointment. Why don’t you take a look for yourself (previous numbers in brackets [] ):

Triglyceride (mg/dl): 48 [112]
Cholesterol (mg/dl): 224 [153]
HDL (mg/dl): 56 [31]
LDL (mg/dl): 158 [100]
TC/HDL ratio: 4.00 [4.94]

First the good news, triglycerides are down… way down. And HDL is up. But there is also bad news, my overall cholesterol and LDL increased dramatically. So am I worried? A little. The conventional wisdom is that higher cholesterol is bad. But I’ve also read several things which suggest that high triglycerides are an even greater predictor of heart disease. Also, I remember from Good Calories, Bad Calories that all LDL cholesterol is not the same and that larger, fluffier LDL is not nearly as dangerous as smaller, denser LDL, and that the kinds of foods I’ve been eating should lead to fluffier LDL. If most of the increase in my LDL is due to the size of my LDL cholesterol, rather than the number of them, perhaps it’s further good news.

Quotes like this about triglycerides from www.healingdaily.com encourage me:

It is believed that the triglycerides/HDL ratio is one of the most potent predictors of heart disease. It is generally considered that if this number is below 2 the person is generally at a low risk of heart disease. So, the lower your triglycerides, or the higher your HDL, the smaller this ratio becomes.

However, I’m not sure of the veracity of the info on that site. I have some research ahead of me. I’d love to see some more definitive research on the actual relative risks of LDL, HDL and triglycerides, to see if I want to rearrange my diet to get my overall cholesterol back under 200.

UPDATE: Originally, I had 244 for my total cholesterol, but I got the actual report today and it’s 224, significantly better. That also changes my TC/HDL ration to 4.00. I’m a little happier with these numbers. I have decided to cut down on eggs a little bit, more like 1-2 a day instead of 2-3. And I should really get an exercise program going. That should also have a positive effect on several of these numbers.

The most common symptom of biliary sludge — when it causes symptoms — is pain in the abdomen often associated with nausea and vomiting. This occurs when the particles obstruct the ducts leading from the gallbladder to the intestine.

Now, it’s not the worst pain I’ve felt in my life. I can certainly imagine pains that are deeper and more acute. However, it’s a very frustrating pain. My first few attacks, I didn’t even know what it was. I thought it was food poisoning. The nausea that accompanied it made me feel like vomiting might help, but it never did.

I tried a variety of products to lessen the symptoms. Alka Seltzer seemed to be the only one that had any effect.

When I finally talked to a doctor about it, he suggested that a pain reliever like Advil might help. “Take a few Advil when you feel the pain coming on.” So that is what I do now. When that pain starts to come on, I take a few Advil and/or some Alka Seltzer and lie down. Surprisingly it does the trick.

Now these attacks are infrequent. I had several last fall, but I think I’ve only had two this year. The hypothesis that I’m currently working under is that starches in my diet aggravate it. The first few attacks I had were after large meals with lots of rice. I also noticed that the lignans that accompany flax seed oil also irritate it, as do ground flax seeds themselves (the oil without lignans seems to be fine).

I’m now two weeks into a very low carb diet and one of my hopes is that it would improve my gallbladder. I have felt a little better lately. Although, I have occasionally felt a bit of pressure near my gallbladder, it has been faint and less frequent since my diet became mostly meat, eggs and cheese (I also consume a fair amount of walnut and flax seed oil).

But yesterday, I had another attack. It would have been bad if I’d not taken the Advil right away and been able to lie down for an hour. It did pass, but now I’m left with a mystery. What if anything in my diet brought on the attack? Here is what I can remember about my diet in the previous 24 hours:

• The bulk of my diet was meat, eggs and cheese. That morning, I had two eggs and some ham for breakfast.
• I also had some yogurt with a few berries for breakfast. I haven’t had any yogurt for at least a week. It’s always gone down easy before however.
• The night before I had a diet Pepsi. I haven’t had one of those in a while. It doesn’t feel like a likely cause however.
• I had an early lunch consisting of a small piece of grilled chicken, a boars head hot dog and a small sandwich with a slice of salami, some colby cheese and a slice of whole wheat bread. I had also had a single piece of this same bread the night before.

I’m left with several possibilities. One is that the low carb diet is not helping. Perhaps it’s even worsening my gallbladder, and that what you are eating over the medium term (the last few weeks) is more important than what you have eaten in the last 12-24 hours.

Another possibility is that one of the new items in my diet brought on the attack. The most likely candidate was the whole wheat bread. I had decided to add some bread back into my diet and bought the most whole wheatiest bread I could find, from the local health food store. I had one slice on Tuesday night, just after I bought it and another Wednesday morning with my small sandwich.

If it was the bread that set off my gallbladder, that is very alarming. A single piece of wheat bread brought on an attack (maybe two small slices including the one from the night before). This makes me quite sad, I really like dense, grainy breads and hoped that I could reincorporate them once I had lost a few more pounds. If I’m right, I may not be able to ever eat them again, or at least for a very long time.

Of course the other most likely culprit is the low carb regimen in general. Perhaps I’m bound to have more and more of these attacks and that the added fats in my diet are two much for the gallbladder.

Lastly, the medical literature often speak of “rapid weight loss” as a factor in gallbladder sludge. Perhaps I’m doomed to have gallbladder problems as long as I lose weight.

For now, I’m going to keep bread completely out of my diet and see what happens. If it’s the low carb diet doing it, I’ll have another attack sooner rather than later. If it is the bread, then this should help.

After five days, I’ve had no real weight loss. After a big meal, I’ve occasionally felt a bit overfull, which probably means I’m eating more than I need to. And on day two I had a small carb crash. But in general I’ve felt good. I haven’t felt very hungry. The food is relatively satisfying and the restrictions haven’t been hard to stay within. I miss the fruits and vegetables a bit, but I’m thinking that I’ll add a few servings of them back eventually.

I’ve also noticed many slight improvements like better oral hygiene, and there is no delicate way to put this… I have no gas. Yep all you vegetarians, I can confirm, it’s the carbs that are making you fart. I’ve had barely a peep the last few days.

Is this too much information? I think it might be, but in order for this experience to be of any use to something reading this, they have to hear the details. With all this fat in my diet I’m experiencing none of following:

• Heartburn
• Gas
• Indigestion
• Constipation
• Abdominal pain or discomfort

In other words, the body seems to process this food easily. This is hardly surprising since humans have been meat eaters for something like 200 million years. But it’s also not very meaningful. It will take a few months like this to figure out if there is much benefit to it.

Lastly, I think that my gallbladder feels a bit better. Of course, I’ve not had an attack, but also, the slight pressure that I’ve often felt on my right side is missing. Again this doesn’t prove much, since I’ve had plenty of good days over the last six months. The real proof will be having another ultrasound in months and finding that the gallbladder looks much better. I’m looking forward to a checkup after 3 or 4 months free of any gallbladder issues and report to my doctor that I achieved it by doing the exact opposite of what he suggested with lots of cholesterol rich foods like eggs and cheese.

Oh and I would not recommend this to someone who is having gallbladder issues. It’s a shot in the dark and I could easily be very wrong. Check back in a few months and I’ll let you know if I’m still feeling better.

The book is dense, bringing together a huge number of scientific studies that date back to the beginning of the the 20th century. His goal seems to be to overwhelm the reader with evidence that many of the assumptions about diet, obesity and disease are wrong. He isn’t content to give you one or two examples of studies that suggest that carbohydrates are the primary factor behind obesity, diabetes, heart disease, cancer and a range of other modern illnesses that were rare before the 20th century. He piles it on, determined to make sure that someone can’t read his book and dismiss it as “some fad diet book.” If you say he is wrong, you better bring your citations with you.

I’ve enjoyed the ride, but I wonder how many readers get bogged down and don’t finish it, or don’t care so much about the reams of evidence that Taubes has compiled and want to skip to his conclusions. One passage near the end that jumped out at me as something that people need to know:

By the mid-1960s, four facts had been established beyond reasonable doubt: (1) carbohydrates are singularly responsible for prompting insulin secretion; (2) insulin is singularly responsible for inducing fat accumulation; (3) dietary carbohydrates are required for excess fat accumulation; and (4) both Type 2 diabetics and the obese have abnormally elevated levels of circulating insulin and a “greatly exaggerated” insulin response to carbohydrates in the diet

He has done a good job. His book is why I’m trying a low carb diet. I’m taking a gamble, even going directly against my doctor’s orders to lower my already low cholesterol, hoping that would help my ailing gallbladder (after all, my first three gallbladder attacks all came after large restaurant meals full of carbs).

I’m going to give it a try. I’ll see how I feel in a month. Will I feel better? Will I lose the 20 pounds I have left to lose? Will I have another gallbladder attack? I’ll let you know.

UPDATE: I blogged too soon. I’m now in the epilogue and he has 7 main points he was trying to communicate in the book. I’ll add them here later.

It’s very odd eating this much meat, cheese and eggs, especially when it’s not mixed in with noodles or bread. It’s almost a chore to eat two scrambled eggs and a ham steak for breakfast. I get full fast and even after a couple of days I’m kinda bored with the menu. On the positive side, I’ve already seen the scale start to budge a little and I’m feeling pretty good overall.

On the negative side, I think I’m experiencing a little carb crash. Today after lunch, I got very tired and my body felt a little tingly. It’s supposed to go away after a few days as your body switches gears and gets used to all the missing carbs. My plan is to eat a few berries with plain yogurt when I feel that way.

Yesterday morning (3/26), before I started the low carb diet, I weighed 176.4, about 20 pounds from my goal weight.