Low fat diet advice please

[wiseguy]

After finally getting a handle on the low carb diet I now find that I must also reduce my fat intake (high triglycerides reading). I swear this disease is determined to make a vegetarian out of me.

From what I've been reading there are basically four types of dietary fat. Two bad (saturated and trans fat) and two good (monounsaturated and polyunsaturated). At my current calorie level I've been told to limit my "total fat" intake to 60 grams per day. What I'm wondering is why the limit on "good fat"? Is too much good fat bad for you? How much good fat is too much? Wouldn't it be easier to simply limit the bad fats? If only limiting bad fats, what would be a daily limit considered "low fat"?

[REDLAN]

I'm sorry I can't advise you on what are the best fats - I personally don't find the evidence very convincing, but that it is another story.

However, and I apologise if you've already sussed this, but you can't eat a low fat AND a low carb diet.

You can do one or the other, but not both. While there is little evidence of harm, no human diet (that I know of) goes much higher than 30% calories as protein. 35% would be an absolute maximum - besides which it's very hard to eat high protein, without also eating high fat.

typical intakes for protein range between 15%-25%. The rest of your calories is balanced between carbs and fat.

so a typical low carb diet would be 20% carbs, 20% protein and 60% fat, while a typical high carb low fat diet would be 55% carbs, 20% protein and 25% fat.

you have to choose...

at the end of the day eating less fat means eating more carbs.

[volleyball]

There has much said that bad carbs are the source of bad triglycerides. I had high triglycerides before my diabetes and at diagnosis. I went good carb and the triglyceride problem went away.
Bad fats are the ones that are modified such as anything hydrogenated. That is the simple answer.
Funny thing is the bad carbs are usually paired with the bad fats in processed foods.

[BlueSky]

... I now find that I must also reduce my fat intake (high triglycerides reading). .....
While dietary fat does get broken down into triglycerides, the main cause of high triglycerides is carbohydrate. And the more insulin resistant you are, the bigger that effect tends to be. Soon after it is consumed, carbohydrate is broken down into glucose. But if it can't get into cells because of insulin resistance, this glucose finds its way to the liver where it is converted into triglycerides. This is why people with metabolic syndrome and/or type 2 diabetes often have very high triglycerides. And why replacing carbo with fat in the diet normally reduces triglycerides.

If this is not happening with you, perhaps it is a reflection of your insulin resistance. Giving it more time may help as it takes a while to become "fat adapted". Cutting back on fat essentially mean that you have to eat more carb to maintain your weight, and that won't help. IMO, the only fat that should be restricted is trans fat. In addition to reducing tri's, getting your calories from saturated fat also increases your HDL ("good" cholesterol). ;)

[Cyborg]

Personally, I try to limit fats to the good fats, without keeping track of those. The only bad fats I have are pretty much my weekly chicken wings and my bi-monthly smoked baby back ribs (homemade, of course). I probably eat more grams of protein than carbs on any given day, but I try to only eat good carbs (no refined sugars, breads or high glycemic index carbs).

I am overweight, I don't exercise enough, and I do have fairly high insulin resistance. My ISF is about 20 (1 unit of insulin will drop me 20 units in about 4 hours) and my I:C ratio is 1 unit per 5 grams of carbs. I go through 50 to 100 units of insulin per day.

I had an a1c of 5.4 and my triglycerides were 58 as of last week. You don't have to become a vegetarian to control your bg and triglycerides. Good luck...

[REDLAN]

from what I have read - insulin resistance can contribute to raised triglyceride levels. High triglycerides are considered a symptom of metabolic syndrome.

my understanding is that high fat diets can increase insulin resistance - although the evidence for this isn't very strong, and the effect probably isn't very significant. Calorie restriction significantly improves insulin resistance and is the source of all those miracle cures we keep hearing about - well at least that's my conviction.

anyway some good fat advice (with some real proper honest to goodness solid evidence to back it up)

if you want to lower your triglycerides then increase your omega 3 intake. AHRQ (Agency for Healthcare Research & Quality - a branch of US gov) conducted a systematic review of the effect of omega 3 on cardiovascular risk factors, and they concluded

A large, consistent beneficial effect of omega-3 fatty acids was found only for triglyceride levels.

they concluded that omega 3 increased total cholesterol and LDL a small amount, while lowering HDL levels - both in the wrong direction

Health Effects of Omega-3 Fatty Acids on Cardiovascular Risk Factors and Intermediate Markers of Cardiovascular Disease: Structured Abstract (http://www.ahrq.gov/clinic/tp/o3cardrisktp.htm)

You can read the full PDF document from this page if you wish. They concluded that omega 3 supplementation could reduce triglycerides by 10-25%. Greatest reductions were seen in those with the highest triglyceride levels.

However it has to be borne in mind that the clinical studies all used pharmacological quantities of omega 3 - dosage was between 1g and 6g daily. 6g was considered maximum as it was believed that there was no therapeutic benefit to omega 3 supplementation beyond these levels. You would need to consult your doctor before taking these kind of levels of omega 3, and one other caveat...

I couldn't find a mention of omega 3 on triglyceride levels in type 2 diabetes, so the results may not hold for this group.

[wiseguy]

However, and I apologise if you've already sussed this, but you can't eat a low fat AND a low carb diet.
This of course would be relevant to what you consider "low carb" and "low fat". My low carb diet consists of under 20 carbs per meal and a maximum of 80 carbs per day. The doctor says to keep total fat to under 60 grams per day. I have been able to meet both these criteria over the past week.

[Handybear]

Hi, I am on a very low carb diet and initally during the diet your triglycerides will increase due to weight loss. But my body has adjusted. Look at my triglyceride level. I eat bacon, ham, steak(no fat trimming) pork chops. I use coconut oil to fry my eggs in. I use butter on all of my vegetables and olive oil and vinegar for my salad dressings. I personally don't believe that eating fat is the cause of high triglycerides or all eskimos would be taking cholesterol medication!

[Cyborg]

However, and I apologise if you've already sussed this, but you can't eat a low fat AND a low carb diet.

You can do one or the other, but not both. While there is little evidence of harm, no human diet (that I know of) goes much higher than 30% calories as protein. 35% would be an absolute maximum - besides which it's very hard to eat high protein, without also eating high fat.

Why not? That's how I eat. Some days I eat practically no carbs at all, while still eating low fat...

[REDLAN]

I think there is some misunderstanding/disagreement as to the meaning of "low" - in this case low carb or low fat.

My understanding is that the low refers to the relative contribution each nutrient makes to total calories. A typical low carb diet is 20% or less total calories to come from carbs. This is the meaning applied in scientific nomenclature.

I would suggest that using it to refer to quantities, means that in practice low fat AND low carb actually means a low calorie intermediate carb and intermediate fat diet.

wiseguys example...

80g of carbs and 60g of fat would give a total of around 860 calories.

assuming a welterweight 2000 calorie daily requirement, this is still a lot of protein - 285g or so

this translates to around 1kg of grilled rump steak (according to my diet book, this is cooked not uncooked weight). Interestingly this would give you around 50g of fat - so your daily allowance of fat from other sources is just 10g

you could substitute chicken breast instead to give yourself more leeway, but this still translates to around 1 kilo of chicken .

I personally don't see how such a diet is sustainable in the long term.

I would suggest in reality you are looking at getting no more than around 35% of your calories from protein, which translates to around 1300 daily calories- this is a very low calorie diet, and I really don't see how you can maintain this for any length of time.

this is what I was getting at - hope that clarifies things (",)

[BlueSky]

Why not? That's how I eat. Some days I eat practically no carbs at all, while still eating low fat...
Most so-called protein foods also contain a lot of fat. As a general rule, only 25% of the of the weight is in fact protein. So you would get about 25 grams of protein from a 100 gram steak, piece of fish or chicken.

Protein is relatively expensive. And there is not much point eating more that 0.8-1.2 grams per Kg of body weight every day (depending on activity level). The body doesn't need those surplus amino acids, so much of them are just converted to glucose, before it is turned into fat anyway. Excess protein is an expensive and inefficient source of energy.

[Cyborg]

For protein consumption, I try to ensure the lowest fat content possible when it comes to meats, such as fat free lunchmeats, skinless chicken breasts, 90% lean ground beef, fresh fish, lean pork, beans, eggs, etc. For me, the exceptions would be cheese, which I try to limit and my weekly chicken wings.

Of the good fats I enjoy, those would include olives and olive oil, avocados, almonds and other foods that are not high in bad fats.

I suppose I should keep track of what I eat for a few days and figure out the precentages of each nutrient...

[BlueSky]

.... I suppose I should keep track of what I eat for a few days and figure out the precentages of each nutrient...
You can do that at FitDay - Free Weight Loss and Diet Journal (http://www.fitday.com/) . The online system is free. Enter all the food you eat and it calculates the number of calories, as well as the breakdown between the different macronutrients. It also does lots of other stuff that is useful for dieting. You may find the percentages work out quite differently to what you expect them to be. ;)

[wiseguy]

I think there is some misunderstanding/disagreement as to the meaning of "low" - in this case low carb or low fat.

My understanding is that the low refers to the relative contribution each nutrient makes to total calories. A typical low carb diet is 20% or less total calories to come from carbs. This is the meaning applied in scientific nomenclature.

I would suggest that using it to refer to quantities, means that in practice low fat AND low carb actually means a low calorie intermediate carb and intermediate fat diet.

wiseguys example...

80g of carbs and 60g of fat would give a total of around 860 calories.

assuming a welterweight 2000 calorie daily requirement, this is still a lot of protein - 285g or so

this translates to around 1kg of grilled rump steak (according to my diet book, this is cooked not uncooked weight). Interestingly this would give you around 50g of fat - so your daily allowance of fat from other sources is just 10g

you could substitute chicken breast instead to give yourself more leeway, but this still translates to around 1 kilo of chicken .

I personally don't see how such a diet is sustainable in the long term.

I would suggest in reality you are looking at getting no more than around 35% of your calories from protein, which translates to around 1300 daily calories- this is a very low calorie diet, and I really don't see how you can maintain this for any length of time.

this is what I was getting at - hope that clarifies things (",)
Actually, this daily menu consists of my usual flax seed meal muffin for breakfast (2 carbs - 24 grams fat) and a Lean Cuisine meal (20 carbs - 7 grams fat) for lunch and dinner. This leaves a little carb and fat allowance for snacking throughout the day.

But you are right, I cannot stay on this type of diet for an extended period of time.

[volleyball]

I was wondering if the high trigy. were new and a product of the very low carb. I'd expect the trgy. to reduce in the long term but they may rise in the first few month.
And are you building more muscle now?
And what about your alcohol intake?

I don't know the definitive answer but maybe we can come to a solution.

I agree you don't want too much protein and 1300 calorie is too low.
Maybe a good mixed salad with olive oil and vinegar would be helpful

[wiseguy]

I was wondering if the high trigy. were new and a product of the very low carb. I'd expect the trgy. to reduce in the long term but they may rise in the first few month.
And are you building more muscle now?
And what about your alcohol intake?

I don't know the definitive answer but maybe we can come to a solution.

I agree you don't want too much protein and 1300 calorie is too low.
Maybe a good mixed salad with olive oil and vinegar would be helpful
The high Triglycerides, along with genetics, may be a product of the low carb diet although this would go against everything I've been reading on the subject. The previous reading (last January), before I started low carbing, was only slightly elevated.

I have been doing some heavy resistance training for the past nine months or so. I do not drink alcohol in any form.

[volleyball]

I went low carb and then I went to mostly cutting out the bad carbs. I eat plenty of fat and do a fair amount of weight exercises.
Maybe upping your carbs with only whole grain or any slow release carb will put you on track. Ask your doc if going another 30 - 60 days and being retested to see if you are back on track before going on meds

[wiseguy]

I went low carb and then I went to mostly cutting out the bad carbs. I eat plenty of fat and do a fair amount of weight exercises.
Maybe upping your carbs with only whole grain or any slow release carb will put you on track. Ask your doc if going another 30 - 60 days and being retested to see if you are back on track before going on meds
Since last January I have been on a diet of no more than 80 carbs per day while also consuming nothing with a GI rating of over 55. With a triglycerides reading of over 5,000 I don't think any diet is going to get it into normal range. I have decided to forget about counting fat carbs. I can find no evidence that reducing fat intake helps to lower triglycerides. I will stay on my low carb diet, continue to take the Lipitor, and see what the tests say in a couple of weeks. If no improvement at that time I will be forced to add the Gemfibrozil to the regimen.

[Cyborg]

With a triglycerides reading of over 5,000 I don't think any diet is going to get it into normal range.

I still doubt those test results... :vroam:

[wiseguy]

I still doubt those test results... :vroam:
It has been confirmed. I nagged the doctor until he sent me in for another test. Although this one was not a fasting test the triglyceride results (5,965) were even higher than the previous test.

[Cyborg]

What could possibly be causing it to be so high? Perhaps there is some other unknown disorder that is causing it. It doesn't seem like any type of diet change could bring those numbers down. Your daily diet now certainly doesn't consist of gallons of saturated fat! There has to be some other explanation. Are you seeing an endocrinologist?

[wiseguy]

What could possibly be causing it to be so high? Perhaps there is some other unknown disorder that is causing it. It doesn't seem like any type of diet change could bring those numbers down. Your daily diet now certainly doesn't consist of gallons of saturated fat! There has to be some other explanation. Are you seeing an endocrinologist?
It's genetics. My father once had a triglycerides reading of over 7,000. He was able to control his with medication so hopefully I will be able to do the same.

[BlueSky]

It's genetics. My father once had a triglycerides reading of over 7,000. ....
If it was genetics, surely your triglycerides would have been high all along. Your tri's went from normal (<200) to 5,000+ in a short time..... :confused:

[wiseguy]

If it was genetics, surely your triglycerides would have been high all along. Your tri's went from normal (<200) to 5,000+ in a short time..... :confused:That short time was a span of ten months. All inherited conditions do not start at birth. Like diabetes, all your life you don't have it then suddenly you do. People live half their life with normal cholesterol levels to one day find they are severely elevated.

As with the case of my father, who had a complete physical annually, triglycerides were always fine until the year they were over 7,000.