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Dr. wants me to stop Paleo and start Engine 2 Diet. Should I?

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Updated about 7 hours ago
Created January 03, 2014 at 6:09 PM

My TLDL is 166, TC is 252, TVLDL 24, Trig 173, all my LDL Subclass 1 to 4 are win range except my Apoloproprotein B100 which is 122. My Apo B100/A1 Ratio is 0.73. My myeloperoxidase is 326. My A1C is 7.9; high runs in my family, maybe a little too much chocolate. My Dr says that my cholesterol is so bad that either I start eating the Engine 2 Diet or pick out my coffin. Since I have a 2 yr old daughter that is scary. I have lost right at 100 lbs and kept it off, but have stalled at 194 to 197 lbs. I am 5"8. What is frustrating is that he wanted these tests but can't explain them to me. I don't know if I need to go Vegan as he suggests or if I am on the right track. I've been following Paleo except for some sugar pretty good, feel good, haven't had a great amount of weight loss though. Any Paleo friends out there who can understand the numbers and give me some clues on what to do and if my numbers are that bad? Thanks!!

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41546 · January 04, 2014 at 5:03 AM

A1c to average glucose may not be exact, but it may be more accurate than Kresser is likely giving it credit for. A1c of 8% corresponds to an average BG of 183 mg/dL. 2 standard deviations is a range of 147-217 mg/dL. Even if Martha had very long-lived RBCs, she'd still probably be in the 147 mg/dL neighborhood, solidly diabetic.

I was not aware of the fructosamine test, but it's simply other A1c-like measure with the many of the same nuances and problems. Fasting BG can tell you how low your BG can get, and post-meal tells you how high it can get.

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915 · January 04, 2014 at 1:02 AM

Matt is the voice of reason on many posts & i second his concern. I'm not in any position to state fact, but i do agree with him. This needs sorting asap.

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26182 · January 04, 2014 at 12:58 AM

well the fact that he cannot explain them to a lay person does not mean that he does not understand them. My doctor confides in me that he hates the fact that many conditions are so complex that it requires a biology degree to explain them.

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4458 · January 04, 2014 at 12:43 AM

thx for the link Linds. i'm guessing that the reliability of the a1c increases with a high number ie. in this case 7.9.

Kurt Harris comments; "if it is below 5.5 you are done. If it is 5.5 to say, low 6s, do 24 hr and pp bg with fingersticks. If it is much above 6, then confirm it is high with fructosamine"

& Chris summarises; "To put the most accurate picture together, I like to have all four: fasting blood glucose, A1c, post-meal glucose and fructosamine. But if I only had to choose one, it would definitely be post-meal glucose"

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2318 · January 03, 2014 at 11:38 PM

I found this article stating why a1c is not a reliable marker ... just some food for thought although I agree that it seems very high

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41546 · January 03, 2014 at 11:25 PM

7.1% is still insanely high, and if that's as low as diet takes it, there's something wrong here. You really ought to find a doctor that deals with diabetes.

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41546 · January 03, 2014 at 11:23 PM

It's beyond the point of diet fixing it, very likely. How can your doctor not have you on medication for that blood glucose?

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8140 · January 03, 2014 at 10:18 PM

I second this. You should be VERY worried about that A1c and getting that down. That means dropping the sugars (even "natural" sugars permitted on paleo, limiting fruit (SMALL servings of low glycemic fruits like berries or melon a few times a week are OK), and watching those carbs if you want to be around and healthy for your family.

Your triglycerides will come down when you lower sugar/carbs. The total cholesterol and LDL will take care of themselves.

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10234 · January 04, 2014 at 9:07 PM

Considering your high TG's and A1C, the Engine 2 Diet contains everything you need to make a nice coffin. French toast. Fruits with chocolate sauce. Southern grits. This diet is a high glycemic carb atomic bomb.

When I was in a similar state - obese with A1C above 7 and blood glucose 200 fasting - my doctor recommended a carb counting diet which heavily restricted most of the foods the Engine 2 Diet promotes. Following that diet, it took several months to get my A1C down, but I was able to get the blood glucose levels under control within a couple weeks, well before I started losing weight. Having a blood glucose meter, and using it several times a day to check my response to various foods, helped a lot.

People used to post blood tests a lot here, but not so much in the last year. Paleo dieters tend to have high lipid numbers, TG's usually well below 100, and HDL's usually above 50.

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584 · January 04, 2014 at 1:08 PM

What exactly are you eating? List some of your staples and your main go-to foods. Are you following any specific paradigm, low-carb/high-carb/PHD/peatarian/low-fat/etc? Your triglycerides lead me to believe that you consume quite a lot of carbs. Not optimal for someone who is diabetic.

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0 · January 03, 2014 at 11:45 PM

Get a second and third opinion. Also I think Paleo can be adapted somewhat to individual needs, without violating any paleo rules--meaning perhaps for you you eat more chicken and vegetables and lay off red meat and pork--not sure if this would work or not, but I wouldn't jump ship. Also, it might be time to start tracking your calories and carbs for a bit to see if you are eating way too many carbs or way too many calories and thus stalling your weight gain.

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0 · January 03, 2014 at 8:33 PM

Check out these podcasts :

http://www.bulletproofexec.com/85-in-a-state-of-ketosis-with-dominic-dagostino-podcast/

http://www.bulletproofexec.com/69-clearing-up-cholesterol-with-jimmy-moore/

Lots of interesting thoughts on cholesterol. Bottom line is there are lots of people like you that have gone paleo/keto/high fat/low carb type diets and have improved every aspect of life except for cholesterol numbers going up and most doctors don't look at the big picture. You lost a ton of weight, energy levels are up, inflammation is down, gut irritation is gone, you feel better then you have in your entire life but one test number is up so immediately stop what you're doing. That makes no sense to me....but of course I'm not a doctor either. But I do believe that cholesterol isn't the end all be all evil that conventional medicine tells us it is.

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58 · January 03, 2014 at 8:25 PM

I agree with what people have already said. A lot of doctors really refuse to accept that foods can heal you! YOu can reduce cholesterol and still eat paleo :)

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208 · January 03, 2014 at 8:23 PM

I'm not a medical professional so I can't advise you on those numbers. However you said "What is frustrating is that he wanted these tests but can't explain them to me"

That tells me you need a new doctor. You might also want to track what you eat for a few weeks on paper or one of the online programs like paleotrack or cronometer. Then post results or do it yourself and evaluate how good you are being in eating. I wouldn't be consuming any sugar and my carbs would be veggies mostly, no fruits until you got your weight down closer to a goal.

Congrats on the initial major weight loss !!!!!!!!

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26182 · January 04, 2014 at 12:58 AM

well the fact that he cannot explain them to a lay person does not mean that he does not understand them. My doctor confides in me that he hates the fact that many conditions are so complex that it requires a biology degree to explain them.

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0 · January 03, 2014 at 7:42 PM

Ddiabetes is rampant in my family for generations back, along with high BP and low progesterone. (in the females). The lowest I have ever been able to get it is to 7.1, and that is only with massive exercise and eating nothing but meat and veggies. If I eat any sugar at all it immediately shoots up. I thought with loosing so much weight it would get better, but it has not. I have been stalled now at 195 to 197 lbs for about 10 months and it doesn't seem to matter what I do I'm not loosing any more. I do exercise about an hour a day and lift weights about 1 1/2 hrs a week. Going to stick with it, I want to live as long as I can for my daughter.

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41546 · January 03, 2014 at 11:25 PM

7.1% is still insanely high, and if that's as low as diet takes it, there's something wrong here. You really ought to find a doctor that deals with diabetes.

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915 · January 04, 2014 at 1:02 AM

Matt is the voice of reason on many posts & i second his concern. I'm not in any position to state fact, but i do agree with him. This needs sorting asap.

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41546 · January 03, 2014 at 6:47 PM

Ok, you've lost 100 pounds, you're doing awesome already as that a reduction in your risk.

Your cholesterol is not your problem. Sure, it's a smidgeon high and your trigs are high as well.

But your major issue is that A1C… 7.9%?! Translates to average blood glucose of 150-200 mg/dL! That's full-blown diabetes.

What exactly do you mean by "paleo except for some sugar"? Was the 100 pound loss doing paleo or something else?

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8140 · January 03, 2014 at 10:18 PM

I second this. You should be VERY worried about that A1c and getting that down. That means dropping the sugars (even "natural" sugars permitted on paleo, limiting fruit (SMALL servings of low glycemic fruits like berries or melon a few times a week are OK), and watching those carbs if you want to be around and healthy for your family.

Your triglycerides will come down when you lower sugar/carbs. The total cholesterol and LDL will take care of themselves.

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