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  • Low Carb Danger for FH

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    Old 10-21-2004, 07:17 AM   #1
    Join Date: Sep 2004
    Posts: 205
    ty123 HB User
    Low Carb Danger for FH

    If you have FH, or THINK you have FH, you should be aware of some dangers in low carb dieting.

    For the average person there is probably little danger in a low carb diet in the short term. Nobody knows what a very high fat diet low carb diet will do in the long run, although all responsible medical authority predicts it to be unhealthy.

    What you should know is that it is extremely dangerous for someone with FH, because FH is characterized by an inability to process fat in the blood.

    If you don't know what FH is, you're in good company. Few on this board had heard of it, and most people who have it don't know it. It is a hereditary disease that affects 1-500 people in the US. This makes it possibly the most common blood disorder in the country.

    FH (Familia Hypercholesterolemia) comes in two basic flavors: Homozygous and Heterozygous. The former is very rare, and if you have it, you already know it because you'll have visible orange patches and severe atherosclerosis by your early 20's. Cholesterol levels in such people can top 2000.

    Heterozygous FH is inherited from only one parent (as apposed to two in the above type). It is characterized by:

    a) Total cholseterol levels above 350
    b) High LDL and low HDL numbers
    c) A parent with high cholesterol
    d) Significant atherosclerosis by early 40's
    e) Metabolic Syndrome
    f) Corneal arcus

    There are other cholesterol problems stemming from the thyroid, kidney, and the liver mainly. A doctor can diagnose FH either by inference from medical history which is most common, or a skin culture test that determines LDL receptor growth and capacity.

    Heterozygous FH is characterized by a genetic flaw that results in having roughly half of the LDL receptors in the liver and elsewhere. The LDL receptor is a protein that sits on liver cells (primarily) and provides what is called the LDL Receptor dependent pathway for the liver to take in and process LDL cholesterol.

    The LDL receptor takes in cholesterol to the cell, the cell fills with it, turns off the receptor, stops producing cholesterol itself, and processes the material in various ways. When it empties, it turns the receptor back on, and begins producing cholesterol.

    Having half the number of LDL receptors in FH means that the uptake of LDL is far slower. Your receptors are usually less efficient too, that means they take up LDL more slowly than normal. As a result the cell fills with cholesterol much more slowly and it doesn't stop producing cholesterol nearly as efficiently. It over produces. Your cholesterol "thermostat" doesn't shut off properly.

    Why isn't an FH homozygous/heterozygous person's cholesterol even higher than indicated above?

    That is because there is another way to process cholesterol. It is called the independent pathway. in high concentrations LDL cholesterol enters through a different route, literally forcing its way into cells without entering via the LDL receptor.

    The higher your concentration of LDL, the more this happens, the lower it is, the less. That's not only why FH cholesterol levels aren't higher than they are, it is also a reason why once you begin to lower LDL concentration, you lose some of that boost from the independent pathway, making reduction tougher.

    Low fat diets high in complex carbohydrates have shown efficacy in lowering blood cholesterol in FH, but usually only about 15% in a 20-30% fat diet, which is 10-20% lower than the average american diet of 40%.

    More extreme low fat diets such as Dr. Ornish's reversal diet have established efficacy in halting and even reversing atherosclerosis in the average person, but no specific scientific studies have been done for FH in particular. The few study participants unable to lower their cholesterol levels below 200 did show some reversal however.

    Statins and other related medicines do show good efficacy in FH, but typically stronger dosages are required to get the desired levels.

    In FH the response to weight loss and exercise is often dissapointing. It may not raise HDL or lower LDL. However, since an optimal weight and good exercise program promote good heart health, they're still recommended withing the bounds of your current health and ability.

    In conclusion, whatever your opinion on low carb dieting is, you would be wise to rule out FH in any of its many forms before trying it.

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    Old 10-21-2004, 10:08 AM   #2
    Join Date: Sep 2004
    Posts: 205
    ty123 HB User
    Re: Low Carb Danger for FH

    "Interesting to note Dr. Ornish diet led to a 50% increase in deaths (relative risk of course)"

    Phil, you don't even argue positions, you simply flat out lie and distort.

    Last edited by ty123; 10-21-2004 at 10:14 AM.

    Old 10-21-2004, 10:26 AM   #3
    Join Date: Oct 2004
    Posts: 41
    phil58 HB Userphil58 HB User
    Re: Low Carb Danger for FH

    Originally Posted by ty123
    "Interesting to note Dr. Ornish diet led to a 50% increase in deaths (relative risk of course)"

    Phil, you don't even argue positions, you simply flat out lie and distort.
    The relative risk showed a 50% increase in deaths. Remember this is the same relative risk calculation that shows a 25% reduction in heart attacks on Statins.

    2 people on the diet died
    1 person not on the diet died

    You can't have it both ways either reject relative risk on statins and accept the 1.7% overall statin improvement or accept the 50% relative risk on Dr. Ornish diet.

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