Cholesterol & Hormones | Diane Sanfilippo

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  1. Hey, Diane! I just watched your video, I’m still confused about the relationship between cholestrol and saturated fat (what’s the difference and what the relationship between cholestrol and saturated fat) . I just found out I have an APOE defect (I think it’s called APOE 3/4). I also don’t seem to be able to lose weight or manage weight very well by following the standard paleo advice about fats – types of fats and amounts of fat, also I think amounts of carbs. If I understand correctly, the APOE thing might mean that I might do better with less saturated fat and perhaps more unsaturated fat (I heard that olive oil might be especially good) or maybe less fat altogether. I don’t understand what the APOE thing might mean for my future of consuming animal fats. Also, APOE is just one little Gene (and what I have is I think just one little SNP of one little gene); I don’t know how to put that in prospective with everything else but I do know that the way that I have been eating has not been serving me well. I’d also like to do what I can to prevent Alzheimer’s, which I understand I am at some increased risk for because of the APOE.

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      We cover this in more detail in the Balanced Bites Master Class – it’s honestly too much for a basic YT video. We don’t get into the genetics or the detailed minutiae but we cover what matters. If you’re deeply concerned, work with a medical professional. Also, I’d peg you as a Questioner — are you? 🙂

  2. My doc is telling me I need to eat a low-carb and low-fat diet. I have to roll my eyes. The biggest reason I stay there is b/c of the tests they are willing to run…complete thyroid panel (not just TSH), complete cholesterol panel (not just the basic), but their dietary recommendations do not make any sense in light of the science. It’s frustrating b/c they seem to not understand the relationship between proper thyroid function and optimal cholesterol.

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  3. Hi Diane, I am a 58 year old female and have transitioned to a paleo lifestyle January of this year. On 3/16/17 blood tests revealed my LDL was up to 205, the lipid clinic suggested statins even though I eat clean, pretty much paleo as well as exercise. I said I would see if I could tweak my diet and check back in 3 months. Test results yesterday, LDL went down to 170. I was asked what I had done to lower my so called “bad” cholesterol, with a smile I replied absolutely nothing! You are so right about us taking responsibility for our own bodies and not being talked into taking a drug to mask underlying problems. You have been such an inspiration for my success, thank you!

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  4. I LOVED your comment and rant about taking a pill not being the same as taking care of yourself. I was just talking with a friend the other day that might have hypothyroidism and she basically said she just wants to find the right pill to take so she can move on with her life eating donuts and pringles. We rely so heavily on the quick fix that we forget there is an actual root cause to everything in the body! Great video!!

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  5. Thanks Diane! This gave me a little re-assurance. I’m a 30year old female who crossfits 5-6x a week, eats predominantly Paleo and my cholesterol came back high. Total was 244, LDL 164, HDL 77 and triglycerides were 74. I said what the heck. How much more can I change/implement to make this better. I’ve been eating Paleo and working out like this for 5 years. I was told it was “familial” by my dr. I’m glad I am just a somewhat normal, healthy female. Thanks!

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  6. Hi Diane! I am a long time listener of the BB podcast and I’m totally on board with the “take responsibility and take care of yourself” message you share! I am a new grad Pharmacist and I want to offer a counter perspective about statins. My role in the medical community is to advocate for appropriate use of medications, and I need to say that there is a reason statins are the drug of choice for high cholesterol. You make the point that cholesterol numbers don’t tell you what is going wrong in the body, and I agree! However, there is no other biomarker that better predicts someone’s risk for having a heart attack or stroke – especially when combined with blood pressure. So if someone comes into the doctor’s office with high cholesterol, it is irresponsible NOT to do what you can to reduce that risk. The approach of starting with medication may be the wrong one, but when statins have been proven to reduce the risk of death in those patients, it is the best we can do a lot of the time.
    When you see patients as a nutritionist, I’m guessing they are often the ones who are motivated to make a change in their diet. Physicians in this country don’t have that luxury, and I think many of them are jaded to offering diet advice, even if they had any good advice to give. As it stands, there is weak scientific evidence showing that any one diet can decrease cholesterol or decrease cardiovascular risk. Compare that with the evidence supporting statins and it makes sense why we use them so often.
    It is a seriously flawed system that doesn’t prioritize diet and lifestyle! BUT we have to recognize that the system is built on evidence, which means that we have use what we can prove works. The system is also full of people who got into medicine to help people.
    To summarize this long comment…
    1) Cholesterol numbers are a biomarker to predict cardiovascular risk (I also forgot to mention that the best way to interpret the numbers and what numbers to shoot for is still being debated)
    2) Statins have been proven to reduce mortality (especially for people who have already had a heart attack or stroke)
    3) There is no diet that has been proven in large trials to reduce cardiovascular risk
    4) The average patient is more likely to take a pill than any diet advice (ouch, it hurts to say that)
    Anyway, that is just my opinion. I’m doing my part to correct misinformation all the time by informing my colleagues that eating fat doesn’t giving you high cholesterol!!

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      Unfortunately, I don’t think you’re right on most of your summarizing points. Hopefully once you’re farther along in your practice you’ll learn more to help you see that.
      1- more and more cholesterol is NOT a predictor of heart disease – as proven by the Framingham study – and that many who suffered heart disease had lower cholesterol than those who did not
      2- this we can agree upon, but most being prescribed the meds have not yet had a heart attack
      3- a diet to improve CVD risk is one that reduces inflammation – which a paleo/real foods based diet DOES
      4- I think if you’re heading into the medical field and carrying that assumption with you and perpetuating that, then that’ll continue to be the norm. I challenge you to demand more of your patients, raise the standard, and disrupt the norm. People will do what works best in the long term, but they need the truth and the information. If you only expect low standards of people, then you will continue to set that standard of expectation for them and then so the cycle continues.

  7. Hi Diane, just now watched your video … great job. But please also explain to people that most Dr.’s (General Practictioners especially) do not know too much about nutrition (and the fact that some foods are healthy for us, some are damaging for us and others are neutral). Dr’s have very little nutrition education in MED School … so their focus IS ON drug therapy. But that should not prevent them from recommending to a patient that they seek the advice of a specialist in nutrition (Nutritionist). I’d been trying to explain all of these things to my 94 yr old mother-in-law. But since she had never heard about most of this stuff during her entire life, she was hesitant. But I could observe her getting sick after eating certain foods (gluten and sugar, in particular). So finally I suggested that she go to her Dr. to ask him about all this … and he gave her a referral to a nutritionist, who met with her last week. That specialist confirmed ALL that I had been telling my mother-in-law and now she is convinced she has to stay away from gluten and sugar and she will be on a diet that is more Paleo or ketogenic (my husband and I are also doing Ketosis with intermittant carbs). So she will see for herself if over the next few months her inflammation starts to subside. She also had a microbiome imbalance because after taking a treatment of antibiotics (which kills off all the bacteria in the gut) her Dr. had failed to instruct her HOW to build back up the good bacteria in her gut with the proper probiotic and prebiotic foods. We had fixed that as well and the Nutritionist confirmed all that I had been teaching her about which foods feed the good bacteria and which foods feed the bad bacteria in the gut. Thanks again for the good work you are doing to educate the public because the majority of the Dr.’s out there cannot do it, they were not trained in these things (for the most part).

  8. I just watched your video and read through the comments. My Doctor has told me that my LDL is high and I am on a pill to help reduce it. I only have a small part of my thyroid left and was diagnosed with hypothyroidism and am on a pill for that. I completely agree that I need to be addressing what’s going on inside and my Dr. is of little help. I am to exercise more and eat approx. 1000 cal per day but that doesn’t get to the “root” of the problem. I have tried a Paleo diet but haven’t stuck with it. I am 62 yrs old and about 50 lbs overweight. I have sleep issues, congestive issues and want to get better. Help!

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      I highly recommend working with a naturopathic doctor or functional medicine practitioner 1:1 either locally or via an online/Skype consult for your health concerns. As a nutritionist, author, and blogger, I can provide basic info as a spark for you, but the additional support for your particular case is best addressed in that setting.

  9. Dear Diane,

    First, I want to THANK YOU so much for your wonderful book, “Practical Paleo.” I had checked it out at our local library and decided I needed my own copy. 🙂 In the last 2 days, I have purchased a copy for both my mother-in-law and my daughter. LOVE the menus, the recipes and all the wonderful knowledge you share in that book! It led me to following your vlog.

    Triglycerides. Mine always run high, in fact in my last blood work (April of this year) they were 356! 🙁 My cholesterol was 195, HDL 35, chol/hdl ratio 5.57, LDL calculated 88.8, non HDL chol. 160. I have had hypothyroidism for over 28 years and my diet has been very close to paleo for years. The Dr.’s told me to stay away from “white” stuff – flours, etc., which I have not eaten for many, many years (except rare occasions if eating away). The last time the Dr. told me to eat low fat to get trig. down. You provide much more info. than they do. Would you have any advice for me?

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      1. Thank you for your response and your interest, Ms. Diane. I appreciate it so much!

        My diet consists of eggs, meat, veggies, nuts, seeds, almond and coconut flours, almond milk, berries, sweet potatoes, squash, and stevia for sweetener. I drink water, decaffeinated teas and shakes made with almond milk, pumpkin seeds, berries, stevia, and protein powder (occasionally). I never had alcohol or smoked and my activity level is mild to moderate exercise. My weight is not budging, even though I eat well. We thought I was in menopause (am 51 yrs old) until May when my cycle started in again after a year. My GYN scheduled me for hormone blood work and for ultrasound to check endometrial wall. My brain is currently working a little more than part-time, but becomes overwhelmed quite easily. In the past, I had episodes of hypoglycemia, but am doing better with that. On the upside, I can get out bed, make meals for my family, home school my boys and do my housework. 🙂 I am thankful for that.

        I would be willing to pay you if you would take me as a patient. 🙂

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          Hi Brenda – While I don’t take 1:1 nutrition clients any longer, I can definitely recommend that you find a naturopathic doctor or functional medicine practitioner who can run some test to help you out. Your nutrition seems really solid, so beyond that I’d say that being more active can help a lot, and otherwise you may have some liver support necessary. The liver detox meal plan in Practical Paleo 2nd edition is good start, but a professional is going to take you a lot farther!

          1. Thank you! I appreciate your advice and insights. I will see what tests results are, continue eating the way I do (Paleo and lovin’ it!), up my exercise, which btw my favorite is T-Tapp, and continue to study your book . 🙂 If none of those improve my condition, I will seek professional help.

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