Are you ready for the most alarming statistic you will find in this book? About 75 percent of people who have diabetes will die of heart disease.1
The deteriorated state of health—now known as the metabolic syndrome—that brought you to your diabetes diagnosis eventually leads to the formation of artery-narrowing plaques that cause reduced blood flow to your heart. In the worst cases, this progresses to arterial blockage, causing a heart attack. Half of those who do not survive their heart attack will die within the first hour; many will not make it to the hospital.2 Even if you do survive that heart attack, your heart muscle will never be the same.
PROTECTING YOUR HEART
Heart disease and diabetes are a deadly duo. In fact, if you have diabetes, your risk of having a first heart attack is about as high as the risk of someone without diabetes who’s already had a heart attack.3 In other words,the moment you officially become a diabetes patient,you are automatically at risk for heart disease, even if you’ve never had any heart problems.During the decades in which you gradually developed diabetes, your blood vessels were suffering the kind of damage that often leads to a heart attack.
Because you can control what goes in your mouth, you have a unique opportunity right now to choose the alternative path to better health. Heart disease and diabetes aren’t inevitable—there’s plenty you can do to minimize your risk. In addition to getting your blood sugar and blood pressure under control, you also need to look at your blood lipids—the cholesterol and fats in your blood. And instead of relying on the standard pharmaceutical approach of cholesterol- lowering drugs to manage high blood lipids, wouldn’t you rather target the underlying reason for this condition? That’s what you’ll do on the Atkins Blood Sugar Control Program (ASBCP).
RESEARCH REPORT: A HIGHER RISK OF HEART DISEASE
Wherever you are on the road to diabetes,your risk of heart disease is already substantially higher than that of people not on the diabetes continuum. How much higher? According to results from the 118,000 women in the Nurses’ Health Study, it’s almost four times as high. The researchers in charge of this long-running study observed the women over a 20-year period.At the start, about 1,500 already had diabetes and 394 had a history of a heart attack. Over the next two decades, nearly 6,000 more developed diabetes and 2,500 women were newly diagnosed with coronary heart disease.The study found that women with both diabetes and prior heart disease were 20 times more likely to die from any cardiovascular disease such as a stroke and 25 times more likely to die from coronary heart disease.4
The risk doesn’t apply just to women. Middle-aged men with high blood sugar levels, even if they don’t have diabetes, are at greater risk of death not just from heart disease but also from all causes.We know this from a revealing analysis of three long-term studies conducted in Europe.Over a 20-year period,the health of some 17,000 men was carefully followed. The researchers found that among all three groups, the men who fell into the top 20 percent of the normal blood sugar range had an overall risk of death 1.6 times higher than the men whose blood sugar was in the lower 80 percent of the normal range. The men whose blood sugars were in the upper 2.5 percent of the normal fasting and normal two-hour glucose ranges were about 1.8 times as likely to die from heart disease as the men with low-normal blood sugar.5
Here’s an example of how well the program works—even for people who have suffered years of health problems related to their blood sugar. When 73-year-old Muriel R., whom you met in Chapter 4, first came to see Dr.Atkins, she had been a Type 2 diabetic for 30 years. She was on numerous medications to control her blood sugar and lipids— and they weren’t working. Her blood sugar was high, her total cholesterol was 318, and her triglycerides were almost off the chart at 1,455. After just three months on the ABSCP, she had lost only five pounds, but her risk factors for a heart attack had dropped considerably. Her blood sugar was down, her total cholesterol had fallen to 202, and her triglycerides had plummeted to 101! Muriel is a classic example of how it’s never too late to improve your health.
A SILENT KILLER
The classic symptoms of a heart attack include a crushing sensation in the chest,chest pain (angina),pain radiating into the left arm or up into the jaw, and shortness of breath. However, it’s important to realize that women and people with diabetes may not experience these symptoms. For them, symptoms are more likely to include nausea and vomiting, tiredness,sweating,and collapse.Doctors call these silent heart attacks. They are actually more dangerous than the more obvious sort, because life-saving,heart-preserving intervention may be delayed or never even administered.
The message: Don’t wait until you’re facing a crisis. If you have the metabolic syndrome, prediabetes, or diabetes, discuss with your physician a course of action should you experience any of these symptoms. It is in these emergency situations that standard American medicine shines—but you must recognize the signs and get help quickly.
Heart attacks are not the only problem. Obesity alone can overwork your heart to the point where its ability to pump blood efficiently is severely compromised.6 This problem,heart failure,can also be caused by hypertension and the leftover scarring caused by a heart attack.Among people with heart failure,20 to 40 percent have diabetes.7
UNDERSTANDING BLOOD LIPIDS
Throughout this book, we talk a lot about your blood lipids: LDL cholesterol, HDL cholesterol, and triglycerides. Now that we’re talking about your heart health, it’s time to take a closer look at them.
People with the metabolic syndrome, prediabetes, or Type 2 diabetes almost always have low HDL cholesterol, high triglycerides, and normal or only somewhat elevated levels of LDL cholesterol. As more and more research shows, the combination of low HDL and high triglycerides is practically a formula for a heart attack.8–10 Whether or not you need to lose weight, if you have problems with your lipids, controlling your carbs will help. A high-carb diet is often associated with bad lipids, and controlling your carbs can help lower your triglycerides, raise your HDL, lower your LDL, and shift your overall cholesterol production toward less dangerous forms.
IS LDL CHOLESTEROL BAD?
High levels of LDL cholesterol in your blood are associated with a greater risk of vascular disease such as heart disease and stroke from clogged arteries—that’s why it’s often called the “bad” cholesterol. Calling LDL cholesterol “bad,”however, is a simplistic approach that’s more useful for selling cholesterol-lowering drugs than it is for helping you to avoid blocked arteries. When you look closely at LDL cholesterol, the picture is more complex.
Types of LDL can be divided into subfractions based on the size of the cholesterol particles. Very low density lipoprotein (VLDL) particles are fairly large; intermediate-density lipoprotein (IDL) particles are smaller, and low-density lipoprotein (LDL) particles are the smallest of all. The smaller the particle, the more potentially atherogenic (damaging to the arteries) it is.11 In people with the metabolic syndrome, prediabetes, and diabetes, the particles tend to be mostly small, dense LDL cholesterol, rather than the bigger, lighter, “fluffier, less dangerous”particles.
The reason for this is a lot more complex than we have space to discuss here.Suffice it to say that high insulin levels shift your production of cholesterol away from the larger, lighter particles and toward the smaller,denser particles.Lower your insulin by controlling your carbs, and you help move your cholesterol production back in a healthier direction—think of it as loosening or “fluffing up” these particles of cholesterol.12
Why are we explaining this in such detail? After you’ve been following the ABSCP for a few months, your LDL cholesterol number will probably be the same or might even go up a bit, even as your HDL cholesterol rises and your triglycerides drop.For most people,the LDL increase is modest and temporary and not at all harmful,and it’s more than offset by the improved HDL/triglyceride ratio. In almost all people following the ABSCP properly, LDL numbers drop back to normal levels in three to six months. If your LDL did go up, see your physician to discuss further evaluation,as discussed below.Ask him or her to pay attention to other positive changes in your blood lipids. He or she is likely to respond to a rise in your LDL—or even to no drop in your LDL—by reaching for the prescription pad and writing out an order for a statin drug.
Before you take a drug to lower your LDL cholesterol,ask your doctor to investigate your LDL further to find out the proportions of dense and light particles. Even if your total LDL number has gone up, there’s a good chance that your switch to a controlled-carb approach has raised the proportion of lighter, fluffier particles and shifted you toward what doctors call Pattern A. Recent studies have confirmed that the Atkins Nutritional Approach can shift your LDL to the favor- able,“fluffy”type.13, 14
You can also ask your doctor to do a blood test for a type of lipid called lipoprotein little a and written lipoprotein(a), or lp(a) for short. This is another form of blood lipid that has been shown to be an independent risk factor for heart disease.15 Even if your LDL cholesterol is normal, your lp(a) number could be high. Most doctors believe that your lp(a) number is inherited and can’t be changed by diet or anything else, but Dr. Atkins reported seeing some cases where it went down when the patient went on a controlled-carb program and lowered his or her insulin levels.
An example of such improvement resulting from dietary changes also occurred in one of my patients. Maureen Y., a 28-year-old woman who weighed only 100 pounds, lowered her lipoprotein(a) from a dangerously high 64 mg/dL to a safer level of 36 mg/dL, simply by controlling her intake of carbohydrates. The process took about six months—and her other blood lipids, which had been on the high side, improved as well. All this happened without weight loss, which was not appropriate in her case. —MARY VERNON
Research in this area is still emerging; however, there’s not enough information yet to say that lowering your insulin can also lower your lp(a) number.
WHY IS HDL CHOLESTEROL GOOD?
Offsetting the LDL cholesterol is HDL cholesterol, the “good”or “protective” cholesterol. HDL cholesterol clears unused cholesterol from your bloodstream and carries it back to your liver. The higher your HDL level, the more cholesterol is being removed from your bloodstream before it has a chance to oxidize and damage your blood vessels; this explains the current thinking about why high HDL levels are protective of your heart and arteries.16
Like LDL, HDL comes in different particle sizes, or subfractions. People with the metabolic syndrome not only have low HDL levels,but their type of HDL tends to be small, dense particles, just as is the case with LDL. These particles, called HDL3, aren’t as efficient as the large, fluffy variety (called HDL2) at transporting stored lipids to your liver. The more you have of the lighter, larger HDL2 particles, the lower your risk of heart disease. And as with LDL cholesterol, high insulin levels shift your cholesterol production away from HDL2 particles and toward smaller, denser particles called HDL3. Lower your insulin level by following the controlled-carb approach,and you help shift your HDL production toward the more desirable,lighter HDL2 particles.17, 18
The fat globules in your blood known as triglycerides are sometimes called triacylglycerol. High levels of triglycerides are undesirable. Dr. Atkins felt the optimum number should be under 100. Here’s where controlling your carbs really pays off, because high levels of carbs in the diet translate directly into high triglycerides in the blood.19, 20 Just about everyone who follows the controlled- carbohydrate approach finds that his or her high triglyceride levels drop considerably.We have seen triglycerides that were literally off the chart drop to less than 100 within a few months of the patient’s starting to control carbohydrates. The combination of lowering triglycerides and raising HDL markedly improves your cardiac risk.21, 22
STATIN DRUGS AND LDL CHOLESTEROL
Because people with diabetes often have normal or only slightly elevated LDL cholesterol levels, there’s been some question as to whether these patients should still try to lower their levels to the low-normal range. Some researchers say yes and believe all patients with diabetes should take statin drugs, even if their LDL is normal.
But we say: Not so fast. Some studies of statin drugs show that modest lowering of LDL, even if it’s not on the high side, may help some people with diabetes lower their risk of heart disease. What they don’t prove is that you need statin drugs to do this, although of course the patients in the studies were treated with statins. The drugs weren’t compared with a controlled-carbohydrate program. Dietary changes that control carbohydrates are a very effective way to improve your lipid profile.So why take an expensive drug that can cause muscle pain and weakness, liver problems, and a possible increased risk of heart failure, when you can accomplish the same thing with the ABSCP? Most patients who follow the Atkins program correctly manage to bring their blood lipids to normal or near-normal levels within three to six months without the use of drugs.
Some of you who have a strong hereditary tendency toward extremely high cholesterol and triglycerides may not want to disagree with your physician on the issue of cholesterol-lowering drugs. Even if that is the case, taking the drugs shouldn’t prevent you from following the ABSCP. Many will be pleasantly surprised by the results you will experience in your lipid values and other blood work—results that you didn’t get from taking the drugs alone. Once your doctor sees these results, he or she may be willing to discuss making an adjustment in your medication.
A SECOND LOOK AT STATIN DRUGS
A popular group of drugs used to treat lipid abnormalities,statins (see the sidebar on page 111) are often prescribed for patients with the metabolic syndrome, prediabetes, and diabetes. In fact, if you have high cholesterol, your doctor may feel the only treatment option is to suggest these drugs to you. That’s because doctors today are strongly pressured to follow the recommendations of the National Cholesterol Education Program (NCEP), which advise them to use these medications.23 A large body of research shows that statins lower cholesterol, however, Dr.Atkins rarely needed to use them.Ask your doctor to give you the opportunity to try lowering your cardiovascular risk factors without medication.
Statins were initially thought to exert their cholesterol-lowering effect by blocking production of an enzyme your body uses to make cholesterol. Recent research, however, suggests that much of their effect may not be related to cholesterol lowering at all. Instead, statins seem to work by decreasing inflammation, especially in the endothelial cells that form the lining of your blood vessels.
However they work, these drugs require careful monitoring and have the potential for serious side effects. Because they block the synthesis of a compound called coenzyme Q10 (CoQ10 or ubiquinone), used in your cells for energy metabolism, statins can cause liver and muscle damage—including damage to the heart muscle.24 Muscle damage can be so severe that one statin drug (Baychol) was voluntarily withdrawn from the market after some deaths occurred. Liver injury can occur as well. The manufacturers of statin drugs recommend blood tests every three to six months to monitor for evidence of liver damage.25
If there were no other way to improve your lipids, we would agree that the significant health risks of statins were worth it. But here’s why we don’t agree. With regards to lowering risk factors, the same effect that is achieved by the drugs can be achieved by following the Atkins controlled-carb approach. That’s because decreasing insulin concentrations in the body can theoretically lower your production of an enzyme called HMG Co-A reductase—the same enzyme targeted by statin drugs—simply and naturally.And what’s the most effective tool for bringing insulin down to normal levels? Controlling your carbohydrate intake.26
What about the statins’ability to reduce inflammation in the blood vessel lining? The controlled-carb approach can help there, too. High levels of insulin increase inflammation—and controlling insulin levels by controlling dietary carbohydrates can help control inflammation all over the body.27, 28 Also, controlling carbs helps rid the body of excess fat, the secretions of which contribute to the inflammation of the cells that line blood vessel walls.29 Add in the beneficial effect of essential oils from both diet and supplements, which further decrease inflammation, and you’ve got an effective, natural way to impact in- flammation without statins or any other drugs.
TARGETING BLOOD LIPIDS
In 2001,the third Adult Treatment Panel (ATP III) of the NCEP issued new guidelines for the evaluation and treatment of high blood cholesterol.30 The panel significantly lowered the thresholds for high cholesterol. This had the effect of substantially increasing the number of Americans who would be candidates for drug treatment—from an estimated 15 million adults under the old 1993 guidelines to an estimated 36 million under the new guidelines.31 At the same time, the panel issued new low-fat, high-carb dietary recommendations. The panel’s findings were a dream come true for drug manufacturers. The dietary recommendations are practically guaranteed not to work, unless the patient loses weight, meaning more patients will “need” statin drugs.32 Combined with the more aggressive approach to lowering cholesterol, the new guidelines guarantee the drug companies huge profits for years to come.
COMMON STATIN DRUGS
Generic ingredient: atorvastatin
Brand name: Lipitor
Generic ingredient: fluvastatin
Brand name: Lescol
Generic ingredient: lovastatin
Brand name: Mevacor
Generic ingredients: lovastatin and niacin
Brand name:Advicor
Generic ingredient: pravastatin
Brand name: Pravachol
Generic ingredient: Simvastatin
Brand name: Zocor
These guidelines were developed from statistical data on patients who ate the typical high-carb American diet. The guidelines do not take into account the total lipid picture, which includes other cardiovascular risk factors such as homocysteine, lipoprotein(a), fibrinogen, and C-reactive protein. As you already know, in the presence of high glucose and insulin, your cells immediately stop burning fat and prepare to store fat instead. To manage these risk factors effectively, the problem must be corrected where it starts. By controlling carbohydrates, you can prevent the hormonal fat storage effect of excessive insulin, which results in increased cardiovascular risk factors. These include high triglycerides, low HDL, and small, dense, dangerous lipoprotein particles. Standard guidelines focus simply on the total and LDL cholesterol values.35
RESEARCH REPORT: CHOLESTEROL AND CONTROLLING CARBS
Two highly significant recent studies have shown that controlling carbohydrates can have a powerful impact on blood lipids. In the first study,12 healthy,normal-weight men followed a very low carbohydrate diet for six weeks.At the end of that time, their HDL cholesterol was up and their triglycerides were down. Perhaps more important, among the men who had mostly small,dense LDL particles at the start of the study, LDL size went up, moving these men toward a better cholesterol pro- file.33 A similar study of 10 healthy, normal-weight women also showed excellent results. Their triglycerides went down and HDL went up. The beneficial effects of a low-carb approach in women were even stronger than they were in men.Three of the women with small particles at baseline had particles change to the large,fluffier type.34
Whether or not the ATP III guidelines make sense, they’re the ones that set the lipid standards for physicians all over the country. Check the following chart to see what these guidelines are.
ATP III GUIDELINES
Source: National Cholesterol Education Program.
WHEN TLC IS BAD FOR YOU
The latest dietary recommendations from the NCEP are known as TLC, or Therapeutic Lifestyle Changes. The current version of this low-fat, low-cholesterol diet isn’t very different from the diet that NCEP has been promoting for years. This diet calls for keeping total fat to 25 to 35 percent of daily calories and limiting dietary cholesterol to less than 200 mg a day, and it recommends getting 50 to 60 percent of total calories from carbohydrates. This approach may lower your LDL cholesterol somewhat—but at the expense of also lowering your HDL cholesterol. Not only that, the TLC diet may also shift your HDL production to smaller, denser particles that aren’t as good at clearing LDL cholesterol from your blood.And of course, eating all those carbs will probably raise your triglycerides.
THE BETTER WAY TO BETTER BLOOD LIPIDS
The Atkins approach improves all aspects of your blood lipids naturally—not by blasting your body with drugs and judging the results by the numbers on only one blood test. Controlling your carbs is the first step. Your triglycerides will drop as your insulin-glucose metabolism improves. Even before you lose the first ten pounds, you may see an immediate improvement in triglyceride levels. HDL will begin to rise—although in our experience it takes between three and six months to get HDL to its best level—after glucose metabolism is normalized. At the same time, levels of tiny LDL particles will decrease, and LDL will shift toward those larger, fluffier particles that aren’t as dangerous to your arteries.As you follow the program, your lipid pro- file will almost certainly continue to improve.
One of Dr. Atkins’ patients, 68-year-old Claudia W., had the lowest HDL he had ever seen—at only 20 mg/dL. She started following the ABSCP and three months later her HDL had risen to 70 mg/dL. In fact, she was now unusual in a much healthier way, because her HDL number was higher than that of her triglycerides.
Although the dietary changes of the ABSCP are a very effective way to elevate your HDL,exercise and supplements provide additional improvement. Is that because of the exercise itself or because exercise helps you lose weight? It’s hard to tell, because in just about every study that has looked at the effect of exercise on HDL, the subjects lost weight. It’s hard to separate the two effects, but it doesn’t really matter. After all, losing weight also raises your HDL level, along with all its other benefits. And exercise is undeniably good for every aspect of your health.
THE DANGEROUS CHEMISTRY OF ABDOMINAL FAT
In case you thought it was all about your cholesterol, we’re about to disabuse you of that misconception. Cholesterol is only part of the heart disease story. Did you know that it is quite possible to have cholesterol numbers that fall within the normal range and still have a heart attack?
Remember, a heart attack is caused when blood flow to the arteries of the heart is blocked, usually by a blood clot. The biochemical imbalance driving the metabolic syndrome causes an increased tendency toward blood clotting. In part, this is because the abdominal fat that is such a telltale sign of the metabolic syndrome secretes chemicals that raise the level of clotting factors in your blood and make your platelets “stickier” and more likely to form a clot. The inflammatory response that occurs in the metabolic syndrome—partly due to those same secreted chemicals—damages the endothelial cells that line your blood vessels.36 This is a recipe for blood clot formation, arterial blockage, and deep venous thrombosis.If you have ever wondered why our society is plagued by stroke,heart attacks,and blood clots in the lung (pulmonary embolus), now you know.
Here’s the good news! Dr.Atkins observed in his practice that when people with abdominal obesity and the metabolic syndrome, prediabetes, or diabetes start following the Atkins approach, they generally lose proportionally more weight in the abdominal area.In many cases, even when total weight loss is fairly modest,the effect is powerful if the weight comes from fat stored in the abdominal area: HDL cholesterol goes up and triglycerides go down more than the weight loss alone would normally accomplish. Other dangerous substances in your blood,such as clotting factors,also can go down,because you have less of the fat that makes them. Add in some exercise, which also seems to target abdominal fat, and the effect on your lipids and inflammatory and clotting factors is even greater. Losing even small amounts of visceral fat may be enough to bring your metabolic syndrome under control and improve your heart health.
OTHER RISK FACTORS
So much attention gets paid to cholesterol as a risk factor for heart disease that other important risk factors tend to be ignored, especially if your cholesterol is in the normal range. Let’s look at three additional independent risk factors Dr. Atkins considered to be more important than total cholesterol level.
Homocysteine
A normal by-product of metabolizing the amino acid methionine, high levels of homocysteine in your blood are an independent risk factor for heart disease from clogged arteries. This automatically raises the risk of death from heart disease for the estimated 25 percent of the population that has a genetic tendency toward high homocysteine levels. And if you have the genetic tendency and also have diabetes, your risk is about 2.5 times greater.37 A recent study in Finland found that even moderately elevated homocysteine is an independent risk factor for fatal heart attacks in people with Type 2 diabetes, even when other risk factors such as smoking and high blood sugar were taken into account. The study found that the elevated risk began at homocysteine levels of 15 µmmol/L or higher—or not that much higher than the upper end of normal.38
Whether or not they have the genetic tendency to high homocysteine, people with insulin resistance or diabetes seem more likely to have high homocysteine levels than do people with normal glucose tolerance; also, people with diabetes and high homocysteine are more likely to have complications such as kidney disease.39 Dr.Atkins would treat his patients who had high homocysteine levels with the dietary changes of the ABSCP and also with additional supplements of vita- mins B6,B12, and folic acid. Although the normal range for homocysteine is 5.2 mmol/L to 12.9 mmol/L, his goal for his patients was a homocysteine level of 8 mmol/L or less. Most of them were able to achieve this goal.
C-reactive protein (CRP)
An elevated level of this protein, produced in your liver, is a sensitive marker of inflammation. Because inflammation is believed to be one of the underlying processes that causes your arteries to clog, high CRP levels in general turn out to be a good warning sign of heart disease. In the Physicians’ Health Study, for instance, the men who had higher levels of CRP when the study began were much more likely to have a heart attack over the next ten years than the men who had normal CRP levels—even though they seemed equally healthy based on other measurements, such as their cholesterol.40 Results for women in the Nurses’ Health Study were similar.41
People with abdominal obesity, impaired glucose tolerance, and Type 2 diabetes generally have elevated CRP levels.42 Other factors, such as an acute illness or the use of some hormones, can also elevate CRP.) But again, there’s reason to be optimistic. A recent study of overweight women with high levels of inflammation (according to blood markers such as CRP) showed that when they lost just 10 percent of their body weight through a diet and exercise program, the markers fell back to much healthier levels. In fact, their levels were very close to those of normal-weight women.43 And despite some claims to the contrary, following a low-carbohydrate approach does not raise CRP levels.44
Fibrinogen
This is a protein in your blood that plays a crucial role in the complex process of blood clotting. When your fibrinogen levels are high, your blood may clot too easily—and a clot that blocks an artery can cause a heart attack or stroke. People with the metabolic syndrome, prediabetes, or diabetes can all have elevated fibrinogen levels, as well as an increase in other chemicals that increase blood clotting.45 This tendency to clot may be related to the inflammatory process that is part of the metabolic syndrome. (As with CRP, other factors, such as the use of certain birth-control medications and hormone imbalances, can increase fibrinogen levels.) This is one of the reasons many doctors recommend low-dose aspirin as a way to lower your risk of heart disease. Dr. Atkins found that aspirin, with its risk of gastrointestinal bleeding, wasn’t necessary for most of his patients. Instead, he prescribed fatty acid supplements to decrease platelet stickiness and for their anti-inflammatory effects.
TAKE HEART!
As this chapter makes clear, first, if you have the metabolic syndrome, prediabetes, or diabetes, you have an increased risk of heart disease. Second, and most important, no matter where you are on the diabetes continuum, heart disease is not inevitable. By following the ABSCP you’ll begin to correct the underlying metabolic problems that threaten your heart health.And once you start controlling your carbohydrate intake and normalizing your metabolism, the risk to your heart drops—safely, naturally, and without the use of drugs.
WHAT’S YOUR HEART RISK?
Use the self-quiz below to assess your risk of cardiovascular disease.
1. I am:
- male [1]
- female [0]
2. My age is:
- under 40 [0]
- 41 to 44 [0]
- 45 to 49 [1]
- 50 to 54 [2]
- 55 to 60 [3]
- 61 or older [4]
3. I smoke or use other forms of tobacco:
- yes [2]
- no [0]
4. I have prediabetes or diabetes:
- yes [4]
- no [0]
5. My blood pressure is:
- normal (less than 120/80) [0]
- prehypertensive (130/90) [1]
- hypertensive (140/90 or higher) [3]
6. My triglycerides are:
- desirable (150 mg/dL or less) [0]
- high (151 mg/dL or more) [1]
7. My HDL cholesterol is (according to ATP III guidelines):
- low (40 mg/dL or less) [2]
- borderline low (50 mg/dL or less) [1]
- high (60 mg/dL or more) [0]
To determine your risk of developing heart disease, add up the numbers in square brackets for each of your answers.
Scoring
0 to 6: lowest risk
7 to 10: moderate risk
11 and above: high risk
A NEW LEASE ON LIFE
Joe McCoy had a heart attack at age 44. While he was on a prescribed low-fat diet, his blood sugar and blood pressure careened out of control. Today, thanks to Atkins, it’s on a smooth ride.
My father was a doctor and, I realize now, he was ahead of his time when it came to diet and nutrition. My brother, sisters, and I were raised on a diet of protein and vegetables. I never ate bread or dessert at home, except for the occasional birthday cake, until I was out on my own. In high school, I also played lots of sports, including football, and being overweight was never an issue.
I started to gain weight after I got married, mostly due to my wife Karen’s home cooking and unbelievably delicious challah bread. It took about 15 years, though, before I reached the point where I really needed to lose weight. In 1995, I had a heart attack and my doctor put me on a lowfat diet. I had been hypoglycemic prior to this time and I believe this lowfat regimen plunged me into full-blown Type 2 diabetes by 1999. My glycated hemoglobin (A1C) was an abysmal 13. My blood sugar numbers ranged between a scary 500 and 600. I also developed a case of peripheral neuropathy, a common side effect of diabetes that causes numbness and soreness in the feet and hands. I was in so much pain, you wouldn’t wish it on your worst enemy. One of my friends suggested I see Dr. Mary Vernon, who practices in Lawrence, Kansas, where I live. I didn’t know then that she used the Atkins Nutritional Approach.
In her office, Dr. Vernon took one look at me and said, “You certainly have the body type that will benefit from carbohydrate restriction.” As she wrote my menu she told me to stop taking Glucovance. I wasn’t surprised that she said I needed to lose weight, but I couldn’t believe my ears when she told me to stop taking my diabetes medication. I was feeling so lousy, though, I just jumped right in and did what I was told. It took a month for me to lose ten pounds. Within three months my blood sugar, cholesterol, and triglycerides all improved. As did my kidney function. Five months later, I contracted pneumonia in both lungs and spent three weeks in the hospital. I know that I probably would have died if I had not made such a remarkable improvement in my health from doing Atkins. I resumed the program after I recovered and after six more months, I was down to 220 pounds. By then I needed a whole new wardrobe. I probably should have invested in a pair of suspenders because I was having trouble keeping my pants up!
I have been hovering around 200 pounds since February 2003, and I still keep my grams of Net Carbs at around 20 per day. Still, I’d like to lose another 15 pounds. I continue to test my blood sugar every day and take a very small amount, about one-quarter to a half tablet, of Glucovance, which keeps my blood sugar around 110. My A1C reading is 5.3, which is quite good. My triglycerides are still a little high and I’d like to improve that number, too. I’m told my heart is also in excellent shape. The pain from the neuropathy is not nearly as bad as it once was and one of the nerves has regenerated in my right hand—I’m hoping that more of them will do the same. I can’t really exercise or return to work as an auto mechanic because of this problem, but I’m telling you, I have an energy that wasn’t there before going on the program.
BEFORE AFTER
NAME:Joe McCoy
AGE:53
HEIGHT: 5 feet 10 inches
WEIGHT BEFORE: 278 pounds
WEIGHT NOW: 196 pounds
TOTAL CHOLESTEROL BEFORE: 880
TOTAL CHOLESTEROL AFTER: 168
BLOOD PRESSURE BEFORE: 200/130
BLOOD PRESSURE AFTER: 145/78
TRIGLYCERIDES BEFORE: 6,600
TRIGLYCERIDES AFTER: 273
When I was fat and sick with diabetes, I prayed and prayed that I would live to see the birth of my grandchildren. Now, our only son and his wife are due to have their first baby soon, right around our 25th anniversary. It’s easy to understand why my wife and I recommend Atkins every chance we get.
Note: Your individual results may vary from those reported here.