Analysis of my new lipid panel

The results are in. I have to admit, I expected better numbers compared to my lipids measured 1.5 years ago, but here goes:

- – - – - – - – - – - – - – - – - – - – 5/2006 - – - – - – 2/2008

• Total Cholesterol – - – 197 – - [<200] – - – - – 191
• HDL-C – - – - – - – - – - – 34 – - [>39] – - – - – - 36
• LDL-C (calculated) – - 140 – - [<130] – - – - – 146
• Triglycerides – - – - – - 113 – - [<150] – - – - – 44
• TC/HDL ratio – - – - – - 5.8 – - [<5.0] – - – - – - 5.3
• Fasting glucose – - – - – 71 – -[<100] – - – - – - 78

My observations:

1. HDL is slightly higher, not to goal.
2. LDL slightly higher (OUCH . . . really can’t explain this one).
3. Triglycerides are considerably lower – I don’t know if I’ve ever seen one this low. At least one portion of my lipid panel changed considerably – too bad it was already normal.
4. TC/HDL ratio is slightly improved, but still not to goal.

I have a couple theories to explain the less-than-stellar improvements in these numbers.

1. Family history – there is definitely a history of low HDL/high LDL on my maternal side.
2. Labs were performed at different labs – hard to estimate the impact of this one, but certainly can be a factor.
3. Last year, I really only stuck to my solid regimen for 4 months. After that, I had a tremendously busy, stressful year that precluded a good fitness routine. Thus, these numbers probably reflect only a solid 6-7 weeks of my regimen from this year, following a 7-8 month period of relative inactivity prior to that.
4. I discovered a study that demonstrated the HDL responding less to exercise in individuals with low Triglycerides compared to individuals with high Triglycerides. This article highlights a possible explanation for why the HDL did not increase as much as I expected. This finding is news to me – never heard/read about this concept before.
5. Last year, I was taking a protein supplement that had quite a bit of fat, including saturated fat. That may have accounted for the higher LDL. I’m currently using a pure protein supplement with no fat. That’s the only supplement I will use. [That's a topic for another day.]
6. HDL probably increases better as a result of longer-duration endurance training workouts than I get with High-Intensity Interval Training (HIIT) workouts on the elliptical. Could this be one limitation of HIIT?

Regardless, this just serves as another motivator for me to turn everything up a notch. I’m not a fan of long-duration endurance training, but I will probably incorporate more into my training. At least in the summer, I will do a large amount of biking.

I’ll be checking these numbers again in a year. I refuse to depend on medication, so I’ll be working hard.

My old lipid panel – pre-transformation

Back in May, 2006, I last had some blood work done, for an insurance exam, that included a lipid panel. I, of course, held onto those results, because I obsess over my risk factors for heart disease. Here they are, in their unimpressive glory.

• Total Cholesterol – - – 197 [<200]
• HDL-C – - – - – - – - – - – 34 [>39]
• LDL-C (calculated) – - 140 [<130]
• Triglycerides – - – - – -113 [<150]
• TC/HDL ratio – - – - – - 5.8 [<5.0]

And, of course, as part of metabolic syndrome, one must be concerned about the fasting glucose . . .

• Fasting glucose – - – - – 71 [<100]

My HDL had actually been worse a few years before that, in large part due to some bad habits learned in college and carried into med school.

Stay tuned for the current lipid panel results. We’ll see how much progress I was able to make since cleaning up my diet and starting an exercise regimen.  I’m nowhere near my fitness goal, but I’m hoping to see some progress.

Off to my physical exam

You’ve probably heard the saying about how healthcare personnel (doctors/nurses, etc.) are the worst patients – rarely seek attention, rarely do the preventative exams that they encourage to patients, ignore advice when given to them.

It’s true . . . to some extent. I’ve encountered hundreds of much worse layperson patients, but there is some truth to that saying.

Well, I’ve decided to make use of the ol’ insurance coverage by scheduling a physical exam, really just to get my cholesterol rechecked. My “bad” (LDL) cholesterol has always been borderline okay, but my “good” (HDL) has definitely been low.
Now that I’ve busted my butt on diet and exercise, I’m expecting to see a significant improvement in both my HDL and LDL cholesterols. I’m expecting that all my lipid values will be in range now, including the TC/HDL ratio.

We’ll see if my advice to myself was any good.

I’m hungry . . . I always eat breakfast.

- Another interesting article on doctors and their family members as patients.

Do I HAVE to work out today?

Funny how the mind works. I was feeling quite unmotivated to do anything yesterday. After needing to leave the house too early to fit in my morning workout and then working all day, all I wanted to do was kick back and relax last night, especially since I would have numerous sleep disruptions being on call last night. I had just fit in a great workout the previous night, but knew I wouldn’t be able to do weights tonight, thanks to my schedule.

Since I don’t hold myself to a rigid workout schedule like some people do, I give myself the freedom to pick those lazy nights. My life is far too unpredictable with work demands, etc. to ever stick to a weekly schedule. So, I just aim to do cardio most mornings and weights 3 nights/week.

Then, my wife gave me a mini pep-talk and hopped on the elliptical.

Say no more . . .

Once I started working out, I fell into a groove and had a really good time. I made some improvements in some lifts and felt some good muscle burn that makes it all worthwhile. Can’t wait for the DOMS!

Some times it just takes a little extra motivation to get things going.

“The difference between a successful person and

others is not a lack of strength, not a lack of

knowledge, but rather a lack of will.”

Vince Lombardi

“The Biggest Loser” and reality TV deception

Television is notorious for its sensationalist approach to presenting news and other programming.  When in the business to keep people glued to the screen, they are going to use nonsense teasers and other trickery to keep viewers glued to the screen through another set of sponsor’s commercials in order to get to the punch line.  This situation has been rampant for years.

Then came so-called “reality TV“.  Obviously a misnomer, there is nothing “realistic” about “reality TV”.  Examples abound.  These so-called “reality” TV shows have rightfully come under scrutiny for their contrived scenes that are obviously intent on stirring up some controversy and drama in an attempt to retain viewers.

The producers have to appeal to the voyeuristic nature of TV viewers – plenty of people apparently live lives that are so boring that they need to live vicariously through their television.  In a sense, then, they are asking for this fake portrayal of human experience.

So, what about “The Biggest Loser“, a hit amongst those interested in weight loss and fitness for whatever reasons?  How much goes on behind the scenes when you’re watching someone waste away on the TV screen weekly?  An editorial in the Journal of the American Dietetic Association titled “When Overweight and Obesity become ‘Reality’” describes some of the sly production waves-of-the-hand that occur unbeknownst to the viewers, without specific reference to a particular show but instead making vague references.

The author references reports by participants of a particular weight-loss show who describe severe weakness and dehydration, while the viewers only saw their dedicated diet and exercise habits portrayed in a healthy light.  Also, the winner of the first season allegedly regained 7 pounds within days of the finale by simply rehydrating with water. (See links at end of post) 

Obviously, there are unhealthy weight-loss methods being employed in a situation like this where individuals are competing for a significant monetary prize.  Of course the networks and the shows cannot outright encourage these methods, but they are creating an unhealthy competitive environment that all but encourages these drastic methods.

Here, the producers have a unique opportunity to provide an educational service to the viewers, to offer a glimpse into what it takes to change one’s life by diet and exercise.  Unfortunately, it is instead a bit of a freakshow due to the sensationalist perspective that is presented to the viewers rather than the real-life perspective.  

Most viewers should be savvy enough to detect the fraudulent presentation of these stories – we know when we’re getting real “reality” programming – I’ve yet to see it.

Time article

Seattle Times article

More motivational success stories in weight loss

I find that it helps once in a while to  read about how other people achieve their success with weight loss, not only to see what techniques they use, but also to reiterate the idea that it’s possible for anyone in any state of health to take charge and transform their bodies.

Instead of looking at the “young bucks” today, let’s look at the “over-40″ crowd.  Though metabolism slows with age, there is never an excuse not to work towards improving your body.

First, a woman in her 50’s who struggled with weight gain in her 40’s, but turned the tide by cleaning up her diet and hitting the weights.

Then, this amazing transformation, not so much by his incredible results, but because of his age.  This 65-year-old man achieved incredible results with a disciplined plan that evolved as he learned how diet and exercise affected him.  Note especially the effect this transformation had on his blood pressure.

It can be done . . . by anyone.

Value of whole grains

Carbohydrates get all the negative press. . . perhaps for good reason.  Simple carbohydrates are certainly not friendly to the body in the sense that they create a high-sugar load in the bloodstream, compared to a more gradual increase in sugar from complex carbohydrates (e.g. whole wheat, whole grain). 

Here’s a study suggesting benefit from a diet high in whole grains in reducing abdominal fat and reducing a marker of inflammation that has been implicated in heart disease risk. 

Weight training tidbits

I love this list of weightlifting/fitness tidbits that was compiled on www.ironmagazine.com.  It was created as a “Top” list of tips for building muscle and improving fitness, observations about the fitness world, and a few random useless thoughts about the rest of the world that were apparently just thrown into the mix to get to a “Top 50″ list. 

10 Tenets of Effective Weight Loss – #7 – Exercise, exercise, exercise

Exercise is clearly a beneficial element of a weight loss regimen.  As demonstrated in the image to the right, there are two mechanisms by which the balance of calories can be adjusted in your favor to trend towards weight loss: cut down on calories ingested or increase calories burned.  If that calorie balance is sufficiently in your favor, you should lose weight over time.

There is only so much you can do with diet; crash diets are uncomfortable and counterproductive to your weight loss goals.  The more effective and more healthy alternative is to increase physical activity. 

Exercise is often broken down into two types: cardio and strength training.  Cardio is generally accepted as the obvious answer to burning off calories in an attempt to burn fat, lose weight, etc.  The general starting recommendation is to be active for 30 minutes a day most days of the week, activity that causes an increase in one’s heart rate.

Strength training (weight lifting), unfortunately, gets left out of most exercise regimens.  Read this post, and you should be convinced that strength training is a critically important element of a weight loss regimen.  It doesn’t have to be Arnold-caliber bodybuilding; a moderate weightlifting routine is sufficient. Weight-lifting can be an aerobic activity itself and contributes to increased lean body mass, which together can increase one’s basal metabolic rate for increased calorie burning throughout the day.

“How can I cut get off of [or cut back on] my medications?”

Time and time again, I hear patients request to have their medications reduced, but it is nearly always met with a blank, uninterested stare when I give them the answer.

Most of these individuals are on numerous medications for the problems associated with metabolic syndrome: high blood pressure, high cholesterol, diabetes. Since these are all major risk factors for heart disease and heart disease is the leading cause of death in the US, the medical profession takes them very seriously. Presumably, patients do, too, or they wouldn’t have sought help or agreed to take a medication in the first place.

Believe me, I don’t want to put people on any more medicine than they absolutely need – it exposes the patient to more potential problems and me to more potential liability, not to mention the time demands of discussing the ins and outs of the medication and handling refills, etc.

So . . . what’s the solution?

Pretty simple, really – FITNESS. It’s the fix-all for a multitude of conditions. All of the above-mentioned medical conditions are deeply-rooted in inactivity, obesity, etc. Our bodies require that we lead fairly active lifestyles, especially to balance the poor nutrition habits of so many. I know it’s easier to be inactive than to embark on an exercise regimen (I’ve done both).

Unfortunately, medications don’t “cure” any of these chronic conditions – they merely alter the conditions of our bodies to simulate a more normal state of being. The body needs to be re-trained on how to handle glucose (sugar), cholesterol, or blood pressure. Exercise can be free, proper diet can be cheaper than a poor diet, and the lifelong benefits outweigh the hassle of making such a lifestyle change.