Free Fatty Acids and Low Carb

Below is a copy of the post which I have responded to at forum.lowcarber.org about Fatty Acids and Low Carb

Jrh22’s query:

So I went to a primary care doc who was the first I’ve ever met that was a borderline genius on cardiac issues and diet and overall health. After losing 50 pounds on Atkins, my lipids skyrocketed, and I’ve been searching for a primary care doc who didn’t do the typical knee jerk reaction…statins, quit Atkins, etc.

And by and large, he blew me away with his expertise, demonstrating his dismay at the medical community’s ignorance at their dietary recommendations. 

But my point of divergence was when it came to low carb diets, which he admitted he preferred over the standard diet, but he still had issues with because of the heavy free fatty acids and the liver’s role in processing them for people like me, who have high LDL particle counts. 

His contention is that low carb diets tend to be high in fat (true for me), which results in high free fatty acids, which results in higher production of cholesterol packets. This isn’t a bad thing for people with normal cholesterol profiles, but for people like me with high LDL particle counts (>2000), it can be dangerous.

I’ve seen limited commentary online supporting his claim, but ultimately he prefers to recommend a diet that is very low sugar (and substitutes) and processed foods, as opposed to dedicated low carb. He’s okay with carbs, because he’s not as comfortable with the impact of free fatty acids. He’s fine with fruits and vegetables, even potatoes, as long as the carbs aren’t sugar.

Normally I’d nod and move on, because low carb works for me and I have 20-30 pounds more to lose. But my LDL particle count is too high, he’s proactively treating a potential thyroid issue, and he embraces the foolery of the modern diet. 

Anyone else have any insight on the issue of free fatty acids and how they impact cholesterol and LDL issues? 

He’s the only doc I’ve ever met who has impressed me with his research and knowledge, and the only doc I’ve ever met who has made me question – albeit slightly – the low carb diet for someone with an LDL problem.

Here was my answer:

Hi Jrh22,

I think you’re discovering what a lot of us have discovered over the years that we simply can’t rely on the expertise of anyone doctor. More to the point, we can’t put the responsibility for our health on anyone else’s shoulders but our own. As you have found out, they typically do, well, the good ones anyway, go as far as they dare in following what to the medical profession seems contrary to everything they know,. Yet, I suppose, understandably, won’t stick their necks on the line when it comes to going the last mile and adapting or at least admitting that diets like Atkins and so on do work even though they run contrary to what is unfortunately the considered norm.

I am actually impressed that you are continuing to research, that you’re continuing to read around the subject. By doing that, your understanding will obviously increase and your confidence to take charge of your own health with insensible limits will carry you forward to achieve the level of health that you really want.

Hope that helps,

Mark