Saturday, August 29, 2009

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Nonfasting Lipid Level Measures Deemed OK

This was the title of one of the articles in Family Practice News which holds themselves out as "The Leading Independent Newspaper for the Family Physician-Since 1971."

The first paragraph of this story stated "Nonfasting lipid status may be a better marker for impaired lipid metabolism than fasting lipids..." What all this mumbo-jumbo means is that it may be better for us docs to tell our patients not to fast before they give their blood to check their lipid panel.

My patients already know that I tell them not to fast before they give their blood for their routine lipid checks. I've been telling my patients for years that when they fast they are changing their blood chemistry into what it normally isn't. I want to see their blood chemistry as it normally is. I have called fasting "cheating" as it changes the blood chemistry, specifically the triglycerides and blood sugar, and can bring these numbers into the normal range with as little as an 8 hour fast.

By telling patients to fast, we docs will miss those patients who are insulin resistant as their triglycerides (trigs) and blood sugars can become normal with even an 8 hour fast. I have caught many new onset insulin resistant, type 2 diabetics by telling them NOT to fast prior to giving blood for lipid analysis.

For instance, even a trig value of say, 170, will tell me that I have a potential type 2 diabetic in the making. This trig value is certainly high, but it is a trig value which will easily correct itself by as little as an 8 hour fast. So if I would have told my patient to fast, I would have missed this as the trig value would have been normal; and I would not have been able to counsel my patient accordingly.

The same is true with blood sugar readings. By telling my patients not to fast, I catch many a type 2 diabetic extremely early in their disease and I can intervene alot quicker than other practitioners, solely because I told my patient not to fast.

All docs need to tell their patients not to fast before they give blood for routine lipid analysis.

Do I have to say to my colleagues "I told you so." Nah, that would be just plain rude :-)

Dr Jim

(The full article can be found in Family Practice News, Vol. 39, No. 14, p.15.)

Have a great weekend everyone and if you live in the NorthEast---stay dry :-)

Thursday, August 27, 2009

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Low Carbs and Man's Best Friend

First off, isn't 'man's' best friend a bit gender biased. Shouldn't it be more like everyone's best friend or people's best friend. Since everyone is not a dog lover, or animal lover for that matter, I guess those two are out. So forgive the politically incorrect colloquialism and on with my blog.

I have been involved with low carb (lc) dieting for so long (over 11 years now), that I have had countless reports of how people have placed their dogs on lc diets to help their dog lose weight with excellent success. I currently have an 18 month old yellow lab who I provide lc food to who is in great shape. The point of this blog is to discuss the benefits of feeding our doggies the lc way.

Whenever I purchase food for Princess (my yellow lab's name in case you're wondering) I always read the ingredient list and make sure the first ingredients are meat or protein related. I wasn't too surprised to see that most dog foods first 3-5 ingredients were carbohydrate laden. We humans think that a fat and cholesterol presence is dangerous in our foods, so why wouldn't we bring this same ignorance to the animal kingdom. I guess it's not enough we're killing off our own species; we need to eradicate the canine world as well.

This is even more prevelant when I read the ingredient list for the dog foods which are supposed to help our canine companions 'lose weight.' It was the same low fat, low cholesterol mentality that we adhere to in the human world.

No wonder we are seeing alot of overweight dogs out there. It is interesting to note the weight of the owner of that overweight pooch; almost always, like doggie, like owner. This is because the poor dog is eating too many carbs as fed to them by their owner, who, by the way, is obviously eating the same way.

Low carb eating is safe for your beloved doggie as well as yourself. In fact, there is a feeding method out there known as BARF, which is an acronym for Biologically Appropriate Raw Food. The BARF eating style is simply a low carb eating regimen for your pet. It focuses on feeding your furry family member raw foods) obviously, which includes raw meats (as they would find in the wild) along with nutrient rich vegetables and some fruits. Just type in BARF diet in your web browser and you'll get a bunch of hits.

Just a little public service message for all you dog lovers out there.

Dr Jim

To purchase my book go to or go to to request a digital copy of my book for only $11.99!

Tuesday, August 25, 2009

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7 to 9 Teaspoonfuls of Sugar??!!

So the American Heart Association has demonstrated their extreme dietary ignorance yet again. Last night, the evening news stated the AHA recommended that women consume no more than 7 teaspoonfuls of sugar a day and males were/are allowed 9. This equates to 28 grams of sugar a day for females and 36 a day for males. The female anchor made the witty comment that "Once again, males are allowed more than women."

Of course I was at first shocked and then wondered why I was shocked. I already know the AHA drops the ball way far of the goal line when it comes to dietary recommendations. One must remember that this sugar intake is in addition to the whole grains and fruits that they already recommend we all eat on a daily basis. The AHA has absolutely no understanding that sugar is sugar is sugar.

It is sad that the very organization which is supposed to be protecting is, is in fact putting us in harms way. When will they understand that sugar is sugar is sugar? How can they even remotely suggest that it is OK to have table sugar on a daily basis, when it provides us with no nutritive value whatsoever? How can they continue to support the consumption of large amounts of fruits and whole grains on a daily basis, when all this does is supply our bodies with what we need to make plaque forming deadly cholesterol and get us fatter and more insulin resistant?

One word helps explain why----Ignorance. This is dietary ignorance at its finest.
Way to go AHA, you should be ashamed of yourself!

Dr James E Carlson B.S.,D.O., M.B.A., J.D.

PS-I'll talk about our furry friends maybe tomorrow. I just felt compelled to comment on the riduculous guideline the AHA just published.

To purchase my book go to or go to to request a digital copy of my book for only $11.99!

Monday, August 24, 2009

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94 % Fat Free!

I just love the marketing tactics used to try to get us to purchase products. When it comes to food, these gimmicks run rampant. For instance, I was using a low carb wrap to put my eggs and bacon in over the weekend when I noticed at the top it stated "94% Fat Free." I immediately wondered why I hadn't read this before, realized I probably had and just ignored it; and then wondered to myself 'how much fat is in a non-low carb piece of bread or wrap?'

Of course the answer is that most breads are pretty low in fat as they are made from wheat, or processed from wheat or multi-grains etc. The 94% fat free comment is there to coerce the fat phobic consumer to purchase the product, as most people (doctors) still hold on tenaciously to the fallacy that eating fat is dangerous.

Actually, those who have read my book or have been following my blog know that eating fat is not only safe, but healthy. And the more saturated fat one eats, the higher the HDL will go. So we really do not want the food we're eating to be low fat. We want the fat and by this I am referring to saturated, poly and monounsaturated fatty acids.

So in my mind when I see fat free or low fat, I say to myself 'No, I want the food that has the fat in it' and I try to avoid eating low fat foods. In fact, I tell my patients to try to avoid eating low fat/low cholesterol products whenever they can.

It also makes me chuckle when I see a product that has always been low carb, now with the words "Low in Carbs" written on the package. I've seen this on hot dog, sausage, chicken and believe it or not on mayonnaise as well. This is good for us low carbers for alot of people just starting out aren't sure how many carbs are in the food they're about to eat--it makes me laugh as to how food manufactures, who could care less about your health, change their marketing to opportunize certain diets.

Just my thoughts for the day. Tomorrow I'll talk a little bit about how our pets should be eating. That's right, I did say pets, but my focus will be mainly on our canine friends.

Dr Jim

To purchase my book go to or go to to request a digital copy of my book for only $11.99!

Monday, August 10, 2009

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Jelly Fish Have No Brains

I found this to be amazing. Seems to me that when most doctor's analyze a lipid profile, they use a jellyfish mentality when looking at the numbers. They emphasize the total cholesterol and calculated LDL, the two numbers which offer the least useful information; and use these numbers to determine if one should be started on a cholesterol lowering medication.

We learned in an earlier blog that the term 'cholesterol lowering medication' is really a misnomer as most people's cholesterol needs to be raised, not lowered. Specifically, the HDL needs to be raised. So by saying we are starting someone on a cholesterol lowering medication is truly misleading.

The fact is, total cholesterol is an absolutely irrelevent number, let's all stop thinking that it is more important than it is.

Dr Jim

Monday, August 3, 2009

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You Dont Need To Exercise To Lose Weight

It was Saturday morning when I was watching Good Morning America where they had a special on about 3 overweight kids. One child was over 330 LBs. They won a trip to a camp that specializes in weight loss.

Of course, the camp had it all wrong when it came down to diet. One could see that the children were eating bread and corn and fruit, all very high carbohydrate containing foods. Consumption of these foods will make it much more difficult for these highly motivated children to lose weight.

My heart went out to these children, who were not only eating the wrong way, but were engaged in strenuous activities as well. Obviously, the camp leaders are still buying into the myth that one has to exercise to lose weight.

This is not so and I actually include this as my fourth biggest dietary myth.

(Dietary myth # 1-Eating fat makes us fat---False.
Dietary myth # 2-Eating cholesterol containing foods causes heart disease-False.
Dietary myth#3-The calorie means something in human nutrition-False.)

I know one does not need to exercise to lose weight as I have seen it happen thousands upon thousands of times in my patients. In fact, I will argue that it is downright negligent to have a child who is over 330 LBs exercise vigorously (even an adult for that matter), as this will place a tremendous burden on the heart placing that child (or adult) at risk for a cardiac event.

No, I am not against exercising. What I do with my patients is I have them lose weight first. I will allow them to engage in simple exercises, like walking or swimming. I check their hearts out with at least an EKG and an echocardiogram of the heart; and if need be possibly even a stress test.

When I get a good amount of weight off, which is dependent upon the person and as long as their tests come back OK; then I will let them exercise more strenuously.

Physicians, dieticians, weight loss counselors or any one who is involved with weight loss needs to understand that we dont need to exercise to lose weight. And sometimes it can be dangerous or even deadly to do so, without taking weight off first.

Dr Jim