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#program goals











Let’s focus on some of the program goals that are achievable in various lab values that reflect metabolic health.

These values reflect the status of your insulin resistance or sensitivity; the status of fatty liver; markers for cardiovascular risk; liver health; and thyroid status.

Measures to consider therefore include an NMR lipoprotein panel (with lipoprotein(a) on the first time this is run); hemoglobin A1c, fasting glucose, fasting insulin; 25-hydroxy vitamin D; TSH, free T3, free T4, reverse T3, thyroid antibodies; AST, ALT.


    Among the metabolic goals you can aim for are:

    • HDL cholesterol of 60 mg/dl or greater—HDL is a useful index of the quality of your diet and health. Low HDL values of, say, 42 mg/dl, reflect excess weight, inflammation, high carbohydrate intake, etc.

    • Triglycerides of 60 mg/dl or less—Like HDL, triglycerides are also a useful index of diet and health. When maintained at or below 60 mg/dl, it means that VLDL particles in the bloodstream rich in triglycerides are relatively unavailable to create small LDL particles that lead to heart disease and stroke. In other words, maintaining triglycerides at this low level (not the ridiculous 150 mg/dl or conventional guidelines associated with flagrant quantities of small LDL particles) means that small LDL particles have been minimized or reduced to zero.

    • Small LDL particles of no higher than 200 nmol/L—Though I am most reassured by small LDL particles of zero, obtained by not consuming the foods that provoke the formation of small LDL particles: grains and sugars. (The amylopectin A carbohydrate of wheat and grains are flagrant triggers of small LDL particles, as they are of postprandial, or after-meal, rises of VLDL that lead to small LDL.)

    • Hemoglobin A1c (HbA1c) of 5.0% or less—Keeping glycated hemoglobin, i.e., HbA1c, to such low levels tells us that you have eliminated the huge rise in risk for cardiovascular death and events from this measure and that you have slowed the process of aging via glycation of body proteins to a minimum.

    • Hemoglobin A1c (HbA1c) of 5.0% or less—Keeping glycated hemoglobin, i.e., HbA1c, to such low levels tells us that you have eliminated the huge rise in risk for cardiovascular death and events from this measure and that you have slowed the process of aging via glycation of body proteins to a minimum.


    • Fasting insulin of 4.0 mIU/L or less—Low levels of insulin suggest that insulin sensitivity is restored and that you need very little insulin to process glucose. Pre-diabetics and type 2 diabetics typically have values of 30, 50, or 80 mIU/L, sky-high values reflecting insulin resistance. (Just bear in mind that an occasional person can have a low insulin level because of pancreatic failure: prior damage to the pancreas from grain and sugar consumption, glucotoxicity, lipotoxicity, autoimmunity, and are incapable of making sufficient insulin any more. This applies to a minority of people.

    • TSH 2.0 mIU/L or less—Along with free T3 and free T4 in the upper half of the reference range. Normalization of thyroid antibody levels.

    • AST/ALT—These liver markers should be kept in the normal range, markers of liver damage as in fatty liver.

    0

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