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    Suggest ways to control diabetes in an obese person

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Posted on Fri, 21 Jul 2017 in Hypertension and Heart Disease
Question: I have recently found I have extensive coronary artery calcification on lung CT . I am a diet controlled diabetic and am very fit , asymptomatic and a runner . I have been vegan for several years but recently started eating cage free eggs and have been doing a high fat low carb diet which is controlling my blood sugar perfectly and helping me lose the extra 5-10pounds I would like . I am not strictly overweight but have some small amount of belly fat and want to be on lower percent of body fat for a woman . I am very confused about the literature about the XXXXXXX Cornish philosophy vs the XXXXXXX lifestyle. both seem to claim the same results . what is your opinion / I s it ok to be eating several eggs day . since I don't eat meat this is an easy way to eat a low carb diet . I am eating eggs and avocados to excess!! I am going o statins and aspirin as advised by my cardiologist and want to pursue the healthiest possible diet . would value your opinion
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Answered by Dr. Ilir Sharka 2 hours later
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

I carefully reviewed all your medical history and would like to explain that because you are diabetic and you have confirmed calcifications of your coronary arteries, you are considered at high risk for adverse coronary events.

Coming to this point, it is necessary to undertake two important management strategies:

1- Lifestyle modifications
2- Medical therapy (which is already described by your doctor, including statinsw, aspirin, etc.).


Now returning to your main issue of interest, which is in fact the most important element of preventing future cardio-vascular events, that is lifestyle modification, I would explain as follows:

- there are several strategies that may be effective in controlling your body weight. A low carbs and high fats diet such as XXXXXXX Diet is shown to be very effective in this regard, but it is not considered a physiological modification and doesn't offer cardiovascular protection.
- From the other side we have healthy diet profiles such as Mediterranean Diet (Dr. XXXXXXX Ornish diet follows a similar philosophy), which states that there is a wide range of nutritional elements, which offer different cardio-vascular protection levels and they strongly recommended that the main components of healthy diet should be those who offer cardio-vascular protection.

This latter statement is properly accomplished if we take a balanced proportional carbs (30-45%), fats (round 30%) and more specifically a low level of saturated fat (less than 5-6%) and especially trans-fatty acids (less than !%) and round of 10% of poly-unsaturated fats.

Regarding cholesterol an average daily amount of 250-300 mg would not be harmful, but instead, would prompt an optimal metabolism attitude (dietary cholesterol inhibits the endogenous cholesterol production).

As an egg contains commonly 220-250 mg of cholesterol, it may be an egg a day or one egg in every other day is well tolerated by the cardio-vascular system.

In this regard, the most important clue on how cholesterol behaves inside our bodies is our total daily amount of dietary calories.

It has been shown by several studies, that if we take 1-4 eggs daily, but we follow also calories restriction, this will lead in lipid profile improvements and cardio-vascular protection.

But, if we take the same amount of eggs, concomitantly with dietary calories excess, this cholesterol supplement will adversely impact our blood vessels and promote the acceleration of atherosclerosis.

So, to conclude and make it clear and short for you, I would advise you to follow a healthy Mediterranean Diet, including eggs consumption, but at the same time to be careful at your daily calories balance, in proportion with your daily requirements.

Hope you will find this answer helpful!

Wishing good health,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 7358 Questions

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