I feel fantastic on a Low Fat Diet and I found recently that My Arteries Were Clear of Plaque, so I believe what I am doing is working. However, I keep reading over and over again that Low Fat Diets increase triglycerides and create a deadly “Pattern B” (small particle) lipid pattern. Dr. Davis, the famed plaque-reversing clinician, constantly attacks Low Fat Diets with this point.
While I greatly respect Dr. Davis and don’t doubt him for a minute, this accusation has never made sense to me, because I have never had high triglycerides on a Low Fat Diet. Yet I know that Dr. Davis is a very smart guy and has loads of practical field experience. So why the discrepancy?
Well, my belief is that I have stayed in good territory, because I eat a Low Glycemic Low Fat Diet. For example, I eat a relatively low amount of grains – virtually no wheat or oats – and mostly fruit along with peas/lentils/chickpeas for carbohydrates. Paleo and low carb folks love to criticize fruit – well, at least many of them treat it like it was cheesecake – but the reality is the fruit is usually a low glycemic choice. And I do not know any expert that would argue that peas/lentils/chickpeas are anything but healthy: these are incredible superfoods and packed with “resistant starch” if you’ve been following the latest buzz on that subject.
So let me show you my last lipid numbers, so you can get an idea what a Low Fat Low Glycemic Diet will do for you.
- Total Cholesterol: 121
- Triglycerides: 98
- LDL: 76
- VLDL: 20
- Lab Pull Date: 9/4/2014
Notice below that my LDL and triglycerides are actually very close to what Dr. Gould, another famous plaque-reversing researcher, has set in his guidelines. (See my page on HDL, LDL and Triglyceride Levels for Plaque Reversal for more details.) In fact, I am less than 10% higher that his thresholds, which may explain why I have doing been very well: my latest blood pressure reads are actually below 110/70, which is excellent for a guy in his mid 50’s.
- LDL < 70
- Triglycerides < 90
So I do NOT have high triglycerides by any stretch of the imagination even though I eat a lot of carbs compared to any low carb or Paleo peers. And the reason is simple and was explained years ago by two low fat diet researchers named, coincidentally, Dr. Bernard:
1. Dr. R. James Bernard. This Dr. Bernard has done more studies on Low Fat Diets than probably any man on the planet. He worked extensively with Nathan Pritikin for example. And he pointed out that the research showed that:
“The writers fail to recognize that a low-fat diet does not cause triglycerides to rise if the fat is replaced by unrefined, complex carbohydrates, naturally high in fiber, as reviewed by Anderson et al.” 
2. Dr. Neal Barnard. This Dr. Bernard wrote a classic book, called “Dr. Barnard’s Program for Reversing Diabetes,” where he did just what the title of his book says with a Low Fat Diet. This flies in the face of the Low Carb propaganda that claims that carbs accelerate diabetes and prediabetes. In fact, the opposite is true: you can eat a goodly amount of carbohydrates and actually reverse diabetes if you do it the right way.
What is “the right way?” Well, Dr. Barnard showed that by only allowing his participants to eat only low glycemic carbohydrates. And it worked very well: participants dropped their A1C by a full point from what I remember. (You can read more about it in my page on Low Fat Diets and Diabetes.) This clearly shows that low fat diets do not have to send blood glucose and insulin out of control. (High triglycides result from refined carbs and certain grains.)
By the way, Dr. R. James Bernard in the Circulation journal article above also pointed out that “Ornish et al reported regression of CAD on a 10% fat-calorie diet in spite of a rise in triglycerides.”  In other words, there is evidence that with a good low fat diet, even higher triclyerides can regress plaque. I would err on the side of caution here though and follow Dr. Gould’s guidelines above, i.e. clamp down on your triglycerides.
CAUTION: It is very important to not just assume you are regressing plaque because of your lipid numbers. A number of things can trip you up, so get an IMT or Heart Scan and prove that your diet is working. Neither require a doctor’s orders in most states. You should be able to get a Heart Scan, which does involved some radiation, for under $100. And Lifeline – I have no affiliation – offers a CIMT for $70 as of this writing.
CONCLUSION: This shows that the propoganda coming out of many Low Carb and Paleo gurus is simply not true: all carbs are NOT created equal and you CAN eat a significant amount of carbs and have good triglyceride levels. Again, you just have to go low glycemic.
One more pertinent question is if my triglycerides of 98 are good emough? My personal opinion is that it probably is good enough, but that I should shoot to get it below 90 to match Dr. Gould’s guidelines. Plus, I am a huge fan of the low fat-consuming Tarahumara, the famed ultramarathoners with no hypertension and incredible longevity. The Tarahumara are probably the healthiest people on the earth and their cholesterols is in the 120’s like mine and their triglycerides are 91.  Note that their numbers correspond almost exactly with Dr. Gould’s guidelines
Also, the night before I had had a 20 oz beer and I’m not a big guy, so this may have skewed the numbers a little negatively. (Alcohol can raise triglycerides.) In addition, I am relatively sedentary – I do exercise religiously an hour a day, but do sit a ridiculous amount as I basically have two jobs requiring me to be seated in front of a computer.
I think I can get my triglycerides below 90 simply by avoiding all alcohol – I am a one beer per night guy at most – and exercising more. Of course, I could always take some niacin, but I would rather avoid megadosing a supplement if possible.
1) Circulation, 1999; 100:1011-1015, “Correspondence: Very-Low-Fat Diets”
2) N Engl J Med. 1991 Dec 12;325(24):1704-8, “Changes in lipid and lipoprotein levels and body weight in Tarahumara Indians after consumption of an affluent diet”