Health Screening 101 (Part 3 of 3)

Health Screening 101 (Part 3 of 3)

This is article 3 of the 3 part series of Health Screening 101.  The first two articles in the series of Health Screening 101 are the following:

Health Screening 101 – Part 1:  Introduction to Blood Tests /​ Insulin Resistance /​ Cholesterol Education

Health Screening 101 – part 2:  Courses of Action to Follow:  Diet, Exercise, Medications Recommended

In this article, we will discuss the changes in his Health Screening Test after four months of following a Low Carb /​ Paleo diet, an exercise program, and a statin drug.

As you recall in part 1 of this series, we received a question concerning recent blood tests from a non-​​smoking officer.  See below for four month scores, most recent scores, and follow on actions to take over the rest of the year.

(RED = danger, YELLOW = borderline, GREEN = good)

Blood Test (Nov 2012)  Blood Test Four Months Later
 z1-redlight Body Mass Index
(BMI) Must be <25
(waist 41”)
BMI 31.5 — lost 22 lbs – still high
(Waist 39 but under 40!)
 z1-redlight Blood Pressure
Must be <120/​80
148 /​ 84 103/​74  z1light_green
 z1-redlight HDL (good chol)
Must be >60
31 35  — needs to be over 40 — 60  z1-redlight
 z-yellight LDL (bad chol)
Must be <100
117 61  z1light_green
 z1-redlight Triglycerides
Must be <150
362 119  z1light_green
 z1-redlight LDL – P (Lipoproteins)
Must be <1050
2231 1026 – best if below 1000  z1light_green
 z1-redlight Insulin resistance Ratio  (Trig /​ HDL)
Must be < 3.5
11.7 3.4  z1light_green

* Ranges of acceptable numbers for the above tests on Health Screening 101 – part 1

By changing five of the seven RED LIGHTS to GREEN LIGHTS, you have reduced your risk of heart attack, coronary artery disease, stroke, and type 2 diabetes significantly.  Prior to this Health Screening Cycle you were Insulin Resistant and had Metabolic Syndrome which is defined as by the National Institute of Health:  Metabolic Syndrome is present if you have three or more of the following symptoms:  high blood pressure, waist over 40”, low HDLs, high triglycerides, high fasting blood sugar levels.

When asked, “What was the biggest contributor to patient’s success?  Diet, Exercise, or Meds and how do we get the good cholesterol (HDL) up?

Dr. Greenwald concludes:  “
I think it is the combination of exercise, diet, and the meds.  All of them are equally important.  Here is why:

Diet:  The nutritional program is especially good at dropping the Triglyceride levels. He loses two inch around the middle during the process and that is nice to see.   He is burning the Visceral Fat that is most metabolically active and in severe cases can act like an extra endocrine organ secreting all sorts of inflammatory bad stuff    Insulin Resistant cases can continue to improve over the long haul.

Exercise:  With an Insulin Resistant (IR) patient, the exercise program improves the insulin sensitivity of the muscles especially.  HDLs take time and we like to see a gradual rise over time that I think may reflect the continued exercise program as much as anything.  HDL is not a target of therapy and is an area of great interest in the lipid world as we speak. In fact, it is looking like HDL– P the particle number again could be very important.   (Jim  Otvos PhD  Liposcience)

Medications:  The statin is the best medicine I know of to drop the Lipoproteins (particle number – LDL-​​P).

Due to diet and exercise over the 4 month period, patient has become much more of a “ fat burner” and that is reflected in the Triglyceride drop (a fat ).  If its dropping in the blood sample it is also dropping in the Liver and reversing the underlying Insulin Resistance.   243 points is a big drop in triglycerides!!”

Dr Greenwald continues:  I’m happy to see the red /​ yellow lights turn green, but I really don’t care about the standard cholesterol numbers anymore if I know that I have an IR patient.  The total focus becomes the particle number in a case like this, LDL– P getting under 1000.  That’s nice to see so keep him on the program.  It is very important to maintain contact with a patient like this and follow the numbers appropriately.

How about some tips to help with this new way of eating?

Robb Wolf of the Paleo Solution concludes:  We do not have self-​​control. PLAN AHEAD! Don’t have tempting foods in the house. Remove the bread, rice, pasta, cookies, crackers, puddings, ice cream, waffles, juice, sodas, cereals, oatmeal, artificial sweeteners, yogurt, soy sauce, teriyaki sauce, canned soups, apple sauce, noodles…all refined, packaged foods.

Sleep & Stress:  Black out your room. No, REALLY black out your room. No LED lights from alarm clocks, fire alarms, TV’s etc. Do not watch TV or check email for at least 1 hour before bed. Go to bed early, get at least 8– 9 hrs of sleep. You should wake up without an alarm, feeling refreshed.  This will help you in SO many areas of your life.  It is our natural recovery /​ stress reducing tool.

Losing 22 lbs in four months demonstrates effort on the officer’s part.  Largely it comes down to the individual and how much extra weight you are carrying and your personal effort.  All the best foods, exercise programs, and medications will not help anyone if the person does not follow the plan and do his part.  So good job and congrats!  Your efforts are paying off and will not only add more years to your life, but more life to your years, if you will excuse the clich’e.

Robb Wolf Adds:  While we are on this “weight topic” please just throw your scale away. Do NOT rely on it as a significant marker of whether this process is working or not. The fact is that you may not lose a ton of weight on this plan. Why? Because you are increasing muscle mass and losing fat.  Increasing your muscle mass is good for controlling your blood sugar, helping your body to naturally regulate appetite, and has anti-​​aging properties. Muscles make you look good naked! So, don’t focus on scale weight.

Keep doing what you are doing.  There is a saying in the fitness /​ health world, “Give health and fitness a month and it will change how you look and feel, give it a year and it will change your life.”



  1. Mattoomba says:

    I\‘m curious: when does the doctor decide that the lifestyle choices are going well enough that the artificial medications can be discontinued? Is this officer still on statins?

    • Stew Smith says:

      It’s a very good question . This is where the art of it comes into play . You follow the numbers and the patients wt and abdominal girth etc . Its really an assessment of compliance certainly taking into account how bad things were in the beginning . Sometimes it’s a good idea to lower dosage before discontinuing meds completely . There is certainly no one simple formula to fit all patients .

      Thanks Dr Greenwald

      E. James Greenwald, MD

      Medical Director
      SpecialtyHealth, Inc.
      330 East Liberty Street, Suite 200
      Reno, NV 89501

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