Did you know March is National Nutrition Month? I want to discuss your blood work and what some of the results truly mean about your health. Last month I had the pleasure of being a guest on The Lisa Valentine Clark Show.
In this segment from the show, Lisa interviewed me about what you should be looking out for when you get your blood work results. Have you had high levels of triglycerides or cholesterol? Are you confused by your own results? Listen to the show yourself or read an enhanced transcript of it that I have included below. If you have questions, feel free to email me at firstname.lastname@example.org.
LISA: Welcome back to The Lisa Valentine Clark Show. Do you know what your blood type is? Do you know how high your cholesterol is? Well, according to Women’s Health magazine, most adults get blood work done every one to five years, but what do all those numbers mean? As we grow older there are problems that can crop up and we should be thoughtful in our health. So today we’re talking with the very experienced and helpful Dr. John Poothullil, from whom we will learn about blood work. Welcome doctor. How often do you advise people get their blood work done?
JOHN: It depends on what you are looking for. If you are in good health, once a year should be enough for blood work. On the other, hand if you have a particular reason, whether you are anemic, whether you have high cholesterol. high triglycerides, high blood sugar, then your doctor may advise you to do it more often, once every six months, or even once every three months if you are on diabetic medications.
LISA: And what are the basic things that a normal blood work reports on?
JOHN: It reports on the blood cells that show our oxygen carrying capacity and our immune system. Red blood cells indicate hemoglobin, hematocrit, and the different types of white blood cells show the condition of the immune system, with some white cells fighting infection, and some responsible for immune regulation and prevention. That is one category. The second category of a blood test reports on our different types of fat in the blood such as triglycerides and cholesterol.
Let me make a point here regarding triglycerides: Most people don’t think about triglycerides. What is it? Everybody knows about cholesterol, but what exactly are triglycerides? The name tells us: “tri” means three molecules of fatty acids connected with one molecule of glycerol. This is the name for the normal fat we store in the body. If you eat more than what your body can use before the next meal, your liver has to convert the excess — whether it comes into the body as glucose, fatty acid, or amino acids — into a long-term storage form, and that is what we call triglyceride or fat.
LISA: Oh and that is how you gain weight. The more triglycerides you have in your body, the more weight you gain. Yeah, that’s the stuff we want to get rid of.
JOHN: This is what is interesting to think about. Where does the excess of what we eat go? The liver turns the excess into triglycerides, but the liver cannot store them. The liver sends the triglycerides to your fat cells. The problem is, each of us inherits only a certain amount of fat cells. In other words, your fat storage capacity is limited by the genes that you inherit. So your parents give you the fat storage capacity. Your fat storage is just like going to a store and buying a particular refrigerator with a specific cubic feet capacity.
Your capacity to store fat is therefore limited by the genes. Don’t forget you inherit one set of genes from your father and one from your mother. However only one gene for fat storage can be active. So if your mother is lean and if the gene you inherit from her is active, you are going to have very little fat storage capacity. But if your father is heavy and if that is a gene active in you, you can become heavy because you have a large storage capacity. Your fat may stay in your fat cells rather than in the blood.
What I’m also saying is if you have inherited a 5-pound fat storage capacity, once that storage capacity is filled up, your triglyceride level in your blood will start going up.
LISA: Oh, I see because there’s nowhere else for it to go?
JOHN: Correct! Whereas if you have inherited a 20-pound storage capacity, then you may gain 20 pounds but your blood triglycerides maybe normal.
LISA: Okay so when we look at these levels of the triglycerides in our blood, what should we be concerned with every year is if that keeps going up? Are you are getting a sign that your fat storage capacity is being filled up? So if it’s a high level in your blood, then you are over capacity. Does this mean that you need to really be careful.
JOHN: Right. So then the question is: Why should you be careful if your fat storage capacity is filled up? Here’s why. Two things can happen: first, fat sticks to your arterial walls. For example, fat is similar to oil; if you put oil on your skin, it sticks, water cannot move it out or wash it off right, so the fat sticks inside the blood vessel. It can block the blood vessel and you are setting yourself for a heart attack or stroke or damage.
LISA: Wow. So who is most at risk? Are thin people more at risk for heart attack?
JOHN: Yes. The risk is higher not because of the way you look. You may look heavy or you may look even obese, but if your fat is stored outside the blood, you are actually much safer than a thin person with a small storage capacity who is accumulating the triglycerides or fat inside the blood.
LISA: Wow I didn’t know this. This means that blood work is important because you’re checking for these warning signs for heart attack and heart disease.
JOHN: Right, but it’s not only that. When the triglyceride level goes up high, the liver senses that there is no point in converting excess glucose that you absorb after a meal into fat because fat can clog up your arteries. So the liver will leave glucose molecules in the blood. Then your blood sugar starts going up. And what do you call that person?
LISA: Diabetic or pre-diabetic?
JOHN: Yes. Diabetes happens not because there is something wrong with your pancreas or insulin as we are led to believe by experts, but in my opinion, it comes from you filling up the fat storage capacity too early.
This explains why a pregnant woman who has never had diabetes before or no family history of it can suddenly develop gestational diabetes. At eight weeks of pregnancy, because she has been eating for two people, right, everybody encourages her to eat. “Oh eat this, it is good for the child’s complexion.” “This is good for the brain.” So she eats and eats and her fat storage fills to total capacity and the liver leaves the glucose in the blood because there is no place to store the fat. She’s a diabetic or gestational diabetic. After delivery, when she loses weight, her storage capacity is restored. She can put the fat back in there and the blood sugar come comes down to normal.
LISA: What is the biggest question we should be asking ourselves about our blood work numbers?
JOHN: When we have our blood tested, whether you are looking for prevention or you are being treated, for something, pay attention to your blood test results as they can be misleading. For example, let us say you are a diabetic and you take shots of insulin to make your blood sugar go down. The insulin may help your glucose go out of the blood, but it does not go out of the body. This is why even if you keep blood sugar low using insulin, you can still end up the same complications as anybody else with type 2 diabetes.
Now, let’s talk about cholesterol. We have got good cholesterol and bad cholesterol. Where is the good cholesterol? In my opinion, I have been searching for it as it does not do any good. We were told when we were in the medical school that the good cholesterol will go and pick up the bad cholesterol which is stuck to the arterial wall and bring it back to the liver. That is why it is called supposedly good cholesterol, right?
But cholesterol is just a molecule. How can good cholesterol pull off bad cholesterol? Let’s say we have a stick-on paper on the on the desk, and you put another stick-on paper on top of it. How can the second one pull the first one off the table? It does not have the energy or cannot have energy to pull it off? Similarly, the good cholesterol, called HDL, is just a molecule. It cannot produce energy. Only cells can produce energy. So in other words, good cholesterol cannot remove the bad cholesterol stuck inside the arterial wall, right?
So the good cholesterol can’t get rid of the bad cholesterol. All right, it’s just there. Why is it called good? It’s only because it does not do any harm but to me that’s not enough. To say you are good puts a value on it, a moral value.
LISA: What blood tests are important to really scrutinize and look at carefully?
JOHN: If you have a history of diabetes, even before your blood sugar level goes up, keep an eye on your triglyceride count because that goes up weeks, months, or years before the blood sugar goes up. So if you want to prevent type 2 Diabetes, keep track of your triglyceride numbers.
Type-2 diabetes is what is called a lifestyle condition, that means you should be able to control it without medication. You have two options: one is you can drive the blood sugar out of the blood by taking a medication such as insulin OR you can avoid putting sugar into your mouth. I’m talking about the main types of food that are absorbed into the blood as glucose. In general, I’m referring to grains and grain flour products.
LISA: Grains and grain flour product, right?
JOHN: Yes, 16 years ago, we had the Green Revolution that made grain flour products and foods cheaper for everybody in the world. In my opinion, grains were never meant for humans, otherwise we would have had beaks.
LISA: I never thought of it that way.
JOHN: We cannot digest the chaff of the grain. It has to be milled. It has to be refined and every government subsidizes grain farming. 50 or 60 years ago, only 25 percent or less of our daily energy intake came from grains. Now in developed countries, it is 50 percent or above and in developing countries it is 70 percent of food energy.
JOHN: This is a common factor all over the world. Type-2 diabetes is increasing and the next epidemic going to be cancer if we continue the same trend. We really need to be vigilant about watching our health and how we do it well.
LISA: We are out of time, but thank you so much Dr. John Poothullil, the author of Diabetes: The Real Cause and The Right Cure. You’ve practiced medicine for over 30 years and we’re so grateful that you could share your perspective with us and your research. Thank you.
JOHN: Thanks for having me.
If you happen to live in the San Diego area, come meet Dr. John in person. He will be giving a book talk at the Loma Theatre Barnes and Noble tomorrow!
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