Overweight, diabetic, and high cholesterol


A while back you wrote about a guy who wanted to know about a diet to reduce his cholesterol. I think his name was Bert. He was a skinny guy and you helped him to fix his diet. I need that kind of help too but I am a 58 year old overweight guy and pre-diabetic. My doctor is really pushing me to take a statin for my cholesterol. What should I do?”


I am not a doctor, as I mentioned in an earlier Ozempic question, Consequently, as I also told Bert, I won’t take a position on whether you should take a statin or any other cholesterol lowering medication. But I can suggest how your diet may be impacting your overall health including your cholesterol. And what you might do about it.

So let’s start with a little background.

With rare exception, overweight means you are consuming more calories than you need. Calories represent fuel for energy and fuel comes from food. As we parents all know, children have a never ending need for energy because they are growing. Adults of 58 years should be in maintenance mode, not be growing. And yet you are.

Pre-diabetic means before diabetes. Unchecked, you are headed for diabetes. While other genetic stuff might be factoring in, the path to diabetes almost always starts and continues apace with weight gain.

Your blood sugar (glucose) is climbing, pressing your pancreas to produce more insulin.

Your pancreas’ primary job is to make the hormone insulin. The insulin is supposed to keep blood sugar in balance and store excess energy in body fat. Early on your pancreas made enough extra insulin to compensate for your blood sugar spikes. But arriving at pre-diabetic means compensation is not working so well.

Diabetes allows glucose to build up in the blood. That excess glucose sticks to any protein it can find which includes the walls of the blood steam, the red blood cells that carry oxygen, plus body organs connected to the blood stream (which is all of them), This can wreak havoc on virtually every part of your body.

An A1c blood sugar test specifically measures the amount of glucose stuck to your red blood cells. This is one way a doctor knows to diagnose diabetes.

Bottom line, there is too much sugar AND extra insulin rolling around in your blood stream.

A chronic level of high insulin will damage parts of your body with no obvious connection to blood sugar. This article from BMC Biomed Central explains this in exquisite detail, noting that “Prolonged exposure of cells to high insulin concentrations can therefore be regarded as toxic.”

There is a lot that can go wrong including but not limited to cardiovascular disease, high blood pressure, high triglycerides, kidney disease, retinal (eye) disease, nerve diseases (neuropathy), ED, and PCOS (for women) plus contributing to certain conditions like lung disease, cancer, and dementia.

We would like these things NOT to go wrong.

Here you stand, at the trailhead leading to a lot of trouble with a doctor concerned about your cholesterol, fearful that cholesterol and some other stuff will embed in your blood vessel walls and cause a heart attack. So how likely is that to happen?

Depends on the condition of your blood vessel walls along with the number and condition of the lipoproteins carrying cholesterol in your blood. Cholesterol is necessary and not a bad thing. It just happens to be packaged in a lipoprotein container that bounces along in your blood stream. The container can be the problem.

We already know there is some damage to your blood vessels due to high sugar and insulin and other stuff we haven’t even discussed. The number and condition of the lipoproteins is a bullets vs balloons thing.

Imagine you are at a shooting range doing target practice. How much damage would you do to the target shooting lots of bullets from an AK-47 rifle? How about throwing fluffy balloons? Would the condition of the target matter? Might it matter how many people shot at the target before you got there?

There are three goals here. First, to lose weight, essential to achieving the other two. Secondly, to minimize new damage to the blood vessel walls, allowing them an opportunity to recover. And finally to minimize the number of lipoproteins with pointy edges.

All three are accomplished through the same diet, minimizing the carbohydrate foods that generate too much blood sugar, calling for more and more insulin.

This diet is simple enough, one that almost always results in weight loss and often results in a reduction in cholesterol.

Eat meals, not snacks. Eat meat, vegetables, and fruit. Limit starchy foods like potatoes and beans. Avoid as much as possible ultra-processed foods created from flour, sugar, and fat, particularly those commercially made and/or served at fast food restaurants. Avoid drinks of any kind containing sugar. These are the foods that can generate high levels of blood sugar and ultimately insulin.

This is essentially the same diet recommended for anyone with one possible exception. The people who aren’t gaining weight and don’t have blood sugar issues probably don’t need to limit starchy foods. In fact they can get away with the occasional ultra-processed food.

There can be more involved than diet. Stress, inflammation (activation of the immune system), and treatment of inflammation (like steroids) are guaranteed to also increase blood sugar and insulin. These are sometimes more difficult to diagnose and treat. Consider diet as the highest and most controllable priority.

Try this for a month or two and see what happens. And by the way, whether and when you take a cholesterol lowering medication is between you and your doctor.


Pat Smith is the author of “It’s All about the Food,” a book that guides nutritious food choices as the way to avoid illness and maintain a healthy weight. Proceeds from her book benefit the Montgomery County Food Pantry. Her book is available on Amazon and at Bob’s Food City, Mount Ida Pharmacy, and Turtle Cove Spa. Her website is http://www.allaboutthefood.org/ She can be contacted at patsmith2@live.com, 501-605-3902. Her Facebook page is www.facebook.com/patsmithbooks.