3. Science AMA Series: I’m Dr. John Bisognano, a preventive cardiologist at Unive...

Science AMA Series: I’m Dr. John Bisognano, a preventive cardiologist at University of Rochester, N.Y. Let's talk about salt: What advice should you follow to stay or get healthy? Go ahead, AMA.

Hi Dr. Bisognano,

Thank you so much for doing this AMA. I posted this a short while ago: http://www.reddit.com/r/AskDocs/comments/37t8ub/weight_loss_and_cholesterol/

This is about my dad, he's 65. His blood pressure is normal (70/ 110, sometimes go as low as 60/100) But he has high cholesterol and has been overweight (BMI 26) for years.

With his doctor's blessing he started an intermittent fasting regime 5 months ago, he only eats for 6 hours a day but drinks tea and water throughout the day. In five months, he went from BMI 26 to BMI 24, he's still losing half a pound a day steadily, his belly is visibly gone, all his old belts and pants no longer fit, and his knees are doing so much better due to the weigh loss, he is actually exercising a lot more now.

So it's SHOCKING to us that his latest blood test came back with cholesterol skyrocketed. (6.7 to 8.5) He went from moderate heart disease risk to walking away feeling like a dead man walking. Up until this point his doctor left it up to him to decide if he wants to be on statin. After this blood test his doctor insisted he MUST get on statin now.

My dad is really disappointed, he was so excited about his weight loss, everybody has been amazed by his progress and it really enhanced his social life and makes him more active, but his lab work seems to suggest we are killing him.

He's traveling right now so his doctor says to wait till he comes back before starting statin. I know my dad wants to avoid medications but will comply.

I'm just wondering if there are other things we could look into. Should he stop his fasting diet? (He still eats everything, carb, meat, fish, eggs, veg, a lot of fruit, a lot of nuts, oatmeal. A glass of wine or beer once or twice a week. But just cramped into 6 hours only.) Are there other blood tests or physical exams he could be doing that's better indicator of his heart health?

Both his mother and his sister needed pace maker, my grandmother passed away in her late 90's to stroke; his sister passed away in her 50's to respiratory track infection. I don't know if that counts as 'genetic' risk factor. Low blood pressure runs in his family.

Please help, it was my idea for him to start fasting, I've used the fast for a few years as a marathoner and it worked wonders for me. I never thought it would turn my dad into 'dead man walking.' He is still fasting even though he's traveling right now, because he is used to it now and doesn't want to break that routine, I think he is also really proud of his weight loss. But I'm really scared that it's the fasting that's wrecking his cholesterol.

I would love your opinion on what could be the culprit, and whether statin is unavoidable.

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