Triglycerides reveal heart and stroke risk....

Today's post: Friday, 11-14-2008

One day, several months ago, I was lucky enough to hear a doctor, Randy Stafford, MD, PhD, from Stanford University’s Prevention Research Center speak.

I’d known that HDL cholesterol was beneficial and helped remove excess LDL cholesterol and might prevent cardiovascular disease in other ways.

And, I’d known that the two kinds of LDL cholesterol that damaged your arteries and contributed to plaque build up in them are the small sized, or “small particle” LDL and LDL which has been oxidized. The small sized, or “small particle” LDL is quite literally so tiny it can fit into the chinks in your artery walls. LDL that is in larger particles tends to roll along the surface of your arteries and is far safer for you.

So, measuring your levels of small particle LDL is clearly quite valuable. If it’s high, you need to take steps to bring it down if you want to prevent heart attacks, strokes, and other cardiovascular problems. There IS a high tech test that can be used to measure your levels of small particle LDL. But it costs several hundred dollars to do. We know that regular exercise lowers these levels. And we know that ingesting transfats and high fructose corn syrup tends to raise them. (So we know people who exercise regularly and completely avoid ingesting transfats and high fructose corn syrup are far less likely to get heart attacks and strokes.)

But wouldn’t it be nice if we had a whole list of other things that would bring these levels down? And, wouldn’t it be nice, if we had a much less expensive test for levels of small particle LDL?

Dr Stafford said something in his talk that day that caused me to realize my entire trip to hear him speak was one of the luckiest days of my life.

We DO have both these things NOW!

Dr Stafford said that research has shown that you can get an extremely accurate picture of the level of small particle LDL in your blood by simply measuring your HDL and triglycerides. Their ratio gives you the level of small particle LDL. If your HDL is high, over about 60 and your triglycerides are low, under about 90, your level of small particle LDL is quite low and so is your heart attack risk and your risk of stroke. Conversely, if your HDL is quite low, 35 or less and your triglycerides are very high, over 400, you have a very large amount of small particle LDL and should make sure your health insurance, life insurance, and will are in order. Making sure your significant other knows how to do CPR might also be a good idea.

1. Since, HDL and triglyceride levels are part of the normal, much less expensive, cholesterol panel you may already have gotten, this means that testing your level of small particle LDL is affordable. And, you or your doctor may already have that data for the last time you had that test done. Just look up your HDL and triglyceride readings.

2. In addition to doing regular exercise, ideally some strength training and interval cardio, each week, and completely avoiding foods and drinks that contain any partially hydrogenated oils (transfats) and/or high fructose corn syrup, we ALREADY know a whole list of other things that increase HDL and ANOTHER list of things that lower triglycerides. By adding everything we can from both lists, we can dramatically lower our risks of heart attack, stroke, and other cardiovascular diseases by reducing our levels of small particle LDL.

In addition to regular exercise, taking 300 mg of niacin twice a day and drinking a low moderate amount of red wine each week increases HDL. Using extra virgin olive oil instead of oils such as corn, soy, and canola keeps those other oils from lowering your HDL levels. And, eating some egg yolks if you aren’t allergic, taking lecithin or choline supplements, and eating foods such as nuts and avocados that have a similar profile of oils to olive oils also helps increase HDL. So does eating onions and garlic.

In addition to NOT eating high fructose corn syrup, NOT eating refined grain foods, limiting the amount of sugar you eat, eating onions, and taking DHA and purified fish oil supplements and eating foods such as wild caught salmon that are high in omega 3 oils all lower triglycerides.

Doing ALL these things lowers your risk of heart attack, stroke, and other cardiovascular diseases by reducing our levels of small particle LDL. Many of these actions will also lower CRP levels if yours measures as high. (And, regular exercise and completely avoiding the things on the NOT to eat or drink list also tends to help you lose excess fat and keep it off as an extra benefit.)

These things certainly worked for me. My last test measured my HDL as 90 and my triglycerides as 41.

Recently, I was reminded of this by two news articles. One reported a study that found that people with levels of triglycerides of over 400 had something like 5.6 times as many strokes as people with triglyceride levels of 89 or less! So, it’s beginning to be recognized that triglycerides are a more revealing and important measure than we once knew.

(Reuters had this article, “Triglycerides may be blood fat to watch: studies” while Health Day had, “High blood fat levels tied to ischemic stroke.” The blood fat in that article was triglycerides.)

Lastly, note that statin drugs are NOT needed to do any of these things. So, I believe strongly that most people are better off without their high risk of serious side effects and cost. Most people CAN do most of the lifestyle upgrade in this post. And they offer even better protection from heart attacks and strokes than statin drugs.