Of the four measures available on any standard cholesterol blood panel, triglycerides are the most neglected. Yet that one value contains a wealth of information and insight into your health, information about your diet, insulin status, even a sign that you could have fatty liver–but I’ll bet, of the many times you’ve had a cholesterol panel drawn, your doctor never thought to even mention any of this.
Don’t let the medical system’s misguided obsession with cholesterol (because of the influence and marketing of the drug industry) keep you from learning and benefiting from the secrets in your triglyceride value.
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You know there are four values reported back to you in your cholesterol panel, a typical standard cholesterol panel. They’re total cholesterol, HDL cholesterol, triglycerides, and LDL cholesterol.
By the way, of those four measures, only the first three are actually measured: total cholesterol, HDL cholesterol and triglycerides. The LDL cholesterol, the value that is the focus of statin drug treatment, is a fictitious number. It’s not measured. It’s calculated from those other three values, using an equation that is miserably outdated, imprecise, and subject to all kinds of errors — not in the calculation — but in the assumptions made to generate that equation. That is the source for billions and billions of dollars and millions of prescriptions given to people for this number that’s not even a real value. But anyway back to the point …
That triglyceride value is often neglected. It’s often not even mentioned by many doctors. Yet, buried in that value is tons of useful information. So when you get that cholesterol panel, I recommend you ignore the LDL cholesterol — and the Total cholesterol by the way (that’s whole other conversation; you’ll find the Undoctored book and Undoctored Blog and some of the older conversations in the Wheat Belly materials as well), but that triglyceride value — often neglected — is packed with useful information.
For instance, it gives you an index of your carbohydrate consumption and tolerance. If your triglyceride value is above the ideal (the ideal is 60 milligrams per deciliter or less); if it’s above that, say, 180 or 300, it suggests you are substantially over-consuming carbohydrates, and you’re developing metabolic distortions as a result. So high triglycerides give you an idea about that.
High triglycerides, above 60, also give you an idea about how resistant you are to insulin — not as precise as measuring insulin resistance by other measures, but it’s a crude and easy number that just about everybody has. If your triglycerides are high, 180, 200, 300, 400 mg/dL, it means you have insulin resistance. You are not responding to your body’s own insulin. It means your pancreas has to work harder and produce higher levels of insulin. If you were to measure blood insulin, it would be high. It’d be 30 micro units, or 40, or something, and that’s not good. That causes visceral fat (inflammatory fat) to accumulate. It leads to phenomena like dementia risk, cancer risk, heart disease risk, hypertension, Type 2 diabetes, weight gain, etc. So that triglyceride value above ideal is a problem.
High triglycerides also give you an idea of whether you have a lot of visceral fat. Now you may just know that by looking of course, or pinching your waist, but because fat, stored fat, serves as a depot, a storage place for triglycerides and fatty acids, and they’re always transacting or releasing those fatty acids and triglycerides into the bloodstream. If triglycerides are high, or even high-ish, like 90 or 120 mg/dL, it means your fat is transacting triglycerides, and you should lose some that visceral fat.
Having higher triglycerides also means that you’re likely to have an excess of small LDL particles. Recall that small LDL particles are the real cause for a lot of heart disease (not high cholesterol; that’s ridiculous) — small LDL particles, caused by carbohydrate consumption. Well, the series of reactions in the body that lead to formation of small LDL particles requires triglycerides, because triglycerides float in the bloodstream as what are called VLDL particles (very low-density lipoprotein particles, rich in triglycerides).
Those VLDL particles interact with LDL particles (not LDL cholesterol; that’s the kindergarten version of how heart disease is understood by most doctors, because they believe the sales reps in their office). No, LDL particles, low-density lipoprotein particles interact with those VLDL particles, and they become enriched in triglycerides (the LDL particles do) and then a series of modifications that particle lead to small LDL. Point being, if you have triglycerides above the ideal 60 mg/dL, it means you have increasing numbers of small LDL particles that lead you to heart attack and stroke. So we want those triglycerides down.
Having higher triglycerides also often suggests you have a fatty liver, because it’s triglycerides that gum up the liver in fatty liver. That’s why it’s called fatty liver; not because fat consumption causes fatty liver; because fat accumulation causes fatty liver, and it’s triglycerides (triglycerides are fats, but those triglycerides come mostly from carbohydrates and sugars. It’s the process of liver or hepatic de novo lipogenesis. Don’t remember that. Just remember that the liver converts sugars (like the amylopectins of grains, or the sugars in sugary foods and soft drinks), converts sugars to triglycerides. It raises blood triglycerides. It raises liver triglycerides (fatty liver).
So in that triglyceride value, often neglected, is a ton of useful information, for you — to empower you in crafting a diet, in managing weight, and gaining better health. But you want an ideal triglyceride value which is no higher than 60 md/dL.