Saturday, September 29, 2012

The Nutrition Debate #68: Triglycerides, Fish Oil and Sardines

DATE
Trig.
8/3/1978
115
5/7/1980
137
6/12/1980
118
12/23/1985
147
10/14/1987
170
8/7/1990
84
4/3/1991
74
5/10/1991*
107
11/5/1992
146
8/17/1993
187
10/18/1994
127
2/27/1996
110
6/4/1996
165
9/5/1996
115
2/11/1998
165
8/15/2001
159
12/12/2001
158
2/14/2002
135
4/9/2002
141
6/12/2002
166
8/6/2002
144
9/3/2002
99
10/3/2002
157
11/4/2002
124
12/4/2002
87
1/2/2003
87
2/4/2003
77
3/4/2003
94
4/2/2003
84
4/29/2003
155
5/28/2003
69
7/1/2003
222
8/6/2003
133
9/10/2003
46
10/8/2003
45
11/4/2003
108
12/3/2003
71
1/6/2004
36
4/15/2004
40
6/17/2004
60
8/18/2004
48
11/10/2004
80
4/22/2005
55
6/21/2005
53
9/7/2005
59
12/5/2005
67
4/19/2006
57
6/14/2006
57
8/2/2006
79
10/9/2006
110
12/12/2006
88
5/1/2007
74
7/17/2007
69
11/27/2007
21
5/5/2008
41
7/12/2008
54
10/7/2008
49
12/16/2008
52
4/29/2009
26
8/3/2009
42
11/23/2009
34
4/26/2010
50
7/27/2010
49
12/2/2010
52
4/19/2011
38
8/15/2011
32
12/12/2011
53
4/17/2012
na
8/14/2012
65

The table on the left of this column displays my Triglycerides (TG) for the last 34 years. (See, being a compulsive record keeper is a good thing.) Last week’s column (#67, here) has a similar table of my HDL Cholesterol. Later I will link improvements in my HDL and display ratios.
As you can see, I’ve never had really high triglycerides. The reference range for healthy triglycerides is less than 150mg/dl, and only 10 of my 69 TG tests have been over 150. Seven of those were over 10 years ago before I started eating Very Low Carb (VLC) and the other 3 were in the first year of VLC before I started fish oil supplements and eating sardines.
The “before and after VLC” test results are revealing: The average of the 21 TGs before I began VLC was 137. The average of the first 10 months that I was on Atkins and lost 60 pounds (but wasn’t taking fish oil) was 103. The average of the last 18 tests during which I did Bernstein (for the most part), and lost a lot of weight (then regained some), and was taking four, then three, now 2 grams of fish oil/day, and eating a can of sardines for lunch, is 49mg/dl (range 21 to 88). This before and after contrast is indeed stark. To what is it owed?
I now eat VLC. Seventy percent 70% of my diet is fat -triglycerides! I eat plenty of saturated fat. I eat about 700 mg of cholesterol a day (including a breakfast of 2 eggs with 2 strips of bacon and half and half in my coffee. So obviously avoiding dietary fat is not the answer. It is indeed a paradox, if you accept the dietary and nutritional advice of mainstream medicine.
There’s lots of evidence in the scientific literature to support the results on the left, but the best evidence to me is the outcome for me. True, this is only n = 1, but it would be a mistake to think that this outcome is an isolated result. It is widely reported in the scientific literature under the subject “carbohydrate hypothesis.”  Do your own independent research on the Web.
Award-winning science writer Gary Taubes has pioneered in popularizing this hypothesis starting  with his game changing article, “What If It’s All Been a Big Fat Lie,” in the July 7, 2002, NY Times Sunday Magazine. He later addressed the subject in much greater detail in his tome, “Good Calories-Bad Calories” (“The Diet Delusion” in the UK), and the more ‘accessible’ “How We Get Fat: And What to Do About It.” He influenced many young clinicians (and me).
A compelling case for the benefits of low triglycerides, especially in combination with high HDL, was made in “Clinics” at PubMed Central 2008 August 63(4) 427-432. In this peer reviewed paper they describe the ratio of Triglycerides to HDL (TG/HDL) as “the single most powerful predictor of extensive coronary heart disease among all the lipid variables examined.” Note that neither Total Cholesterol (TC) nor LDL, “the bad Cholesterol,” is mentioned as a factor.
Using this new (but not yet widely adopted) standard, a TG/HDL ratio 1.0 is considered ideal, a ratio of 2.0 is good, a ratio of 4.0 is considered high and a ratio of 6.0 is much too high. So, how does my TG/HDL “before and after” ratio calculate and stack up? Referring to the table in the previous blog (#67), “HDL and the Very Low Carb Diet,” for HDL, here are my calculations:
When I was a heavily medicated Type 2 diabetic and eating a “balanced” diet: TG/HDL 3.2
When I was losing weight on “Atkins induction” but not taking fish oil capsules: TG/HDL =2.2
When I was eating VLC, losing weight, taking fish oil and eating sardines daily: TG/HDL = 0.67
Maybe the seeming paradox of eating Very Low Carb with lots of fat, including lots of saturated fat and cholesterol, and taking fish oil supplements and eating a can of sardines daily, is NOT a paradox. Maybe it’s a healthy Way of Eating. These lab results sure suggest that. Could it be? More and more people (including many experts) seem to think so. What’s your ratio?
© Dan Brown 9/30/12