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