Wednesday, April 24, 2019

Retrospective #68: Triglycerides, Fish Oil and Sardines

The table on the left displays (or will display, when I figure out how to do it in Blogger) my Triglycerides (TG) for the last 34 years. Yesterday’s Retrospective #67, has, or will have when it is fixed, a similar table of my HDL Cholesterol. Another Retrospective later will display TC/HDL and TG/HDL ratios.
The reference range for healthy triglycerides is less than 150mg/dl. Only 10 of my 69 TG tests have been over 150. Seven of those were more than 10 years ago, before I started eating Very Low Carb (VLC), and the other 3 were in the first year of eating VLC.
The “before and after VLC” triglyceride 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 ate 20g of carbs a da,y and lost 60 lbs. (but wasn’t taking fish oil), was 103. The average of the last 18 tests during which I continued VLC on Bernstein (30g/day of carbs), and lost another 100 lbs., 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.
I now eat VLC. Seventy percent 70% of my diet is fat -triglycerides! I eat lots of saturated fat. In 2012 I ate 700 mg of cholesterol a day, including, for breakfast, 2 eggs, 2 strips of bacon and half and half in my coffee. Obviously avoiding dietary fat is not the answer. It is indeed a paradox, if you accept the dietary and nutritional advice of mainstream medicine.
It is true, my results are only anecdotal, n = 1, but it would be a mistake to think that this outcome is an isolated result. It is widely reported in the literature under the subject “Carbohydrate Hypothesis.” You can discover this for yourself with an Internet search.
Award-winning science writer Gary Taubes pioneered in popularizing this hypothesis, starting with his game-changing, 2002 NYT Sunday Magazine cover story, “What If It’s All Been a Big Fat Lie.” He later addressed the subject in great detail in his 2007 tome, “Good Calories-Bad Calories” (“The Diet Delusion” in the UK), and later the more ‘accessible’ “How We Get Fat: And What to Do About It.” Taubes has influenced many young clinicians.
A compelling case for the benefits of low triglycerides, combined with high HDL, was made in this 2008 August 63(4) 427-432 PubMed Central peer-reviewed paper. Retrospective #27 refers to it with this quote: the ratio of Triglycerides to HDL (TG/HDL) is “the single most powerful predictor of extensive coronary heart disease among all the lipid variables examined.” Note: neither Total Cholesterol (TC) nor the “bad” LDL, is mentioned.
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 do my TG/HDL “before and after” ratios calculate and stack up? Referring to Retrospective #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 first lost 60 lbs. on VLC but was not taking fish oil: TG/HDL =2.2. Later, when I was eating VLC, lost 100 lbs. more, was 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 saturated fat and cholesterol, and taking fish oil and eating sardines daily, is NOT a paradox. Maybe it’s a healthy Way of Eating. Ya’ think? These results certainly suggest that to me. More and more folks (including many clinicians) now seem to think so too. So, what’s your ratio?

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