Don't be fooled by RATIOS like Triglycerides:HDL-C

Are ratios like triglycerides:HDL-C or total cholesterol:HDL-C a reliable measure of our risk of heart disease? We cover the good, the bad and the ugly about cholesterol ratios and common misunderstandings.

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Animations: Even Topland @toplandmedia

References:

Past videos covering ApoB and correlation vs causation:

Disclaimer: The contents of this video are for informational purposes only and are not intended to be medical advice, diagnosis, or treatment, nor to replace medical care. The information presented herein is accurate and conforms to the available scientific evidence to the best of the author's knowledge as of the time of posting. Always seek the advice of your physician or other qualified health provider with any questions regarding any medical condition. Never disregard professional medical advice or delay seeking it because of information contained in Nutrition Made Simple!.

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0:00 Cohlesterol ratios correlate with risk
1:10 Correlation vs causation
3:49 Hearing from the EAS President
4:31 Population vs individual
8:17 Take-home message
8:28 ApoA-I

[georgehornsby]

I heard waist circumference to height ratio was better correlated with health outcomes than just using BMI. Feeling pretty good right now in my corset and high heels.

[wdeagle]

Type 2 diabetes is associated with heart disease the most, metabolic syndrome second, high blood pressure third, smoking 4th ... So it is no surprise that the triglyceride to HDL ratio is HIGHLY associated with heart disease since the higher your blood glucose level the higher your triglycerides normally are and the lower your HDL levels. When I went very low carb (less than 20 a day) my blood pressure also dropped and I found out the reason is that glycogen is what actually causes water retention not salt.

[gerrywaneck]

You made this video 8 months ago. I don't know if you've made a more recent video. But it's my understanding that Triglyceride:HDL ratio is probably the best INDIVIDUAL marker, because it's not based on population statistics. It's based on the science of metabolism. And there are many other markers that are not routinely tested, like insulin and LDL particle size, that could be even better markers than ones used currently. You did an excellent job of explaining statistical correlation and relative vs absolute risk. But there's a huge difference in the interpretation of statistical data based on population studies vs data obtained from understanding the biochemistry of metabolism. Metabolic data are based on causal, not coincidental, correlations.

[kevinlenz]

The references call outs as you speak are great. I wish everyone did that.

[richardthompson]

Saw my doctor last week, asked her about an Apo-B test, she didn't know what Apo-B was.

[tnprincess]

I'd love to see a video with @DrKenBerry debating this information.

[paulelkins]

Great video explaining the correlations vs causation of Trigs/HDL. However, it seems the same argument can be made for LDL being a correlate vs APoB being causative. Nevertheless all guidelines for hypercholesterolemia are based on LDL levels and not APoB. 🤷‍♂️

[brentgraham]

Good job. The lighter analogy is a good one.

[bobbybecker]

Excellent explanation of a topic that might be difficult to understand if someone else tried to present it.

[dmmcmah]

They aren't actually causal, but they DO indicate risk - they reflect underlying insulin resistance which IS causal.

[CalumHall]

I have to say thanks too, as many others have, for making these numbers and ratios clear. It all comes down to cause and the fact that I need exercise and eat a healthy diet.

[donrounds]

I stand corrected, completely! Thanks for this as I would have been heading down the ratio rabbit hole and potentially ill health.

[lpslpslpslpslpslps]

You've definitely persuaded me that HDL-cholesterol isn't causal and manipulating its level is unlikely to change risk of heart disease or atherosclerosis. But what's missing is an explanation of *why* HDL-cholesterol correlates with risk. It's pretty clear why having a lighter would correlate with risk of lung cancer. You very clearly explain the third variable that is actually causal: smoking. So what's the third variable that is actually causal, that both influences cardiovascular disease and also influences the level of HDL-cholesterol? I don't think you've ever clearly explained that in your various lipid videos (or maybe I've just missed it?) I would love a nerdy biochemical explanation of that.

[DrBradStanfield]

Fantastic explanation and easy to understand analogies

[mrjeffvan]

you are amazing - Really appreciate your videos - Tx from Vancouver BC

[SimonSezSo]

I found this EXTREMELY well explained . Than you.

[tinathecrafter]

Thank you for demystifying and debunking so many issues in an intelligent way. You are a rare find on YouTube!

[DanEngell]

My faith is unshaken. I STILL like my 1 to 1 trig to HDL ratio. With that said, I value knowing Apo B as well. Why would one or the other need to be mutually exclusive?

[patorjk]

This is a fantastic video, thank you for making this! Before this I had just watched a video talking about how life insurance companies use the Total Cholesterol / HDL ratio, and that high LDL was meaningless. It seemed pretty convincing. Your arguments about imperfect predictors make everything make a lot more sense though.

[PhilippeOrlando]

That's great you've talked about this.