Forget LDL-Cholesterol, Low Triglycerides More Important (here's why)

Elevated triglycerides are consistently linked with poor cardiovascular events. Let's discuss why that's the better marker to focus on.

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-----------------------------------------Show Notes--------------------------------------

0:00 Intro
00:40 LDL reduction treatments has a minimal, marginal and inconsistent benefit with overall reduction in all-cause and cardiovascular disease mortality and incidence of stroke.
01:15 Heart disease was the leading cause of mortality, even during the pandemic. It was a leading risk factor behind age and obesity in severe COVID.
02:05 Triglycerides and triglyceride-rich lipoproteins tend to be more atherogenic. They are also linked with insulin resistance. If you are on a Statin or told to be on one, check your ApoB to A1 ratio. It is an inexpensive test.
04:40 When you are insulin resistant, there are more triglyceride molecules compared to cholesterol esters.
05:17 The Friedewald equation does not account for triglyceride-rich lipoproteins.
06:00 A decrease in triglycerides is a reflection of improvement in metabolic health.
06:36 Post-prandial increase in atherogenesis and heart disease is linked more closely to remnant lipoproteins and triglyceride-rich lipoproteins.
07:15 Triglycerides fluctuate. Levels of 60 to 70 is what Mike recommends to clients. Get a baseline. Test while fasted. Next time, do a lipid load test. Before you test, consume a typical mixed meal with 60 to 70 grams of fat.
09:00 The degree of your insulin resistance is reflected in your post-meal triglyceride level. When your liver becomes infiltrated with fat, there will be a dramatic increase in post-meal triglyceride levels.
09:36 Post-meal triglyceride levels should be under 220 mg/dl. Levels over that reflect an inability to process post-meal fats.
10:00 LDL particles also carry triglycerides. They can become enriched in triglycerides. Low LDL does not tell you about your cardiometabolic risk.
10:55 Exercise is one of the best ways to lower your triglycerides. Eat a low carb diet. Improve sleep quality and circadian rhythm. Cold exposure/thermal stress can help. Fasting and supplementing with myoinositol and berberine can help.

[JonesJensen]

One important message you forgot: LDL goes UP the more active you are. LDL also goes up the longer you fast. LDL also goes up the more weight you lose. So essentially, going low carb, starting exercise and losing weight will sky rocket your LDL. Which is a really good thing, don't get me wrong. I really like the work that Dave Feldman has done, makes a lot of sense. But it's important to note why these changes are happening, if you ever want to "win" the discussion about cholesterol with your doctor. And if they tell you that eating more fat raises your LDL, ask them which biomechanism triggers this. (Hint, there are none, it's just returning to a normal level, after being supressed by lack of fat in the diet.)

[keithzastrow]

Yep. Bottom line: You want low triglycerides, low vLDL and a high HDL. Total chol. and LDL are irrelevant. You achieve this by greatly reducing/eliminating ultra-processed foods (stop snacking), adhering to a low-carb/sugar diet and by doing some exercise. It's that simple.

[joshuasharrock]

I love how people are still stuck in the 90s. We might have been wrong for villainizing fats in the past but I blame America today for willfully remaining ignorant on saturated fat and cholesterol..

[Moiez]

I'm a 32 south asian healthy and very active male(do martial arts and lift weights). I got my lab results today(urine and blood test) which returned HDL at 71 and LDL at 147(doctor said this is concerning and that I should try to lower it) but my triglycerides are low(all this is matching up with what you're saying). Thank you for making this video, I feel so much more relieved and that I'm going in the right direction.

[bobdec]

STOP GOING TO THE DOCTOR. I just read so many comments. My doctor wants to put me on this, My doctor wants me to do that. Get blood work on your own.

[yamani]

💡💡💡I love how people are sharing their lab results here. I wish we had access to lab results for all the people worldwide while maintaining privacy somehow. People would be able to do data analysis and find patterns for themselves without depending on an institution to do that sort of analysis. 💡💡💡

[lindabladon]

Excellent lesson. Shame my doctor knows nothing of this. Linda, UK.

[genejordan]

This helps explain my tests. Over the past 3 years my LDL has not changed, around 100. I’ve been put on statins for the past year because my triglycerides have climbed from 110 to 320 ( fasting ). Statins are having no effect. My faults; too many cookies and not enough exercise. I stopped going to the gym when Covid hit. Now I’m back on track and cut out all sweets. I anxious to see my 6 month results. 68 years old hoping for another 30.

[dtn]

I appreciate you bringing in both triglycerides and ApoB to the discussion. I feel like most channels focus on either Triglycerides/HDL or LDL (and sometimes ApoB), but not both. Same story with postprandial triglycerides and postprandial glucose. Really appreciate you telling the full story, even if the full story is more nuanced.

[casapilanola]

my triglycerides have been at 59 and 89 in last couple of years; my HDL ratio at 2.5, and my neurologist wanted me on statins because he said my LDL needed to be below 70. The statins were pure poison scary hell on my body. Horrible. Thank you for seeing and sharing the larger picture! For giving value to other markers.

[exhaustguy]

Just got my labs back after 10 months of Keto (119 lbs lost and stopped statins 3 months ago). Trig. at 83, LDL at 163, and HDL at 38. I am going to up my kippers/sardines/mackerel consumption. Glad to throw away the statins.

[bcakste]

i just had to get bloodwork done and battled this topic with my new Dr. My triglycerides were great! 58 My HDL was good...but my total cholesterol was up and my LDL. She was pushing statins. I've been keto for 4 years!!!! Lost 50 lbs. my AIC is 5.5 now. She said I was going to have a stroke....like now.

[makeupminx]

For the second year in a row, my triglycerides came in at 35. My doctor was truly astounded and she said they are the lowest she’s ever seen in her life. Granted, they were post 20 hour fast, but let’s goooo 💪🏼.

[mike]

My ldl went up and triglycerides went down when I intermittent fasted and was losing weight. I'm glad to hear this information.

[gailyta]

I'm just learning about this as my LDL numbers have put me on edge until my latest doctor suggested he wasn't worried about the LDL number because my Triglycerides & HDL were so good. It's first time I've even paid attention to Triglycerides. I'm 41. Last bloodwork showed LD at 132, HDL at 69 & Triglycerides at 41.

[stilmotionpicture]

Yay! Well my faster triglycerides is 32, HDL 81, and my LDL is 174. BMI at 21 and I am 39 years old. Interesting to know about a post meal!

[monicabailey]

I was concerned about my blood test numbers . Cholesterol was high but my HDL was 110 and my Trig's were 51. My doctor wants me on Statins but I said no.My total cholesterol were in the 300's. Watching you and other experts helps me . I am normal weight by A1c was 5.5 and I have low blood pressure. My doctor wants me to see a cardiologist. I said sure.

[Chiroman]

Mike, very interesting video and info. I'm a 71 yo man, and have had high Cholestrol for over 10 years - with LLDs over 130+. My Trigs were consistently around 200. In 2018, my Gallbladder was removed. After my 2021 Annual Physical showed my LDLs at 145 my PCP "scared" me into starting Zetia (I tried a mild dosage of a Statins a few years before, and My calfs cramped up in 3 days - threw them out the window). I failed to take the Zetia regulalry as prescribed (10 MG -1 X aday). I would take 1 pill than forget, etc. The blood test taken about 2 months later showed that the levels rose to 165. Then I took them regulalry, 1 X a day. Another blood test done about 6 weeks later - showed they did go down to 138, BUT my TRIG were over 400!! The doctor (who is retired now) said Not To Worry about that now. I'm in the midst of finding a replacement PCP / Internist. The info on TRIGs is very interesting and makes a great deal o sense. My CRP is 2 . I do suffer with a number of Spinal Issues includimng Stenosis at a number of levels in my spine, Facet Joint arthritis everywhere, Disc Bulges at multiple levels, OA in my Knees, Hips, and fingers. Lots of Inflammation. One galring question is that my GB was removed in 2018 and I wonder what kind of effect that has on TYRIGs?

[dieselgears]

The best 13 minutes 43 seconds I've spent on any you tube video...love the content 👍

[krzcho]

A high time for continuous triglycerides monitoring device…