Cardiovascular disease

LDL Cholesterol Lowering w/ Drugs Has Been a Failure: High Triglycerides are More Problematic

by Mike Mutzel

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Ample research shows that elevated triglycerides and triglyceride-related lipoproteins are more problematic than LDL-C when it comes to the risk of heart and metabolic disease.




In today’s show, we discuss the details of these “forgotten” lipids along with strategies for how to maintain healthy levels naturally.


Studies Mentioned:

Sandesara, P. B., Virani, S. S., Endocrine, S. F.,. (2019). The forgotten lipids: triglycerides, remnant cholesterol, and atherosclerotic cardiovascular disease risk. Endocrine Reviews.


Time Stamps:

0:45 Triglyceride-rich lipoprotein is a hallmark of diabetic dyslipidemia. It cannot be controlled by statins.

04:50 Remnant cholesterol is independently associated with the onset of diabetes.

05:33 Remnant lipoproteins are a consequence of lipid absorption from the GI tract.

06:50 Apo-B is on the extra cellular surface of atherogenic vLDL, IDL, LDL, and remnant lipoprotein.

07:40 HDL have the Apo-A1 protein on the extra-cellular surface.

08:35 Test your Apo-B to Apo-A1 ratio and your vLDL, LDL and remnant lipoprotein assessment.

09:15 IDL and vLDL are enriched in triglycerides and cholesterol and drive inflammatory processes.

09:45 Statins are anti-inflammatory.

10:45 Remnant lipoproteins drive metabolic disease by increasing ectopic lipid deposition.

11:35 Remnant lipoproteins induce endothelial dysfunction.

12:00 Clotting cascades can be driven by remnant lipoproteins.

13:35 Remnant lipoproteins can penetrate the arterial wall and become trapped and oxidized, creating plaque.

15:00 Remnant triglyceride rich lipoproteins are more atherogenic than LDL cholesterol.

15:50 Dietary fat composition can render lipoproteins more oxidizable.

17:00 Request the labs listed on page 1 of the Bloodwork Cheat Sheet. Do fasted labs then non-fasted lipid levels.

18:15 Lipid Load Test: if your blood triglycerides are more than 220 nanograms/ml, you have difficulty processing fats in the post meal window.

18:55 Lose weight, especially around the abdomen.

19:35 Eat a low carb diet.

20:05 Exercise regularly, both resistance training and aerobic exercise.

20:25 Statins lower triglycerides 20 to 30%. They also induce insulin resistance, which increases triglycerides.

20:55 Omega 3 fats reduce triglycerides. Test your omega 3s.

23:05 Optimal fasting triglycerides are around 60 and 70. Postprandial triglycerides should be less than 180.


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