Cardiovascular

Why Lowering Your Triglycerides Is More Important Than Lowering LDL-Cholesterol

by Mike Mutzel

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You’ve probably been told that lowering your LDL cholesterol by way of a statin will have a major influence on your future risk of cardiovascular disease.

But a new analysis involving over 140,000 people from 22 studies found “minimal and inconsistent benefits” supporting LDL cholesterol reduction by using statins.

Elevated triglycerides, on the other hand, are consistently linked with poor cardiovascular events.

 

 

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Key Takeaways:

-The JAMA article finding minimal benefit from LDL cholesterol reduction

-Why triglycerides are a better way to estimate heart disease

-Safe and effective ways to lower triglycerides naturally

-Testing fasting vs. non-fasting triglycerides

 

Related: 9 Essential Blood Tests You Should Order & Track at Your Next Physical

 

Episode Time Stamps:

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 myo-inositol and berberine can help.

Key References:

Byrne, P., et al (2022). Evaluating the Association Between Low-Density Lipoprotein Cholesterol Reduction and Relative and Absolute Effects of Statin Treatment: A Systematic Review and Meta-analysis. JAMA Internal Medicine.

 

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