Tests to measure cholesterol levels in the blood are called ‘lipid panel’ or ‘lipid profile’. A normal lipid panel test usually has these 6 parameters:
- Total cholesterol
- LDL
- HDL
- Triglycerides
- VLDL
- Cholesterol/HDL ratio
I’ve read the books – the Great Cholesterol Con, the Cholesterol Myths, Big Fat Lies, the Big Fat Surprise, and Cholesterol Clarity, and most of them talk about how cholesterol tests are almost pointless and that only triglycerides and HDL matter. Jimmy Moore in Cholesterol Clarity elaborates upon all the numbers in the general lipid panel test. And this is what I’ve learnt from what I’ve read.
Total cholesterol
Total cholesterol number is useless. From a common sense point of view, if it is an addition of the bad stuff number (the supposed bad LDL) and the good stuff number(HDL), how can the total number be an indication? Are you okay with a low total number, even if your good stuff number is low and your bad stuff number is high? That’s like saying that the total number of goals in the football match was 7! What matters is how many goals your team scored.
So, total cholesterol number is irrelevant.
HDL
HDL is high-density lipoprotein. It is commonly known as the ‘good cholesterol’.
For good for heart health, it is better that HDL cholesterol is at 70 mg/dL or higher. Anything below 50 should be cause for concern.
LDL
LDL (also known as LDL-C) is low density lipoprotein. It is commonly called the ‘bad cholesterol’. There is a big fuss about this number, and everybody wants you to lower it. In the standard lipid panel test, LDL is not measured, it’s calculated.
The truth is: the number does not matter; the size matters.
- There are small, dense LDL particles (also called pattern B). Pattern B are potentially dangerous.
- There are large, fluffy LDL particles (also called pattern A). Pattern A are generally harmless.
If you find that most of your LDL consists of pattern A particles, you need not be anxious.
It is more useful to take these tests for LDL:
- LDL particle size test (blood)
- Oxidised LDL test (urine)
VLDL
VLDL is very low density lipoprotein. High levels of VLDL are considered unsafe, because VLDL carry triglycerides in the blood throughout the body. It is usually calculated by diving LDL by 5. Jimmy Moore says that a level of between 10-14mg/dl is safe.
Triglycerides
Increased levels of triglycerides indicate increased risk of heart disease and atherosclerosis. HDL and triglyceride numbers are inversely proportional; the higher your triglyceride, the lower your HDL.
Triglycerides must be lower than 100mg/dl. It’s even better if it is lower than 70mg/dl.
Dr. Uffe Ravnskov in his book ‘the Cholesterol Myths’ says that while high triglycerides are a marker for heart disease, a stand-alone test number is not really indicative. Triglycerides depend on various factors – smoking, overweight, sedentary lifestyle, mental stress and diabetes. Moreover, eating elevates triglycerides. That’s why the test is taken in a fasted state. He also says that test results are inaccurate and may be a hundred more or less than the actual result (If the result shows 200, you may actually be anywhere between 100 and 300). So, if you want an accurate result, take the average of 3 tests taken at different instances.
Cholesterol/HDL ratio
Since total cholesterol number does not matter, cholesterol/HDL ratio does not matter either.
If you must look at a ratio, then measure your Triglyceride/HDL ratio. Optimum level is 1:1 Safe level is below 2. (It’s the number you get when you divide triglyceride number by HDL number)
Conclusion: Only 2 numbers out of your cholesterol test matter – HDL and triglyceride.
I tell people to quit getting your cholesterol measured—just stop doing it. All it does is raise red flags that have no basis in solid evidence. The sad thing about this is that you’ve got all these doctors who have been indoctrinated with the cholesterol message and they are completely clueless about the role nutrition plays. – Dr. Donald W. Miller, former chief of the Division of Cardiothoracic Surgery at the University of Washington School of Medicine.
What is the solution? How to reduce triglyceride and increase HDL?
Follow the LCHF way of eating. To know what to eat, go to Beginner’s Guide to LCHF foods
PS: DO NOT TAKE A LIPID PANEL TEST while you are in the process of losing weight. Wait for your weight to stabilise. When your weight is around the same for 4-6 weeks, then take a test. The reason is: when you are losing weight, you are using your stored body fat as a source of energy. The fat is released into your blood as fatty acids and triglycerides, and will show up as high in your blood test results. Dr. William Davis says that it may even interfere with your blood sugar and blood pressure values.
