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Triglyceride-HDL, A Blood Fat Ratio to Watch

A decade or so back, I generated an avalanche of online controversy by suggesting that Dr. Doug McGuff’s Body by Science book calling for 12-minutes-a-week of high-intensity strength training may dovetail nicely with The Maffetone Method focusing on building an aerobic base. https://www.cbass.com/McGuff-Maffetone.htm

Shown here practicing what he preaches, Dr. Maffetone believes everyone from athlete to average person can benefit from building an aerobic base.

Photo courtesy of Dr. Phil Maffetone

Maffetone's 1-20-21 blog is now calling our attention to a blood fat ratio shedding new light on my latest Cooper Clinic blood test results. Interestingly, it bolsters what I wrote in 2009 and what I’m doing now.

(We both recommend a balanced diet of whole foods. He says the lowest risk numbers come from eliminated sugar and other refined carbs.)

We find substantial support for what Dr. Maffetone terms “the latest-greatest heart-health indicator.”

TG-HDL Basics

A Google search brought up the following basic information and commentary on the Triglyceride – HDL cholesterol ratio by Dr. Richard Maurer, ND, author of The Blood Code-Unlock the Secrets of Your Metabolism (2014):

(I’ve edited down to the bare bones.)

Simply take the Triglyceride number and divide by the HDL. The closer to one, the better.

High TG-HDL, especially over 3, indicates significant risk of heart attack and stroke.

While high cholesterol, especially LDL, gets most of the press, Dr. Maurer says this is primarily due to interest in hard-selling the cholesterol story.

Triglycerides alone is not an adequate test.

As TGs go up, fat and sugar are stored in the liver, making it less able to function properly. Therefore, the liver does not produce the healthful HDL. The medical journals refer to this condition as diabetic atherogenic dyslipidemia. Intimidating name, but as it implies, when these lipids get out of balance, atherosclerosis and heart disease follow.

On the other hand, your disease risk goes down with improvement in your TG-HDL ratio.

Details from the Cooper Institute

We’ve previously cited fact-filled articles on fitness and health by Steve Farrell, PhD, FACSM, on the Cooper Institute website. He’s back with details and research on fitness, TG-HDL, heart disease, and mortality.

We’ll start with the importance of high and low TG-HDL blood fat ratios. What do they mean? (You’ll see that Dr. Maffetone’s excitement about TG-HDL blood fat ratios is well grounded.)

Low ratio values…indicate good insulin sensitivity; which means that insulin is doing a great job helping to move glucose and amino acids from the blood into your cells. It also means that you have a relatively low risk of developing prediabetes, type 2 diabetes, and metabolic syndrome. Additionally, low ratios indicate that you have the relatively innocuous ‘large and fluffy’ LDL cholesterol type, which makes you less prone to coronary heart disease (CHD).

On the other hand, let’s say that your blood triglycerides were 240 mg/dL and your HDL was 30 mg/dL. Some quick math tells us that the ratio this time is 8. This is a high ratio, suggesting that you are insulin resistant. Simply put, even though you are producing insulin, too much glucose is remaining in the blood. As a result, you have a relatively high risk of developing prediabetes, type 2 diabetes, and metabolic syndrome. A high ratio also tends to indicate that you have the more sinister ‘small and dense’ LDL cholesterol type, which makes you more prone to coronary heart disease (CHD) and stroke. 

He then adds fitness to the mix.

We’ve known for a few decades that having a moderate to high level of cardiorespiratory fitness (CRF) significantly decreases the risk of death from CHD as compared to having a low level of CRF. So with all this in mind, my colleagues and I decided to take a look at all possible combinations of CRF and Triglyceride:HDL ratio values to see how they impacted the risk of dying from CHD.

We studied 40,269 apparently healthy men who underwent a comprehensive physical exam at the Cooper Clinic between 1978 and 2010. All of the men had a maximal treadmill stress test and blood work at the time of their exam.

Here’s their bottom line:

The take-home message is that regardless of the Triglyceride:HDL Ratio, men need to achieve at least a moderate level of CRF in order to achieve the lowest risk possible. Most men should be able to achieve this level of CRF by meeting the current public health guidelines for physical activity: Adults should accumulate at least 150 minutes per week of moderate aerobic activity or at least 75 minutes per week of vigorous aerobic activity. If achieving significant weight loss or a high level of CRF is the goal, then as much as 300 minutes per week of moderate, or 150 minutes per week of vigorous aerobic activity may be necessary. Be sure to start slowly and gradually work up to these suggested levels of activity.

So, the next time you have blood work done, calculate your Triglyceride:HDL Ratio if you do not see this value on your report. Remember that the higher the ratio, the higher the risk of developing prediabetes, diabetes, metabolic syndrome, and dying from CHD. It also pays to remember that unlike prescription medications, lifestyle changes (i.e. regular physical activity, healthy diet, quitting smoking, and modest weight loss if needed) cost nothing and have no side effects!

You can read full details online: https://www.cooperinstitute.org/2017/11/28/cardiorespiratory-fitness-the-triglyceridehdl-ratio-and-coronary-heart-disease-mortality-risk-in-men

My Take

My latest Cooper Clinic blood test report does not include TG/HDL blood fat ratio. If it wasn’t for Dr. Maffetone, I wouldn’t know that my low TG (92) and high HDL (73) produce a very healthy ratio of 1.26, lowering concern for my relatively high cholesterol and LDL levels.

I apparently have the relatively innocuous ‘large and fluffy’ LDL cholesterol type.

Good news indeed.

That combined with a high level of fitness and leanness, and a healthy diet put me in the low risk category.

My once-a-week high-intensity strength and cardiovascular workouts, and rest-day walking appear to be keeping me healthy.

Harkening back to my earlier article, my versions of McGuff’s brief high-intensity strength workout and The Maffetone Method - building an aerobic base with moderate-to-high intensity weekend sessions and weekday walking - appear to be working quite well.

This photo by Laszlo shows me on a daily recovery walk

Finally, the landmark Biomarkers book by William Evans, PhD, and Irwin H. Rosenberg, MD, places muscle mass and strength first and second among markers of aging. At minimum, strength training took its rightful place as an equal partner with aerobics. See https://www.cbass.com/Biomarkers.htm

Combining the teachings of McGuff and Maffetone looks pretty good!

*  *  *

For more about Dr. Maffetone's research and the MAF Method visit his website: www.philmaffetone.com

March 1, 2021

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