![]() Here, an enzyme called CETP (cholesteryl ester transfer protein) facilitates the exchange of cholesterol in large HDL and large LDL with TG. It is from the National Lipid Association’s website, used with permission from Tom Dayspring (Lillo, 2020). ![]() The image below shows how LDLs and HDLs transport TG. Do high TG levels affect HDL and LDL cholesterol levels? It is calculated by subtracting LDL and HDL cholesterol levels from total cholesterol number (Feldman, 2020). RC is also higher in the serum of those with CV disease risk (around 15 mg/dL and above). This breakdown is accomplished by lipoprotein lipase lining the luminal surface of capillaries. They are then metabolized into other lipoproteins by the breakdown of triglycerides inside an RC particle. RC particles appear only briefly after a meal. Remnant cholesterol is short-lived in the plasma of a healthy person. Image from the Cholesterol Code by Dave Feldman. It’s also called triglyceride-rich lipoproteins (TGRLs), which consists primarily of VLDL (very low density lipoproteins) and IDL (intermediate density lipoproteins) (Dhindsa, 2019). Remnant cholesterol (RC) is the most dangerous type of cholesterol particle. There’s another thing we ought to cover-remnant cholesterol. ![]() We’ve talked about TG, HDL, and a bit about LDL. ![]() (Possibly) improving reverse cholesterol transport.Improvement of HDL function improves arterial health (Chiesa 2019). Will an improvement in HDL level lead to better health? That’s the reason some people are still calling LDL the “bad cholesterol” and HDL the “good cholesterol.” That’s opposed to LDL or low-density lipoprotein which brings cholesterol to different parts of the body. HDL particles are considered being responsible for bringing cholesterol from the body to be metabolized by the liver. HDL is an acronym for high-density lipoprotein. TG can also become elevated in several inherited diseases. These excess fatty acids take up space in HDL and LDL particles. This results in the release of too many fatty acids from fat cells. Chronically high insulin stimulates adipokines and hormone-sensitive lipase. The most common reason for elevated triglycerides is prediabetes. Some disease states feature TG levels over 500 mg/dL or 5.7 mmol/L. Target TG levels between 100 and 200 mg/dL (or about 1 to 2 mmol/L) are usually considered borderline. The image below of triglyceride components is from Chemistry Libre Texts. Fatty acids are fats, while glycerol is a carbohydrate. Each triglyceride molecule contains 3 fatty acid molecules held together by a glycerol molecule. The rest of this article will ask and answer a few basic questions about the TG/HDL. And he’s ready for another 50 years of healthy living. His cardiovascular (CV) inflammation panel is perfect. So he switched his diet from low fat to low carb. He was one of 60,000 people that watched my video on the basics of TG/HDL. Meanwhile, he fumbled in the back seat for some nitro tabs, which he spilled on the floor.ĭuring his recovery, Chuck investigated how he could have a heart attack after losing 50 pounds. So he put the Tesla on autopilot, driving him to the hospital. It happened while Chuck was traveling on US Highway 1 in his Tesla at 55 mph. He lost 50 pounds on Esselstyn’s low-fat diet. He saw Caldwell Esselstyn for his preventive care. Chuck Smith’s storyĬhuck is a business owner living in Cocoa Beach, Florida. Many people told me the information saved their lives. I did a simple version of the TG/HDL in a video 3 years ago. But the complicated version just isn’t understandable, let alone actionable. Why would I focus this article on such simple concepts?īecause the basics of triglycerides and HDL are critical to health. A few of their concepts also seemed to contradict some basics mentioned later in this article. They also mentioned that lipoprotein particles pass both cholesterol and fatty acids around like hot potatoes. For example, Attia and Dayspring mentioned that the Framingham study indicates that TG/HDL (triglycerides over HDL ratio) is 5 times more predictive of heart attack risk than LDL. We can only guess how many finished the full 5 hours. Less than 600 people have started even one of these podcasts. If you’d like to spend a few hours hearing cutting-edge concepts in this area, try listening to episodes 20-24 of Attia’s podcast “THE DRIVE.”īut be warned that video is very technical. And Peter Attia is no slouch in this area. That means he’s an expert on cholesterol, fat, and oil metabolism. Thomas Dayspring is a nationally recognized lipidologist. “It’s true of all of us.” – Thomas Dayspring (Attia, 2020) “There are few things that humble me more than my complete and utter buffoonery when it comes to HDL lipidology…” – Peter Attia
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