Another potential nail in LDL's coffin ?

Cheers for the reply @Oldvatr . Thing is I don't actually want or need to lose weight & have been steadily holding my current weight for years. I'm just worried that a) my cholesterol is too low (I'm a middle-aged woman & we apparently do better with higher cholesterol) & b) I'm not burning dietary fat as efficiently as I should be on a low carb diet.

It's entirely possible that I'm overthinking the whole thing

Safi said:

Cheers for the reply @Oldvatr . Thing is I don't actually want or need to lose weight & have been steadily holding my current weight for years. I'm just worried that a) my cholesterol is too low (I'm a middle-aged woman & we apparently do better with higher cholesterol) & b) I'm not burning dietary fat as efficiently as I should be on a low carb diet.

It's entirely possible that I'm overthinking the whole thing

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IMHO if your weight is where you want it, and your BGL is also where you want it, then your diet regime is working fine, In which case it matters not a jot if you are fat burning or running on glucose - If it is working well then why change it? Your lipids are in the right place, and the HDL could perhaps rise a bit more since it is maybe a tad low, but it has risen since previous, so not a worry. Your body will try to make as much HDL as it feels it needs, so on a MF diet it is in the right ballpark, Perhaps upping the fat may take it up bit, but could also affect the other two which you do not want to rise much. I think you are needlessly worrying yourself, but others may feel able to contribute. The important one that is considered the marker for CVE risk is the trigs, TG which needs to be below 1.0 mmol/l for safety. The other two will rise and fall and their actual values are not so important. It is the ratio that is also of interest, and this is where I cannot advise since I do not have access to the target ratio considered to be best. This is new territory, so is not yet set in concrete, but seems to be better than the old Good CHO/ Bad CHO that has been the guidelines in the past.

Thanks again @Oldvatr . I do remember doing the ratio calculations when I initially got the results & it all seemed to be in order so I'm not stressing about my numbers - just curious & hoping to better understand what (if anything!) it all means.

DaveKeto said:

Yes -- Please fast at least 8 hours, preferably 12 before taking a lipid panel. When eating a meal, you WILL have fat packaged into chylomicrons as TG, which WILL increase your serum TG levels (and again, note that TG is part of what is used in the Friedewald calculation for LDL-C). This isn't speculative, it's simple molecular accounting.

The only question is how long it takes for the very last chylomicron to be cleared by the liver from the food you ate -- and there's disagreement in studies there. What I can tell you is that there's basically no disagreement that it will be cleared after 12 hours of fasting.

Moreover, there are many other non-lipid blood markers that can be impacted in the wake of a fed state. And note that the fed state length of time/process is highly varied by the meal and individual's metabolic health itself. This is why the new change in the guideline is so outrageous to me.

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Thanks Dave.

Safi said:

Thanks again @Oldvatr . I do remember doing the ratio calculations when I initially got the results & it all seemed to be in order so I'm not stressing about my numbers - just curious & hoping to better understand what (if anything!) it all means.

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As regards the change in pardigm over LDL then there are several videos linked on this site. The names Sikaris, Noakes, Breckenridge spring to mind so try these in the forum search facility. There are others, but those will do for a start and give good simple explanations.

It took me a while to accept the new way of looking at cholesterol, as it does stand our thinking on its head. There is also several discussions under the topic of statins but they can tend to get either very political or technical so this is another research field to explore.

LDL comes under the field of endocrinology, and it is a different body system than the glucose pathway that is associated with diabetes, so you need to wear a different hat.

Oldvatr said:

and the HDL could perhaps rise a bit more since it is maybe a tad low,

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Can you explain why you think @Safi 's HDL is a tad low? It is 2.7. That is an excellent and ideal level.

Bluetit1802 said:

Can you explain why you think @Safi 's HDL is a tad low? It is 2.7. That is an excellent and ideal level.

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My GP has set my target at 3,0 mmol/l but this is my personal control level, and may be due to my TC being higher.

Oldvatr said:

My GP has set my target at 3,0 mmol/l but this is my personal control level, and may be due to my TC being higher.

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2.7 is still a high level and cannot be described as "a tad low". Mine hovers around 2.5, which delights my nurse.

Bluetit1802 said:

This confuses me

It is very simply calculated: you just subtract HDL Cholesterol (HDLc) and LDL Cholesterol (LDLc) from your Total Cholesterol. (Second paragraph)

In UK measurements, subtracting the HDL and the LDL from the total leaves you with 46% of the triglycerides.
(Total cholesterol = HDL+LDL+46% trigs) So subtracting the HDL and LDL simply leaves 46% trigs.)

No idea why the remaining 54% trigs aren't included in the total.

Am I being brain dead - again?

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https://www.gpnotebook.co.uk/simplepage.cfm?ID=x20030114211535665170

Guzzler said:

Am I understanding all this correctly? Do not not fast before a blood draw to measure Cholesterol but do fast for a Triglyceride count? As all counts are normally taken from one blood draw how should we manage this?

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So shouldn't both be done? I've always thought that?
Mine is always none fasting since insulin but fasting when not on it. None fasting in pregnancy too.
Thyroid influences cholesterol too. Not just hereditary high ldls.

ickihun said:

So shouldn't both be done? I've always thought that?
Mine is always none fasting since insulin but fasting when not on it. None fasting in pregnancy too.
Thyroid influences cholesterol too. Not just hereditary high ldls.

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The problem is that the presence of chylomicrons that follow soon after a meal distorts the result given by the formula. Fasting ensures that these have been used up when the blood is drawn. This is why having a cuppa in the morning invalidates the test if it has milk in it.

The 46% that is in the formula represents an estimation for the amount of VLDL in the sample so this is subtracted to give the remnant trigs that are too small to be viable cholesterol. i.e. sLDL and free acid radicals.