Mastering Metabolic Health with the TG/HDL Ratio

The red-headed stepchild of the cholesterol panel needs a bit of love. During our conversation, we will explore the triglyceride/HDL ratio, and delve into the reasons it does not directly correspond with its significant importance in the assessment of metabolic health.

Most everyone knows their total cholesterol and the LDL number, but triglycerides get swept under the rug instead of being vacuumed up and taken out with the trash.

The exceptional processing power of the liver cranks up this flood of dense triglycerides (small compact fatty molecules) into the bloodstream. But only under specific circumstances, like overload from too many carbs and sugars. The body turns this switch on to shuttle excessive calories to be stored as fat.

These triglycerides break down to be used for various metabolic functions, while tiny particles left over from the process form dangerous byproducts that can penetrate arterial vessel walls, causing heart disease and plaque.

As mentioned before in various newsletters from the past, Triglyceride/HDL ratio > 2-3 represents terrible metabolic health. The HDL cholesterol becomes protective because it takes the leftover dangerous remnants and shuttles them back to the liver to be made into far safer molecules for the body.

You can tell someone’s lifestyle, eating habits and exercise from looking only at these two types of cholesterol.

Major causes of elevated triglycerides

First one mentioned above, excessive calorie intake as carbs and sugars.

Second, obesity and metabolic syndrome amplify the liver factory output. Fat tissue releases free fatty acids. These fatty molecules make it to the liver, which converts the acids into more triglycerides, also blunting the liver to signals geared for reducing fat storage.

Third, genetics and alcohol. Some people will have a genetic predisposition requiring a stricter diet and energy output for compensation. Alcohol acts like excessive sugar and carbs taking on the same path, output dumped into the bloodstream.

So, someone with a high triglyceride ratio probably lives a lifestyle of overconsumption, excessive body fat, genetic predisposition and a sedentary lifestyle, in some varying form and fashion. A low HDL ratio means little to no movement, activity or exercise. That number should be at least over 40, less than that, we know what's happening even if the patient says otherwise.

The terrible 5

1. As a result, we get Metabolic syndrome. Insulin resistance wrapped in the obesity blanket, high blood pressure and crappy blood glucose regulation.

2. Next comes diabetes. Basically chronic high blood sugar and pancreas dysfunction.

3. Also, heart disease. Tiny waste particles help form the plaques which rupture to cause heart attacks.

4. Strokes come next. The cousin of the heart attack. No surprise ratios >3 hike incidence by 50%.

5. Fatty liver disease after the liver burns out from overload. This causes scarring and permanent metabolic fallout. 

High-quality research validates the ratio's impact:

1. A 2023 Iranian cohort study linked high ratios to a doubled metabolic syndrome risk.
2. 2021 NHANES data showed each ratio point increase raises insulin resistance by 10-20%.
3. A 2024 prospective analysis tied ratios >3 to 50% higher stroke risk.

Because of the reasons above, the ratio holds greater significance in LDL when examining the cholesterol panel.

The reversal and fixing of the metabolism

Foods:

Fatty Fish (e.g., Salmon, Mackerel): Rich in omega-3s, they cut triglycerides by 20-50% and boost HDL, per meta-analyses on fish oil supplementation.

Avocados and Nuts (e.g., Almonds, Walnuts): Their monounsaturated fats and fiber improve HDL quality and lower TG, with studies showing 10-15% ratio drops from daily intake.

Whole Grains and Cruciferous Veggies (e.g., Oats, Broccoli): Soluble fiber binds fats for excretion, reducing TG while stabilizing blood sugar. Trials link high-fiber diets to 15-25% better ratios.

Olive Oil and Garlic: Polyphenols in olive oil enhance HDL function, and garlic's compounds lower TG by inhibiting liver enzymes – evidenced in randomized trials showing sustained improvements.

Pair these with cutting sugars and alcohol for maximum effect.

Also, do these:

Increasing Movement: Aerobic exercise drops TG 20% and raises HDL 5-10%; HIIT enhances HDL function in 8-12 weeks.

More Protein: Diets with 25-30% protein curb TG spikes and improve ratios vs. carbs, reducing liver fat.

Losing Fat Mass: 5-10% weight loss lowers TG/HDL, with combined approaches cutting CVD risk 20-50%.

 Summary

Why the ratio get’s overlooked. Been practicing for thirteen years. The guidelines have not changed. We prescribe statins, diabetes medications, and weight loss drugs. Mostly 80% of the patients I seen with the chronic issues up above usually have a high ratio > 2-3. Focus on what lowers triglycerides, increases HDL and fat loss. While context signifies importance simplicity has a place. In summary, TG/HDL is your metabolic ally, so monitoring and awareness are key, understand its liver-HDL interplay, and reverse elevations through proven habits. This could avert chronic diseases and redefine health.