Dr. Sears,
I just got my blood work done and I’m getting contradicting information regarding LDLs. The “bad” news is that my total cholesterol is 210 (up from 167 two years ago) and my LDL-C is 140 (up from 100 two years ago). The “good” news is that my Tg is 58 and my HDL is 58. So according to your latest books, that’s a great ratio, indicating that my cholesterol particle size is large (beach balls rather than baseballs), and I shouldn’t be concerned. However, the blood test came back with three other numbers that supposedly indicate the opposite. My LDL-P is 1686 (optimal is <1000) and my small LDL-P is 1341 (optimal is <600).According to my doctor, these measure the number of my LDL particles per volume; therefore, the higher the number, the smaller my LDL particles are, indicating that I have baseballs. Also, my LDL particle size reading is 20.2, again indicating a predomination of small “Pattern B” particles, associated with “metabolic syndrome and insulin resistance”. Which numbers are more important indicators of my risk, Tg/HDL or LDL-P?
Thank you, Matthew
P.S. Regardless of your answer to the above, I realize I need to get back “on the wagon” with the Zone Diet. (It got great results 10 years ago, but I slowly fell back to old habits). And even though I just picked up your “OmegaRx Zone” book, this week, I have been taking 1200 mg of pharmaceutical-grade fish oils for the last 2-3 years. My doctor thinks the oils are causing the 40 percent increase in LDL count and wants me to stop taking them (and he wants me to start taking 1000mg of prescription niacin per day). I’m going to follow your theory that the increase in LDL is because of my diet, not the fish oil. So I’ll be ramping up the fish oils with EicoRx and becoming a lot stricter on my diet. I’m only 36, so I have a little time to experiment before my situation becomes critical. Thank you for your work.
Dear Matthew,
A: The TG/HDL is not only a good indication of the LDL particle size but also of the degree of insulin resistance. Therefore your likelihood of insulin resistance and thus metabolic syndrome is low. The stricter you become with the Zone Diet, the further you reduce insulin levels that drive the enzyme in the liver to make more cholesterol.