If you want an insight into your heart disease risk, pull out your last blood test results. There’s useful information in there if you know where to look.
Last month I wrote about a long-running US study designed to identify the key risk factors for heart disease in women.
It showed that, aside from smoking, insulin resistance is the sleeping giant — ‘sleeping’ because most doctors are busy looking at cholesterol instead, and ‘giant’ because insulin resistance underlies type 2 diabetes and metabolic syndrome, two red-flashing signs that you’re at greater risk of heart disease.
In fact, insulin resistance plays a big hand in most degenerative diseases of ageing.
It occurs when your body can’t handle the amount of insulin being produced by your pancreas to deal with an overload of sugar in the blood stream.
One of the most useful predictors of insulin resistance, diabetes and heart disease is your ratio of triglycerides to HDL.
Triglycerides are a type of fat in the blood, and HDL carries cholesterol from the arteries to the liver so it can be recycled or excreted from the body (which is why it’s said to be ‘good’).
You want triglycerides on the low side and HDL on the high side. Above 1.7 is getting high for triglycerides and less than about 1.3 is low for HDL, even though the range listed on your test will be more generous than that.
Calculate the ratio between them by dividing triglycerides by HDL. If your ratio is less than 1 you can relax about heart disease, but the lower the better.
As an example, if your triglyceride level is, say, 1.9 and your HDL is 1.2, you’d divide 1.9 by 1.2 which equals 1.58. Not catastrophic, but it’s telling you that to minimise your heart disease risk you need to improve your ratio.
While a basic LDL reading doesn’t tell you much, a couple of aspects of LDL do indicate a higher risk of heart disease. Those are LDL particle size and number, neither of which we routinely test for.
In relation to size, you might remember that last month I said that LDL particles can be big and fluffy or small and dense. The small ones are linked to heart disease, the big ones aren’t. The triglycerides: HDL ratio can predict particle size in that a high ratio points to more small particles and a low ratio to bigger particles.
As for the number of particles, more of them increases our risk. Again, a high ratio indicates more particles.
How can you improve your ratio? By lowering triglycerides, increasing HDL, or better still, both.
To reduce triglycerides cut back on your carb intake, i.e. sugar, alcohol and refined grain foods — most cereals, biscuits, crackers, snack foods, juice drinks, pastries, rice, pasta and anything made with flour. The same goes for trans fats, processed meats and vegetable oils.
Swap them for antioxidant-rich foods such as vegies, salads, berries, herbs and spices, nuts and seeds, olive oil, oily fish, tea and dark chocolate.
A bit more healthy fat and a bit less processed grain is a great place to start, along with good quality protein at each meal.
While different people can have different responses to the same food, in general, fibre and processing matter a lot. For example, if you’re going to eat porridge choose the less milled type with the roughage intact, not the quick oats. And while brown rice is slightly better than white rice, rice bubbles or rice cakes will send insulin soaring (though it’d likely also depend on what you eat on rice cakes).
Healthy fats from avocado, nuts and seeds, olive oil or fatty fish help to increase HDL. Interestingly, so does coconut oil.
Exercise lowers triglycerides and boosts HDL (as well as LDL particle size) too.
Finally, since chronic stress is inflammatory and damaging to our metabolism, it’s crucial to address this. You can eat a wonderful diet and exercise regularly but if you’re still pumping out stress hormones, you’re putting yourself at risk. Diseases like diabetes and heart disease are more than just physical.
So make sure you’re, for example, getting enough sleep, rest and relaxation; doing the things you love; expressing emotion rather than holding it in; spending time in nature and cultivating supportive relationships.
An Italian study from the 1990s found that centenarians had in common low triglycerides and insulin, and high HDL. So it’s fair to say this ratio is an important part of the recipe for a long and healthy life.
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