Well, I was all prepped for a link and quick hits roundup, but first up was a bit about LDL cholesterol, as in the calculated one…as in the one most of you get when you have your blood work done. After a bt of poking around, the link roundup can wait.
But back up a bit, all the way to here, where I posted my first lipid panel about a year ago. At a calculated LDL of 104, I got a warning of "elevated" from the doc. Then, as some of you may recall from last February, those lipid numbers caused one naturopath to email me with some concerns. The solution? Well, in a nutshel, the solution would be to dramatically increase my triglycerides (fat in your blood) from a low of 47 to somewhere perhaps in the 150ish range, thus letting the Friedewald equation do its thing. How's that, you ask? Well, I laid it all out in this post: What Do You Think You Know About LDL Cholesterol? This post has been picked up in links a couple of times in the last few days. The first was by Tom Naughton, maker of Fat Head, a film I highly recommend as a way to introduce people to the fraud of conventional "wisdom" in nutrition.
In brief, the Friedewald equation for calculating LDL (direct measurement is expensive) is that you take total cholesterol, subtract HDL, and then subtract further your triglycerides divided by 5:
LDL (calculated) = Total Cholesterol – HDL – Triglycerides/5
A cursory glance at that equation should help explain what I meant above, where I wrote that the way to have low(er) LDL would be to dramatically increase my triglycerides. How does one do that? It's quite simple: eat lots of hearthealthywholegrains. You can even get the job done quicker by tossing in sugar, sodas, and any manner of processed food in abundance. I think the average Trig level in America is in the area of 200 and increasing. All else remaining equal, had my Trigs been 200 instead of 47, then I would have been able to subtract 40 (200/5) instead of 9.4 (47/5). Thus: 219 – 106 – 40 = 73. That would earn me a hand shake from my physician, all for replacing a good deal of the meat, eggs, veggies, and fruit I eat with bread, pasta, sweets and other crap. (Of course, if I were to do that, all things would not remain equal, because my HDL would also take a huge nosedive.)
Next, Sephan at Whole Health Source picked up that link and also came up with something of help for those of you out there who may not want to go to the expense of paying for your own NMR Lipoprofile or a Vertical Auto Profile (VAP). What has been known for a long time is the Friedewald becomes very unreliable at Trig levels over 400. It has also been suspected that it's equally unreliable for Trig levels below 100, a level of triglycerides achieved by almost al low-carb / paleo practitioners. Dr. Eades explains it in this post.
So, what Stephan came up with is an equation that purportedly does a better job at calculating your LDL when your Trigs are below 100.
LDL (calculated) = Total Cholesterol/1.19 + Triglycerides/1.9 – HDL/1.1 – 38
Now, if I run my same 219 total, 47 Trig, 106 HDL through this new equation, I get a calculated LDL of 75 and not the 104 that motivated my doctor to caution me (and to probably make a note that I'll soon be a candidate for a statin prescription).
Well, guess what else? Turns out I had another lipid panel done a while back and I convinced them to do a direct measure of LDL: 66. That's not too far off the 75 rendered by the equation above, and so, while an NMR, VAP, or direct measure is the best way to go, you can at least perhaps get some immediate peace of mind by doing your own calculation per the above formula.
Would be very interested to see your comments comparing your latest numbers, Friedewald verses the new equation, particularly if you have Trigs significantly below 100.
Finally, my friend Jimmy Moore recently interviewed Dr. Malcolm Kendrick, author of The Great Cholesterol Con. I recommend both.