If you have low HDL cholesterol and high triglycerides, then you may have something called dyslipidaemia.

This is caused by overproduction or defective clearance of triglycerides an underproduction of HDL. Why does it matter. A lower reading means that insulin is doing its job and moving sugar out of the blood and into the cells. It means you have good insulin sensitively and have a relatively low risk of developing diabetes and metabolic syndrome. But let’s say your score is 3, it means you may have or have an elevated risk of becoming prediabetic or diabetic. But, for most people, you can quickly start moving the numbers in the right direction with a change in diet and exercise. In-fact it appears that to get the very best ratio, a good level of aerobic fitness is necessary.

According to the National Library of Medicine published online in March 2021, “Metabolic dyslipidaemia (high triglyceride) and low high‐density lipoprotein cholesterol (HDL‐C) is highly prevalent in type 2 diabetes”. In the study they also analysed data from 4199 overweight people with type 2 diabetes and discovered that dyslipidaemia increases the risks of cardiovascular disease. The good news is that most people can reverse the condition by changing their diet and exercise.

How to Measure

To calculate the ratio, both triglycerides and HDL blood sample are take in a fasted state and the triglyceride level is divided by the HDL level.  The closer to 1 the better. According to Dr Richard Maurer, a reading of 3 significantly increases the risk of a cardiovascular disease, however, heartuk.org.uk, suggest a ratio of 6 or more is considered a higher risk. They key take away is to try and get it as low as possible by eating a healthy diet and exercising.

The link between triglycerides and HDL, was pioneered by Dr Gerald Raven, who was the first person to write about metabolic syndrome. In fact for a while it was even called Raven’s syndrome.

According to Dr Richard Maurer, a reading of 3 significantly increases the risk of a cardio-vascular disease, he wrote the following “TG:HDL is a strong marker of lifestyle factors—Your TG:HDL ratio offers a way to see whether you have a metabolism that naturally has cardiac protection (the lucky ones), or whether you need to earn it (like me). Let me explain the studies. Three thousand people were categorized for known risk factors for heart attack and stroke: smoking, high blood pressure, or a sedentary lifestyle. In all of the categories, those with the higher TG:HDL ratios (>3) had the highest incidence of heart attacks and strokes, compared to those with the lowest ratio (<1.1), and the incidence of events was linear with the TG:HDL ratio”.

Here is some research from the Cooper Institute (founded by xx, the man that first coined the term aerobic exercise) based on following 40,269 men over an average of 16.6 years, during which time 556 men died from CHD. “The take-home message is that regardless of the Triglyceride:HDL Ratio, men need to achieve at least a moderate level of CRF in order to achieve the lowest risk possible. Most men should be able to achieve this level of CRF (cardiorespiratory fitness) by meeting the current public health guidelines for physical activity: Adults should accumulate at least 150 minutes per week of moderate aerobic activity or at least 75 minutes per week of vigorous aerobic activity. If achieving significant weight loss or a high level of CRF is the goal, then as much as 300 minutes per week of moderate, or 150 minutes per week of vigorous aerobic activity may be necessary. Be sure to start slowly and gradually work up to these suggested levels of activity”.

Background Info

The NHS describe triglycerides as, “a fatty substance similar to bad cholesterol”. But it is not the fat that you eat that will put up your triglycerides, let us explain.

It is actually not biologically possible for the saturated fat you eat to raise LDL cholesterol levels, despite what we have been told repeatedly. As Dr Malcolm Kendick explains, “saturate fat is absorbed into the gut wall, where it’s then packed into the very large lipoprotein known as chylomicron. This travels up a special tube called the thoracic duct. At the end of which it is released directly into the blood stream. Directly into the blood stream. It does not, and this is a mission critical point, pass through the liver”.  As they travel around the body their size shrinks and shrinks as they offload fat to cells and eventually they shrink down to a size where they are called LDL, the so called “bad cholesterol” or you could call these tiny molecules chylomicron remnants, chylomicron leftovers. Which means only a tiny portion of the fat you eat ever makes it to the liver, the rest is directly taken up by cells. This incidentally is the same path as ALL fats, whether they be saturated or not, seed oils, olive oils; all fats, all oils. Therefore if you are eating dangerous seed oils and vegetable oils, your liver doesn’t filter them, allowing them to directly wreak havoc on your cells. All this means that there is nothing the absorption, transportation or storage of the fats you eat has anything to do with LDL cholesterol. So those low cholesterol butters, are kind of very misleading, because regular butter can’t therefore raise your LDL at all.


While chylomicrons are made in the gut walls, the liver makes VLDL (a bundle of fat and cholesterol, which in the main it synthesises – also called triglycerides). The so called bad cholesterol, LDL, is not actually made anywhere, but comes into existence as VLDL travels around the body offloading its fat to fat cells; which is in-fact its main job. As it shrinks it becomes an ILD and eventually turns to an LDL. Therefore LDL originates from the liver and not the gut. And therefore must in the main come from carbohydrates and not fat that has been eaten.

Malcolm Kendrick writes, “another way of looking at this system is that the job of VLDL is to take fatty acids from the liver and distribute it around the body for storage. Then when a VLDL has shrunk down into a LDL the second role takes over which is to provide cholesterol to cells that need it. What makes VLDL levels go up? It is not and has never and could never have been saturated fat consumption. Instead what causes VLDL levels to rise is eating carbohydrates. Yes carbohydrates. Bread, pasta, potatoes, fruit, rice, cornflakes, sugar and suchlike”.

The conclusion to the above is that high triglycerides in our blood, even though they are a fat, are not in the main derived from the fat we consume and they way to reduce it in the main is to eat less carbohydrates and to exercise.

If you are concerned about your triglyceride level, please see your doctor.

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