Last month I went through many sources and collected their guidance for various heart-related blood markers and their ratios. Here goes, and note that some (especially CGM companies Levels and Nutrisense) have very strict guidelines that differ from standard guidelines, but you should not view them as absolute. As long as your markers move in the right direction over time, you are on the right track. If you can exercise, that would be great. Exercise alone, without any changes to diet whatsoever, can drastically improve many blood markers.
1) HDL cholesterol.
- Mayo clinic: for women, less than 50 is at risk. 60 and above is desirable. -
- Standard range: between 40 and 60 is normal.
2) Direct LDL. Standard range <130
3) Total cholesterol to HDL Ratio.
- Standard range <5.0.
- Levels: Keep the total cholesterol-to-HDL ratio less than 3.5:1, but optimally as low as <2:1.
4) Triglyceride-to-HDL Ratio (you need to calculate it yourself).
- Levels: "This is a marker you should focus on. Many experts agree that the triglyceride-to-HDL ratio is one of the best surrogate markers of insulin resistance and metabolic syndrome. If the triglyceride-to-HDL ratio is over 2.5:1 in Caucasians, that’s a correlate of metabolic syndrome. Lower is better."
- Nutrisense Nutrition Team: aim for a triglyceride to HDL ratio of less than 1.
5) Non-HDL Cholesterol, Calculated.
- Standard range <160 mg/dL.
- Mayo clinic: "Non-HDL cholesterol, as its name implies, simply subtracts your high-density lipoprotein (HDL, or "good") cholesterol number from your total cholesterol number. So it contains all the ""bad"" types of cholesterol. An optimal level of non-HDL cholesterol is less than 130"
6) Another ratio you need to calculate yourself: Homeostatic model assessment of insulin resistance (HOMA-IR = glucose x insulin / 405), which assesses your risk for diabetes which in turn poses a heart health risk. A HOMA-IR of <2.0 is excellent, 4.0 is average, and anything higher means trouble. This guidance is from Levels.
7) ApoB. You need to ask for this test as it is not given as part of the standard US lipids panel.
"APOLIPOPROTEIN B
Reference Range < 90
Risk Category:
Optimal <90
Moderate 90-119
High > or = 120 "
8) "HS CRP (A high-sensitivity C-reactive protein)
Reference Range
Optimal <1.0
Jellinger PS et al. Endocr Pract.2017;23(Suppl 2):1-87.
For ages >17 Years:
hs-CRP mg/L Risk According to AHA/CDC Guidelines
<1.0 Lower relative cardiovascular risk.
1.0-3.0 Average relative cardiovascular risk.
3.1-10.0 Higher relative cardiovascular risk.
Consider retesting in 1 to 2 weeks to
exclude a benign transient elevation
in the baseline CRP value secondary
to infection or inflammation.
>10.0 Persistent elevation, upon retesting,
may be associated with infection and
inflammation."
for regular C-Reactive Protein. Standard range is <0.5