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A large portion of the fatty substances (lipids) in the blood are triglycerides. The normal triglyceride level is less than 150 mg • The coronary heart disease (CHD) risk ratio is the true determining factor of whether or not you're predisposed to coronary heart disease and a future heart attack. Many times your cholesterol can be ele- vated, but if your LDL (bad) cholesterol to HDL (good) cholesterol ratio is low, you're fine. When your HDL cholesterol is higher, it will offset the ill effects of a slighdy elevated "bad" LDL cholesterol level. A below-average risk ratio is between 2.7 and 4.0 in males and between 2.5 and 3.7 in females. Remember, it's not the fat you eat that raises your cholesterol, blood pres- sure, or blood sugar level; it's the excess insulin from all those carbohy- drates you've been eating. Now that you know what to look for on a blood test, let's take a look at some actual "before and after" blood tests from one of my patients. Case Study Richard was a 44-year-old research scientist who was referred to me by the occupational health nurse at a local biotechnology company. He first went to the health nurse with complaints of fatigue, shortness of breath, and a general feeling of ill health. The nurse had been monitor- ing his progress through blood tests from his local M.D. and was con- cerned that despite his cutting out the fat from his diet and increasing his exercise, his weight loss and blood test results were still poor. He had two children and a loving wife, but his high level of work- related stress and elevated blood fats were becoming a growing concern to his wife. She didn't want to become a widow raising two children without their father. Like many of us, Richard was also caught up in a damaging pattern of skipping meals and not exercising regularly due to long workdays. By the time he arrived home from work, he was exhausted and starv- ing. He would then overeat and after dinner would fall asleep in his fa- vorite easy chair watching TV. The next day he would get up, go to work, and repeat the damaging cycle all over again-day after day, week after week, year after year. The following is a copy of blood test results that he brought from his M.D. for my review. It showed a triglyceride level of 361 mg, al- most twice the high end of normal, which is between 50 and 190 mg His cholesterol was elevated at 268 mg Normal is between 130 and 200 mg Results like this in my private practice are great and very rewarding, but to continue to gain support for a more balanced approach to a low- carbohydrate lifestyle, more unbiased, government-based, non-food- industry-financed studies conducted by accredited institutions are needed. A recent press release, issued on May 17, 2004, by the American Heart Association entided "Annals of Internal Medicine: Low-Fat vs. Low- Carbohydrate Dietary Patterns for Weight Loss," appears to be the most balanced and sensible assessment to date.