In Eat Rich Live Long, I like the early diagnosis of insulin resistance with fasting glucose and insulin level and to treat with Low carbohydrate High Fat diet.
I depart from their advice on lipids except for recognizing the value of CAC CT (calcium scores). On page 262 in Eat Rich Live Long it is stated that
"APOB/APO A1 ratio is the Master ratio"
Cummings and Gerber use this 2005 Ridker reference to prove their point with the chart on "Comparison of Risk Predictors"
Unfortunately when I looked up the reference the ApoB/ApoA1 data was misrepresented.
See big chart from the trial presented below the Comparison of Risk Predictors.
Eat Rich Live Long chart on P 263 from Ridker data. I don't see this data in trial. Real data below.
Eat Rich Live Long p262 does not point out that LDLc at the highest quintile #5 shows LDLc has less events at 156 than ApoB/ApoA1 at 200 events.
Total cholesterol/HDLc had 212 events while LDLc had 156 events at the highest quintile.
Eat Rich Live Long says LDLc is worthless.
P246 "The truth is that when it is high, LDLc is sometimes associated with bad things, but it is a weak and erratic risk factor"
page 255 " If your LDLc value is well above 200 mg/dl, it is more likely to have some meaning"
In this Ridker trial that is sited in Eat Rich Live Long the mean LDLc is 171 (does not have to be greater than 200 to be significant) and the event rate is lower that ApoB/ApoA1 in the 5th quintile.
CONCLUSIONS:
(of the Ridker article that Eat Rich Live Long uses on p 262,263 but contradicts the article.)
"Non-HDL-C and the ratio of total cholesterol to HDL-C were as good as or better than apolipoprotein fractions in the prediction of future cardiovascular events.
After adjustment for age, blood pressure, smoking, diabetes, and obesity, high-sensitivity CRP added prognostic information beyond that conveyed by all lipid measures."
Eat Rich Live Long never mentions non-HDLc (The Tubby Factor)
Ridker 2005 sited on p262 Eat Rich Live Long:COMMENT #1
"ApoB is highly correlated with non-HDLc"
"The strength of association for non-HDLc is clinically equivalent to that of ApoB"
On page 261 in chapter, My Advanced Lipoprotein Test Has Shifted.
I agree that apoB or LDLp is better than LDLc.
However, they never mention non-HDLc in the book.
COMMENT #2
"ApoB/ApoA-1 ratio not superior to ratio of TC/HDLc
In fairness to Cummings and Gerber on p262 do write "Interestingly, the TC/HDL ratio did even better (than ApoB/ApoA-1)"
However it is strange to me they use a reference that contradicts the titled of the chapter ApoB/ApoA1 THE MASTER RATIO.
COMMENT #3
"support the use of standard lipid measures rather than
ApoA-1and ApoB in PRIMARY risk prevention"
COMMENT #4
"Non-HDLc ....were as good as or better than apolipoprotein fractions"
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