Your Nutrition Related Labs and Why We Care

By: Jacqueline Gilpin, co-edited by Skylar Griggs

As the new year approaches, people become inspired to make changes that benefit their health, such as exercise and diet. While it is great that people become more committed to their health around the new year, honoring your health needs should be a motivator of its own. However, in our modern day healthcare system, patients are often given a laundry list of medicines and general recommendations without understanding how these are working in your body.

At Newbury Street Nutrition, we promote steps to preventive healthcare and educate our clients on how nutrition and lifestyle and dietary changes will improve their cardiovascular health. By understanding your lab results and applying lifestyle changes you will be educated and empowered, and won’t look to the new year to give you the push to do so!

Often, our clients come to NSN with specific labs that tell us about their cardiovascular health. We look at

Fasting Lipid (Cholesterol) Panel
Fasting Glucose
Hemoglobin A1C
Additional labs – Vitamin D, B12, Iron studies

Total Cholesterol Panel

Total Cholesterol Panel is made up of your HDL + LDL cholesterol + Triglycerides (TG) Cholesterol. The total cholesterol number is less indicative of your health, than the breakdown of the components.

Cholesterol vs Triglycerides

Cholesterol and Triglycerides are both lipid cells that circulate in the body, but perform different functions.

Cholesterol

Cholesterol is fat used to make cells and hormones. Your liver produces the necessary amount of cholesterol for your body to support cellular and hormone production, but additional cholesterol is taken into the body from the foods we eat. There are two different types of cholesterol in the body: LDL (lousy) and HDL (healthy) cholesterol. Both of these are lipoproteins, which carry cholesterol back and forth between the cells and the bloodstream.^[1]

What are the Different Types?^[2]

LDL (lousy) cholesterol can be considered harmful in excess, due to its contribution to atherosclerosis (fatty build up in arteries), that narrow arteries and increase risk of heart attack, stroke, and peripheral artery disease (PAD).
HDL (healthy) cholesterol is considered to be beneficial to the body for its ability to remove LDL cholesterol from the blood and return it to the liver, to be broken down and removed from the body as a waste product. Thus, HDL cholesterol can act as a preventative mechanism for the mal effects of LDL cholesterol.

Triglycerides

Triglycerides are fat cells converted from food nutrients, mostly simple carbohydrates, that are stored in the blood and utilized for energy during periods of fasting. While triglycerides are essential to the body, an excess can be an indicator of prediabetes/diabetes and contribute to thickening and/or hardening of the arteries and artery walls (atherosclerosis). Like LDL cholesterol, excess triglycerides can lead to heart attacks, heart disease, and strokes.^[3]

Separately, significantly elevated levels of TG can lead to pancreatitis which can be dangerous, painful and potentially fatal. Providers may look at the risk ratio in the lipid panel to assess overall CVD risk.
There are some rare types of lipid disorders including homozygous familial hypercholesterolemia, sitosterolemia and lipoprotein lipase deficiency – dietary and medical interventions for these are specific and more aggressive. If you hold this diagnosis, seeing a cardiologist and cardiac dietitian is essential.

Glucose

Glucose is the body’s main source of energy in the form of sugar that is taken from the carbohydrates. The blood supplies glucose to all the body’s cells to carry out its necessary functions. While glucose is necessary, its levels are regulated by systems like the pancreas that creates insulin. A fasting blood sample measures your glucose levels and checks for elevations. Blood glucose levels that are elevated (hyperglycemia) is often a result of diabetes, which is a condition in which the pancreas is unable to produce enough insulin to lower glucose levels.^[4]

Normative vs Abnormal Fasting Blood Glucose Ranges^[5]

Healthy/normative range, non-diabetic:

Values 70 to 99 mg/dL (3.9 to 5.5 mmol/L) is standard

* Values 50 to 70 mg/dL (2.8 to 3.9 mmol/L) can be “normal” too.

Pre Diabetic Ranges:

Values 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is typically indicative of prediabetes.

Diabetic Ranges

Values 126 mg/dl (7.0 mmol/L) or higher on more than one testing occasion is typically indicative of diabetes.

Hemoglobin A1C

Hemoglobin AIC is a blood test that measures an average blood sugar over three months to check for diabetes/ pre-diabetes. The blood-glucose level is represented by percentages on a point system^[6]:

≤5.7 is normal

5.7%-6.4% is prediabetic

≥6.4% is diabetic

Additional Lab Studies

Minerals and micronutrients are crucial to heart health, and measuring and managing such levels can play an important role in improving overall wellbeing. At Newbury Street Nutrition, we are primarily concerned with Iron, Vitamin B-12, and Vitamin D to support our clients’ health journeys.

Iron

Iron is an essential nutrient that is responsible for the production of hemoglobin, a protein in red blood cells that helps transport oxygen from the lungs throughout the body. Without enough iron, there is a risk of iron-deficiency anemia, fatigue, weakened immunity, and has been linked to cardiac illness such as heart failure.^[7]^[8] With its role is oxygen transportation, healthy iron levels support cardiovascular function and healthy blood pressure. However, iron toxicity (too much iron in the body) can have detrimental effects on one’s health ranging from gi upset, like constipation and vomiting, to strokes.^[9]^[10] If you have questions about your iron levels, it is best to talk to your doctor, who can measure your active iron and ferritin (iron stores).

Iron RDI-USA^[11]

Vitamin B-12

Vitamin B-12 is essential for cellular formation and production. Vitamin B-12 is utilized in the formation of red blood cells, cellular metabolism, nervous system function, and nucleic function, such as DNA production and genetic information storage. Vitamin B-12 is absorbed in the gastrointestinal tract and is broken down by digestive enzymes in the stomach. Thus, older individuals, whose digestive acids decrease with age, and people with GI complications, such compromised digestive enzymes, Crohn’s Disease, and UC are at greater risk of deficiency.^[12] Vitamin B-12 deficiency can have deleterious effects on the body such as anemia, muscular weakness, anemia, intestinal and nerve complications, and mood irregularity.^[13]

Vitamin B-12 RDI^[14]

Vitamin D

Vitamin D is an essential nutrient in the body that impacts bone, muscular, immune, and brain health and contains anti-inflammatory, antioxidant, and neuroprotectant properties. This vitamin is also utilized for glucose metabolism, which is essential for maintaining energy and regulating cholesterol and triglyceride levels.^[15] Vitamin D is absorbed primarily through sun exposure, but nutrition and supplementation are also sources of this nutrient. Signs of vitamin D deficiency include: frequent illness and infection, fatigue and tiredness, bone and back pain, bone density loss, impaired wound healing, muscle pain, hair loss, etc. Your doctor may recommend a blood test to test for deficiency and make a plan to support your individual needs.^[16]

Vitamin D RDI^[17]

Chart showing recommended daily intake of Vitamin D. Working with a cardiologist and a dietitian in managing your cholesterol is essential. At NSN, we take the time to review your labs and work with you to create science based, approachable dietary changes to improve your overall health. Skylar wholeheartedly believes that knowledge is power and aims to teach her clients about the current state of their body, and educate them on the powerful role that nutrition plays in optimizing heart health.