> If eating carbs increases
> triglycerides (which is precisely why Ornish's high carb plan does not
> lower triglycerides), then is there any benefit to lower insulin levels
> and/or marked insulin sensitivity when triglycerides remain high?

The study didn't monitor triglyceride levels.  Its possible that the 20
participants who self-reported completing one-year on the Ornish "lifestyle"
also experienced improvements in triglyceride levels.

We can't disregard why another 20 participants dropped out of Ornish's
lifestyle before one-year.  Did they drop out because they felt unsatiated?
Because they couldn't lose weight?  Maybe the 20 participants completing the
self-reported program are metabolically adapted to an agriculture-based
diet.

A study published in 1998 in the Journal of the American Medical Association
looked at traditional risk factors compared to fasting insulin levels to see
which was more predictive of developing heart disease.  The relative risk of
heart disease is as follows:

insulin - ~5 times
triglycerides - ~2.75 times
LDL cholesterol - ~2.25 times
HDL cholesterol - ~1.5 times]

Fasting insulin levels are more than twice
as predictive for the development of heart disease than LDL cholesterol,
which is currently considered the gold standard.

Notice also triglycerides are also more predictive of
developing heart disease than LDL cholesterol levels are.  One of the first
signs of hyperinsulinemia is increased triglycerides.

Although HDL cholesterol by itself is a less powerful
predictor of future risk of heart disease than is LDL cholesterol, when you
multiply the increase in risk of elevated triglycerides by the increase in
risk of decreased HDL cholesterol, the result is only slightly behind
fasting insulin as a predictor of heart attacks.

This should not be too surprising since fasting triglyceride/HDL ratio is a
surrogate marker for fasting insulin.  One of the reasons why the fasting
triglyceride/HDL ratio is very predictive for heart disease may be due to
the formation of small dense atherogenic LDL particles that are very prone
to oxidation.  The higher the fasting triglyceride/HDL ratio, the greater
the proportion of the small, dense atherogenic LDL particles, and the
greater the risk of heart disease.

Researchers at
Harvard Medical School in a 1997 took patients who had survived their first
heart attacks (these are the
strong ones, since others died within the first 6 weeks) and then compared
them to matched patients who had no history of heart disease.  When they
looked at the triglyceride/HDL ratio to see how predictive it was, a
dramatic result was observed:

TG/HDL ratio                    Relative Risk
    1.4                                         ~1.0
    2.3                                         ~4.0
    3.3                                         ~6.0
    7.5                                         ~16.0

Rob