What are triglycerides? A close relative of cholesterol, you may not have heard about them before. They don’t get as much attention from the medical community as cholesterol, but the are certainly important to overall health. Triglycerides are the most common form of fat in the diet and the human body. Almost all the fat you eat is in the form of triglycerides, and the more fat you eat, the more cholesterol you liver will produce because triglycerides are used as fuel by the liver to make cholesterol. Besides entering your bloodstream through what you eat or drink, these fats can also be made in the body by your liver.
Why are they important to health? High triglyceride levels in your blood may put you at increased risk for heart disease. They can contribute to the clogging of the arteries in the heart even if cholesterol levels are normal. Too much triglyceride in the blood can lead to a very serious condition called pancreatitis, or inflammation of the pancreas.
How high is high? There is conflicting opinion among medical experts regarding when a triglyceride level is too high. The National Cholesterol Education Program Expert Panel’s current policy is that any level of triglycerides under 200 is considered normal. Many medical experts, including Dr. William Castelli, former director of the Framingham Heart Study, feel that a level of 200 is too high and that under 150 should be the goal. To accurately measure the triglyceride level in your bloodstream, it needs to be drawn after a 12-14 hour fast. Anything taken in, other than water, during that time can elevate the triglycerides. If your level is elevated, recheck it every 4 months until it reaches the desirable level.
Does what I eat affect triglycerides? Yes. The first line of treatment is a change in diet. Many people with mildly elevated triglycerides are overweight and eat too much fat. Weight reduction, combined with a low fat diet, usually lowers of triglycerides. According to the American Heart Association guidelines, a person consuming 1800 calories per day should eat no more than 60 grams of fat, or 30% of total calories from fat per day. Following these dame guidelines, a 1500-calorie diet should contain no more than 50 grams of fat per day.
What should I eat? Within the diet itself, sugar and alcohol have the greatest influence on triglycerides. If sugar and concentrated sweets are consumed in large amounts, eating less of these foods is an important step in lowering triglycerides. Foods to avoid include candy, baked goods, syrup, table sugar, soft drinks, jelly, and honey. Even a high intake of fruit juice can raise triglycerides, because of the natural sugar content. A reduction of alcohol intake is also crucial in keeping triglycerides in check. An individual with elevated triglycerides who consumes alcohol should discuss this with his or her health care provider. Reduced intake or not drinking alcohol at all my be advised. A healthy diet to help reduce triglycerides should primarily include grains, beans, fruits, vegetables, and low-fat animal products. If triglycerides do not respond to this level of fat restriction, decreasing intake further may be needed, i.e. less than 40 grams of fat per day. Discuss this with your health care provider.
Is exercise important? Increased physical activity can help lower triglycerides by as much as 40%, according to Mary P. McGowan, M.D., and author of Heart Fitness for Life. Aerobic activity, such as walking, swimming, and biking are good choices. If you are starting an exercise program, be sure to check with your doctor for the safest and most appropriate exercise. The recommended approach of diet and exercise may also correct high blood pressure and abnormal blood sugar, which are often seen in people with high triglycerides.
Triglycerides and HDL: Triglycerides and HDL (high-density lipoproteins, also known as "good Cholesterol") are closely related. Anything you do to lower triglycerides will likely increase HDL, especially losing weight and increasing exercise. Since HDL is protective against heart disease, the higher the better. It appears common for people with high triglycerides to have low HDL’s, and these same people also tend to have high levels of clotting factors in their blood stream, which is unhealthy in protecting against heart disease.
Do other medical conditions cause elevated triglyceride? Yes. Diseases that can cause the liver to produce too much triglycerides include diabetes, hypothyroidism, kidney and liver disease, alcoholism and lupus. Your health care provider should check for these if high triglycerides are discovered.
How are triglycerides and diabetes related? Blood fat abnormalities, such as elevated triglycerides, are often seen in people with diabetes. Achieving desirable blood sugar control will also help improve triglyceride control. Diet and exercise are the first steps, along with any medications that may be prescribed. There have also been studies on the beneficial effect of chromium supplementation on blood triglyceride levels. Although further studies need to be conducted, it appears people with diabetes and high triglycerides may benefit from dietary supplements of chromium picolinate. Supplementation is low cost (less that $5.00 per month on average) and appears free of side effects. A study done by Nancy A. Lee, M.D. and Charles A Reasner, M.D. reported a 17% decrease in triglyceride levels of people with non-insulin dependent diabetes who took 200 micrograms of chromium picolinate for 2 months. Any decision regarding supplementation should be discussed with your health care provider.
Summary of lifestyle recommendations: Although the restrictions advised to help lower triglycerides may seem hard, it is "heartening" to realize you can achieve significant reductions without medication if you put your mind to it.
Lose weight
Cut back on sugar and sweets
Reduce fat and cholesterol intake
Exercise more
Cut back on alcohol – just one drink can increase triglycerides in susceptible people
If diabetic, control blood sugar levels
Check for other medical conditions
What if diet doesn’t work? If after sincere efforts of diet, exercise and weight loss have been tried, the triglycerides are still elevated, medication may be needed. Being on medication doesn’t mean you failed – just that you need a little more help that diet and exercise can provide. Medications that lower triglycerides usually also improve HDL cholesterol. Check with your physician first to see if medications are needed and what the appropriate one would be.
