Since we just celebrated Thanksgiving, and likely ate more than we should have, it seems like the right time to discuss triglycerides. Everyone knows about cholesterol. There is “good cholesterol”, known as HDL, and “bad cholesterol”, known as LDL, but for most people Triglycerides are much more important.
We want everyone to know that there is a heart disease risk calculator that will give you a very good estimate of your risk for a heart attack or stroke over the next 10 years. The calculator can be found here. (https://www.cvriskcalculator.com/). This is a very good tool to calculate cardiovascular risk for people aged 40 to 79 years old with total cholesterol below 320. Those below age 40 should have very low risk, and those over 79, or with total cholesterol over 320 have very high risk. This calculator uses your age, HDL, Triglycerides, gender, blood pressure, and if you are diabetic or a smoker to determine your risk for heart attack and stroke. The major point I want you to see here is that there is no mention of “bad cholesterol” in the is calculation. It asks for the level of “good cholesterol”, HDL, and Triglycerides. Our focus is often simply on LDL because the “statin” drugs are so profitable for pharmaceutical companies. This merits further discussion but will have to wait for a separate blog post. Statin drugs are essential to cardiovascular risk discussions, but Triglycerides are often overlooked, and arguably just as important.
Triglycerides are the main constituents of body fat in humans. They are composed of a glycerol molecule with three fatty acids bonded to it. Fatty acids are long chains of carbon atoms joined together that are either saturated with hydrogen (saturated fat) or contain carbon to carbon double or triple bonds and do not have as many hydrogen atoms in them (unsaturated fat).
Triglycerides mainly come from the foods we eat but our liver can also make them. Eating foods high in simple sugars and/or complex carbohydrates (starches) is the most significant contributor to high Triglyceride levels. We often get huge amounts of sugar and starches in our food without realizing it. Some of them, such as colas, fruit drinks, candy, chocolates, ice cream, and desserts are obvious foods that can raise Triglycerides. There are many other foods that may even be worse than these. Foods we consider healthy but have large amounts of Triglyceride raising carbohydrates are cereals, fruits, honey, bread, crackers, tortillas, and yogurts. Alcoholic beverages can also significantly raise triglyceride levels.
Many of the steps you should take to lower triglycerides are the same ones you should take to protect your heart and health overall. If you're overweight, shed a few pounds. Get regular aerobic exercise (the kind that increases your heart rate). Limit the saturated fats in meat and dairy products. Watch your alcohol intake, even moderate drinking ramps up triglyceride levels. Diet is hugely important. High-carb/low-fat eating will increase your triglycerides and lower your HDL, which in turn leads to increased chances of heart attack and stroke. If you're taking a statin to lower your LDL, one side benefit may be reduced triglyceride levels. Depending on the dose, statins can lower triglycerides significantly. The omega-3 fats in fish and fish oil capsules are another triglyceride-lowering option. For a very high triglyceride level, your doctor can prescribe a high-dose omega-3 medication. This is great example of HEALTHY FAT. If you eat more omega-3 fats your body will shift its metabolism from storing and producing as many of these unhealthy Triglycerides. This lowers your triglyceride level and decreases your risk for cardiovascular diseases such as heart attacks and strokes.
Omega-3 fatty acids are derived from food. They can't be manufactured in the body. Fish oil contains two omega-3s called docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Dietary sources of DHA and EPA are fatty fish, such as salmon, mackerel and trout, and shellfish, such as mussels, oysters, and crabs. Some nuts, seeds and vegetable oils contain another omega-3 called alpha-linolenic acid (ALA).
If you have a high Triglyceride level, you should discuss ways to lower it with your healthcare provider. This is because elevated Triglycerides leads to atherosclerosis, or “hardening of the arteries”, which is the main cause of heart attacks and strokes. People with high Triglycerides often have other risk factors for heart disease, such as diabetes, obesity, and low HDL. For good health, your triglyceride level should be less than 150mg/dL. Borderline high levels are 150 to 199mg/dL. High is 200 to 499mg/dL. Very high is over 499mg/dL.
No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. For more information about Triglycerides, cardiovascular disease, or to discuss an individual treatment plan help lower your risk for heart attack and stroke call Medical Specialty Clinic at 731-257-1500 to schedule an appointment with one of our clinicians.
References:
1. Harvard Health: Should you worry about high triglycerides? - https://www.health.harvard.edu/heart-health/should-you-worry-about-high-triglycerides
2. Tangney CC, et al. Lipid management with diet or dietary supplements. https://www.uptodate.com/contents/search.
3. Omega-3 supplements: In depth. National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/omega3-supplements-in-depth.
4. Shearer, Gregory C et al. “Fish oil -- how does it reduce plasma triglycerides?.” Biochimica et biophysica acta vol. 1821,5 (2012): 843-51. doi:10.1016/j.bbalip.2011.10.011
5. Omega-3 fatty acids fact sheet for health professionals. Office of Dietary Supplements. https://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/.
6. Pizzorono JE, et al., eds. Fish oils and omega-3 fatty acids. In: Textbook of Natural Medicine. 5th ed. Elsevier; 2021.