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Optimizing Your Triglycerides

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IMAGE Many authorities advise more aggressive treatment of high triglycerides. Here is a rundown on these blood fats and why optimizing them is important for your health.

What Are Triglycerides?

Triglycerides are the chemical form most fats take in the body. They have a backbone consisting of a glycerol molecule to which three fatty acid molecules are attached. All glycerol molecules are the same, but the fatty acids may vary greatly. The types of fatty acids that are attached to the triglyceride determine whether it is a saturated, trans, monounsaturated, or polyunsaturated fat. These triglycerides come from fats in the foods you eat or they are made from other energy sources, like carbohydrates. When you eat a meal, the calories your body isn't using right away are converted into triglycerides and stored in your body's fat cells. When your body needs energy between meals, triglycerides are released from fat tissue to be used for making energy.

Importance for Health

Having too much triglyceride in your blood can adversely affect your health in several ways. Extremely high triglyceride levels can trigger an attack of pancreatitis. Pancreatitis is the inflammation of the pancreas, an abdominal organ that secretes digestive enzymes.
Research has also identified high triglycerides as an important risk factor for cardiovascular diseases such as heart attack, stroke, or hardening of the arteries. Though the data are not as well established as for high cholesterol, it's a huge issue since coronary heart disease causes over 600,000 deaths each year and is the leading cause of death in the US.

Desirable Range

Once you have gotten the results from a fasting blood fat profile, you can compare your triglyceride score with what experts have to say about these values:
Triglyceride Level
(milligrams/deciliter [mg/d]) 		Classification
less than 150 Normal
150-199 Borderline high
200-499 High
500 and greater Very high

Risk Factors for High Triglycerides

If your triglyceride level is not normal, you and your doctor may want to search for a treatable cause. Factors that can increase your risk of high triglycerides include:
  • Sex—Men are more susceptible than women. After menopause, a woman's risk increases.
  • Age—The risk of high triglycerides increases with age.
  • Genetic disorders, including a family history of high triglycerides or diabetes
  • Lifestyle factors such as:
    • Physical inactivity
    • Overweight or obesity
    • High carbohydrate intake (over 60% of total calories)
    • Excess alcohol intake
    • Smoking
  • Medical disorders, such as:
  • Certain drugs such as:
    • Cortisone drugs
    • Estrogens
    • Retinoids
    • Beta-blockers and diuretics

Lifestyle Therapy

Treatment for abnormal triglyceride levels usually involves lifestyle changes. Saturated fat should make up less than 7% of the calories you consume.
Most saturated fat should be replaced with healthful monounsaturated and polyunsaturated fats. Increasing your intake of omega-3 fatty acids is especially important. Omega-3 fatty acids are polyunsaturated fats found in fatty fish (such as salmon, mackerel, herring, sardines, trout, and tuna) and certain plant sources, including flax seeds, canola oil, and walnut oil. The American Heart Association recommends eating fish at least twice each week. Taking fish oil capsules can also help lower triglyceride levels.
Weight loss also helps lower your triglyceride levels, as can limiting alcohol intake, quitting smoking, and getting regular, moderate exercise. If you are already at risk for heart disease, talk with your doctor before starting an exercise program.

Drug Therapy

When lifestyle measures fail to control triglyceride levels, your doctor may recommend lowering your triglycerides with the help of medicine. Drug treatment may also be advised if you have diabetes or another chronic disease associated with coronary artery disease. In addition to fish oil capsules, medicines such as nicotinic acid, fibrates, or statins can be used to help optimize your triglycerides.

RESOURCES

American Heart Association http://www.americanheart.org/

National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov/

CANADIAN RESOURCES

Healthy Canadians http://www.healthycanadians.gc.ca/

Heart and Stroke Foundation of Canada http://ww2.heartandstroke.ca/

References

American Dietetic Association. Disorders of lipid metabolism evidence-based nutrition practice guideline. National Guideline Clearinghouse website. Available at: http://www.guideline.gov/content.aspx?id=32479&search=disorders+of+lipid+metabolism. Published March 2011. Accessed July 31, 2012.

Cardiovascular risk prediction. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated July 2, 2012. Accessed July 31, 2012.

Essential fatty acids. Oregon State University. Linus Pauling Institute website. Available at: http://lpi.oregonstate.edu/infocenter/othernuts/omega3fa/. Updated January 27, 2012. Accessed July 31, 2012.

Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001;285:2486-2497.

Fish and omega-3 fatty acids. American Heart Association website. Available at: http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyDietGoals/Fish-and-Omega-3-Fatty-Acids%5FUCM%5F303248%5FArticle.jsp. Updated September 7, 2010. Accessed July 31, 2012.

Hypertriglyceridemia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated July 19, 2012. Accessed July 31, 2012.

Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids. Washington, DC: National Academies Press; 2002. National Academies Press website. Available at: http://www.nap.edu/openbook.php?isbn=0309085373. Accessed July 31, 2012.

Lauer MS, Fontanarosa PB. Updated guidelines for cholesterol management (editorial). JAMA. 2001;285:2508-2509.

Leading causes of death. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/nchs/fastats/lcod.htm. Updated January 27, 2012. Accessed July 31, 2012.

Low HDL (high-density lipoprotein) cholesterol level. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated January 11, 2012. Accessed July 31, 2012.

NCEP ATP III guidelines. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Accessed July 31, 2012.

Oh RC, Lanier JB. Management of hypertriglyceridemia. Am Fam Physician. 2007;75:1365-1371. American Academy of Family Physicians website. Available at: http://www.aafp.org/afp/2007/0501/p1365.html. Accessed July 31, 2012.

Safeer RS, Ugalat PS. Cholesterol treatment guidelines update. Am Fam Physician. 2002;65(5):871-881. American Academy of Family Physicians website. Available at: http://www.aafp.org/afp/20020301/871.html. Accessed July 31, 2012.

Triglycerides. American Heart Association website. Available at: http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/Triglycerides%5FUCM%5F306029%5FArticle.jsp. Updated January 20, 2012. Accessed August 6, 2012.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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