Optimizing Your Triglycerides
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 major fats in foods. 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.
When you eat any type of fat, it passes through your stomach and is digested and absorbed in your small intestines. From there it is sent to your liver for processing and shipping throughout your body. Your body can also make triglycerides from excess carbohydrates.
The liver packages fat into very-low-density lipoproteins (VLDLs), which are molecules made of protein and fat, but are mainly composed of triglycerides.
Next, VLDLs travel through your bloodstream to unload fat, depositing most of the triglycerides in fat cells for storage. Once unloaded, the VLDLs become low-density lipoproteins (LDLs)—mainly made of "bad" cholesterol, which in excess can cause arterial plaque.
Another type of blood fat called high-density lipoprotein (HDL, or "good" cholesterol) takes your body's unwanted cholesterol back to the liver where it is excreted or used to make more VLDLs.
Importance for Health
Having too much triglyceride in your blood—usually attached to a VLDL molecule—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.
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:
|less than 150||Normal|
|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:
Medical disorders such as:
- ]]>Kidney]]> or thyroid disease
- ]]>Gouty arthritis]]> or high blood levels of uric acid
- ]]>Metabolic syndrome]]> or insulin resistance syndrome (excess abdominal fat, high blood pressure, and elevated blood levels of fat and sugar)
- ]]>Systemic lupus erythematosus (SLE)]]>
Certain drugs such as:
- Cortisone drugs
- Beta-blockers and diuretics
Treatment for abnormal triglyceride levels usually involves lifestyle changes. The American Heart Association recommends a diet that is ]]>low in saturated fat]]>.
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. Taking fish oil capsules can also help lower triglyceride levels.
Weight loss—often as little as 5-10 pounds—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.
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, resins, fibric acid, or statins can be used to help optimize your triglycerides.
American Heart Association
National Heart, Lung, and Blood Institute
Heart and Stroke Foundation of Canada
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Clinical application of ATP III guidelines. Lipid Management. Fall 2001.
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Hypertriglyceridemia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Accessed February 26, 2008.
Institute of Medicine. 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 February 26, 2008.
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 December 2009. Accessed June 17, 2010.
Oh RC, Lanier JB. Management of hypertriglyceridemia. Am Fam Physician. 2007;75:1365-1371.
Last reviewed June 2010 by ]]>Brian P. Randall, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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