Triglycerides



Triglycerides are a type of fat in the body made of up a glycerol compound attached to three fatty acids. The fatty acids can be classified as saturated, monounsaturated, polyunsaturated or a mixture. They are a source of energy stored in adipose tissue which protects the internal organs from injury and provides insulation for the body. Fats are calorically dense and provide twice as many calories per gram as proteins and carbohydrates. When consumed in excess, fats contribute to obesity, heart disease, metabolic syndrome, fatty liver disease, and cancer, however, avoiding all fats is detrimental as well. An appropriate amount of the right types of fat is important for optimal health.

 
  • Overview
  • Action Plan
  • Ask The Doctor
  • Related Info
  • Success Stories

Overview


The prevalence rates of elevated triglyceride levels was 27% in adults older than 20 years from 2007-2010. Among male adolescents, the prevalence rate was found to be 9.4%, while among female adolescents, the rate was 6.7%. There is limited data on the prevalence rates among children.1

Saturated fatty acids are dense and solid at room temperature (e.g. butter and coconut oil). Polyunsaturated fats tend to be liquid at room temperature (vegetable oils). Trans fatty acids are found naturally in dairy and animal products or produced commercially by partial hydrogenation. Shortening, baked goods, and margarine all contain trans fatty acids that increase the risk of cardiovascular disease. Consumption of excess saturated and trans fatty acids that are not needed for energy are stored as triglycerides in adipose tissue. This tissue can be found under the skin as subcutaneous tissue or around the organs as visceral adipose tissue which contributes to an inflammatory environment in the body. Having elevated triglyceride levels does not often result in symptoms directly but can cause acute pancreatitis, which results in severe abdominal pain and, if severe enough, death. Basically, high triglycerides result from a combination of genetic predisposition in conjunction with modern disease-causing foods, especially processed foods.

Causes of elevated triglycerides include

  • consuming refined grains, simple sugars like fructose and glucose
  • consuming excess fats
  • alcohol abuse
  • obesity
  • diabetes
  • hypothyroidism
  • renal disease
  • certain medications like beta-blockers, diuretics, steroids, estrogen, etc.

Visceral adipose tissue contributes to insulin resistance and diabetes which, in turn, cause further dysfunction. Insulin stimulates the storage of triglycerides and increases body fat when there is an excess of calories consumed. Excess glucose consumed is also converted into fatty acids which are also stored as triglycerides. Insulin inhibits the breakdown of fat leading to further weight gain, worsening insulin resistance, and increased risk of heart disease and cancer.

Elevated triglyceride levels often occur with abnormal HDL and LDL cholesterol levels. It is associated with abnormalities such as low levels of protective HDL, the presence of small dense harmful LDL particles, insulin resistance, and increased coagulability of blood. Meeting the criteria for metabolic syndrome (low HDL cholesterol and elevated triglycerides, glucose, waist circumference, and blood pressure) dramatically increases the risk of heart disease, stroke, and diabetes.

 
References
  1. Go AS, Mozaffarian D, Roger VL, et al. Heart disease and stroke statistics--2014 update: a report from the American Heart Association. Circulation 2014, 129:e28-e292.

Action Plan


Diet

  • A Nutritarian diet with a variety of vegetables, fruits, beans, nuts, and seeds will supply an array of micronutrients while supplying adequate amounts of fat without the excess intake of calories leading to triglyceride accumulation in adipose tissue. A Nutritarian diet is both glycemically favorable and nutrient-rich.
  • Healthy fats found in nuts and seeds are micronutrient dense and can help with weight loss.
  • Omega-3 fatty acid supplementation with DHA/EPA can help lower triglyceride levels.
  • Avoid eating foods with trans fatty acids, such as processed snack foods, baked goods, margarine, and shortening. Avoid oils, dairy, and animal products as these contribute large amounts of saturated fats and trans fat in the diet. Avoid refined grains and simple sugars (baked goods, sugary beverages, etc.).1

Weight Loss

Weight loss helps lower triglyceride levels. A 5-10% decrease in body weight can lower triglyceride levels by 20-30%.2 A Nutritarian diet is the safest and most effective way to lose weight

Exercise

Regular exercise will help lower triglyceride levels in conjunction with a Nutritarian diet. Aim for a combination of interval training, body strengthening, and at least 2, 20 minute aerobic exercise sessions per week with two resistance training sessions.

Avoid alcohol consumption

Alcohol consumption is a cause of hypertriglyceridemia in some patients, leading to fatty liver disease. Avoiding alcohol will help lower triglyceride levels and improve liver function.

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References
  1. Kris-Etherton PM, Taylor DS, Zhao G. Is there an optimal diet for the hypertriglyceridemic patient? J Cardiovasc Risk 2000, 7:333-337.
  2. Van Gaal LF, Wauters MA, De Leeuw IH. The beneficial effects of modest weight loss on cardiovascular risk factors. Int J Obes Relat Metab Disord 1997, 21 Suppl 1:S5-9.

Ask The Doctor


The following are sample questions from the Ask the Doctor Community Platinum and higher members can post their health questions directly to Dr. Fuhrman. (All members can browse questions and answers.)

Q.

My cholesterol vastly improved since last year except for triglycerides.

2013:
Total: 160
LDL: 89
HDL: 43
ratio: 3.7
Triglycerides: 139

2012:
Total: 209
LDL: 137
HDL: 56
ratio: 3.7
Triglycerides: 79

I am 5'9'', 166 lb. I do pinch almost 2 inches at the belly and about 1 at the thigh, very skinny everywhere else. So, is the high triglyceride level anything to worry about? Is it due to being overweight? My target weight is 149 lb.

A.

High triglycerides can be related to you not quite reaching your ideal weight yet but can also be related to you eating too many grains, fruits (>4 cups daily or so) or overeating at your meals or snacking, etc. But, the level isn’t concerning since it is at the upper side of normal and your other numbers are so good. You may want to check it again in the future once you have lost even a little more weight and modified your routine, just to notice more improvement.

 
Q.

In your book Eat to Live, you wrote that excess consumption of refined carbohydrates may lead to higher levels of triglycerides in the blood. Does a higher level of triglycerides contribute to clogging of the arteries? I’m just trying to understand how triglyceride levels can be a predictor of heart disease.

A.

Having high triglyceride levels is almost always a marker for insulin resistance, which leads to endothelial dysfunction, inflammation, and vascular disease.