What are triglycerides?

[Naveed Yaseen]

Triglycerides are chemical compounds digested by the body to provide it with the energy for metabolism. Triglycerides are the most common form of fat that we digest, and are the main ingredient in vegetable oils and animal fats.

The triglyceride molecule is a derivative of the chemical glycerol (tri=three molecules of fatty acid + glyceride=glycerol) that contains three fatty acids. To be absorbed, these parts are broken apart in the small intestine, and afterwards are reassembled with cholesterol to form chylomicrons. This is the source of energy for cells in the body. Fat cells and liver cells are used as storage sites and release chylomicrons when the body needs the energy.

Elevated triglyceride levels are a risk factor for atherosclerosis, the narrowing of arteries with the buildup of fatty plaques that may lead to heart attack and stroke. Markedly elevated triglyceride levels may also cause fatty liver disease, pancreatitis.

Elevated triglyceride levels in the blood may be associated with other diseases including:

* poorly-controlled diabetes,

* kidney disease,

* some medications (for example, beta blockers, diuretics, birth control pills).

Alcohol consumption can raise triglyceride blood levels by causing the liver to produce more fatty acids. However, there are some beneficial aspects of moderate alcohol consumption, defined as one alcoholic beverage per day (a glass of wine, a bottle of beer, or an ounce of hard liquor), that may balance this triglyceride rise. Moderate consumption may mildly increase HDL (the good cholesterol) levels in the bloodstream and red wine, which contains antioxidants, may decrease the risk of heart disease. It is not recommended that people start to drink alcohol to obtain these effects.

How are triglyceride levels measured?

Triglyceride levels in the blood are measured by a simple blood test. Often, it is part of a lipoprotein panel in which triglycerides, cholesterol, HDL (high density lipoprotein), and LDL (low density lipoprotein) are measured at the same time.

Fasting for 12 hours before the test is required. Fat levels in the blood are affected by recent eating and digestion. Falsely elevated results may occur if the blood test is done just after eating.

What are normal triglyceride levels, and what does high triglyceride levels mean?

Elevated triglycerides place an individual at risk for atherosclerosis. Triglyceride and cholesterol levels are measured in the blood to provide a method of screening for this risk.

* Normal triglyceride levels in the blood are less than 150mg per deciliter (mg/dL).

* Borderline levels are between 150-200 mg/dL.

* High levels of triglycerides (greater than 200 mg/dl) are associated with a increased risk of atherosclerosis and therefore coronary artery disease and stroke.

* Extremely high triglyceride levels (greater than 500mg/dl) may cause pancreatitis (inflammation of the pancreas).

How can I lower my triglyceride levels?

Returning triglycerides to normal will decrease the risk of heart attack and stroke. Depending on the level, treatment may include dietary modification, medications, or both. A health care practitioner is an important resource to help a patient keep both cholesterol and triglyceride levels within normal limits. The following recommendations from Betty Kovacs, MS, RD, will help lower triglyceride levels:

1. Decreasing your intake of sugar: If you have a sweet tooth, try to set limits on how often and how much sugar you consume. You can cut your intake in half to begin with, and continue cutting back from there. Remember to read the labels to check for sugar content in both food and beverages.

2. Changing from white to brown: If you eat white rice, bread, and pasta, switch to whole wheat products. It may take a little while to get used to the difference in taste, but it’s worth the effort for the benefits to your health. There are lots of new products on the market, so experiment until you find the one that you like best.

3. Cut back on the booze: Even small amounts of alcohol have been shown to elevate triglycerides, so cut back to as little alcohol consumption as possible. If you choose to drink, try to cut down on the amount of alcohol in your drink by mixing it with non-caloric beverages such as seltzer, tonic water, or diet soda.

4. Switching fats: To lower your triglycerides, you want to change the kind of fat that you eat. Limit or avoid foods with saturated and trans fat. These include fried foods, lard, butter, whole milk, ice cream, commercial baked goods, meats, and cheese. Switch to monounsaturated and polyunsaturated fats. The best sources of these fats are olive oil, canola oil, nuts, and fatty fish like salmon, mackerel, lake trout, sardines, herring, and albacore tuna. The food labels will tell you which kind of fat you are eating, so be sure to check them out.

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