Triglycerides: The Good, The Bad, the Ugly

What are triglycerides?

Triglycerides are a type of lipid (fat). They are the chemical form in which most fat exists in food as well as in the body. They're also present in blood plasma and, in association with cholesterol, form the plasma lipids.

Triglycerides are the most common type of fat storage and energy transfer in our bodies. Triglycerides are absolutely necessary for survival but that too much of a good thing can prove damaging and even deadly.

Excess calories are converted to triglycerides. Then they are transported to fat cells for storage. When the body has need of additional energy, like between meals, hormones trigger the release of these stored fats which rush to fill the energy gap. It is a wonderful system providing sustained energy release without us even thinking about it.

Measuring triglyceride levels

Like cholesterol, increases in triglyceride levels can be detected by plasma measurements. The measurements should be made after an overnight food and alcohol fast. The National Cholesterol Education Program guidelines for triglycerides are: Normal Less than 150 mg/dL

• Borderline-high, 150 to 199 mg/dL
• High,   200 to 499 mg/dL
• Very high, 500 mg/dL or higher

These are based on fasting plasma triglyceride levels.

Hypertriglyceridemia

Excess triglycerides in plasma is called hypertriglyceridemia. It's linked to the occurrence of coronary artery disease. Elevated triglycerides may also be a consequence of other disease, such as untreated diabetes mellitus.

Excluding old age, three of the most common causes of hypertriglyceridemia are:

• Obesity
• Poor diet
• Lack of exercise 

How are triglycerides harmful?

Unfortunately, as people get older and heavier, triglycerides, along with cholesterol levels tend to rise. When levels rise significantly higher than normal some health problems can also develop. Triglycerides that exist in the bloodstream produce a negative impact on heart health. While in the blood stream they are packaged with small amounts of cholesterol, and protein. They are then known as VLDL (very low-density lipoprotein). Under certain conditions these produce LDL (low-density lipoprotein) otherwise known as bad cholesterol. Unfortunately high levels of triglycerides and LDL usually coexist with low levels of HDL. HDL is the healthy cholesterol.

Researchers have believed for some time that elevated triglycerides are an indication of increased risk for coronary heart disease (CHD). Recent research indicates that high triglyceride levels are themselves an independent risk factor.

There are a number of medical conditions that are causally related to hypertriglyceridemia, as well. These include:

• Kidney disease
• Liver disease
• Familial hypertriglyceridemia 

Reducing triglyceride levels

Changes in lifestyle habits are the main therapy for hypertriglyceridemia.These may include:

• Losing extra bodyweight. If you're overweight, losing the excess pounds can help lower your triglycerides. Motivate yourself by focusing on the benefits of losing weight, such as more energy and improved health.   
  
  
• Consuming fewer calories. Remember that excess calories are converted to triglycerides and stored as fat. Reducing your calories will reduce triglycerides.   
  
  
• Choosing healthier fats. Avoid saturated fat and instead choose healthier monounsaturated fat, found in olive, peanut and canola oils. In addition, eat fish high in omega-3 fatty acids - such as mackerel and salmon - instead of red meat.
  
• Reducing the saturated fat, trans fat and cholesterol content of your diet.
  
• Reducing meat consumption.
  
• Choosing low fat protein  over carbohydrates
  
• Reducing your intake of alcohol considerably. Even small amounts of alcohol can lead to large changes in plasma triglyceride levels.
  
• Avoiding sugary foods. Simple carbohydrates, such as sugar, can cause a sudden increase in insulin production. This can increase triglycerides
  
• Limiting cholesterol, intake. Aim for no more than 300 milligrams of cholesterol a day - or less than 200 milligrams if you have heart disease.
  
• Avoiding the most concentrated sources of cholesterol, including organ meats, egg yolks and whole milk products.
  
• Avoiding cigarette smoking.
  
• Exercising. Be physically active for at least 30 minutes on most or all days each week.
  
  
• Adding fish to your diet. Fatty fish like mackerel, lake trout, herring, sardines, albacore tuna and salmon are high in omega-3 fatty acids .
  
  
• Supplementation. The American Heart Association recommends 2 - 4 grams of Omega-3 per day for anyone with high triglycerides.
  

Other Treatments for Hypertriglyceridemia

In the event diet and exercise are not enough other treatment becomes necessary. If elevated triglyceride levels are caused by some other medical condition then the underlying ailment needs to be addressed by your doctor.

In the absence of other causal medical conditions there are medications that are very effective in reducing triglycerides. These, of course, must be prescribed by your doctor.

Along with medication your doctor will also prescribe a triglyceride lowering diet and exercise. He or she should suggest eating more cold water fish like salmon, herring, sardines, albacore tuna, lake trout and possibly taking fish oil supplements.