Triglycerides and your health

Triglycerides are a type of fat that accounts for about 95 percent of all dietary fats. Both animal and vegetable fats contain triglycerides. Once digested, triglycerides circulate in the bloodstream to be used as energy by our cells. Any excess triglycerides are stored as body fat to fuel the body between meals or when fasting. Our bodies also manufacture triglycerides.

Those who regularly consume excess calories may be overweight or obese and have elevated triglyceride levels in their blood. High blood triglycerides are linked with an increased risk of adverse health conditions including heart disease. High blood triglycerides are also known as hypertriglyceridemia.

High blood triglyceride levels cause the blood to become thicker and stickier, which may increase the development of clots. According to some studies, elevated triglyceride levels alone or when combined with other risk factors such as high LDL cholesterol levels in both men and women are associated with an increased risk for stroke and cardiovascular disease.

High triglyceride levels may also be an indicator of metabolic syndrome. Metabolic syndrome in individuals includes having high blood sugars, high blood pressure, central (abdominal) obesity or being apple-shaped, high triglycerides, and low HDL (healthy) cholesterol.

Metabolic syndrome increases your risk for diabetes, heart disease, and stroke. Triglyceride levels may be elevated when type 2 diabetes is poorly controlled, with hypothyroidism, kidney or liver disease and when one drinks a lot of alcohol. Medications such as birth control pills, steroids, beta blockers or diuretics may elevate serum triglyceride levels.

A lipid profile ordered by your physician will measure your blood cholesterol levels as well as your triglyceride levels. Generally you will be instructed to fast for 12 hours prior to the test but may have water.

The National Heart, Lung and Blood Institute guidelines for fasting triglyceride levels in healthy adults are:

Normal: Under 150 mg/dl
Borderline High: 151–200 mg/dl
High: 201–499 mg/dl
Very High: 500 mg/dl or higher

Levels higher than 200 mg/dL are associated with an increase in the risk of heart attack, stroke and death.

Triglycerides can be lowered with dietary and lifestyle changes. If you are diagnosed with hypertriglyceridemia there are several things you can do to reduce your serum triglyceride levels and improve your heart health.

They include:

Lose weight and stay at a healthy weight. The heavier an individual is, the higher their triglycerides are likely to be. Following a balanced diet and exercising as well as reducing your intake of high-calorie foods and beverages will aid in achieving weight loss goals. Eat more fruits and vegetables to provide fiber, nutrients and a feeling of fullness. Losing 5 to 10 pounds can assist in lowering triglyceride levels.

Reduce the calories you consume. Extra calories are converted to triglycerides and stored as body fat.

Reduce your intake of saturated fat and trans fatty acids. Start by reading food labels to avoid foods containing hydrogenated fats and trans fats. Severely limit or avoid whole or 2 percent dairy products, fried foods, doughnuts, cakes, cookies, candy bars, pizza and high-fat meats. High-fat meats include most deli meats, most steaks, poultry skin and dark meat poultry, bacon, hotdogs and sausage. Substitute skinless chicken or turkey breasts, pork loin, lean cuts of beef (flank or sirloin steak, bottom round or 95 percent extra lean hamburger). Replace animal fats with plant-based proteins such as beans, lentils or soy foods. Try soy milk, tofu, tempeh, edamame or roasted soy nuts.

Healthier food preparation methods include roasting, broiling, grilling, steaming, poaching, boiling or stir frying in a minimal amount of vegetable oils. Trans fats are found in fried foods, potato chips, several packaged baked and snack foods, and fast foods prepared with hydrogenated oils. Avoid stick margarines and select tub margarines that are not manufactured with partially hydrogenated oils and have 0 grams of trans fats. Substituting small amounts of olive, canola or peanut oil for margarine is a healthier choice.

Cut back on alcohol. Besides being high in calories and sugar, alcohol has a strong effect on triglyceride levels. Serum triglycerides levels can be elevated by small amounts of alcohol.

Eat more foods containing omega-3 fatty acids. Research indicates omega-3 fatty acids decrease triglycerides, raise HDL cholesterol, reduce high blood pressure, reduce inflammation and make blood less sticky and thinner which helps reduce blood clot formation. Eat omega-3 rich fatty fish two to three times a week with the portion being the size of a deck of cards.The best food sources include wild salmon (canned or fresh), mackerel, herring, sardines, anchovies, Pacific oysters and rainbow trout. Other omega-3 fatty acid food sources include fortified eggs, chia seeds, ground flaxseeds, seaweed, walnuts, walnut oil, soybeans, and canola oil.

Avoid sugary foods and beverages as well as foods prepared with refined carbohydrates. Avoid white rice and flour and anything made with white or enriched flour. Eat high-fiber, whole-grain breads, cereals, pasta, cereals, crackers and brown or wild rice. Increase your fiber intake with beans, whole fruits and vegetables which aids in lowering both blood cholesterol and triglyceride levels.

Quit smoking.

Exercise is essential to aid in lowering triglyceride levels as well as cholesterol. Work your way up to 30-40 minutes of moderate physical activity at least five days a week.

Sometimes, healthy eating and regular exercise can't lower high triglyceride levels. This may occur if you have familial hypertriglyceridemia or if you already have heart disease. Your doctor may prescribe medication to help lower high blood triglyceride levels. Medications alone will not overcome the hazards of an unhealthy lifestyle. A healthy diet, regular exercise and maintaining an appropriate weight are important lifestyle strategies for managing high triglycerides. Always consult with your physician or healthcare provider before making any dietary/nutrition changes or commencing or changing your physical activity.

Debra Dobies, MA, RD, LDN, is Beebe Healthcare's Ornish Reversal Program registered dietitian and medical nutrition therapist. Beebe Healthcare's Ornish Reversal Program is in the Beebe Medical Arts Building at the Rehoboth Beach Health Campus. For more information, go to www.beebehealthcare.org/ornish.