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An Overview on Triglycerides

Triglycerides are a type of fat (lipid) obtained from the diet or produced by the liver, and are a source of energy.  Whenever you eat, your body puts some calories into the bloodstream to use for energy immediately.  The excess calories are converted into triglycerides by the liver, and then travel to be stored as fat cells.  In between meals, your body breaks down these fat cells (triglycerides) to use as energy.

When we eat more calories than we burn, we have excess triglycerides in the blood and stored as fat.  If a person does this regularly, they probably have high triglycerides.  The following is the range for triglyceride levels:

  • Normal:  Less than 150 mg/dL
  • Borderline High:  150-199 mg/dL
  • High: 200-499 mg/dL
  • Very High:  500mg/dL and above

Triglycerides and cholesterol are both types of lipids, but triglycerides store unused calories for energy while cholesterol is used for cell membranes and some hormones.  Since they are both lipids, they do not dissolve in the blood.  Instead they need the help of lipoproteins for transport.

Up until recently, it wasn’t clear how high levels of triglycerides caused a hardening of the arteries (Mayo Clinic).  This condition is known as atherosclerosis, and when combined with high cholesterol may cause plaques to build up in the arteries.   This places people at risk for coronary artery disease and heart attacks.

High triglycerides may be a result of obesity, type 2 diabetes, low thyroid, liver or kidney disease, beta blockers, birth control pills, diuretics, steroids, or the breast cancer drug tamoxifen.

New Studies

A report published May 6, 2010 found that high levels of triglycerides can cause heart disease.  Up until this point, cholesterol levels were the main focus of heart disease prevention.  The lead researcher of the study said, “Despite several decades of research, it has remained uncertain whether raised levels of triglyceride can cause heart disease.”  We now know that people with a genetic tendency for high triglycerides also have a higher risk of heart disease.

The study found a genetic link between triglycerides and heart disease, with mutations in the apolipoprotin A5 gene.  This gene determines triglyceride concentrations.  The study found that for every copy of the mutation, there was a 16 percent increase in triglyceride concentration.  People with two copies of the mutation had a 32 percent increase in triglyceride concentration, and a 40 percent increased risk in developing heart disease.

This study is significant because for so many years, the role of triglycerides in heart disease has not been fully understood.  For example, high LDL (“bad” cholesterol) levels are a definite risk factor for heart disease, and low HDL (“good” cholesterol) may also increase risk for heart disease.  This study suggests that triglycerides can affect coronary artery disease, independent of cholesterol levels.

“This study indicates that we need to now worry about high triglyceride levels as well.”

In addition to heart disease, people with high triglycerides have an increased risk of stroke.  A 2009 study published in the Journal of the American Medical Association found that people with elevated non-fasting triglyceride levels had increased incidence of ischemic strokes.  The study claims to have discovered a “previously unnoticed association” between non-fasting triglycerides and ischemic stroke.  This is important because “Even the most recent European and North American guidelines on stroke prevention do not recognize elevated triglyceride levels as a risk factor for stroke.”

This study now encourages testing the non-fasting triglyceride level, as opposed to the usually tested fasting level.

Lowering Triglycerides

The Mayo Clinic recommends the following methods to lower triglycerides:

  1. Lose weight:  Losing even 5-10 pounds can help lower triglycerides.
  2. Cut down on calories:  Excess calories are converted to triglycerides and stored as fat.
  3. Avoid sugary and refined foods (like white flour):  These foods are simple carbohydrates, and are easily converted to triglycerides
  4. Limit dietary cholesterol:  Eat less than 300 mg of cholesterol a day, and avoid meats high in saturated fat, egg yolks, and whole milk.
  5. Eat healthier fats:  Monounsaturated fats are found in plants, and include olive and peanut oil.  Also omega-3 fatty acids are essential, and found in fish like salmon and mackerel.
  6. Eliminate trans fats:  Foods containing partially hydrogenated oil, especially fried foods and commercial baked products, are sources of trans fats—stay away from these at all costs!
  7. Limit alcohol:  Even small amounts of alcohol can raise triglycerides.
  8. Exercise regularly:  Aim for at least 30 minutes of physical activity a day.

If medication is necessary to lower triglycerides, usually your doctor will prescribe medication to lower LDL (“bad”) cholesterol first.