Those tricky triglycerides

imageYou already know you need to have your cholesterol checked regularly. If you have a sweet tooth, you may need to know your triglycerides numbers, too.

Catherine McNeal, MD, PhD, Internist and specialist in lipid disorders at Scott & White Healthcare, details how a high triglyceride count can be a marker for a lifestyle that leads to serious health problems.

What Are Triglycerides?

“Triglycerides are one of the two lipids, or fats, found in your blood. Cholesterol is the other lipid. Whereas cholesterol comes from the fatty foods you eat, triglycerides are metabolized and are the byproducts of the sugars and starches you eat,” says Dr. McNeal.

“Of all the things in the lipid profile, triglycerides are the most easily modifiable and can respond within days to dietary changes and physical activity.”

The more sugary and starchy foods you consume, the greater risk you have of developing high triglycerides. Leftover calories not burned off by exercise are converted by your body into triglycerides and stored in your fat cells.

In some cases, a high triglyceride level may be genetic and not dependent on your food consumption, Dr. McNeal says.

How Are Triglycerides Measured?

Your triglycerides are measured in a fasting blood test called a lipid profile. Also checked are your:

  • HDL (good cholesterol)
  • LDL (very bad cholesterol)
  • VLDL (bad cholesterol)
  • Total cholesterol

Are Triglyceride Levels Important?

Triglycerides are a good measure of your overall health.

Dr. McNeal says that a higher triglyceride level (above 150 mg/dL) comes as a “package plan,” called the metabolic syndrome, which often includes:

  • Low HDL cholesterol (the good or healthful cholesterol)
  • An increased waist size (above 35 inches for a woman and 40 inches for a man)
  • A higher blood pressure
  • A blood sugar in the pre-diabetic range

Sometimes just a few of these features are present, but having at least three of these problems markedly increases your chances of developing type II diabetes mellitus and increases the risk of developing coronary artery disease, Dr. McNeal says.

“In this case, a high triglyceride level is usually due to poor lifestyle choices, that is, not being active enough and/or consuming too many calories, which can then lead to type II diabetes and heart disease,” Dr. McNeal cautions.

How Do I Lower My Triglyceride Levels?

Having high triglyceride levels doesn’t have to be a permanent state.

“Of all the things in the lipid profile,” Dr. McNeal says, “triglycerides are the most easily modifiable and can respond within days to dietary changes and physical activity.”

Dr. McNeal says the most effective way of lowering triglyceride levels is with a little TLC — therapeutic lifestyle changes:

  • Limit or avoid starches
    • Bread
    • Rice
    • Potatoes
    • Pasta
  • Limit or avoid sugars
    • Sugared beverages
    • Fruit drinks
    • Sweets of all kinds
    • Milk-based products
    • High fructose corn syrup
  • Replace red meats with fish
  • Avoid alcohol, even small amounts
  • Substitute monounsaturated and polyunsaturated fats for saturated fat – use canola and olive oils rather than butter or bacon fat
  • Have a better calorie balance – reduce calories to achieve your ideal body weight
  • Get at least 150 minutes of exercise each week

“With exercise, after you burn glucose, you burn triglycerides as fuel. That’s how exercise lowers your triglycerides,” encourages Dr. McNeal.

For people with severely elevated triglycerides or with type II diabetes and high triglycerides, especially women, a class of drugs called fibrates may be recommended.

How Do High Triglycerides Affect the Total Cholesterol?

Dr. McNeal urges caution when interpreting results of your lipid profile, as high triglycerides can affect your total cholesterol count.

Dr. McNeal explains: “Your LDL equals your total cholesterol minus your HDL minus your triglycerides divided by 5. That means if your triglyceride level is really high, you’ll have a higher total cholesterol level as well.”

Total cholesterol = LDL-cholesterol + HDL-cholesterol + VLDL-cholesterol (TG/5)

“When your total cholesterol is high because your triglycerides are high,” Dr. McNeal says, “using cholesterol-lowering medications isn’t going to help any. It’s more effective to lower the triglycerides using lifestyle changes.”

What Is the Biggest Risk with High Triglycerides?

“People with ultrahigh triglyceride levels generally don’t have a higher risk of heart attacks and strokes. Their biggest risk when triglyceride levels are above 1000 is having pancreatitis,” says Dr. McNeal.

Uncontrolled diabetes mellitus and alcohol are the primary contributors to high triglycerides leading to pancreatitis, a potentially life-threatening condition. If you’ve had a lipid profile that indicates high triglycerides, eliminating or significantly reducing sugared beverages and alcohol is strongly advised.

What Medications Raise Triglyceride Levels?

Certain medications may increase your triglyceride levels:

  • Some acne medications, especially those containing retinoic acid
  • Some oral contraceptives
  • Many antipsychotics
  • Prednisone
  • Beta blockers

If you are taking one or more of these medications and you have high triglycerides, discuss their use with your physician.

How Often Should I Have My Triglycerides Checked?

The American Heart Association recommends a fasting lipid profile for all adults age 20 or older every five years.

You may need to have your triglycerides checked more frequently if:

  • Your triglycerides are 200 mg/dL or higher.
  • You are over age 50.
  • You have other risk factors for heart disease or type II diabetes.

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Those tricky triglycerides