Triglycerides: How to Keep Them in Check

Triglycerides are a type of fat (lipid) found in the blood. When we eat, our body converts any calories it doesn't need to use right away into triglycerides. The triglycerides are stored in the fat cells, which are later released by hormones for energy between meals. According to Dr. Ritika Samaddar, Dietician at Max healthcare, "If you are consuming too much sugar in your diet, there is a possibility that your triglyceride levels can be high. Your body has the tendency to convert the excess sugar into triglycerides and then store them as fat".

Let’s delve deeper.

What are Triglycerides?

Triglycerides are fats (lipids) that account for 99% of the fat stored in the body. It is an ester formed from glycerol and three fatty acid groups. To tackle the problem, we should understand

triglycerides' meaning. When we eat, our bodies use some calories for various activities. The rest of the calories are stored in the body in the form of triglycerides to utilise later if the body needs them.

If we regularly eat more calories than we burn, particularly "easy" calories such as those from sugary beverages and high-fat foods, it may lead to high triglycerides, a condition known as “hypertriglyceridemia”. High triglycerides combined with high LDL (bad) cholesterol or low HDL (good) cholesterol can increase the risk of heart attack and stroke.

Rarely very high triglycerides levels(usually >500) can cause severe pancreatitis which is a medical emergency and needs urgent intervention.

What are Normal and High Triglyceride Levels?

Triglycerides, up to a certain level, are normal, but their excess quantities might increase your chances of various lifestyle diseases. The below table states different triglyceride quantities in milligrams per deciliter (mg/dL).

Category Triglyceride Level (mg/dL)

Normal Less than 150

Borderline High 150 - 199

High 200 - 499

Very High 500 and above

To summarise, a normal triglyceride level should be less than 150 mg/dl of blood; they are closely associated with HDL (good cholesterol) and factors that help in lowering cholesterol. Any triglyceride level of 200 mg/dl of blood is considered high. That said, it is not uncommon to see elevated triglyceride >200 and low HDL (less than 40 for men, or less than 45 for women) occur together.

What are the Best Ways to Reduce Triglycerides?

Dietary recommendations

• Avoid sweetened foods: Simple sugars are the primary ingredient of triglycerides and hence excess intake of sweets or drinks can raise triglycerides. Eliminate intake of food items loaded with sugars like cookies, pastries, sweet desserts, and fruit juices.
• Choose whole grains over refined: Intake of refined cereals such as white rice, bread, pasta made from white flour, or cornflakes can significantly raise triglycerides in sensitive individuals. Instead, choose whole grains such as multigrain chapati, and other grains such as quinoa, barley, and millet.
• Choose fish instead of red meat: Swap out red meat for fatty fish such as salmon, mackerel, trout, and sardines. These fish are rich in omega-3 fatty acids, which have been shown to lower triglyceride levels. Aim to include fish in your diet at least twice a week to reap the cardiovascular benefits.
• Eat nuts and greens: Incorporate more nuts and leafy greens into your meals. Nuts such as almonds, walnuts, and pistachios are high in healthy fats, fibre, and antioxidants, which can help lower triglycerides. Similarly, leafy greens such as spinach, kale, and Swiss chard are nutrient-dense and low in calories, making them excellent food choices.
• Eat more plant foods: Vegetable proteins such as beans, peas, nuts, and lentils are excellent ways to improve your health and will have a direct effect on lowering your triglycerides and cholesterol.
• Choose high-fibre foods: Foods high in fibre will help to control your triglycerides and LDL ("bad") cholesterol. Consume beans, whole grains- Oats, Quinoa, brown rice; Nuts and seeds -Almonds, chia seeds, flaxseed; fruits and vegetables. Drink more water with an increase in fibre.
• Limit trans fats: The primary dietary source of trans fats in processed food is "partially hydrogenated oils" which are found in fried foods like doughnuts, and baked goods including cakes, pie crusts, biscuits, cookies, margarine, and other spreads.
• Eat healthy oils: Increase intake of MUFA-rich oils to lower the triglycerides levels. Replace saturated fats like butter, ghee, shortening, lard, or margarine with MUFA-rich oils like canola oil, rice bran, and soybean oil.
• increase the intake of unsaturated fats: Replace saturated and trans fats with healthier unsaturated fats, such as those found in olive oil, avocado, nuts, and seeds. Unsaturated fats can help improve cholesterol levels and reduce triglycerides.
• Establish a regular meal pattern: Maintain a consistent eating schedule by eating meals and snacks at regular intervals throughout the day. This can help stabilise blood sugar levels and prevent spikes in triglycerides that may occur with irregular eating patterns.
• Add soy protein to your diet: Incorporate soy-based foods such as tofu, tempeh, edamame, and soy milk into your meals. Soy protein is a plant-based alternative to animal protein that can help lower triglyceride levels and improve heart health.
• Choose foods rich in omega-3 fatty acids (the "good" fats): Omega 3 fatty acids have been shown to significantly reduce the elevated triglycerides level. Hence include foods high in omega-3 fatty acids such as fatty fish (salmon, mackerel, sardines, tuna, trout), flax seeds, flaxseed oil, Almonds, and legumes.
• Drink enough water: Stay hydrated by drinking plenty of water throughout the day. Water helps support overall health and may aid in digestion, metabolism, and the elimination of waste products from the body.

General recommendations

• Maintain a healthy weight: You may be surprised to discover that a modest weight loss of 5-6 kg can reduce your triglycerides, and cholesterol level, and decrease your risk of heart disease. Eat a healthy diet to lose weight and prevent lifestyle diseases like diabetes, CVD, etc.
• Exercise regularly: Exercise will increase HDL cholesterol and burn off excess triglycerides. Weight-bearing activity, in particular, increases muscle mass and raises your metabolic rate. This will help your body burn more carbohydrates, leaving less storage for triglycerides.
• Quit smoking: Smoking can raise triglyceride levels and increase the risk of cardiovascular disease. Quitting smoking can help lower triglycerides and improve overall health.
• Limit or quit alcohol: Drinking alcohol raises triglyceride levels. For people who are sensitive, a small amount of alcohol can trigger it.

What are the Medications for High Triglycerides?

If lifestyle changes alone are not sufficient, several medications may be prescribed to help lower high triglyceride levels. Common medications for high triglycerides include:

• Statins: Statins are a class of medications that primarily work by lowering LDL (bad) cholesterol levels but can also modestly reduce triglycerides. Examples include atorvastatin, simvastatin, and rosuvastatin.
• Fibrates: Fibrates are another class of medications that are specifically effective at lowering triglyceride levels. They work by reducing the liver's production of triglycerides and increasing the removal of triglycerides from the bloodstream. Examples include gemfibrozil and fenofibrate.
• Omega-3 fatty acid supplements: Omega-3 fatty acids, found in fish oil supplements, can help lower triglyceride levels, particularly in high doses. They work by reducing the liver's production of triglycerides and may also improve triglyceride clearance from the bloodstream.
• Bile acid sequestrants: Bile acid sequestrants are medications that primarily work by binding to bile acids in the intestine, which reduces cholesterol absorption and may also modestly lower triglyceride levels. Examples include cholestyramine and colesevelam.
• Prescription fish oil: In some cases, high doses of prescription-strength fish oil may be prescribed to help lower triglyceride levels, particularly in individuals with very high triglycerides. These medications contain concentrated amounts of omega-3 fatty acids.
• For extremely elevated levels, sometimes patient need to be admitted and insulin is administered for rapid decline in levels.

It's important to note that medication should be used as directed by the doctor, and in conjunction with lifestyle changes. As medication choices are individualised, it's essential to consult with a healthcare provider to determine the most appropriate treatment plan.

Checkout: 25 foods and 7 days diet to lower triglycerides

Final words

Managing high triglycerides requires a comprehensive approach that includes lifestyle modifications, dietary changes, and, in some cases, medication. By incorporating healthy habits such as regular exercise, a balanced diet rich in fruits, vegetables, and omega-3 fatty acids, and maintaining a healthy weight, individuals can effectively lower triglyceride levels and reduce their

risk of cardiovascular disease. However, those who may need additional support or guidance in managing their triglycerides may consult a specialist at Max Hospitals to receive personalised care and treatment options.

Frequently Asked Questions

1. What is the Fastest Way to Lower Triglyceride?

Avoiding sweetened drinks is one of the first things a person should do to reduce triglyceride levels. Exercising regularly will further speed up the process.

2. What Foods Decrease Triglycerides?

Eating a vegetable diet, using MUFA-rich oil substitutes like Canola oil, and incorporating fatty salmon, flax seeds, almonds, etc., will help lower your triglyceride levels.

3. How Long Does it Take for Triglyceride Levels to Lower?

According to a review published in the May 2012 edition of the journal Molecular and Cell Biology of Lipids, visible results can be seen within 1 month of consuming fish liver oils.

4. Do Eggs Raise Triglycerides?

Yes. Eggs contain saturated and trans-fats, which can increase triglyceride levels considerably. Hence, people with high triglyceride levels should avoid eggs.