Reduce Triglyceride Levels to Boost Heart Health

With stories about health so prominent in the news, we sometimes see technical terms tossed around as though everyone understands what they mean. “Triglycerides” is one of those, it seems to me. They are talked about more and more as doctors realize that cholesterol is only one of the markers for heart disease and heart attack risk, yet I’m not sure people understand the important role triglycerides play in nutrition and health. A National Lipid Association survey in 2006 found that nine out of 10 doctors agreed that elevated triglycerides are an independent risk factor for heart disease—but that message isn’t reaching their patients, as only 13% of the adults queried knew what are considered normal triglyceride levels. With triglycerides gaining importance as a measure to watch, we all need to understand what they are and how to control them.

TRIGLYCERIDES ARE FATS

According to Jonny Bowden, author of The Most Effective Natural Cures on Earth, triglycerides are the main form in which most fat exists, both in our bodies and as components of the foods we eat. “About 95% of the fat stored in your fat cells is in the form of triglycerides,” he said.

In our bodies, triglycerides are packaged, along with cholesterol and protein, into lipoproteins, two kinds of which are familiar to us as “good” and “bad” cholesterol. HDL (“good cholesterol” or high-density lipoprotein), has a higher proportion of protein, while LDL (“bad cholesterol” or low-density lipoprotein) has less protein and more cholesterol and triglycerides. The body uses these broken down-triglycerides as fuel.

But there can definitely be too much of a good thing, and there are significant problems with high levels of triglycerides. A Harvard research group led by J. Michael Gaziano, MD, found both triglycerides and HDL cholesterol to be sensitive indicators of risk for heart disease—and taken together, more accurate than cholesterol alone. The figure derived from dividing the triglyceride reading by the HDL reading turned out to be predictive of heart attack, researchers found. Those with the highest ratios of triglyceride to HDL were 16 times more likely to have a heart attack than those with the lowest ratios. A ratio of five or higher is of concern—and the lower the number, the better odds for your health. For example, a person with triglycerides of 200 and an HDL of 40 would have a ratio of 5, whereas someone with triglycerides of 100 and the same HDL of 40 would have a ratio of only 2.5. Usually people with elevated triglycerides will also have low HDL, Bowden told me.

It turns out that people with high triglycerides often have other major risk factors for heart disease, such as diabetes, obesity and high blood pressure. Even so, emerging evidence indicates that triglycerides themselves are a risk factor—not only for heart disease but also for stroke.

CONTROL TRIGLYCERIDES THROUGH DIET

Beyond the ratio, is there a target level of triglycerides for optimal health? The guidelines themselves are a matter of debate among physicians and nutritionists. Many of the forward-thinking ones believe that while current standards state that triglyceride levels of less than 150 can be considered “normal,” the top of that range is far higher than is optimal. “We like to keep the triglyceride readings of our patients below 100 if possible,” Mary Dan Eades, MD, and Michael Eades, MD, authors of The Protein Power Life Plan, told me, adding that in most cases dietary changes alone can accomplish that.

Reducing intake of excess carbohydrates and sugars, especially processed carbohydrates—those nasty “white flour foods”—can effectively lower triglyceride levels in the bloodstream. Bowden explained that this is because the body turns much of the extra calories and sugars in those foods directly into triglycerides to be stored as energy for future use. “Some of the calories are converted to glucose for immediate use,” he said. “Excess calories left after that get made into triglycerides. That’s why cutting back on foods with excess calories and sugar can lower triglyceride levels.”

Because triglycerides are the main form of fat in food, conventional wisdom is that eating less fat reduces triglycerides in the bloodstream. This can work, particularly when fiber is increased and weight loss accompanies the lower-fat diet, but the real leverage in lower triglycerides is reduction of simple carbohydrates. Carbs don’t have to be completely eliminated, Bowden says, “just concentrate on eating the ones from vegetables and fruits and those with high fiber. Don’t eat ‘the white stuff.’ “

Reducing triglycerides is not just about what you can’t eat—Bowden says adding fish oil and garlic to your diet will also help. Numerous trials have established that fish oil supplements significantly lower triglycerides, leading the American Heart Association to recommend 2 to 4 grams of EPA and DHA (from omega-3 fatty acid supplements) daily for people who need to lower triglycerides. Other studies have shown a reduction of triglycerides with garlic which has the added benefit of lowering LDL (“bad”) cholesterol in the bargain. You can take garlic in supplements too, but this is best done under expert supervision as they can interact with medications and also affect blood coagulation. Or, you could revise your dinner menu to include fish entrees seasoned with garlic a couple of times a week…easy, delicious and healthy, too.