Triglycerides

What are triglycerides?

Triglycerides are fats from the food we eat that are carried in the blood. Most of the fats we eat, including butter, margarine and oils, are in triglyceride form. Excess calories, alcohol and sugar in the body turn into triglycerides and are stored in fat cells throughout the body.

How are triglycerides different from cholesterol?

Triglycerides and cholesterol are both fatty substances called lipids. But triglycerides are fats; cholesterol is not. Cholesterol is a waxy, odorless substance made by the liver. It is used to build cell walls, helps the nervous system and plays an important role in digestion and hormone production.

Pure cholesterol cannot mix with or dissolve in the blood. Instead, the liver packages cholesterol with triglycerides and proteins called lipoproteins. The lipoproteins move this fatty mixture to areas throughout the body.

How do elevated triglycerides increase my risk of cardiovascular disease?

High levels of triglycerides are linked to atherosclerosis, which is the hardening and thickening of the arteries. Atherosclerosis increases the risk of developing cardiovascular (heart and blood vessel) disease. The condition can also lead to a heart attack or stroke.

Many people with high triglyceride levels often have other health problems that increase their risk of atherosclerosis. These conditions include obesity, poorly controlled type 2 diabetes, and metabolic syndrome. Metabolic syndrome is a cluster of risk factors that includes a large waist, high blood pressure, high triglyceride levels and abnormal cholesterol levels.

High triglycerides can be caused by a medical condition, such as an underactive thyroid (hypothyroidism) or liver and kidney disease. Some medications, like beta blockers, birth control pills and steroids, can also raise triglyceride levels. Triglyceride levels can also be affected by alcohol, diet, menstrual cycle, time of day and exercise.

When should I have my triglycerides levels measured?

Triglyceride levels are usually measured when you have a blood test called a Lipid Profile. The Lipid Profile shows the levels of triglycerides, total cholesterol, HDL cholesterol (high-density lipoprotein/ good cholesterol) and LDL (low-density lipoprotein /bad cholesterol) in your blood.

Everyone over age 20 should have their cholesterol checked at least every 5 years. Your healthcare provider can check your cholesterol and triglyceride levels by taking a blood sample, which is sent to a lab for testing. Triglyceride levels are normally high after you eat. So, you shouldn't have anything to eat or drink for 12 hours before you have your levels tested.

What are normal triglycerides levels?

The chart below lists the national guidelines for triglyceride levels taken after fasting. Levels higher than 2.26 mmol/l (200 mg/dL) are associated with an increased risk of heart attack, stroke and death.

Normal	Borderline High	High	Very High
Under 1.70 mmol/l (150 mg/dl)	1.71-2.26 mmol/l (151-200 mg/dl)	2.27-5.64 mmol/l (201-499 mg/dl)	5.65 mmol/l or higher (500 mg/dl)

How can I lower my triglycerides?

If you have a high triglyceride level, you may be able to reduce them by making the following changes.

• Lose weight if you are overweight. The first step to losing weight is to cut back on calories. To do this, eat smaller portions and be mindful of calories from snacks and drinks. Your body stores extra calories as triglycerides.
• Cut back on simple sugars. Eating foods high in simple sugars leads to high triglycerides. Try these tips to cut back on simple sugars:
  1. Avoid sweetened beverages like soda, juice, fruit drinks, sweetened iced tea and lemonade. Instead, choose water, zero-calorie flavored water, unsweetened drinks (tea, seltzer water, coffee), or beverages labeled sugar-free or diet
  2. Avoid adding sugar to coffee, tea, beverages and food. Use an herbal zero-calorie sweetener or sugar substitute instead
  3. Avoid or limit candy, gum or mints with sugar
  4. Choose syrups, jams, jelly, preserves, cow gelatin and pudding that have not sugar added or are labeled diet, light or low-sugar
  5. Snack on whole fruit instead of fruit-flavored treats
  6. Choose cereals with no more than 8 grams of sugar per serving
  7. Avoid or limit ice cream, baked goods and candy
• Limit natural sugars. Even natural sugars can lead to high triglyceride levels if you eat too much. These tips will help you limit the natural sugar in your diet:
  1. Use honey and molasses sparingly
  2. Choose light or plain yogurt
  3. Choose whole fruit instead of fruit juice
  4. If you eat dried fruit, choose types without added sugar. Limit dried fruit to 57 grams (1/4 cup) of per day. Dried fruits are a more concentrated source of sugar than fresh, whole fruit.
  5. If you eat canned fruit, choose types packed in natural juice, not syrup

• Limit portions or starchy vegetables such as potatoes, peas, corn, dried beans and lentils. Have no more than 113 grams (4 ounces) per meal.
• Choose whole grains. White and refined breads, cereals, rice, pasta and crackers change to sugar in the body much faster than whole-grain varieties do. This can raise your triglyceride levels.
  To limit refined grains:
  1. Choose breads, crackers and cereals that contain whole grain oats, barley, corn, rice or wheat as the first ingredient. Avoid the words bleached and/or enriched as the first ingredient
  2. Use whole wheat pasta and brown rice
  3. Choose breads, crackers, rice and pasta with at least 2 to 3 grams of dietary fiber per serving
  4. Choose cereals with 5 or more grams of dietary fiber per serving
  5. Start your morning with a bowl of high-fiber oatmeal or oat bran
  6. Use barley, bulgur, whole wheat couscous, millet, quinoa or wheat berries as a side dish
  7. Choose whole wheat crackers instead of saltines
• Avoid alcoholic beverages. Alcoholic beverages raise triglyceride levels. If your triglyceride levels are high, it is best to not drink alcohol or limits to less than 1 drink per day.
  1. One serving of an alcoholic beverage is equal to 45 ml spirits (1.5 ounces); 148 ml wine (5 ounces) OR 355 ml beer (12 ounces)
• Pay attention to the fat in your diet. Eating a lot of fats, especially saturated and trans fats, can cause high triglycerides. It is important to plan a low-fat diet that doesn't contain too many carbohydrates and sugar, which raise triglyceride levels.
  1. Choose low-fat, fat-free and light dairy products and condiments. Avoid added fats like butter, margarine and mayonnaise
  2. Limit saturated fats, which are found in high-fat dairy, fatty cuts of beef, poultry skin, fried foods, processed meats and cheeses, as well as palm, palm kernel and coconut oils (found in many packaged foods)
  3. Avoid foods that contain trans fats (partially hydrogenated oils)
  4. Avoid cholesterol-rich foods such as egg yolks, butter and liver
  5. Choose plant-based, healthy fats like monounsaturated and polyunsaturated fats. These include extra virgin olive oil, canola oil, nuts, seeds and avocado
  6. See your dietitian or healthcare provider for more information about your daily fat limit
• Increase your intake of omega-3 fats.
  We need omega-3 fatty acids in our diet. They are found in fish like salmon, herring, sardines, mackerel, and tuna. Other foods that contain smaller amounts of omega-3 fats are walnuts, flaxseed, chia seeds, hemp seeds, soybeans, soybean oil.
  Your healthcare provider or dietician may want you to take a dietary supplement, like fish oil, to get enough omega-3 fats to lower high triglyceride levels. Ask them first about mine the right amount for you.

Medication

Diet and exercise play an important role in triglyceride control. But, you may also need to take medication to lower your triglyceride levels. Your healthcare provider may prescribe taking a statin, niacin or other medication. It is important to talk to your healthcare provider before taking any medication or supplements.