Lifestyle modification is the first-line therapy for people with elevated triglycerides.
Many individuals with high triglycerides have insulin resistance and metabolic syndrome (14). In these cases, hypertriglyceridemia is often associated with visceral obesity (15), low levels of HDL cholesterol, high blood pressure and type 2 diabetes. For these patients, weight loss, regular physical exercise, and avoidance of added sugars (16) are all important. Other risk factors such as smoking and high blood pressure should also be addressed (17).
Following a fatty meal, blood levels of triglycerides will rise. However, it is important to understand that raised blood triglycerides following a meal (postprandial hypertriglyceridemia) are caused by chylomicrons produced in the intestine, whereas elevated fasting levels are due to VLDL produced from triglycerides in the liver. The latter is often a result of excessive carbohydrate intake.
Chylomicrons disappear from the circulation soon after the triglycerides have been delivered to the tissues. Thus, moderate fasting hypertriglyceridemia is usually due to increased VLDL.
Fatty acids used by the liver to produce VLDL are derived mainly from two sources. Firstly, during conditions such as obesity, diabetes, and insulin resistance, there is increased fatty acid flux from adipose tissue to the liver. Secondly, there is an increased de novo synthesis of fatty acids in the liver mainly from carbohydrates.
For this reason, in mild to moderate hypertriglyceridemia, losing weight and reducing carbohydrate intake (especially high glycemic index foods and high fructose foods) can lower VLDL and triglycerides.
Dietary fat is not a significant source of liver triglyceride (15), and high fat diets usually don’t raise fasting triglycerides.
The situation may be different in more severe hypertriglyceridemia (above 500 to 1000 mg/dL (5.6 to 11.3 mmol/L)), where the clearance of chylomicrons becomes very slow. Under these circumstances, it is crucial to reduce dietary fat intake to lower triglycerides.
It is necessary for patients with severe hypertriglyceridemia to avoid alcohol abuse as it can cause substantial increases in triglyceride levels and cause acute pancreatitis.
Written by
cure
Administrator
To view profiles and participate in discussions please or .
When VLDL particles in the blood come into contact with LDL and HDL particles, triglycerides are transferred to those LDL and HDL particles. These triglyceride-loaded LDL and HDL are ready targets for enzymes in the blood and liver that reconfigure them into smaller versions: small LDL and small HDL. Small LDL and HDL powerfully stimulate growth of atherosclerotic plaque in the arteries of the heart and elsewhere. Small LDL particles, in fact, have skyrocketed to occupy the top spot as cause of heart disease in North America. Excess triglycerides and VLDL lurk behind the creation of small LDL and small HDL.3
This process starts at a triglyceride level as low as 45 mg/dl or 0.5 mmol/L, becomes progressively worse with increasing levels of triglycerides, and gets really bad with triglycerides >150 mg/dl or 1.7 mmol/L. The Adult Education Treatment Panel-III of cholesterol treatment guidelines in the U.S. and Health Canada suggest 150 mg/dl or 1.7 mmol/L as the cutoff for normal – an absurd level, in my view, that virtually ensures increased risk for heart disease.
Low HDL and increased triglycerides are also patterns that characterize metabolic syndrome, or pre-diabetes, and diabetes. In our world of inactive, sedentary lifestyles and packaged, processed foods, metabolic syndrome and diabetes are rampant. That means increased triglycerides from VLDL, along with low HDL and small LDL, are also out of control. This is because the poor insulin responses of these conditions, along with the high-carbohydrate diet that created these issues, allow the liver to produce VLDL particles without restraint.4 The result: up to several-fold increased risk for heart attack.5
Triglycerides originate mostly from abdominal fat, followed by contributions from carbohydrate intake. Consuming dietary oils and fats does not contribute to excess triglycerides. While these oils and fats are made of triglycerides, they do not usually contribute to triglyceride blood levels. The triglycerides that come from fat stores and from liver conversion of carbohydrates to triglycerides outstrip our intake of triglycerides through oils and fats by a long stretch.
How to Reduce Triglycerides
Unfortunately, low-fat dietary blunders of the last 40 years still corrupt standard advice to reduce triglycerides. Low-fat diets, in fact, increase triglycerides. Typically, someone adhering to a strict low-fat dietary regimen has triglyceride levels in the 200 mg/dl (2.3 mmol/L) or higher range.6
Wheat, grains, sugars, and starchy legumes are the biggest culprits in causing high levels of triglycerides. Excess intake of alcohol can also contribute. These are the foods that cultivate excessive insulin levels, which lead to poor responsiveness to insulin, providing the fuel for increased VLDL production which appears as high triglycerides on a cholesterol panel.7
Reducing—or even better, eliminating―grains, added sugars, and starchy legumes, especially in the form of junk snacks such as chips, pretzels, and crackers; all wheat-flour containing foods like breads, pasta, pretzels, bagels, and breakfast cereals; foods made with cornstarch or cornmeal, such as tacos, tortillas, wraps, and gravies; white and brown rice; and white potatoes reduces triglycerides dramatically.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Study says dairy fat could lower risk of diabetes
How high is high fat in diet?
High HbA1c Updates after 2 weeks test results
Blood Fasting Sugar tests , hb1ac, triglycerides,vldl. Different labs different results, hard to understand
Rationale of Low Carb High Fat (LCHF) diet
