Why Lowering High Triglyceride Levels Matters
The national guidelines for fasting triglyceride levels in healthy adults are:
- Normal: Under 150 milligrams per deciliter .
- Borderline High: 151200 mg/dl.
- High: 201499 mg/dl.
- Very High: 500 mg/dl or higher.
When your triglyceride levels are high and you have a high amount of LDL cholesterol or a low amount of HDL cholesterol, all of this could contribute to the development of fatty buildups within the artery walls of the heart. The buildup can increase your risk of heart attack and stroke.
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A Promising New Treatment For High Triglycerides
- By Gregory Curfman, MD, Assistant Professor of Medicine, Former Editor-in-Chief, Harvard Health Publishing
When you think about fat circulating in the bloodstream, you might immediately think of cholesterol. But theres another type of fat you shouldnt ignore: triglycerides. As with cholesterol, high triglycerides can also increase the risk of having a heart attack. Existing drugs for lowering triglycerides arent that good at reducing heart attack risk. Thats why a report on a new way to lower triglycerides, New England Journal of Medicine, is generating some excitement among cardiologists.
What Vitamins And Supplements Help Lower Triglyceride Levels
Fish oil lowers triglycerides. The dose needed to reduce triglycerides is 1 to 4 grams of EPA/DHA per day. Four grams per day has been shown to reduce triglycerides by 25% to 30%. People with the highest triglycerides benefit most. It is worth noting that non-marine omega 3 fatty acids do not appear to lower triglycerides in the same way. The prescription form of synthetic omega-3 fatty acids, Lovasa, Vascepa, or Epanova is approved by the US Food and Drug Administration for people with triglycerides over 500 mg/dL.
Niacin is another supplement for lowering triglycerides. Both regular and extended-release nicotinic acid has been shown to reduce triglycerides by up to 40% . Niacin has the added benefit of increasing HDL and lowering LDL. The high doses of niacin needed to lower triglycerides can cause uncomfortable flushing in some people. To avoid this, niacin can be taken with baby aspirin, with food, or with an extended-release form of niacin/nicotinic acid . Inositol-hexanicotinate, marketed as no-flush niacin, is NOT the same thing and contains very little nicotinic acid.
Fibers, such as chia, flax, psyllium, or bran, help lower triglycerides. Fibrates, a class of cholesterol-lowering drugs that have been used for decades, also have a triglyceride-lowering effect through the same general mechanisms.
There are other supplements with limited research supporting their benefit in hypertriglyceridemia.
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Nutrition And Dietary Supplements
In addition to eating a healthy diet, low in saturated fat, with plenty of whole grains, fruits, and vegetables, some specific foods and supplements may help lower cholesterol.
Fiber: Several studies show that soluble fiber lowers LDL cholesterol and triglycerides. Fiber can also help you lose weight because it makes you feel full. Your doctor will encourage you to get more fiber in your diet. You may also take a fiber supplement. Men should get 30 to 38 g of fiber per day. Women should get 21 to 25 g per day.
Beta-glucan is a type of soluble fiber found in oat bran and other plants. It slightly reduces LDL cholesterol, which is why oat bran is touted as a cholesterol-lowering food.
Soy: Many studies have shown that eating soy protein , rather than animal meat, helps lower blood cholesterol levels, especially when you eat a diet low in saturated fat. One study found that as little as 20 g of soy protein per day is effective in reducing total cholesterol, and that 40 to 50 g shows faster effects . Another study found that soy can help reduce triglyceride levels. The AHA recommends that people with elevated total and LDL cholesterol add soy to their daily diet, and that soy is safe when consumed as part of your regular diet. But talk to your doctor before you take soy supplements. Soy isoflavones may have estrogen-like effects in the body, which might lead to an increased risk of breast and other cancers.
Have A Glass Of Wine Or Not
Drinking in moderation might increase good cholesterol levels. At least thats what some of the research says. A review published in October 2019 in the journal Molecules concluded drinking red wine , which contains the antioxidant compound resveratrol, may have a protective effect on the heart, but more research is required to understand the mechanisms involved. But you dont have to have a glass of vino to boost your HDL cholesterol. Antioxidants found in red wine can also be found in fruits such as blueberries, grape juice, dark chocolate, and peanuts.
If you decide to drink, remember to do so in moderation. The Dietary Guidelines for Americans recommends one drink or less a day for women, and two drinks or less a day for men.
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Atherosclerosis And Cardiovascular Disease
Despite being called good cholesterol, research suggests that very high levels of HDL may increase your risk of mortality.
In a 2017 Danish study , researchers analyzed the rate of mortality in groups of 52,268 European men and 64,240 women over an average of 6.4 years.
The researchers found the lowest mortality rates at HDL levels of 73 mg/dL in men and 93 mg/dL in women. Mortality rates increased significantly with HDL levels above 97 mg/dL in men and 135 mg/dL in women.
Focus On Monounsaturated Fats
As opposed to saturated fats, unsaturated fats have at least one double chemical bond that changes the way your body uses them. Monounsaturated fats have only one double bond.
Some recommend a low fat diet for weight loss, but research is mixed on its effectiveness in controlling blood cholesterol.
One research report acknowledged that lower fat intake is an effective way to reduce blood cholesterol levels. However, researchers were concerned over potential negative effects of low fat diets, such as lowering HDL and increasing triglycerides .
In contrast, research has shown that a diet high in monounsaturated fats, such as the Mediterranean diet, helps reduce levels of harmful LDL and increase levels of healthy HDL .
Monounsaturated fats may also reduce the oxidation of cholesterol, according to research. Oxidized cholesterol can react with free radicals and contribute to clogged arteries. This can lead to atherosclerosis or heart disease .
Overall, monounsaturated fats are healthy because they decrease harmful LDL cholesterol, increase good HDL cholesterol and reduce harmful oxidation (
summary
Monounsaturated fats like those in olive oil, canola oil, tree nuts, and avocados reduce LDL cholesterol, increase HDL cholesterol, and reduce the oxidation that contributes to clogged arteries.
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Try Having One Vegetarian Meal Every Week
Dont let the word vegetarian scare you. By choosing a smartly prepared vegetarian meal, youre hitting multiple cholesterol-lowering goals at the same time, like eating healthier fats and getting more soluble fiber. Plus, many vegetarian meals are just as flavorful and filling as their meaty cousins.
Heres one idea for a low-cholesterol recipe: Try a freshly prepared salad with a sesame vinaigrette and some grilled, spiced tofu. For dessert, add some fresh blueberries, strawberries and oats to low-fat vanilla yogurt.
The key here is to build up a routine, like making every Tuesday night vegetarian night. Once that becomes the norm, try expanding to different nights, or add a weekly vegetarian lunch, too. You can also be flexitarian by just eating smaller portions of meat. Over time, these modifications can really pay off.
Can Lowering Carbs Actually Improve Tg/hdl Rc And Cv Risk
Yes. There is plenty of evidence showing this. Multiple studies range from clinical trials in animals and humans to meta-analyses. Here are 4 of them:
- The Abbasi study was a human clinical trial using a crossover design. People ate high carbs for 2 weeks, then low carbs for 2 weeks, with a washout period of 2 weeks in between. The high-carb diet doubled TG levels, tripled remnant cholesterol, and lowered HDL by 15% .
- The Wang study is a randomized clinical trial in laboratory mice .
- The Volek study is a meta-analysis. It reviews pre-2005 studies which had already shown that low-carb diets decrease triglycerides and remnant cholesterol while increasing HDL cholesterol level .
- The Ebbeling study was also a human subjects clinical trial. It was done at Harvard. Subjects on a low-carb diet had lower TG and higher HDL cholesterol. Also, researchers showed that low-carb diets were less likely to result in weight rebound due to improved energy expenditure and leptin .
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Cocoa And Dark Chocolate
Nope, your eyes arent tricking you. Both cocoa and dark chocolate contain compounds that can lower bad cholesterol and help you get to a healthier total cholesterol level overall.
How? It seems that both foods help prevent LDL cholesterol from oxidizing, which can up the risk for heart disease.
The key to reaping the benefits is enjoying cocoa and dark chocolate in a healthy context.
Instead of guzzling a sugary hot chocolate with whipped cream, stir cocoa powder into your morning oatmeal or yogurt. If opting for dark chocolate, make sure the cocoa content is at least 75 percent and stick to a 1-ounce portion.
Cholesterol And Healthy Eating
What we eat has an impact on our cholesterol levels and can help reduce our risk of disease. Try to eat a wide variety of foods from each of the five food groups. Not only does this help to maintain a healthy and interesting diet, but it provides essential nutrients to the body.
The Heart Foundation recommends:
- Plenty of vegetables, fruits and wholegrains.
- A variety of healthy protein sources , legumes , nuts and seeds. Smaller amounts of eggs and lean poultry can also be included in a heart healthy diet. If choosing red meat, make sure it is lean and limit to 1-3 times a week.
- Unflavoured milk, yoghurt and cheese. Those with high blood cholesterol should choose reduced fat varieties.
- Healthy fat choices nuts, seeds, avocados, olives and their oils for cooking
- Herbs and spices to flavour foods, instead of adding salt.
Also, be mindful on how much you are eating and whether you are filling up on unhealthy foods. Portion sizes have increased over time and many of us are eating more than we need which can lead to obesity and increase our risk of cardiovascular disease.
Ideally, a healthy plate would include servings of ¼ protein, ¼ carbohydrates and ½ vegetables.
Serving size can vary depending on age, gender and specific nutrition needs.
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Choose Healthy Fats Over Saturated Fats
Another way to lower triglycerides and cholesterol naturally is by eating healthy fats. Omega-3 fatty acids lower triglycerides and bad cholesterol by increasing fat metabolism, according to the AHA. Omega-3 fatty acids are found in oily fish, such as salmon and herring, olive oil, and dietary supplements. For people with high triglycerides, the AHA recommends prescription-strength omega-3 fatty acid supplements at a dose of 4 grams per day, although its still best to get it from foods. Saturated fats, which come mainly from meat sources, should be limited to no more than 5 to 6 percent of your total daily calories, and your daily intake of cholesterol should be no more than 300 mg, according to the AHA.
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Selenium Is Not For Everybody
Apparently researchers are a bit confused as to whether selenium is good for lowering cholesterol or not.
Resent conclusions say yes, selenium does good for your cholesterol levels by raising HDL cholesterol.
However, in the US people already have a high dosage of selenium in their bodies so it is not recommended that they increase it with selenium supplements.
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How Your Healthcare Provider Can Help
Your healthcare provider can help you get your triglyceride levels under control by ruling out possible causes like medications, thyroid issues, unmanaged diabetes and liver or kidney disease. They can then formulate an effective management plan with you. This might include medication and lifestyle changes like losing weight and eating smaller portions.
As mentioned before, a healthy, fiber-rich diet can help in the matter. Exercising regularly can also play a huge part in managing triglyceride levels. By cleaning up your existing routine, you could see changes in your triglyceride levels within a few months.
This article was adapted from Cleveland Clinic Heart Advisor.
Soy Maybe The Verdict Is Still Out
Protein rich soy comes in many different shapes and sizes and regardless of its name it can be a powerful cholesterol fighter.
A study has shown that only 30 grams of soy protein added to an otherwise healthy diet may lower both your total cholesterol, LDL cholesterol and triglycerides. However, the verdict is still out whether it is recommended as a cholesterol lowering food in itself.
What we do know is that soy does contain many healthy nutrients and is a more healthy option than fatty meats.
Also, you might not want to go complete overboard with soy fanaticism as some soy products have been linked to an increased risk in breast cancer. Fermented soy, however, seems to go free of this cancer suspicion.
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Saturated And Trans Fats
Saturated fats can raise triglyceride levels. They can be found in fried foods, red meat, chicken skin, egg yolks, high-fat dairy, butter, lard, shortening, margarine, and fast food. Alternatives include:
- Lean proteins such as skinless white chicken meat and fish
- Pastries, pies, cookies, and cakes
Starchy foods can also raise triglycerides. Try to choose foods with 100% whole grains and opt for long-grain rice instead of instant rice. If possible, eat non-starchy vegetables such as spinach, instead of starchy ones like potatoes.
Q10 Yet Another Powerful Antioxidant
Coenzyme Q10 is an antioxidant and like vitamin C it helps prevent the oxidization of LDL cholesterol and puts up a brave fight against the free radicals.
The verdict is still out whether Q10 actually and directly lowers your cholesterol levels, but it has been found to be a great help to those taking statins for their cholesterol as it reduces statins side effects .
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Role Of Lipids In Atherosclerotic Plaque Formation
To transport TG and cholesterol to peripheral tissues, lipoprotein particles cross the endothelial barrier in blood vessels to reach the extracellular space . The subendothelial retention of apoB-100-containing lipoproteins via a charge-mediated interaction with proteoglycans in the extracellular matrix is thought to be the initiating event in atherogenesis. Smaller, electronegative LDL particles penetrate the endothelial barrier 1.7-fold better than large LDL particles CM and VLDL remnants also can cross. All of these particles interact with positively charged intimal proteoglycans . Oxidation, by reactive oxygen species, of fatty acids of surface phospholipids of the apoB-containing lipoprotein particles results in modification of lysine residues of apoB . Of note, the presence of Ox-PL precedes the appearance of the monocytes dietary cholesterol can lead to Ox-PL .
Which Medications Improve Tg/hdl
- Statins. The major impact of statins on TG/HDL is to lower TG. But usually, statins are given to lower LDL. Sometimes they can also increase HDL levels but still not as much as how they lower TG. They can lower TG by as much as 50% .
- Prescription-strength niacin
- Prescription-strength omega-3s. Icosapent ethyl , Epanova, and Lovaza are prescription forms of omega-3s
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Beans Beans And More Beans True Miracle Veggies
Did you know that beans are some of the most effective foods to lower cholesterol? Well, they are and the variety of beans is amazing. There is something for every taste. You can go for green beans, navy beans, pinto beans, kidney beans and more.
These fierce cholesterol fighters have a remarkable ability to lower your problematic LDL cholesterol significantly .
A study has shown that beans may reduce your LDL cholesterol with as much as 24% if you eat about 100 grams of beans a day.
So take a deep dive into your beans!
The Powerful Pectin In Apples
An apple a day keeps the doctor away is more true than you might think. Many studies have demonstrated that fresh apples have a really good effect on lowering LDL cholesterol and raising HDL cholesterol.
You see, apples contain an unusual high about of the type of fibers known as pectin and pectin is a component that helps reduce the cholesterol in your blood .
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Hdl And Cholesterol Efflux
Although the risk of developing CHD is inversely correlated with plasma levels of HDL-C , recent studies suggest that the amount of cholesterol efflux from cells is a better predictor of CHD than HDL-C concentration . In statin-treated men with LDL-C < 70 mg/dL who had high TG and low levels of HDL-C , cholesterol efflux was reduced compared to normolipidemic subjects . This finding suggests that decreased cholesterol efflux may contribute to the residual risk observed in statin-treated subjects with low HDL-C even when LDL-C < 70 mg/dL. Decreased cholesterol efflux has also been found to be inversely related to carotid IMT and angiographic coronary artery disease independent of HDL-C level . Taken together, the evidence suggests that the functional status of HDL is more important than its level.
Three human infusion studies have been done with apoA-I Milano or reconstituted HDL with the goal of increasing the number of functional HDL particles. Reduction in atheroma volume was 4.2%, and 3.4%, respectively, and decreased expression of VCAM-1 occurred in the third . However, there is no clinical assay yet for the measurement of HDL functionality.