Refined Grains And Starchy Foods
Refined or processed grains are typically made from white flour, which can increase triglycerides. They also often have added sugars. If possible, try to limit:
- Enriched or bleached white bread, wheat bread, or pasta
- 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.
How Often Should My Triglycerides Be Tested
If youâre a healthy adult, you should get a lipid profile every 4-6 years. Children should have it done at least once between the ages of 9 and 11, and one more time between 17 and 21. If youâre making changes to your diet or taking medication for high cholesterol or triglycerides, experts advise you to get a lipid profile afterward.
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Ruling Out Secondary Causes Of High Cholesterol And Triglycerides
If your doctor rules out the other causes of raised cholesterol and triglycerides listed above, then the next step is to look for other possible explanations. These include inherited causes. Tell-tale signs of inherited high cholesterol or triglyceride include:
- close family members with high cholesterol or high triglyceride
- early heart disease in close family members
- an inherited blood fat condition in close family members.
There are over 100 genes that can affect how our bodies handle blood fats. Sometimes just one small change in a gene is enough to raise cholesterol or triglycerides to very high levels. Sometime inheriting a number of genes that each have a small effect can add up to cause problems.
Inherited conditions that cause high cholesterol and triglycerides
Familial Hypercholesterolaemia raised cholesterol caused by a single gene
Familial Chylomicronaemia triglyceride levels can be extremely high, caused by a single gene
Familial Combined Hyperlipidaemia this causes raised cholesterol and triglycerides
Type 3 Hyperlipidaemia this also causes raised cholesterol and triglycerides
Polygenic Hypercholesterolaemia raised cholesterol caused by a number of genes
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Causes Of High Triglycerides
A study that looked at 5.6k people who participated in a National Health and Nutrition Examination Survey found that about one-third of US adults had high triglyceride levels .
A similar study of 5.6k people found that only about 2% of adults experienced extremely high levels , the leading cause of pancreas inflammation in the US .
High triglyceride levels can be caused by lifestyle and dietary factors, genetics, and other diseases .
On a mechanistic level, triglycerides will rise too much if :
- Your liver is producing too much triglyceride-dense VLDL cholesterol
- Your diet is excessive and unhealthy
- You have low lipoprotein lipase activity, which is the enzyme that breaks down triglycerides
All the potential causes outlined below affect one or more of these conditions.
Causes listed below are commonly associated with high triglycerides. Work with your doctor or another health care professional to get an accurate diagnosis.
Effect Of Volanesorsen On Lipid And Lipoprotein Levels
FAMILIAL CHYLOMICRONEMIA SYNDROME
A double-blind, randomized 52-week trial evaluated the ability of volanesorsen vs. placebo to decrease TG levels in 66 patients with FCS . The primary end point was the percentage change in fasting TG levels at 3 months. As expected, there was a marked reduction in Apo C-III levels in the volanesorsen group and a small increase in the placebo group. Most importantly patients treated with volanesorsen had a 77% decrease at 3 months in TG levels whereas patients receiving placebo had an 18% increase in TG levels. The decrease in TGs in patients treated with volanesorsen persisted for 52 weeks . Significantly, 77% of the patients in the volanesorsen group vs. only 10% of patients in the placebo group had TG levels of less than 750 mg/dl, a level that would greatly reduce the risk of pancreatitis. In addition, patients who received volanesorsen had decreases in levels of chylomicron TG by 83%, apolipoprotein B-48 by 76%, nonHDL-C by 46%, and VLDL-C by 58% and increases in levels of HDL-C by 46%, apolipoprotein A1 by 14%, LDL-C by 136% , and total apolipoprotein B by 20%.
HYPERTRIGLYCERIDEMIA
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How Do Triglycerides Circulate In The Blood
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.
Types of these lipoproteins include very low-density lipoproteins , high-density lipoproteins and low-density lipoproteins .
Effect Of Niacin On Cardiovascular Outcomes
MONOTHERAPY
COMBINATION WITH FIBRATES
In the Stockholm Ischemic Heart Disease Secondary Prevention Study survivors of a myocardial infarction below 70 years of age were randomized to a control group and a group treated with clofibrate and immediate release nicotinic acid . Serum cholesterol and TG was lowered by 13% and 19%, respectively, in the treatment group compared to the control group. Recurrent myocardial infarction was reduced by 50% within one year . Total mortality was decreased by 26% in the group treated with clofibrate + niacin while ischemic heart disease mortality was decreased by 36% . Notably, the benefit of clofibrate + niacin was only observed in patients with a baseline TG level > 143mg/dl. In the age of statins, the clinical implications of this early study are unclear.
COMBINATION WITH STATINS
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Visit Ucf Healths Cardiologist Dr Bernard Gros Who Specializes In Lipid Disorders
UCF Healths Dr. Bernard Gros is a board certified cardiologist who specializes in lipid disorders like high triglycerides. Dr. Gros completed his medical degree at Emory University School of Medicine. He completed a residency in Internal Medicine at University of Michigan, followed by a fellowship in Cardiology at the same location. Dr. Gros has been with UCF Health College of Medicine since 2011, as one of the founding health care providers.
At UCF Health, our cardiologists use a collaborative care approach to serve patients in the best way possible and show you how to prevent heart disease. We strive to ensure that all members of the health care team are on board with the treatment plan and facilitate clear communication across specialties.
What Are The Risks Of Elevated Triglycerides
- Coronary heart disease Hypertriglyceridemia may increase your risk of heart disease by increasing your blood cholesterol.
- Stroke Hypertriglyceridemia may increase your risk of stroke by increasing your blood cholesterol.
- Diabetes Certain types of high triglycerides may increase your risk of type 2 diabetes. This happens when the high level of triglycerides causes insulin resistance.
- Kidney disease Hypertriglyceridemia may increase your risk of kidney disease by increasing your blood cholesterol.
- Liver disease Certain types of high triglycerides may increase your risk of liver disease by increasing your blood cholesterol.
- Impotence Hypertriglyceridemia may increase your risk of impotence by increasing your blood cholesterol.
- Fatty deposits in blood vessels Hypertriglyceridemia is thought to cause blood vessel blockages and lead to heart attacks and strokes.
- Fatty buildup in the pancreas Hypertriglyceridemia may increase your risk of fatty buildup in the pancreas. This can lead to pancreatitis.
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How Can I Prevent Hypertriglyceridemia
Some causes are out of your control . But theres still a lot you can do in your daily life to prevent hypertriglyceridemia. Here are some steps you can take to help keep your numbers in the healthy range:
- Reduce sugar and refined carbohydrates.
Ask your healthcare provider for resources to help you manage your triglycerides.
What Are The Symptoms Of High Triglycerides
There are often no symptoms of high triglyceride levels. Very high levels of triglycerides can cause severe pain in the stomach area due to inflammation of the pancreas. Your healthcare provider will usually check for high triglycerides in your blood as part of a lipid panel. Levels above 150 mg/dl may raise your risk for heart disease. A triglyceride level of 150 mg/dL or higher is also a risk factor for metabolic syndrome. The guidelines for triglyceride levels are:
| Category |
|---|
| 500 mg/dL and above |
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Know Your Triglyceride Numbers
A blood test called a lipid panel checks both your triglyceride and cholesterol levels. Usually, your doctor will ask that you fast, or not eat or drink anything other than water, for 9-12 hours before the test. Youâll get blood taken from a vein in your arm. Some labs offer non-fasting lipid panels, or they may prick your finger for blood.
Here are the levels, based on a fastingblood test.
- Normal: Less than 150 mg/dL
- Borderline: 150 to 199 mg/dL
- High: 200 to 499 mg/dL
- Very High: 500 mg/dL or above
Anyone over age 20 needs to get regular tests to track their cholesterol and triglyceride levels, according to the American Heart Association.
Note On Existing Studies
More research is needed to fully understand whether very high HDL levels increase the risk of death.
The authors of a 2019 study suggest that genetic mutations linked to very high HDL levels, impaired HDL function at high levels, and potential bias in research due to flaws in study design may contribute to the potential link found in some studies.
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Drinking Too Much Alcohol
Limiting the amount of alcohol that you consume can help keep your heartand triglyceride levelshealthy. Studies have shown that alcohol can adversely affect your lipids in incremental amounts, so it is suggested that you limit your alcohol to one drink per day if you are assigned female at birth, or two drinks per day if you are assigned male at birth.
Experts suggest that the relationship between alcohol and triglyceride levels is related to alcohol’s effect on the pancreas and liver.
What Are Normal Triglyceride Levels
Normal triglyceride levels for adults are between 100 and 150 mg/dL. The level for children is different from adults. It is usually lower than 90 mg/dL for kids ages 10 to 19.
There are three types of high triglycerides. 150499 mg/dl is moderate hypertriglyceridemia. 500 mg/dl or more is severe hypertriglyceridemia. 880 mg/dl or more is very severe hypertriglyceridemia. If your triglyceride levels are consistently above 150 mg/dL, you should see your doctor discuss ways to lower them.
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Treatment If The Condition Gets Worse
If you have not previously been taking medicines for high triglycerides, you probably will start. If you have been taking medicines but they have not been effective, your doctor may change your dosage or add new medicines. The medicines that you might take are:
If you are taking a statin, you need to be extra careful if you are also taking fibrate medicines. There is a greater risk for a life-threatening muscle problem called rhabdomyolysis, which can lead to kidney failure. Before you can take this combination of medicines, your kidneys and liver must be healthy and functioning normally. If you have any muscle problems or pain, report it immediately to your doctor.
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.
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When To Contact A Doctor
While high triglyceride levels may not usually cause symptoms, anyone who is uncertain or concerned about their triglyceride levels should consult a doctor.
Additionally, any adult who has not had a lipid profile test in the last 46 years should speak with a doctor about their cardiovascular risk factors and possible need for a test. Catching elevated levels of health markers, such as triglycerides or cholesterol, at an early stage may help a person make changes earlier to address the underlying issue.
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- Arnett, D. K., et al. . 2019 ACC/AHA Guideline on the primary prevention of cardiovascular disease: A report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines.
Regular Movement And Exercise
As youve learned earlier in this article, obesity and a sedentary lifestyle as both serious risk factors for high triglycerides. I recommend that you move your body daily and exercise regularly at least 20 to 30 minutes 5 days a week. I recommend that you take regular walks and also make walking part of your daily routine.
Walk to your neighbors or stores nearby instead of driving. Take the stairs. Park further from the store entrance to get some steps in. Go for nature walks or a stroll around the neighborhood.
Along with walks, strength and resistance training are also critical. A 2019 systematic review and meta-analysis published in the Journal of Physical Activity and Health has found that strength training can improve lipid levels and reduce inflammatory issues .
You may try bodyweight exercises, free weights, weight machines, resistance bands, kettlebells, TRX suspension trainers, pilates, or other strength training workouts. Many of these workouts can be done from your home, however, working with a trainer at first may help with the proper form.
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Replace Saturated Fats With Healthier Fats
Replacing foods that contain mainly saturated fats with foods that contain unsaturated fats such as polyunsaturated and monounsaturated fats will help reduce your cholesterol level.
For example, instead of butter and cream in cooking, use olive oil, nut butters or avocado.
Healthy unsaturated fats are found in:
What Are Normal And High Triglyceride Levels
The National Cholesterol Education Program sets guidelines for triglyceride levels:
- Normal levels: Less than 150 milligrams per deciliter
- Borderline high:150 to 199
- High: 200 to 499
- Very high: 500 or more
Elevated levels may lead to heart disease, especially in people with low levels of good cholesterol and high levels of bad cholesterol. The same is true if you have type 2 diabetes.
Experts once debated how important triglycerides are, but it now seems clear that higher levels are linked to problems such as heart disease.
One thing is clear, though: A good diet and exercise plan can lower triglyceride levels, improve cholesterol, and decrease the chance of heart disease.
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Controlling High Triglycerides: Medical Treatment
People with heart disease and high triglycerides may need medication to bring down their levels.
- Fibrates can lower triglycerides. They modestly improve cholesterol levels, too.
- Fish oilwith omega-3 fatty acids can help keep triglycerides under control. Ask your doctor whether you should use prescription fish oil. Omega-3 acids from plant sources like flaxseed may help.
- Niacin can lower triglycerides by up to 50%. It’s available as a non-prescription supplement and as a prescription drug.
Remember that to stay healthy and keep your triglycerides down, you still have to focus on improving your lifestyle.
When you talk to your doctor, discuss all of the medicines, supplements, and vitamins you take. Some common drugs — like beta-blockers, birth control pills, and diuretics — can cause high triglycerides as a side effect. It’s possible that one of them could be causing your problem.
What Are High Triglycerides
Triglycerides are a kind of fat found in blood. Cholesterol is another kind. Stored in fat cells for later use, triglycerides are a major energy source. Normal amounts are important for good health. Eating more fat than the body burns can lead to high triglyceride levels . High triglyceride levels may result in hardening of the arteries , which increases risks of stroke, heart attack, and heart disease. They can be part of metabolic syndrome, which also includes too much fat around the waist, high blood pressure, high blood sugar, and abnormal cholesterol levels.
Sometimes high triglyceride levels mean poorly controlled type 2 diabetes, low thyroid hormone levels , liver or kidney disease, or rare genetic conditions.
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Effect Of High Dose Omega
It should be noted that in this trial mineral oil was used as the placebo. In the placebo group the LDL-C, non-HDL-C, and CRP levels were increased during the trial . The impact of these adverse changes on clinical outcomes is uncertain and whether they contributed to the apparent beneficial effects observed in the individuals treated with EPA is unknown.
4) The OMEMI trial was a randomized trial of 1.8 grams per day of omega-3-fatty acids vs. corn oil placebo in patients aged 70 to 82 years with a recent myocardial infarction . Baseline LDL-C was approximately 76mg/dL, HDL-C was 49mg/dL, and TGs 110mg/dL. The primary endpoint was a composite of nonfatal myocardial infarction, unscheduled revascularization, stroke, all-cause death, and heart failure hospitalization after 2 years of follow-up. The primary endpoint occurred in 21.4% of patients on omega-3-fatty acids vs. 20.0% on placebo . TGs levels decreased 8.1% in the omega-3-fatty acid group and increased 5.1% in the placebo group while changes in LDL-C were minimal in both groups. Thus, similar to the STRENGTH trial no benefits on cardiovascular disease were observed with EPA + DHA treatment.
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