***Easy Way To Cut Heart Attack Risk: Triglycerides 101

Easy Way to Cut Heart Attack Risk:
Reduce Triglyceride Levels to Boost Heart Health

By Jonny Bowden, PhD, CNS

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 (hopefully) doctors are slowly beginning to realize that heart attack risk is about a lot more than cholesterol (which may turn out to be way less important than we thought).

Meanwhile, I’m not at all sure people understand the important role triglycerides play in nutrition and health. One study recently reported 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 lay people queried knew about the accepted national guidelines. With triglycerides gaining importance as a measure to watch, it’s important that you understand what they are and how to control them.

Triglycerides Are Fats

Triglycerides are the main form in which most fat exists, in both our bodies and components of the food we eat. About 95% of the fat stored in your fat cells and circulating in your blood is in the form of triglycerides. Not only do you take them in from food, your liver makes the little buggers, and the more sugar you take in, the more the liver makes.

In our bodies, triglycerides are packaged, along with cholesterol and protein, into little containers called lipoproteins, two kinds of which are familiar to us as “good” and “bad” cholesterol (bad choices for names, but we’ll leave that for another time). 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 triglycerides and cholesterol. The body breaks them down and uses the fatty acids as an energy source.

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 found both triglycerides and HDL cholesterol to be sensitive indicators of risk for heart disease -- taken together, more accurate than cholesterol alone. The researchers found that if you took your triglycerides number and divided by your HDL number, the resultant figure turned out to be way more predictive of heart disease than cholesterol. 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.

It turns out that people with high triglycerides almost always have other major risk factors for heart disease, such as diabetes, obesity and high blood pressure. Even so, emerging evidence indicates the 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 150 or less can be considered “normal,” that level is actually far higher than is optimal. “We like to keep the triglyceride readings of our patients below 100 if possible,” Drs. Mary Dan and Michael Eades told me, adding that in most cases dietary changes alone can accomplish that.

Wanna lower your triglycerides fast? Go on a low-carb diet. Reducing intake of processed carbohydrates -- those nasty “white flour foods” -- has effectively lowered triglyceride levels in the bloodstream in study after study. Why? Because sugar is the “raw materials” for triglycerides. Your liver takes all that extra sugar you’re scarfing down and, in an effort to get it out of the bloodstream where it can do serious damage, ramps up the triglyceride making machinery. Some of the excess sugar in your diet is converted to glycogen, the storage form of sugar, but the liver can only store so much glycogen. Everything else gets made into triglycerides. That’s why cutting back on sugar and junk carbs always lowers triglycerides.

Because triglycerides are the main form of fat in food, conventional wisdom had called for eating less fat to reduce 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, just concentrate on 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 -- there are a couple of things you can add to your diet that will also help: Fish oil and garlic. Numerous trials have established that fish oil supplements significantly lower triglycerides, leading the American Heart Association to recommend 2 to 4 grams of fish oil daily for people who need to lower triglycerides. Other studies have shown an even more pronounced effect 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 a few fish entrees seasoned with garlic several times a week… easy, delicious and healthy, too.