By Colette Dreyer RD (SA)
Triglycerides are one of the most common fats found in the bloodstream. The focus is usually on the other blood lipids such as total cholesterol, low-density lipoprotein (LDL) cholesterol known as your bad cholesterol, and high-density lipoprotein (HDL) known known as the good cholesterol. However, triglycerides should also be focussed on because a high level could indicate a higher risk for cardiovascular disease, whereas a very high level may increase the risk for pancreatitis.
Triglycerides consist of three fatty acids and an alcohol named glycerol. Gut enzymes break down fats into fatty acids from the foods you consume. These fatty acids can enter intestinal cells known as enterocytes. The enterocytes combine the fatty acids which will form triglycerides. They will then combine with cholesterol and protein to form chylomicrons, so that they can be released in the blood stream. The chylomicrons transport triglycerides to various tissues where they will be stored or used as energy. Triglycerides can be stored by the liver in a large molecule known as very-low-density-lipoprotein (VLDL). When VLDL and chylomicrons give up the fats to the body cells, they become small and dense cholesterol rich particles. A result of high triglycerides will be that LDL will form and will start building up in the artery walls. The higher the triglyceride level the less your body produce HDL. HDL is necessary to remove the LDL form the artery walls and the blood.
Eating a very fatty meal can result in a milky colour when taking a blood sample, however this may resolve in a few hours. Certain hormones will release triglycerides between meals when you need the energy.
Carbohydrates can also be converted to triglycerides by the liver, especially when eating these food in excess. Other factors that contribute to an increased triglyceride level include being overweight or obese, drinking high amounts of alcohol, smoking and medical conditions affecting the liver, thyroid and kidneys. Genetics may also cause high triglyceride levels in some people which will cause familial hypertriglyceridemia or hyperlipidaemia.
A recent study showed that a 5-10% of body weight lost could decrease triglyceride levels with 25%, whereas making dietary changes by eating more plant proteins and focussing on unsaturated (healthier) fats by following a Mediterranean diet, lowered triglyceride levels by 10-15%. Resistance training have shown a triglyceride reduction of 5%.
Lifestyle changes are important to lower triglyceride levels to normal ranges. These lifestyle changes include:
- Aim for a healthy body weight (BMI between 18.5-24.9)
- Dietary modification (lower carbohydrate and fat intake)
- Choosing unsaturated fats rather than saturated fats
- Exercise regularly
- Eat whole grain foods
- Avoid refined and processed foods
- Eat fish at least twice a week to ensure an adequate amount of omega-3 intake. Fish sources include salmon, sardines and other fatty fish.
- Stick
to recommended alcohol intake if you are not willing to stop
- Male: 2 units
- Female: 1 unit
1. Sandesara PB, Virani SS, Fazio S, Shapiro MD. The forgotten lipids: triglycerides, remnant cholesterol, and atherosclerotic cardiovascular disease risk. Endocrine reviews. 2019;40(2):537-57.