The Importance Of Triglycerides

By Olag Coney


Most people are familiar with cholesterol but are less knowledgeable about triglycerides. Elevated blood triglyceride level is a significant risk factor for coronary heart disease irrespective of so-called bad cholesterol (Low Density Lipoprotein [LDL]) and other established risk factors.

Similar to elevated levels of fasting triglycerides, very high levels of non-fasting triglycerides may also increase the risk for coronary heart disease. There is growing interest in assessing triglycerides in individuals who have not fasted. The reasoning is that a non-fasting level of triglycerides may be more characteristic of the typical circulating level of triglyceride. Since majority of the day blood lipid levels reflect a non-fasting level.

Elevated triglyceride is the third main reason of acute pancreatitis after gallstone disease and alcohol. A triglyceride molecule is a mixture of three molecules of fatty acids plus glycerides. It is the most common form of fat that human being digest. Improvement in lifestyle is the first-line therapy for all lipid related conditions, including raised triglycerides.

A regular exercise schedule consisting of at least 30 minutes of moderately intense physical activity (e.g., brisk walking), smoking cessation, and restriction of alcohol use and avoidance of high carbohydrate diets could help to reduce triglyceride levels in blood.

Patients with increased blood sugar level or uncontrolled diabetes may have higher level of triglycerides. Some drugs such as corticosteroids, protease inhibitors for HIV, beta blockers, and estrogens can increase blood triglyceride levels.

The American Heart Association, the US Department of Agriculture, and Health and Human Services endorse regular intake of fatty fish (salmon, tuna, herring, sardines, mackerel, and trout) that deliver omega-3 fatty acids (docosahexanoic acid [DHA] and eicosapentaenoic acid [EPA]).

Eating 8 ounces of fatty fish in a week provides an average of almost 500 mg/d DHA and EPA.

Consumption of 4 g of omega-3 fatty acids per day can lead to a median reduction of triglycerides of around 45%. For patients who have very high blood triglyceride level (equal or greater than 500mg/dl), therapeutic choices acclaim dropping this lipid by including in the patient's diet 4g/d omega-3 fatty acids, fibrates, high doses of niacin and, if desirable, high quantities of statins.




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