Encyclopedia of Diets - A Guide to Health and Nutrition

Benefits

The benefits of normal triglyceride levels are

numerous. Triglycerides carry fat-solublevitaminsA,

D, E and K to where they are required, they help the

synthesis of some hormones and protect cell mem-

branes. The fat tissues in which they are stored also

cushion and protect organs such as the kidneys and

provide thermal insulation.

Precautions

The National Heart, Lung and Blood Institute

(NHLBI), through its National Cholesterol Education

Program (NCEP), recommends that the triglycerides

of diabetic individuals should be checked regularly.

Diabetes can increase triglycerides significantly, espe-

cially when blood sugar is out of control. Healthy

adults over 40 should get their triglycerides tested at

least once a year, and more often if levels are high until

they reach the desirable level.

Fat restriction should be carefully evaluated.

When reducing fat intake results in a required weight

loss, triglyceride levels usually improve. When they are

severely elevated (>1000 mg/dL), alow-fat dietwill

decrease chylomicron and VLDL. However, when tri-

glycerides are only moderately elevated, a low-fat diet

will increase them and may also decrease HDL levels.

Risks

Triglycerides do not cause complications until ele-

vations of 1000 mg/dL or more are reached. There is a

risk of chylomicronemia syndrome when levels are 800

mg/dL or higher. The syndrome causes recurrent epi-

sodes of abdominal pain that may be accompanied by

nausea and vomiting. Extreme elevations of triglycer-

ides, usually greater than 1000 mg/dL, may cause an

inflammation of the pancreas (pancreatitis). The pan-

creas is the organ that makes insulin and substances to

help digest food and pancreatitis is accordingly a seri-

ous disorder. People with hypertriglyceridemia are

also at risk for fatty liver, the accumulation of fat in

liver cells. Triglyceride levels of 4000 mg/dL or higher,

may cause a condition known as lipemia retinalis, in

which eye examination reveals retinal blood vessels

that have a pale pink, milky appearance.

Women with elevated triglycerides before concep-

tion may develop severe hypertriglyceridemia with

levels well above 1000 mg/dL, and the associated risk

of pancreatitis. These women require counseling for

diet, exercise, and weight management before becom-

ing pregnant and should be monitored closely during

their pregnancies.

Research and general acceptance

Though it is unclear if elevated triglycerides inde-

pendently contribute to cardiovascular disease, they

have been associated with multiple conditions that

contribute to diabetes and metabolic syndrome X.

After much debate, consensus is emerging among

medical experts that lowering elevated triglycerides is

beneficial. For a long time, triglycerides were over-

shadowed by other blood lipids, especially by LDL,

the ‘‘bad cholesterol’’, previously considered more

important than triglycerides as a contributing factor

to cardiovascular disease. In 1994, a study published

in the American Heart Association’s journal Circula-

tion reported that LDL seemed to be masking arterial

damage caused by triglyceride-rich VLDL and IDL.

The study found that despite aggressive treatment of

the LDL, patients with high triglyceride levels contin-

ued to suffer damage to arterial walls. Another report,

in the New England Journal of Medicine HealthNews,

described a Danish study involving 3,000 healthy men

which concluded that the risk of having a first heart

attack was twice as high in the men with the highest

triglyceride levels, compared to those with the lowest

levels. The connection between high triglycerides and

heart disease is now established. However, some uncer-

tainty remains concerning therelationship between tri-

glycerides and HDL, the ‘‘good cholesterol’’. It has been

observed that whenever triglycerides are increased,

HDL cholesterol decreases.Researchers are still inves-

tigating whether the increased risk associated with high

triglycerides is due to the triglycerides themselves, or to

QUESTIONS TO ASK YOUR

DOCTOR

 What is hypertriglyceridemia?

 What causes hypertriglyceridemia?

 What type of hypertriglyceridemia do I have?

 Can it be cured?

 How is it treated?

 How serious is this condition?

 How effective is diet in controlling

hypertriglyceridemia?

 What are some simple steps for reducing

triglyceride levels in my diet?

 Are there foods that should be avoided?

 Are there foods that are recommended?

 Should I get help from a dietician to prepare an

eating plan?

Hypertriglyceridemia