Manage Triglycerides for a Healthy Heart

A recent nationwide survey found that around 35 percent of men and 25 percent of women in the U.S. have high blood triglyceride levels (hypertriglyceridemia). Like high LDL (bad) cholesterol levels, high triglyceride levels are associated with increased risk of heart disease, heart attack, and stroke.

Dietary and other lifestyle changes can help keep your levels in a healthy range.

Triglycerides 101. Triglycerides are a form of fat used to store energy in the body. Although we get some triglycerides from the foods we eat, the body converts excess calories we consume from any source into triglycerides. Habitually taking in more calories than your body needs can lead to high levels of triglycerides in the blood. Calories from refined carbohydrates and sugars are especially associated with high triglyceride levels.

Consistently high blood triglyceride levels may exacerbate the development of atherosclerotic plaque, which raises the risk of stroke and heart attack. Extremely high levels can lead to pancreatitis.

Along with large waist size, high blood pressure, high blood sugar, and low HDL (good) cholesterol levels, high triglyceride levels are a component of metabolic syndrome (a cluster of conditions associated with the development of cardiovascular disease and type 2 diabetes).

Risk factors for high triglyceride levels include obesity, a genetic predisposition known as familial hypertriglyceridemia, and type 2 diabetes. “People with diabetes will have elevated triglycerides, so it’s important to focus on and screen for diabetes, as treatment of diabetes will lower triglyceride levels,” says Gordon Huggins, MD, cardiologist and director of the Molecular Cardiology Research Institute (MCRI) Center for Translational Pharmacology and Genomics at Tufts Medical Center.

There are usually no symptoms of high triglyceride levels, so you’ll need a blood test to detect any problems. Triglyceride levels are typically checked along with cholesterol levels as part of a blood test called a lipid panel. (For triglyceride levels to be used to determine elevated disease risk, the blood test must be conducted after an eight to 12 hour fast.) A fasting triglyceride level higher than 150 milligrams per deciliter (mg/dl) suggests increased risk for coronary heart disease, stoke, atherosclerosis, and vascular diseases. “There is a gradient,” Huggins says. “One hundred fifty is the threshold when you start to think about health risks increasing.”

The risk of developing high triglyceride levels increases with age. A healthcare provider might recommend more frequent testing for older adults, smokers, people with overweight, obesity, diabetes, or kidney, liver, or thyroid disease, and those with a family history of high triglyceride or cholesterol levels. Drinking too much alcohol and taking certain medications may also increase risk for high triglycerides.

How to Lower Triglycerides. Healthy lifestyle choices can help lower triglyceride levels. In addition to any necessary weight loss, regular physical activity and dietary changes are essential. Within a dietary pattern that includes plenty of fruits, vegetables, whole grains, nuts and seeds, legumes, low-fat dairy, and lean proteins, Huggins suggests a focus on reducing refined carbohydrate intake. “Many people don’t realize that carbs are a source of triglycerides, they think only fat is,” says Huggins.

Healthy, simple dietary swaps can be especially helpful for preventing and treating high triglyceride levels:

• Be Carb Conscious: Choose whole grains and foods made with them (such as oatmeal, quinoa, and whole wheat pasta) instead of refined carbohydrates like white bread and white pasta.
• Skip Added Sugars: Choose naturally sweet foods and look for foods with little or no added sugars when choosing packaged foods.
• Choose Healthy Fats: Opt for monounsaturated and polyunsaturated fats—found in plant oils, nuts, and fatty fish like salmon and tuna.
• Limit Alcohol: Swap out libations, which are high in ethanol and sugar (both of which are rapidly converted to triglycerides) with water, non-alcoholic seltzer, or unsweetened iced tea.

In addition to healthy lifestyle changes, your healthcare provider may recommend medication, such as statins, fibrates, niacin, or prescription omega-3 fatty acids (not over-the-counter fish oil supplements, which are not regulated by the Food and Drug Administration).

Taking steps to manage your triglyceride levels is a heart-healthy choice.