Triglycerides – The Final Piece to the Heart Disease Puzzle

Since February is National Heart Disease month and we’ve already covered quite a few topics surrounding heart disease, it is time to look at the last topic in the series. But before we do that, let’s look back at what we have learned. First we reviewed the top myths surrounding women and heart disease – emphasizing that it’s no longer just “a man’s disease.” Second, we discussed tips to prevent heart disease. Third, we covered what you need to know about your blood pressure. Fourth, we delved into the good, bad and ugly about cholesterol – making a big distinction between LDL, or“ bad” cholesterol, and HDL, “good” cholesterol. Now let’s look at the final piece of the puzzle – Triglycerides!

In my office, I’m frequently asked when reviewing a patient’s lipid profile, “What’s the difference between my triglyceride level and my cholesterol level, and does it even matter?”

Both triglycerides and cholesterol are lipids – they don’t dissolve in our bloodstream – meaning they are not water soluble – so they are attached to certain proteins to be transported through our bodies. Technically, triglycerides are fats, whereas cholesterol is not a fat. Cholesterol is a waxy substance made by the liver and is used for important body functions, like processing Vitamin D and digestion and making certain hormones, such as estrogen and testosterone. Cholesterol also comes from two sources, your body’s own production (liver) and external food sources which are mostly animal sources like beef, pork, etc. Triglycerides, on the other hand, come only from the food that we eat.

After we eat a fatty meal, triglycerides are absorbed and circulate through our bloodstream. They are then converted to and stored as fat. Triglycerides are used for energy and are potentially burned off. If we eat too many calories or don’t burn off enough energy, the excess triglycerides will be stored as fat.

It is easier to reduce your triglyceride level than your LDL (or bad) cholesterol level. Eating less carbohydrates and processed foods will markedly reduce your triglyceride level but not have as much impact on your LDL level. Remember that your liver produces its own cholesterol, so it’s harder to control these levels.

Here’s a Chart That Breaks Down Triglycerides:

How do I Know if My Levels are High?

A simple blood test called a lipid panel checks your cholesterol, can reveal whether your triglycerides levels are healthy or unhealthy. Triglycerides are measured in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L)

Normal Triglyceride Levels: Less than 150 mg/dL (less than 1.7 mmol/L)
Borderline high Triglyceride Levels: 150 mg/dL to 199 mg/dL (1.8 mmol/L to 2.2 mmol/L)
High Triglyceride Levels: 200 mg/dL to 499 mg/dL (2.3 mmol/L to 5.6 mmol/L)
Very high Triglyceride Levels: 500 mg/dL and higher (5.7 mmol/L and higher)

Ever wonder how the total cholesterol number is calculated? I saved this secret until now because I needed to explain triglycerides to you before sharing it. Remember, fast for 10-12 hours before getting your labs done.

LDL level + HDL level + 20% of your triglyceride level = Total Cholesterol

One of my patients, Jackie, recently came in for her lipid panel. Her numbers were:

LDL = 120, HDL = 70, TG’s = 160. To calculate her cholesterol level, here is the equation in action:
120 (LDL) + 70 (HDL) + 0.2 (160 TGs) = 222 Total Cholesterol.

Jackie asked, “Gosh my total cholesterol is high and so are my triglycerides, what’s causing this?” I told her how diet is very important. “You mean, those chocolate chip cookies and the salty caramels that I eat at night are making my triglycerides high?” Yes! That is part of it. I gave her this quick tip: Start by cutting out unhealthy carbs and replacing them with healthy and more nutrient-dense carbs– like fresh fruits and vegetables.

She moaned and said, “I guess I’ll have to cut out the potato chips too then.”

A few of my patients have very high triglyceride levels despite eating a very healthy diet and following a rigorous exercise program. They have a condition known as familial hypertriglyceridemia, a hereditary condition that is passed down in families. Usually medication is needed to treat this condition.

Finally, we have all of the pieces of the puzzle together:

• Blood Pressure – measured with systolic/diastolic numbers, if too high leads to hypertension
• High cholesterol – remember, we want LDL low and HDL high
• Triglycerides: Can be lowered by dietary changes

Calculate your 10-year risk of heart disease or stroke (http://www.cvriskcalculator.com/) using the ASCVD algorithm published in 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk.

Note that this calculator is estimating your risk of developing stroke or heart attack within the next 10 years. It is not for those who have already have heart disease, are less than 20 years of age or older than 79. I do want to emphasize that this is for informational reasons only. Always consult with your doctor before starting or stopping any medication.

Please share this valuable information with your friends, family and others who may benefit from my blogs. You may be saving someone’s life – maybe even your own!

In Health & Wellness,

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