Good and bad cholesterol. Saturated and unsaturated fat. Sometimes it seems like you need a program to keep track of all the fat players in the story of heart disease.
Triglycerides may be the easiest to understand.
Simply put, they are fat in the blood. They are used to give energy to your body. If you have extras, they are stored in different places in case they are needed later.
A high level of triglycerides has been linked to a greater chance for heart disease. But just what your own level means and how much it helps to lower it is sometimes less clear.
You and your doctor have ways to lower your level if it is running high.
What Are Triglycerides?
They are important to life and are the main form of fat -- they are sometimes called “lipids” -- in the body. When you think of fat developing and being stored in your hips or belly, you're thinking of triglycerides.
They are the end product of digesting and breaking down fats in food. Some are made in the body from other energy sources, such as carbohydrates. When you’re between meals and need more energy, your body’s hormones release them so you tap those unused calories.
What Causes High Triglycerides?
There are a number of things that can cause your triglyceride levels to be higher than they should be:
- Regularly eating foods that are high in fat or sugar
- Carrying extra weight or having obesity
- Not getting enough exercise
- Tobacco use
- Drinking large amounts of alcohol
- Some genetic disorders that affect how the body breaks down lipids
- Thyroid diseases
- Type 2 diabetes that isn’t well controlled
- Liver or kidney diseases
- Certain medicines, including those that treat HIV, breast cancer, and sometimes high blood pressure
How Are Triglycerides Measured?
Your doctor may give you a common test called a lipid panel. It checks for different types of cholesterol, including the levels of the "good" kind and the "bad" kind. The American Heart Association recommends that everyone 21 and older get a lipid panel at least every 5 years.
The levels are checked after an overnight fast. Fat from a recent meal can muddy the picture.
These tests are important because you rarely have any symptoms when your triglycerides are high, unlike with many other conditions.
What Are Normal and High Triglyceride Levels?
The National Cholesterol Education Program sets guidelines for triglyceride levels:
- Normal levels: Less than 150 milligrams per deciliter
- Borderline high: 150 to 199
- High: 200 to 499
- Very high: 500 or more
Elevated levels may lead to heart disease, especially in people with low levels of "good" cholesterol and high levels of "bad" cholesterol. The same is true if you have type 2 diabetes.
Experts once debated how important triglycerides are, but it now seems clear that higher levels are linked to problems such as heart disease.
One thing is clear, though: A good diet and exercise plan can lower triglyceride levels, improve cholesterol, and decrease the chance of heart disease.
What Can You Do at Home to Treat High Triglycerides?
The main way to deal with high triglycerides is to eat better and get more exercise. Here are some guidelines to help you manage your level:
Moderate exercise. Try to exercise 5 or more days each week. Lack of movement makes it hard for your body to process blood sugar and triglycerides as it normally does. So it’s important for you to get up and get moving more each day. Skip the escalator or elevator and climb stairs. Get off the bus or subway one stop early and walk. Find activities you enjoy: Walk, swim, or ride a bike. Join a gym. Talk to your doctor before you begin any exercise plan.
Watch your weight. If you’re carrying extra pounds, losing 5% to 10% of your weight can lower triglycerides. People with a healthy weight are more likely to have normal levels. Belly fat is associated with higher numbers.
Eat foods with fewer carbs and less saturated fat. Try to lower the saturated fat, trans fat, and cholesterol in your diet. Cutting back on carbohydrates will help, too. Foods high in saturated fat, such as red meat, boost levels. Butter and cheese contain these same triglyceride-boosting fats. Choose lean meats or protein alternatives, such as chicken and unprocessed turkey, that are lower in saturated fat.
Another healthy option: Make meatless meals. Vegetarian pastas, chilis, and stir-fries are a delicious alternative to meat dishes. Avoid dishes loaded with cream or cheese in favor of recipes that use vegetable or olive oil and feature plenty of vegetables.
Carbs that are “white foods” -- like pasta or bread made with white flour or semolina -- can raise triglyceride levels. So can starchy foods like white rice and potatoes.
Whole-grain pasta is a great alternative, especially for bold sauces. Look for a tasty whole-grain bread for sandwiches. And eat brown rice instead of white rice. It has a rich flavor that's perfect for making stir-fry. Instead of white potatoes, try grains like quinoa and barley.
Drink less alcohol. Beer, wine, and liquor can raise levels. Some studies show that more than 1 drink a day for women or 2 for men can increase levels by a lot. If you’ve cut back and your triglyceride levels aren’t going down enough, your doctor may recommend skipping alcohol altogether.
Eat fish. Mackerel, lake trout, herring, sardines, albacore tuna, and salmon are high in omega-3s, a fat that’s good for you. It may be hard to get enough omega-3s from food. Your doctor may recommend a supplement or prescription. Make sure your fish is prepared in a healthful way. Frying fish uses a lot of added oil -- the unhealthy type, with saturated fat. That fat overpowers the healthier fat found in fish, omega-3 fatty acids, which helps keep triglycerides down.
Instead, choose fatty fish such as salmon, freshwater trout, or tuna, which are especially rich in omega-3s, then grill or broil them. Look for recipes with flavors you like. If you’re still having trouble tempting your taste buds (not everybody likes fish, after all), take heart. Walnuts, flaxseed, soy products, and dark greens are good sources of triglyceride-lowering omega-3s.
Drink more water. Sugar and fructose -- which are used as sweeteners in soda, sweet tea, or fruit juices -- can raise triglycerides. The extra calories in sugary drinks can also make you gain weight, which puts added strain on your heart and contributes to cholesterol and triglyceride levels.
Water is the most convenient and inexpensive thirst quencher around. To add some zing, squeeze lemon or lime in sparkling water. Leave the sugar out of your tea and try one flavored with herbs, spices, or flowers.
Check the portion size. Very large meals can send your triglyceride level into the danger zone. Spikes are dangerous because they can increase your risk of a heart attack. Divide your usual serving in half. At home, cook the usual amount but serve only half. At restaurants, divide your meal into smaller portions. Eat slowly to give your body time to figure out that you're full. Get another helping only if you're still hungry. If you feel satisfied, pack away what's left to enjoy later.
Don’t skip meals: Maybe you're too busy to eat. Maybe you think you'll lose weight if you skip a meal. The problem: You're likely to get so hungry later that you'll grab anything, healthy or not. Or you overeat at the next meal, which causes triglyceride levels to jump. It’s better to eat sensible-sized meals a few times a day. Enjoy breakfast, lunch, and dinner and stick to recommended serving sizes. Have healthy snacks like nuts, fruit, or carrot and celery sticks around when hunger strikes.
Quit smoking. When you have high triglycerides, heart disease is a major concern. If you smoke, your risk of heart disease dramatically increases. Make up your mind to quit. If you need help, talk to your doctor. When you’re ready, take action. Choose a date to give up your habit. Get support from friends and family. Buy sugar-free gum and low-calorie snacks to reach for instead of cigarettes. Talk to your doctor about medications that may help you quit. Find a local support group. Stay committed -- you’ll kick cigarettes to the curb and add years to your life.
Medications for High Triglycerides
For some people, good habits may not be enough. Medication might be needed. The decision for you and your doctor can be complicated because other health conditions are usually involved. Several types of medicine can improve levels. They include:
- Fibrates (Fibricor, Lopid, and Tricor)
- Nicotinic acid (Niaspan)
- High doses of omega-3s are needed to lower triglycerides and should be taken only under a doctor's care. Epanova, Lovaza, and Vascepa are prescription forms of omega-3s.
Your doctor may also prescribe a class of drugs called statins that lower cholesterol. Examples include atorvastatin (Lipitor), rosuvastatin (Crestor), and simvastatin (Zocor).
Like all medicines, triglyceride treatments can have side effects. You may feel:
Some medication can have an aftertaste.
Medicine affects people differently, so keep trying until you find the one that works best for you. It is possible that lifestyle changes alone will be the best approach. If you don’t like how your medicine makes you feel, tell your doctor. It may be possible to switch to another drug or adjust your dose.
If you follow your treatment plan carefully, you could see start to see a drop in your triglycerides within a few weeks. Stay positive and focus on the goals you and your doctor have set. You’ll get there!