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Staying Alive: Triglycerides 101

March 22, 2010
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Triglycerides?

Triglycerides are fats carried in the blood from the food we eat. Most of the fats we eat, including butter, margarines and oils, are in triglyceride form. Excess calories, alcohol or sugar in the body are converted into triglycerides and stored in fat cells throughout the body.

How are triglycerides different from cholesterol?

Triglycerides and cholesterol are both fatty substances known as lipids. But triglycerides are fats; cholesterol is not. Cholesterol is a waxy, odorless substance made by the liver that is an essential part of cell walls and nerves.

Cholesterol also plays an important role in body functions such as digestion and hormone production. In addition to being produced by the body, cholesterol comes from animal foods that we eat.

Pure cholesterol cannot mix with or dissolve in the blood. Therefore, the liver packages cholesterol with triglycerides and proteins in carriers called lipoproteins to transport it to sites throughout the body. An elevated triglyceride level increases the risk of heart disease.

When are triglyceride levels measured?

Triglyceride levels are usually measured whenever you have a blood test called a Lipid Profile. Everyone over age 20 should have their cholesterol checked at least every 5 years. Your health care provider can check your cholesterol and triglyceride levels by taking a sample of blood, which is sent to a lab for testing. The Lipid Profile shows your triglyceride level, total cholesterol level, HDL cholesterol (high-density lipoprotein or “good” cholesterol) and LDL (low-density lipoprotein or “bad” cholesterol) levels.

Following a meal, blood triglyceride levels are normally high. For an accurate reading, blood samples for a triglyceride test should be taken after a 12-hour period of not eating or drinking. Many other factors affect blood triglyceride levels including alcohol, diet, menstrual cycle, time of day and recent exercise.

What are the guidelines for triglyceride levels?

Guidelines for triglyceride levels in healthy adults are:

  • Normal: Under 150 mg/dl

  • Borderline High: 151– 200 mg/dl

  • High: 201 – 499 mg/dl

  • Very High: 500 mg/dl or higher

How can triglycerides be lowered?

If you have high triglycerides, you may be able to reduce them without medication by following the guidelines listed in this handout which include following a low-sugar and low-fat diet, as well as limiting your alcohol intake.

People who have high triglycerides and low HDL or high LDL levels may require medications as well as diet modifications. Patients with triglycerides in the very high range (over 500 mg/dL) generally will require medications, because triglyceride levels this high may cause other medical problems.

How do foods affect triglyceride levels?

Consuming foods high in simple sugars significantly contributes to high triglycerides. Follow these guidelines to limit simple sugars in your diet:

  • Substitute beverages like colas, fruit drinks, iced tea, lemonade, Hi-C and Kool-Aid with artificially sweetened beverages labeled “sugar-free” or “diet.”

  • Limit hard candies, chocolates, candy bars and gummy bears.

  • Avoid adding table sugar and brown sugar to hot and cold cereals. Instead, substitute Equal, Splenda, Sweet-n-Low, Sugar Twin or Brown Sugar Twin

  • Choose sugar-free gum or mints instead of the regular versions.

  • Try light or low-sugar syrups on pancakes and waffles.

  • Spread breads and crackers with no-sugar-added jelly or preserves.

  • Snack on whole fruit instead of fruit roll-ups and other fruit-flavored treats.

  • When selecting cereals, limit the sugar to no more than 8 grams per serving.

  • Try sugar-free gelatin and puddings instead of their regular versions.

  • Choose low-sugar cookies and other desserts. Remember, these foods are not calorie-free and may contain cholesterol-raising fats.

  • Be aware that desserts labeled “fat-free” usually contain more sugar and equal calories than the full-fat varieties.

  • Regulate your intake of cookies, pastries, pies, cakes and granola bars. All of these foods contain high levels of added sugar; choose them sparingly.

  • Reduce your intake of ice cream, frozen yogurt, sherbet, gelato, and flavored ices – all contain high levels of sugar.

  • Limit your daily sugar intake to no more than 8% of your total calories each day. That’s 24 grams for someone following a 1,600-calorie diet, or 40 grams for a 2,000-calorie diet.

  • Read the ingredients list on food labels, and limit foods that contain any of the following words (all simple sugars) as the first few ingredients:

    • Sucrose

  • Glucose

  • Fructose

  • Corn syrup

  • Maltose

  • Honey

  • Molasses

  • Especially High-fructose corn syrup

Naturally occurring sugars, when eaten in excess, can also raise your triglyceride level.

Follow these guidelines to help limit natural sugars:

  • Use honey and molasses sparingly – they are both high in sugar

  • Choose light yogurt (which use artificial sweeteners) instead of regular yogurt

  • Choose whole fruit instead of fruit juice
    Limit the serving size of dried fruits to ¼ cup per day; dried fruits contain a more concentrated source of sugar

  • Choose canned fruit in its own juice and strain before eating; avoid canned fruits packed in heavy syrup

  • Limit your portion sizes of mashed potatoes, yams, beans, corn and peas to ½ cup; limit baked potatoes (with skin) to about 3 ounces. Although these starchy vegetables are a great source of fiber and nutrients, they can contribute to high triglycerides when eaten in excess.

Highly refined breads, cereals, rice, pasta and crackers convert to sugar in the body much more quickly than whole-grain varieties, which may increase your triglyceride level.

To limit refined grains:

  • Choose breads, crackers and cereals that contain whole grain oats, barley, corn, rice or wheat as the first ingredient. Avoid the words “bleached” and/or “enriched” as the first ingredient.

  • Try whole wheat pasta or brown rice.

  • Choose breads, crackers, rice and pasta with 2 or more grams of dietary fiber per serving.

  • Select hot and cold cereals with 5 or more grams of dietary fiber per serving.

  • Use barley, bulgur, couscous, millet or wheat berries as a side dish.

  • Try whole wheat crackers with soup instead of saltines.

Watching your overall portion size of grain-based foods is a key component to triglyceride control.

Below are examples of a single serving size:

  • 1 slice of bread

  • 2 slices of reduced-calorie bread

  • ½ hot dog or hamburger bun

  • ½ English muffin

  • ½ bagel (1 ounce)

  • 1 oz most cold cereals (¼ to 1 cup)

  • 2 graham crackers

  • ¾ matzoh cracker

  • 4 slices melba toast

  • 3 cups popped light popcorn

  • 2 to 6 baked whole-wheat crackers

  • ½ cup cooked cereal (including oatmeal, oat bran, cream of wheat)

Alcoholic beverages are a significant contributor to elevated triglyceride levels. Beer, wine, spirits, mixed drinks, wine coolers and coffee drinks containing alcohol are all examples. Men should not exceed 2 drinks per day, and women should limit to their intake to one drink per day.

One serving is equal to: 1.5-ounce spirits, 3 ounces wine or 12 ounces beer. Keep in mind that these are general guidelines. If you have elevated triglyceride levels, it is recommended that you consume fewer to no alcoholic beverages per day.

Excessive intake of dietary fats, especially saturated and trans fats, can increase your triglycerides. However, reducing dietary fat too much may mean you are getting too much sugar in the diet. If you have high triglycerides, follow these dietary guidelines to reduce dietary fat:

  • Limit your total fat intake to 30 to 35% of your total daily calories

  • Limit saturated fat to 7% of your total daily calories

  • Try to avoid high trans fat foods

  • Limit dietary cholesterol to 200 mg daily

  • Choose monounsaturated and polyunsaturated fats (such as canola and olive oils) most often

  • See your dietitian or clinician for more information on determining your daily fat limit.

Here are some other ways to help lower triglycerides:
  • Eat fewer calories (through portion control) if you need to lose weight

  • Eat small, frequent meals and do not skip meals

  • Avoid late-night snacking

  • Lose weight if you are overweight

  • Participate in regular physical activity

Omega-3 Fatty Acids

Some foods have been found to be very powerful at lowering triglycerides when you also follow the other guidelines in this handout. The fat found in fish, called omega-3 fatty acids, can help to lower triglyceride levels in many people.

To obtain the amount of omega-3 fat that is needed to lower triglycerides, your physician may recommend that you purchase a fish oil supplement. However, ask your physician first. To get more omega-3 fats in your diet, choose two or more meals of fatty fish each week (such as mackerel, salmon, sardines, tuna, tilapia) or include plant-based forms of omega-3 in your diet, such as soy foods, canola oil, flax seeds and walnuts.

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