Triglycerides: How to Keep Them in Check

Triglycerides are a type of fat (lipid) found in the blood. When we eat, our body converts any calories it doesn't need to use right away into triglycerides. The triglycerides are stored in the fat cells, which are later released by hormones for energy between meals. According to Dr. Ritika Samaddar, Dietician at Trinayan healthcare, "If you are consuming too much sugar in your diet, there is a possibility that your triglyceride levels can be high. Your body has the tendency to convert the excess sugar into triglycerides and then store them as fat".

Let’s delve deeper.

What are Triglycerides?

Triglycerides are fats (lipids) that account for 99% of the fat stored in the body. It is an ester formed from glycerol and three fatty acid groups. To tackle the problem, we should understand

triglycerides' meaning. When we eat, our bodies use some calories for various activities. The rest of the calories are stored in the body in the form of triglycerides to utilize later if the body needs them.

If we regularly eat more calories than we burn, particularly "easy" calories such as those from sugary beverages and high-fat foods, it may lead to high triglycerides, a condition known as “hypertriglyceridemia”. High triglycerides combined with high LDL (bad) cholesterol or low HDL (good) cholesterol can increase the risk of heart attack and stroke.

Rarely very high triglycerides levels (usually >500) can cause severe pancreatitis which is a medical emergency and needs urgent intervention.

What are Normal and High Triglyceride Levels?

Triglycerides, up to a certain level, are normal, but their excess quantities might increase your chances of various lifestyle diseases. The below table states different triglyceride quantities in milligrams per deciliter (mg/dL).

Category Triglyceride Level (mg/dL)

Normal Less than 150

Borderline High 150 - 199

High 200 - 499

Very High 500 and above

To summarise, a normal triglyceride level should be less than 150 mg/dl of blood; they are closely associated with HDL (good cholesterol) and factors that help in lowering cholesterol. Any triglyceride level of 200 mg/dl of blood is considered high. That said, it is not uncommon to see elevated triglyceride >200 and low HDL (less than 40 for men, or less than 45 for women) occur together.

What are the Best Ways to Reduce Triglycerides?

Dietary recommendations

Avoid sweetened foods: Simple sugars are the primary ingredient of triglycerides and hence excess intake of sweets or drinks can raise triglycerides. Eliminate intake of food items loaded with sugars like cookies, pastries, sweet desserts, and fruit juices.
Choose whole grains over refined: Intake of refined cereals such as white rice, bread, pasta made from white flour, or cornflakes can significantly raise triglycerides in sensitive individuals. Instead, choose whole grains such as multigrain chapati, and other grains such as quinoa, barley, and millet.
Choose fish instead of red meat: Swap out red meat for fatty fish such as salmon, mackerel, trout, and sardines. These fish are rich in omega-3 fatty acids, which have been shown to lower triglyceride levels. Aim to include fish in your diet at least twice a week to reap the cardiovascular benefits.
Eat nuts and greens: Incorporate more nuts and leafy greens into your meals. Nuts such as almonds, walnuts, and pistachios are high in healthy fats, fibre, and antioxidants, which can help lower triglycerides. Similarly, leafy greens such as spinach, kale, and Swiss chard are nutrient-dense and low in calories, making them excellent food choices.
Eat more plant foods: Vegetable proteins such as beans, peas, nuts, and lentils are excellent ways to improve your health and will have a direct effect on lowering your triglycerides and cholesterol.
Choose high-fibre foods: Foods high in fibre will help to control your triglycerides and LDL ("bad") cholesterol. Consume beans, whole grains- Oats, Quinoa, brown rice; Nuts and seeds -Almonds, chia seeds, flaxseed; fruits and vegetables. Drink more water with an increase in fibre.
Limit trans fats: The primary dietary source of trans fats in processed food is "partially hydrogenated oils" which are found in fried foods like doughnuts, and baked goods including cakes, pie crusts, biscuits, cookies, margarine, and other spreads.
Eat healthy oils: Increase intake of MUFA-rich oils to lower the triglycerides levels. Replace saturated fats like butter, ghee, shortening, lard, or margarine with MUFA-rich oils like canola oil, rice bran, and soybean oil.
increase the intake of unsaturated fats: Replace saturated and trans fats with healthier unsaturated fats, such as those found in olive oil, avocado, nuts, and seeds. Unsaturated fats can help improve cholesterol levels and reduce triglycerides.
Establish a regular meal pattern: Maintain a consistent eating schedule by eating meals and snacks at regular intervals throughout the day. This can help stabilise blood sugar levels and prevent spikes in triglycerides that may occur with irregular eating patterns.
Add soy protein to your diet: Incorporate soy-based foods such as tofu, tempeh, edamame, and soy milk into your meals. Soy protein is a plant-based alternative to animal protein that can help lower triglyceride levels and improve heart health.
Choose foods rich in omega-3 fatty acids (the "good" fats): Omega 3 fatty acids have been shown to significantly reduce the elevated triglycerides level. Hence include foods high in omega-3 fatty acids such as fatty fish (salmon, mackerel, sardines, tuna, trout), flax seeds, flaxseed oil, Almonds, and legumes.
Drink enough water: Stay hydrated by drinking plenty of water throughout the day. Water helps support overall health and may aid in digestion, metabolism, and the elimination of waste products from the body.

General recommendations

Maintain a healthy weight: You may be surprised to discover that a modest weight loss of 5-6 kg can reduce your triglycerides, and cholesterol level, and decrease your risk of heart disease. Eat a healthy diet to lose weight and prevent lifestyle diseases like diabetes, CVD, etc.
Exercise regularly: Exercise will increase HDL cholesterol and burn off excess triglycerides. Weight-bearing activity, in particular, increases muscle mass and raises your metabolic rate. This will help your body burn more carbohydrates, leaving less storage for triglycerides.
Quit smoking: Smoking can raise triglyceride levels and increase the risk of cardiovascular disease. Quitting smoking can help lower triglycerides and improve overall health.
Limit or quit alcohol: Drinking alcohol raises triglyceride levels. For people who are sensitive, a small amount of alcohol can trigger it.

What are the Medications for High Triglycerides?

If lifestyle changes alone are not sufficient, several medications may be prescribed to help lower high triglyceride levels. Common medications for high triglycerides include:

Statins: Statins are a class of medications that primarily work by lowering LDL (bad) cholesterol levels but can also modestly reduce triglycerides. Examples include atorvastatin, simvastatin, and rosuvastatin.
Fibrates: Fibrates are another class of medications that are specifically effective at lowering triglyceride levels. They work by reducing the liver's production of triglycerides and increasing the removal of triglycerides from the bloodstream. Examples include gemfibrozil and fenofibrate.
Omega-3 fatty acid supplements: Omega-3 fatty acids, found in fish oil supplements, can help lower triglyceride levels, particularly in high doses. They work by reducing the liver's production of triglycerides and may also improve triglyceride clearance from the bloodstream.
Bile acid sequestrants: Bile acid sequestrants are medications that primarily work by binding to bile acids in the intestine, which reduces cholesterol absorption and may also modestly lower triglyceride levels. Examples include cholestyramine and colesevelam.
Prescription fish oil: In some cases, high doses of prescription-strength fish oil may be prescribed to help lower triglyceride levels, particularly in individuals with very high triglycerides. These medications contain concentrated amounts of omega-3 fatty acids.
For extremely elevated levels, sometimes patient need to be admitted and insulin is administered for rapid decline in levels.

It's important to note that medication should be used as directed by the doctor, and in conjunction with lifestyle changes. As medication choices are individualised, it's essential to consult with a healthcare provider to determine the most appropriate treatment plan.

Checkout: 25 foods and 7 days diet to lower triglycerides. At Very Below of this page

Final words

Managing high triglycerides requires a comprehensive approach that includes lifestyle modifications, dietary changes, and, in some cases, medication. By incorporating healthy habits such as regular exercise, a balanced diet rich in fruits, vegetables, and omega-3 fatty acids, and maintaining a healthy weight, individuals can effectively lower triglyceride levels and reduce their

risk of cardiovascular disease. However, those who may need additional support or guidance in managing their triglycerides may consult a specialist at Trinayan Hospitals to receive personalised care and treatment options.

Frequently Asked Questions

1. What is the Fastest Way to Lower Triglyceride?

Avoiding sweetened drinks is one of the first things a person should do to reduce triglyceride levels. Exercising regularly will further speed up the process.

2. What Foods Decrease Triglycerides?

Eating a vegetable diet, using MUFA-rich oil substitutes like Canola oil, and incorporating fatty salmon, flax seeds, almonds, etc., will help lower your triglyceride levels.

3. How Long Does it Take for Triglyceride Levels to Lower?

According to a review published in the May 2012 edition of the journal Molecular and Cell Biology of Lipids, visible results can be seen within 1 month of consuming fish liver oils.

4. Do Eggs Raise Triglycerides?

Yes. Eggs contain saturated and trans-fats, which can increase triglyceride levels considerably. Hence, people with high triglyceride levels should avoid eggs.

25 Foods to Lower Triglycerides Level in 7 Days

The most common type of fat in the human body, Triglycerides play a crucial role in metabolism and energy storage. They are formed when the body combines glycerol and three fatty acids, and serve as a crucial energy source. They can be obtained from the foods we eat or can also be produced within the body. Normally, the level of triglycerides should be less than150 mg/dl.

In the case of excess triglycerides, a condition formally called “hypertriglyceridemia”, they start getting stored in different body parts such as the belly, hip, and arms. Besides causing obesity, increased levels of triglycerides are also linked to heart diseases, especially in patients who have high levels of bad cholesterol (Low-Density Lipoproteins or LDL) and low levels of good cholesterol (High-Density Lipoproteins or HDL), as elevated triglycerides can contribute to the buildup of fatty deposits in artery walls, increasing the risk of heart disease and stroke.

Therefore, anyone who has a high level of triglycerides should take immediate steps, starting with regulating their diet and maintaining an active lifestyle.

What Causes High Triglycerides Levels?

High levels of triglycerides can be caused by various factors, including:

Unhealthy Diet: Consuming a diet high in saturated fats, trans fats, sugar, and refined carbohydrates can lead to elevated triglyceride levels. These dietary choices can promote the production and storage of excess triglycerides in the body.
Obesity: Being overweight or obese is strongly linked to higher triglyceride levels. Excess body fat, especially around the abdomen, can increase triglycerides in the bloodstream.
Physical Inactivity: Lack of regular physical activity can lead to weight gain and increased triglycerides. Exercise helps improve triglyceride metabolism and reduce their levels.
Alcohol Consumption: Excessive alcohol intake can raise triglycerides. It's recommended to limit alcohol consumption to moderate levels.
Genetics: In some cases, genetics play a role in high triglyceride levels. Familial hypertriglyceridemia is a genetic condition that leads to elevated triglycerides, even in the absence of other risk factors.
Metabolic Conditions: Conditions like diabetes and metabolic syndrome are associated with high triglycerides. Insulin resistance and high blood sugar levels can contribute to increased triglycerides.
Certain Medications: Some medications, such as corticosteroids, diuretics, and certain beta-blockers, can elevate triglyceride levels. Discussing potential side effects with your healthcare provider is important.
Medical Conditions: Underlying medical conditions like chronic kidney disease, liver disease, and thyroid disorders can impact triglyceride levels.
Smoking: Smoking is associated with higher triglyceride levels and an increased risk of cardiovascular disease.

To manage and lower high triglycerides, it's essential to address these underlying causes through lifestyle modifications, such as adopting a heart-healthy diet, engaging in regular physical activity, and, when necessary, using medication as prescribed by a doctor.

Preferred Amounts of Fats and Substances in Daily Diet

Omega 3-6 fatty acids account for 5% to 10% of your daily caloric intake.
Saturated fats should make up no more than 5% or 6% of your daily calorie intake. 2,000 calories a day.
Trans fats should not be more than 1 percent of daily calories intake.

25 Foods to Lower Triglycerides

Oats - Oats are rich in fibre. Fibre-rich food items take more time to digest, thus preventing a spike of blood sugar levels and causing less release of triglycerides, and forming an important part of the triglyceride diet.
Cauliflower - Cauliflower is rich in fibre and contains less carbs. Hence can be added to the diet liberally.
Blueberries - Blueberries contain less sugar, and more fibre and are full of antioxidants. You can use it as a topping for oatmeal, yoghurt, or make a smoothie.
Spinach - Spinach is a good source of vitamins and is also counted among the foods to reduce triglycerides. You can add it to stews, salads, and egg omelette preparation.
Bananas - Bananas can be a great substitute to satisfy your sugar cravings, and it also contains potassium - an important mineral. Eating bananas can also give you relief from gastric problems. It does not make gas in the stomach quickly.
Strawberries - Many people like strawberries because of its taste, but do you know that it has nutritional value and can even lower triglycerides?
Broccoli - Broccoli is yet another green vegetable that can lower triglyceride levels. You can have it by simply roasting it or adding it to soups.
Cabbage - It is included under cruciferous vegetables that reduce triglycerides and is rich in vitamin K. You can saute it with a few spices and enjoy the delicious and nutritious food.
Salmon - Salmon is fish rich in omega-3 fats. It helps manage triglycerides and is an excellent source of good protein.
Sardines - You might not like the taste of this fish, but you can spice it up with your favourite condiments. It is a good source of omega-3 fatty acids, calcium and protein.
Olive oil - Olive oil is a good source of healthy fat and antioxidants. You can add it to your salads or use it while cooking your veggies.
Beans and Legumes - Beans and legumes are great sources of protein and fibre. There are various options available for legumes so you won't get bored having them regularly.
Avocado - Avocado is a good source of good fat and fibre. Both fibre and good fat help regularise blood sugar levels and triglycerides levels.
Brown rice - A high carbohydrate diet can increase triglyceride levels, but brown rice helps decrease triglyceride levels. The American Heart Association recommends adding brown rice to your diet to control triglycerides.
Citrus fruits - Citrus fruits contain flavonoids and soluble fibres that increase the good cholesterol (HDL) and decrease triglycerides and bad cholesterol (LDL)
Nuts - Nuts contain monounsaturated fats, fibre and omega-three fatty acids that manage triglyceride levels.
Green beans - Green beans, also known as string beans, contain less sodium and more fibres that keep your heart healthy and control your triglyceride levels. You can blanch it or sauté it with some spices.
Low-fat dairy products - Low-fat dairy products such as milk and yoghurt help in managing triglycerides.
Quinoa - Quinoa is a gluten-free grain with high nutritional value and decreased triglyceride levels.
Barley - Barley is a grain that reduces bad cholesterol and triglycerides. It is rich in fibre, manganese, molybdenum, and selenium as a whole grain.
Arugula - Arugula is a vegetable that is low in carbohydrates, fat and calories. It is a good source of fibre and vitamin A and decreases triglycerides by blocking fat deposition in the liver and preventing the transportation of fat in the bloodstream.
Kale - You can include Kale in stews, soups, or sauté it with spices.
Brussels sprouts - Brussels sprouts are versatile vegetables that you can roast with a little olive oil or boil.
Raspberries - The juicy raspberries are high in antioxidants and low in fat; thus can be included in your triglyceride diet.
Grass-fed beef - Grass-fed beef contains omega-fatty acids and lowers triglyceride levels.

So these are the 25 foods to lower triglycerides. Now let's talk about a 7-day diet to lower triglycerides.

7-Day Diet to Lower Triglycerides

Remember, the low triglyceride diet mentioned below is just a sample. Every individual has different calorie demands. Consult your dietician to get a personalized plan of 7 days diet to lower triglyceride.

Week Days	Breakfast	Lunch	Dinner
Day 1	Classic oats with low-fat or plant milk, topped with berries and seeds.	Vegetable and lentil soup with whole-grain crackers.	Curry made with tofu, and butternut squash served over cauliflower rice.
Day 2	Poached egg with salmon and whole-grain rye toast.	Sardines in a whole grain wrap with a salad from the garden and an oil-based dressing.	Brown rice with a stir-fry of chicken and vegetables.
Day 3	Buckwheat pancakes with low-fat yoghurt and berries.	Avocado, spinach and tomato salad with black beans and quinoa.	Vegetable and bean chilli with a side of kale.
Day 4	Whole-grain cereal with plant or low-fat milk and fresh fruits.	Barley wrap with tomatoes, lettuce and tuna.	Grilled salmon or mackerel with brown rice and steamed vegetables.
Day 5	Poached eggs on whole-grain toast.	Chicken or tuna sandwich made with hummus,whole-grain bread and a garden side salad.	Grilled steak with mashed sweet potatoes and vegetables.
Day 6	Whole grain toast with avocado and smoked salmon or a hard-boiled egg	Chickpeas and quinoa over a green salad.	Barley, vegetable, and chicken soup with whole-grain crackers.
Day 7	Rolled oats with plant or low-fat milk and fresh fruits.	Garden side and sardine salad served on a whole grain bread roll.	Whole grain pasta with drained red kidney beans, tomato-based sauce, and a garden side salad.

Other Ways to Lower Triglycerides in Our Diet

Supplements to Lower Triglycerides

Soy protein supplements, garlic supplements, niacin and psyllium can help lower triglycerides.
Exercises to Lower Triglycerides

Basketball, bicycling, jogging, kickboxing and soccer are some exercises which can help in lowering triglycerides.

Symptoms of Hypertriglyceridemia

Hypertriglyceridemia often does not present with specific symptoms. It is typically diagnosed through a blood test during routine medical checkups. However, in some cases, especially when triglyceride levels are extremely high, individuals may experience the following symptoms:

Abdominal Pain: Severe abdominal pain can occur due to inflammation of the pancreas (pancreatitis), which is associated with very high triglyceride levels.

Fat Deposits: Some individuals with very high triglycerides may develop visible, fatty deposits on the skin, known as xanthomas.

Eruptive Xanthomas: These are small, yellowish, and sometimes itchy bumps that can appear on the skin.

As hypertriglyceridemia is often a silent condition, regular check-ups and blood tests are crucial for early detection and management.

Conclusion

To lower the triglycerides level, limit your sugar intake, follow a lower-carb diet, eat more fibre, exercise regularly, avoid trans fats, increase your intake of unsaturated fats and limit your alcohol intake.

Frequently Asked Questions about Triglycerides

1. What is the best drink to lower triglycerides?

Green tea and soy milk are the best drinks to lower triglycerides.

2. What foods raise triglycerides the most?

Bread, pizzas, pastries, pies, and cookies raise triglycerides the most.

3. What level of triglycerides is considered dangerous?

While the optimal level of triglycerides in the blood is generally considered to be less than 150 milligrams per deciliter (mg/dL), triglyceride levels are often categorized as follows:

Less than 150 mg/dL - Normal
150-199 mg/dL - Borderline High
200-499 mg/dL - High
500 mg/dL or more - Very High

4. How is triglyceride level measured?

Triglyceride levels are assessed as part of a lipid panel, which also includes measurements of total cholesterol, HDL (high-density lipoprotein) cholesterol, and LDL (low-density lipoprotein) cholesterol.

5. What foods cause high triglycerides?

Foods that are high in saturated and trans fats, such as fried foods, fatty meats, full-fat dairy products, and sugary items such as candies and sweetened beverages can lead to high triglycerides. Excessive consumption of alcohol and simple carbohydrates, such as white bread, can also raise triglyceride levels.

6. How to reduce triglycerides naturally with Indian food?

To reduce triglycerides naturally with Indian food, focus on a diet rich in fibre, whole grains, lean protein sources like lentils and tofu, and healthy fats from foods like nuts and seeds. Incorporate spices such as turmeric and garlic, which have potential heart-healthy benefits, and limit consumption of high-fat and sugary items like fried foods, sweets, and full-fat dairy. Regular physical activity and portion control are also essential for managing triglycerides.

7. When to consult a doctor for high triglycerides?

Consulting a doctor for triglycerides is advisable if:

The triglyceride levels are consistently high, especially if they exceed 200 mg/dL.
The person has additional risk factors for heart disease, such as high cholesterol, high blood pressure, obesity, or a family history of heart disease.
Persistent symptoms such as severe abdominal pain, which may be a sign of pancreatitis, which can be caused due to extremely high triglyceride levels.
You are unsure about how to manage your triglycerides through lifestyle changes or need guidance on medication options.

8. Which specialist to consult for high triglycerides?

Depending on their specific needs and circumstances, individuals can consult with several types of specialists to address and manage triglyceride levels. These include:

General Practitioner: A general practitioner can help monitor your triglyceride levels, provide initial guidance, and recommend lifestyle changes. They may also initiate treatment or refer you to a specialist, if necessary.
Cardiologist: If someone has elevated triglycerides and other risk factors for heart disease, it is advisable to consult a cardiologist for a comprehensive evaluation and treatment.
Endocrinologist: If high triglycerides are associated with an underlying medical condition such as diabetes or a hormonal disorder, it is advisable to consult an endocrinologist.
Gastroenterologist: In cases where extremely high triglyceride levels lead to pancreatitis, it is advisable to consult a gastroenterologist.
Registered Dietitian or Nutritionist: A registered dietitian can help you develop a personalised dietary plan to manage your triglycerides through healthy eating.

9. Can high levels of triglycerides cause death?

Extremely high levels of triglycerides, particularly those exceeding 1,000 mg/dL or even higher, can potentially lead to life-threatening complications such as acute pancreatitis. Such cases, however, are rare.

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