Why should Triglycerides be within normal limits?

Triglycerides are a type of fat found in the human body.  They come from the fats we consume and further, the body makes a large proportion of the triglycerides from the food we consume.

All the excess calories from the food, especially carbohydrates, that the body does not require immediately, are stored as triglycerides in the body. They are used  as energy to drive the body between meals. They are different from cholesterol which builds new cells and supports hormone function. But too much of a useful thing, may not be good for the body. Excess cholesterol and triglycerides both create various conditions that affect human health and contribute to disease.

What is Triglyceridemia?

Triglyceridemia is a condition in which there are excess triglycerides in the human blood. Triglycerides naturally increase after a meal, as per time of day, etc. But these are normal and short-lived surges. However, when high levels of triglycerides in the blood prevail over a long time, it is a cause for worry.

So, what are normal, and high levels of triglycerides? These would depend on the age of the person. These are detected during a blood test, or lipid profile test, and measured in milligrams per deciliters of blood or simply mg/dl.

	Adults (above 19 years of age)	10 to 19 year olds	Below 10 years of age
Normal	Under 150 mg/dl	Under 75 mg/dl	Under 90 mg/dl
Borderline high	151–199 mg/dl	75-99 mg/dl	90-129 mg/dl
High	over 200 mg/dl	Over 100 mg/dl	Over 130 mg/dl
Very high	over 500 mg/dl

Causes and Risk Factors

• Type 2 diabetes (insulin resistance) or prediabetes that is unmanaged
• Metabolic syndrome — which occurs when hypertension, obesity and high blood-sugar occur simultaneously, which is a big risk for heart disease
• Hypothyroidism or low levels of thyroid hormones
• Genetic conditions that affect how one’s body converts fat to energy
• A family history of high cholesterol
• Excessive alcohol consumption
• Obesity
• Liver disease or kidney disease
• Over-eating and binge-eating on a regular basis
• Menopause
• Cigarette smoking
• A diet high in sugar and simple carbohydrates
• Excess sugar intake, especially from processed foods with added sugars
• High intake of saturated fats
• Sedentary lifestyle or physical inactivity
• Inflammatory diseases, such as rheumatoid arthritis
• Pregnancy
• Taking certain medications, such as:
  • Corticosteroids
  • Diuretics
  • Estrogen and progestin
  • Beta blockers
  • Retinoids
  • Some immunosuppressants
  • Some HIV medications

Symptoms

Triglyceridemia does not reveal itself through symptoms. The condition is often detected during annual health checkups that include a lipid profile test, or when blood tests are done for other conditions.

Consequences and Complications

Triglyceridemia, if detected late or not treated on time, can cause various complications, some of which can be fatal.

• Arteriosclerosis: High triglycerides along with cholesterol result in plaque deposition on the inner walls of coronary arteries, which harden over time, leading to narrowed arteries and reduced blood flow. This condition increases the risk of stroke, heart attack and heart disease.
• Pancreatitis: Very high levels of triglycerides can cause acute inflammation of the pancreas which can be life-threatening.
• Carotid artery disease.
• Metabolic syndrome (a combination of high blood pressure, diabetes and obesity). This syndrome is a risk factor for Triglyceridemia in some people, while it’s a consequence for some people.
• Peripheral artery disease (PAD).
• Strokes
• Liver disease

Diagnosis

A Lipid Profile blood test, also called Total Lipid Profile, is conducted if Triglyceridemia is suspected. This test will provide a count of the following:

• Total cholesterol
• HDL (good) cholesterol
• LDL (bad) cholesterol
• Triglycerides
• cholesterol/HDL ratio
• non-HDL cholesterol

It is good to remember that in Indian population, high triglyceride levels go with low level of HDL, the vascular-protective cholesterol, creating a ‘ double whammy!”

Treatment

Treatment is a mix of medication and lifestyle changes.

• Medications: These help lower triglycerides or bad cholesterol and include statins, niacin, fish oil and fibrates.
• Exercise: Exercise helps burn down the excess triglycerides in addition to various other metabolic and health benefits. One should aim at 150 hours a week (or 30 minutes a day, 5 days a week) of moderate cardio exercises or 75 minutes per week of intense cardio. This includes jogging, swimming, cycling, calisthenics, yoga and a sport of your choice.
• Maintaining weight: While regular exercise can help reduce and maintain weight in the long-run, the person should explore other methods such as limiting portion sizes, having frequent light meals over a few large meals, intermittent fasting, etc.
• Healthy diet: Diet plays a huge role in reducing triglyceride levels. The diet should be low on refined carbohydrates, added sugar, saturated fats and trans-fats, and high on fiber, fruits, fresh vegetables, whole-grains, nuts & seeds, lean meat and low-fat dairy. Sugary sodas, energy drinks and fruit juices with added sugars must be avoided. Stay hydrated by drinking 8-10 glasses of plain water a day.
• Choosing healthy fats: Foods rich in unhealthy fats such as margarine, butter, cheese and red-meat must be avoided. Foods rich in polyunsaturated and monounsaturated foods must be consumed. These include cold-pressed oils such as olive, mustard, peanut, gingelly, as well as ghee. Omega-3 fatty acids from fish such as salmon, tuna and mackerel are also highly recommended.
• Reduce alcohol intake: Alcohol consumption must be limited to one small-sized drink per day, and gradually reduced to thrice a week, and then twice a week.
• Quit smoking: Smoking does not directly impact triglyceride levels, but since smoking reduces good cholesterol, quitting smoking helps promote heart health, which makes up for high triglycerides.
• Get good sleep: Sleeping well helps reduce stress, improve metabolism and has many physiological as well as cognitive health benefits.
• Manage hypertension and diabetes: These help to reduce the risk of triglyceridemia for those who do not have this condition and help overcome it for those who have it.

Outlook

Given the consequences of high triglycerides, doctors advise adults to have a Total Lipid Profile test done once in 5 years. Children should get this test done once between 9 and 11 years, and again between 15 and 17 years.

And if you or any of your dear ones are diagnosed with the condition, do not panic. Consult a cardiologist at a reputed hospital. Based on your test results, he/she will choose the best course of treatment for quick recovery and rehabilitation.

---

Reviewed by Dr Suresh S Venkita, Group Medical Director, Kauvery Hospitals

---

Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.

Chennai – 044 4000 6000 • Trichy – Cantonment – 0431 4077777 • Trichy – Heartcity – 0431 4003500 • Trichy – Tennur – 0431 4022555 • Hosur – 04344 272727 • Salem – 0427 2677777 • Tirunelveli – 0462 4006000 • Bengaluru – 080 6801 6801