Health Tips

by Pou Wee Gan from Dosing Health

Many people know about Low-Density Lipoprotein (LDL), the infamous "bad" cholesterol linked to arteriosclerosis, heart diseases, strokes and peripheral arterial disease. Less people know about "the ugly" fats in our blood – triglycerides!

It’s not cholesterol!

Say what? Triglycerides are not cholesterol?

Both cholesterol (which includes HDL and LDL) and triglycerides are lipids, but they are structurally very different and have different functions in the human body. Cholesterol, as the name suggests, is made up of carbon rings called “sterols” connected to a carbon chain. Conversely, triglycerides do not contain sterols, they are “fatty acids” where three fatty acid chains attach to a glycerol molecule to form an “ester”. No this is not Greek. Time to revise high school chemistry! 

The difference in sources and structure between cholesterol and triglycerides

So what? They still cause heart disease, right?

Yes, you are right. Both high cholesterol (we mean LDL) and high triglycerides (also known as hypertriglyceridemia) can cause heart disease. People with hypertriglyceridemia have higher risk of strokes and heart attacks.

However, that doesn’t mean that the adverse health effects of hypertriglyceridemia are completely the same as high cholesterol levels. Hypertriglyceridemia can also cause a condition called liver steatosis (also known as fatty liver) and pancreatitis (inflammation of the pancreas).

Functionally, they are also very different. Cholesterol is used by the body to produce hormones and cell components such as the membranes of cells. Triglycerides, on the other hand, is primarily used a storage form of energy.

What are the normal levels of triglycerides?

The normal and abnormal levels of triglycerides are summarized in the table below:

*Very high is serious and needs medical attention as soon as possible due to its high risk of acute pancreatitis.

Risk of heart attacks and stroke

For people with high triglycerides, you may also want to know what your risk of heart attacks and stroke is like. Refer to this to calculate your risk.

Instructions for use of risk calculator are as follow:

• Sex: Your gender male or female 
• Age: Your age in years
• Total Cholesterol: Total Cholesterol reading from blood report in mmol/L
• HDL: High-Density Lipoprotein reading from blood report in mmol/L
• Systolic Blood Pressure: This is usually the value that is written on the top after taking a blood pressure reading. It is also the number with greater value of the two numbers
• Treatment for Hypertension: Choose yes if you are currently on treatment or taking medication for high blood pressure
• Smoking: Choose yes if you are currently an active smoker or an ex-smoker who has quit for less than 2 years
• Diabetes: Choose yes if you have been diagnosed with diabetes. Choose no for those who have not been diagnose with diabetes before or those who have been diagnosed with gestational diabetes (diabetes during pregnancy) only
• Known Vascular Disease: Choose yes if you have been diagnosed with coronary artery disease/peripheral vascular disease/stroke. Choose no if you have not been diagnosed with any vascular diseases

Furthermore, your risk may be compounded if you:

• Have high blood pressure
• Have diabetes – Especially when your blood sugar is poorly-controlled
• Smoke cigarettes
• Have a family member (parent, sister, or brother who got heart disease at a young age i.e. younger than 55 for men and younger than 65 for women)
• Are male (males have higher risk compared to females)
• Are overweight
• Are older (risk increases with age)

Self-help in reducing triglycerides

If you would like to reduce triglycerides, here are some methods you can try:

• Exercise regularly
• Lose weight (if you are overweight)
• Avoid oily food such as butter, fried foods, cheese, oils, nuts and red meat (this is more useful if triglyceride level is more than 5.7mmol/L)
• Avoid food and drinks with high sugar/carbohydrate content such as bread, rice, fruit juice, soda, and sweets
• Control alcohol intake to 2 drinks or less daily if you are male and 1 drink or less daily if you are female. For those with triglyceride level more than 5.7mmol/L, it is best to avoid alcohol consumption

Fish oils

Although fish oil has been found to be NOT useful in reducing LDL and heart disease, various studies support its role in reducing triglycerides. With that said, since consuming fish oil does not reduce the risk of heart disease, its consumption is not recommended.

Medications that reduce triglycerides

There are medications that reduce triglycerides and your doctor might prescribe them for you if deemed necessary. This depends on many factors such as age, family history and other conditions.

Such medications may come from the fibrates group such as fenofibrate or gemfibrozil or the statins group such as simvastatin or atorvastatin.

Remember, when in doubt, always consult your pharmacist or doctor.

References

1. Barrett, K. and Ganong, W. (2013). Ganong’s review of medical physiology. New York: McGraw-Hill.
2. Longo, D., Fauci, A., Kasper, D., Hauser, S., Jameson, J. and Loscalzo, J. (n.d.). Harrison’s principles of internal medicine. New York: McGraw-Hill.
3. (2018). Patient education: High triglycerides (The Basics). [online] Available at: https://www.uptodate.com/contents/high-triglycerides-the-basics [Accessed 7 Mar. 2018].
4. D'Agostino RB Sr, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, et. al. General Cardiovascular Risk Profile for Use in Primary Care: The Framingham Heart Study. Circulation 2008; 117; 743-753.

In collaboration with Dosing Health

Written by

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