What are Triglycerides?

Abnormal lipids (fats) in the blood are considered one of the major risk factors for cardiovascular disease, a leading cause of premature death.  Conventional wisdom has been to evaluate blood lipids after abstaining from food for 12 hours.

Most people will get their blood drawn for a “cardiovascular panel” first thing in the morning before breakfast, when they have been fasting for 12 hours.  One of the fats measured in a cardiovascular panel is triglycerides.  Triglycerides literally means three glycerol molecules; this is the storage form of sugar.  When you eat carbs that are burned as fuel right away, the energy (calories) gets stored as fat.

Having high triglycerides typically corresponds with eating too many refined carbs (anything made with white sugar or white flour, and alcohol).  I can usually look at a patient and tell they have high triglycerides: the tell-tale “apple” shape.  Also known as beer gut.  The main problem with packing on the triglycerides, however, isn’t cosmetic.  It is much more than skin deep.  This kind of fat lays down under the muscular layers of the abdomen, and no amount of crunches will burn this off.  You need to dip into those deep energy reserves by working out and practicing light calorie restriction several times a day.  You don’t have to go hungry, but you need to eat lightly, and frequently.  You need to exercise hard enough to burn through the readily available carbs from recent meals, and start dipping into your reserves.  A few grams of L-carnitine daily will also help convert fat to muscle.

In the past few years, a new, quick tool for doctors in performing an annual physical exam has come into vogue.  This is a simple waist measurement, now considered more important (and quicker to figure out) than a hip to waist ratio.  For women, aim to keep your waistlines below 34 inches.  For men, no more than 38 inches.

The topic at hand, however, is how to accurately evaluate triglycerides.  Two recent studies suggest that nonfasting triglyceride levels were much more highly correlated with risk for imminent cardiovascular events (such as stroke or heart attack).  One study looked at nearly 14,000 Danish folk for over 25 years and found that the women with the highest nonfasting triglycerides were five times more likely to die from a cardiac event than women with the lowest nonfasting triglycerides.

Another study involving over 25,000 women, conducted by Harvard researchers, also found that nonfasting triglyceride levels predicted heart attacks and strokes better than fasting levels.  This means that, even tickling out variables such as smoking, hypertension, high cholesterol, and insulin resistance, women with high nonfasting triglycerides were much more likely to suffer serious cardiac events in the near future, compared to women with high fasting triglycerides.

The main function of triglycerides in the body is to move and store fat.  Triglycerides that remain elevated after a meal are speculated to be a special sub-type which may lodge in artery walls and thus contribute to cardiovascular disease.  Conventional doctors have determined that triglyceride levels should be under 150 mg/dL.  As a naturopathic physician, I prefer to have my patients’ trigs under 100 mg/dL.