Health Tips

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 – trigycerides!

It’s not cholesterol!

Say what? Triglycerides is 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! To know more about other cholesterol, read our article that summarizes cholesterol!

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 need medical attention as soon as possible because there is 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 article to understand more about this and calculate your risk.

Furthermore, your risk may be compounded if you:

• Have high blood pressure
• Have diabetes – Especially when your blood sugar is not well-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. Cover image credit: Food Navigator

Written by

Dr Pou Wee Gan