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What
are triglycerides?
Triglycerides are fats carried in the blood from the food we eat. Most of
the fats we eat, including butter, margarines and oils, are in triglyceride
form. Excess calories, alcohol or sugar in the body are converted into triglycerides
and stored in fat cells throughout the body.
How
are triglycerides different from cholesterol?
Triglycerides and cholesterol are both fatty substances known as lipids. But
triglycerides are fats; cholesterol is not. Cholesterol is a waxy, odorless
substance made by the liver that is an essential part of cell walls and nerves.
Cholesterol also plays
an important role in body functions such as digestion and hormone production.
In addition to being produced by the body, cholesterol comes from animal foods
that we eat.
Pure cholesterol cannot
mix with or dissolve in the blood. Therefore, the liver packages cholesterol
with triglycerides and proteins in carriers called lipoproteins to transport
it to sites throughout the body. An elevated triglyceride level increases
the risk of heart disease.
When are triglyceride levels measured?
Triglyceride levels are usually measured whenever you have a blood test called
a Lipid Profile. Everyone over age 20 should have their cholesterol checked
at least every 5 years. Your health care provider can check your cholesterol
and triglyceride levels by taking a sample of blood, which is sent to a lab
for testing. The Lipid Profile shows your triglyceride level, total cholesterol
level, HDL cholesterol (high-density lipoprotein or "good" cholesterol) and
LDL (low-density lipoprotein or "bad" cholesterol) levels.
Following a meal, blood
triglyceride levels are normally high. For an accurate reading, blood samples
for a triglyceride test should be taken after a 12-hour period of not eating
or drinking. Many other factors affect blood triglyceride levels including
alcohol, diet, menstrual cycle, time of day and recent exercise.
What
are the guidelines for triglyceride levels?
Guidelines
for triglyceride levels in healthy adults are:
| Normal |
Borderline
High |
High |
Very
High |
| Under 150 mg/dl |
151-200 mg/dl |
201-499 mg/dl |
500 mg/dl or higher |
How
can triglycerides be lowered?
If you have high triglycerides, you may be able to reduce them without medication
by following the guidelines listed in this handout which include following
a low-sugar and low-fat diet, as well as limiting your alcohol intake.
People who have high
triglycerides and low HDL or high LDL levels may require medications as well
as diet modifications. Patients with triglycerides in the very high range
(over 500 mg/dL) generally will require medications, because triglyceride
levels this high may cause other medical problems.
How
do foods affect triglyceride levels?
Consuming foods high in simple sugars significantly contributes to
high triglycerides. Follow these guidelines to limit simple sugars
in your diet:
Substitute beverages like colas, fruit drinks, iced tea, lemonade, Hi-C and
Kool-Aide with artificially sweetened beverages labeled "sugar-free" or "diet."
Limit
hard candies, chocolates, candy bars and gummy bears.
Avoid
adding table sugar and brown sugar to hot and cold cereals. Instead, substitute
Equal?, Splenda?, Sweet-n-Low?, Sugar Twin? or Brown Sugar Twin?
 Choose
sugar-free gum or mints instead of the regular versions.
Try
light or low-sugar syrups on pancakes and waffles.
Spread
breads and crackers with no-sugar-added jelly or preserves.
Snack
on whole fruit instead of fruit roll-ups and other fruit-flavored treats.
When
selecting cereals, limit the sugar to no more than 8 grams per serving.
Try
sugar-free gelatin and puddings instead of their regular versions.
Choose
low-sugar cookies and other desserts. Remember, these foods are not calorie-free
and may contain cholesterol-raising fats.
Be aware
that desserts labeled "fat-free" usually contain more sugar and equal calories
than the full-fat varieties.
Regulate
your intake of cookies, pastries, pies, cakes and granola bars. All of these
foods contain high levels of added sugar; choose them sparingly.
Reduce
your intake of ice cream, frozen yogurt, sherbet, gelato, and flavored ices
- all contain high levels of sugar.
Limit
your daily sugar intake to no more than 8% of your total calories each day.
That's 24 grams for someone following a 1,600-calorie diet, or 40 grams for
a 2,000-calorie diet.
Read the ingredients list on food labels, and limit foods that contain any
of the following words (all simple sugars) as the first few ingredients:
-
Sucrose
-
Glucose
-
Fructose
-
Corn
syrup
-
Maltose
-
Honey
-
Molasses
-
High-fructose
corn syrup
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Naturally occurring
sugars, when eaten in excess, can also raise your triglyceride level.
Follow these guidelines to help limit natural sugars:
Use honey and molasses sparingly - they are both high in sugar
Choose
light yogurt (which use artificial sweeteners) instead of regular yogurt
Choose
whole fruit instead of fruit juice
Limit
the serving size of dried fruits to ¼ cup per day; dried fruits contain
a more concentrated source of sugar
Choose
canned fruit in its own juice and strain before eating; avoid canned fruits
packed in heavy syrup
Limit
your portion sizes of mashed potatoes, yams, beans, corn and peas to ½
cup; limit baked potatoes (with skin) to about 3 ounces. Although these starchy
vegetables are a great source of fiber and nutrients, they can contribute
to high triglycerides when eaten in excess.
Highly refined
breads, cereals, rice, pasta and crackers convert to sugar in the body much
more quickly than whole-grain varieties, which may increase your triglyceride
level. To limit refined grains:
Choose breads, crackers and cereals that contain whole grain oats, barley,
corn, rice or wheat as the first ingredient. Avoid the words "bleached" and/or
"enriched" as the first ingredient.
Try
whole wheat pasta or brown rice.
Choose
breads, crackers, rice and pasta with 2 or more grams of dietary fiber per
serving.
Select
hot and cold cereals with 5 or more grams of dietary fiber per serving.
Use
barley, bulgur, couscous, millet or wheat berries as a side dish.
Try
whole wheat crackers with soup instead of saltines.
Watching your
overall portion size of grain-based foods is a key component to triglyceride
control. Below are examples of a single serving size:
- 1 slice of bread
- 2 slices of reduced-calorie
bread
- ½ hot
dog or hamburger bun
- ½ English
muffin
- ½ bagel
(1 ounce)
- 1 oz most cold
cereals (¼ to 1 cup)
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- 2 graham crackers
- ¾ matzoh
cracker
- 4 slices melba
toast
- 3 cups popped
light popcorn
- 2 to 6 baked
whole-wheat crackers
- ½ cup
cooked cereal (including oatmeal, oat bran, cream of wheat)
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Alcoholic beverages
are a significant contributor to elevated triglyceride levels. Beer,
wine, spirits, mixed drinks, wine coolers and coffee drinks containing alcohol
are all examples. Men should not exceed 2 drinks per day, and women should
limit to their intake to one drink per day.
One serving is equal to:
1.5-ounce spirits, 3 ounces wine or 12 ounces beer. Keep in mind that these
are general guidelines. If you have elevated triglyceride levels, it is recommended
that you consume fewer to no alcoholic beverages per day.
Excessive intake
of dietary fats, especially saturated and trans fats, can increase your triglycerides.
However, reducing dietary fat too much may mean you are getting too much sugar
in the diet. If you have high triglycerides, follow these dietary guidelines
to reduce dietary fat:
Limit your total fat intake to 30 to 35% of your total daily calories
Limit
saturated fat to 7% of your total daily calories
Try
to avoid high trans fat foods
Limit
dietary cholesterol to 200 mg daily
Choose
monounsaturated and polyunsaturated fats (such as canola and olive oils) most
often
See your dietitian or
clinician for more information on determining your daily fat limit.
Here are some
other ways to help lower triglycerides:
Eat fewer calories (through portion control) if you need to lose weight
Eat
small, frequent meals and do not skip meals
Avoid
late-night snacking
Lose
weight if you are overweight
Participate
in regular physical activity
Omega-3
Fatty Acids
Some foods have been
found to be very powerful at lowering triglycerides when you also follow the
other guidelines in this handout. The fat found in fish, called omega-3 fatty
acids, can help to lower triglyceride levels in many people.
To obtain the amount
of omega-3 fat that is needed to lower triglycerides, your physician may recommend
that you purchase a fish oil supplement. However, ask your physician first.
To get more omega-3 fats in your diet, choose two or more meals of fatty fish
each week (such as mackerel, salmon, sardines, tuna, tilapia) or include plant-based
forms of omega-3 in your diet, such as soy foods, canola oil, flax seeds and
walnuts.
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