The Fat Blob Epidemic – Dealing with Elevated Triglycerides

What would you say is one of the best predictors of heart disease risk?

Most would list cholesterol as number one, at which time I would reply “you are not a listener of our radio program nor are you a regular reader of our newsletter.” If heart disease was compared to a recreational drug problem, cholesterol would be a drug mule (for those who are not up on your police lingo, a drug mule is a very low level person in a drug cartel who simply delivers the drugs). So if cholesterol is a low level drug mule, who would be the “king pin”?

Fat Blobs. That is right…fat blobs. Ok, if you prefer the medical jargon, they are technically called triglycerides. Triglycerides are basically little blobs of fat that float through our blood, in excess they are considered a major risk factor for heart disease by filling the LDL (bad cholesterol) with more junk to deliver to our blood vessels.

So what is too high?

Most lab reports will state that a triglyceride level of 150 mg/dl is considered acceptable. Our opinion, however, is “it depends”. It depends on your HDL cholesterol. You see, HDL (good cholesterol) is responsible for removing the junk from the LDL which decreases the amount of damage that LDL can do to the arteries.

So how low should your triglycerides be?

Triglycerides should never be any more than twice the HDL! According to nutritionist Byron Richards, author of the book “Mastering Leptin” and “The Leptin Diet”, when triglycerides exceed twice the HDL level then the stage is set for trouble in the blood vessels. But there is another problem…

Your blood test is wrong…

Well, not exactly. Here is the problem with the blood test. When your triglycerides are tested, they are usually tested after a fast. Triglycerides rise significantly after a meal. So testing during a fast is not the best way to determine how balanced your body is as it pertains to the production of triglycerides. But that doesn’t mean your fasting triglyceride level is not helpful.

If your triglycerides are elevated during a fast then you know that you have a problem. The problem is, we don’t know how big of a problem. Let us say a healthy person has a triglyceride level of 60 after a fast and 120 after a meal. Assuming that their HDL is in 60 range then we are in good shape. Now let’s say that there another, not-so-healthy, person who has an HDL of 40 and a fasting triglyceride of 160 mg/dl. It is certainly high but not terrible. But wait a minute…when we test the triglycerides after a meal it jumps to 475 mg/dl. Now we have a problem. Compared to people who have a non-fasting triglyceride level less than 89 our not-so-healthy friend has a 2.5 time higher risk of stroke.

So how do we get them down?

I am glad that you asked because a recent study took a look at all of the research published to date on the use of fish oil for lowering triglycerides. At the end of the study, they concluded the following:

1. Triglycerides were lowered an average of 7%
2. Fibrinogen decrease 10% (a risk factor for clotting and heart attack)
3. Platelet stickiness decreased 22%

Fish oil can be a very effective tool in lowering triglycerides. In this meta analysis, the researchers noted a modest but significant decrease in triglycerides through the use of fish oil. In our practice, we have found fish oil to be far more impactful for many people. It is not uncommon to see a 50% decrease in triglycerides in many people, especially people who have very high levels. With that said, it is important to note that elevated triglycerides is first and foremost an indication of insulin resistance and the most important factors in controlling triglycerides are decreasing refined carbohydrates (bread, pasta, cake, candy, etc.) and performing regular aerobic activity, such as walking, for at least 1 hour a day.

For more info please read our Health Protocol for Elevated Triglycerides.

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