Triglyceride Levels Explained

Triglycerides are the most common type of fat in your body. They are essential for energy storage. However, if triglyceride levels become too high, it can raise your risk of developing heart disease. Nearly 26% of adult Americans may have elevated triglycerides.

Triglyceride levels are often measured alongside cholesterol. When high triglycerides are coupled with elevated levels of low-density lipoprotein (LDL) cholesterol (also known as "bad" cholesterol), you may end up at an even greater risk of developing heart disease.

Fortunately, there are several steps you can take to manage triglyceride levels.

Triglycerides

Triglycerides are a type of fat, also known as a lipid. They are an essential energy source and can come from foods such as butter and oils, or your body can create them from extra calories.

Triglycerides are either made in the liver or consumed in the diet and then absorbed into the body through the small intestine. But triglycerides can't travel around the body alone. Instead, they attach to a protein and become a lipoprotein. These lipoproteins are very low-density lipoproteins (VLD).

VLDs are not very dense or heavy. Along with low-density lipoproteins (LDL), they run the risk of potentially contributing to heart disease.

By contrast, high-density lipoprotein (HDL) cholesterol is known as the "good" cholesterol. It's so named because high HDL levels can lower the risk of heart disease and stroke.

Triglyceride Level Ranges

Elevated levels of triglycerides are a risk factor for heart disease. The following are the reference ranges for triglycerides in adults. Ranges are different for children and teens.

• Normal: Below 150 mg/dL (1.69 mmol/L).
• Borderline high: Between 150 mg/dL (1.69 mmol/L ) and 199 mg/dL (2.25 mmol/L)
• High: Between 200-499 mg/dL (2.26-5.63 mmol/L) are considered high
• Extremely high: Above 500 mg/dL (5.64 mmol/L)

Triglyceride levels are obtained through a blood test. When triglyceride levels are high, it means you have too much of that particular fat circulating in your bloodstream. For the results to be as accurate as possible, your provider will likely instruct you to fast before the test.

For children and teens ages 10-19, normal levels are below 90 mg/dL. Talk to your child's healthcare provider if you have a family history of high triglycerides and complications and are concerned. They may choose to test your child sooner.

Risk Factors

High triglyceride levels are also known as hypertriglyceridemia. Metabolic syndromes are a cause of primary hypertriglyceridemia.

Secondary causes are usually due either to diet or other underlying health conditions, such as:

• Diabetes
• Obesity
• Liver disease
• Thyroid disease
• Kidney disease
• Lack of exercise
• Alcohol consumption
• Diet (too much sugar or fats)
• Medication side effects
  

Generally, most healthy adults should have a lipoprotein profile test done every five years. However, if you have certain risk factors, such as a health condition that can cause an increase in triglycerides and LDL, your provider may recommend more frequent testing.

Health Risks

High triglyceride levels are associated with an elevated risk of cardiac disease and stroke. Severely elevated triglycerides (e.g., 500 mg/dL) or more can increase the risk of developing inflammation of the pancreas, known as pancreatitis.

There has been debate over whether or not high triglycerides are an independent marker for developing cardiac disease. While more research is needed, triglyceride levels likely affect the development of cardiac disease, independent of LDL.

Metabolic Syndrome

A high triglyceride level also can contribute to the development of metabolic syndrome. This is not one but a group of risk factors for heart disease, stroke, and diabetes.

When at least three risk factors apply, it is termed metabolic syndrome:

• A high triglyceride level
• A large waistline, known as abdominal obesity
• A low HDL level
• High blood pressure
• High fasting blood sugar (often a warning sign of diabetes)

Treatment and Prevention

Many ways that hypertriglyceridemia is treated are also the same measures used to prevent it.

High triglyceride levels are usually initially treated with dietary and lifestyle modifications. If this is ineffective, your healthcare provider may prescribe medication to help lower your triglyceride levels.

If you have high triglycerides or want to prevent high triglycerides, speak with your healthcare provider before beginning any new diet, exercise regimen, or supplements. The following measures can help lower triglyceride levels:

• Lose weight: A weight loss of 5% or more may help reduce triglyceride levels.
• Exercise: Exercise can both improve cardiovascular health and aid in weight loss.
• Decrease saturated fats and simple carbs: Too many simple carbs can increase the body's production of triglycerides. Aim for a low-carb, high-healthy fat (avoid saturated fats), and high-protein diet (while under medical advice).
• Increase fiber: Adding additional fiber to your diet may also help to reduce triglycerides.
• Omega-3 fatty acids: Increase dietary sources of omega-3s (e.g., salmon, seeds, and nuts). There is also a prescription-strength omega-3 medication available.
• Consider medications: Examples of prescription medications include statins, fibrates, prescription strength Omega-3s, and another medication called icosapent. Prescription-strength Omega-3s and fibrates may help reduce the risk of pancreatitis in those with severely elevated triglycerides.

Other preventative and treatment measures to lower triglycerides include:

• Quitting smoking
• Reducing or eliminating alcohol consumption
• Managing stress
• Getting enough sleep and rest

Dietary Interventions

Diet can play a significant role in triglyceride levels and help to reduce overall cardiac disease risk. Aim to avoid saturated fats and increase consumption of monosaturated and polyunsaturated fats (e.g., avocados, nuts, salmon, and olive oil).

The Mediterranean Diet is an example of a diet rich in healthy fats. Dietary Approaches to Stop Hypertension (DASH) is another diet rich in fruits, veggies, fiber, and lean protein sources.

Fiber may also play a role in decreasing triglyceride levels and the overall risk of metabolic syndrome. Sources of fiber include fruits and vegetables, legumes (e.g., beans), quinoa, and certain grains, such as oats. In one study, a higher dose of quinoa alone lowered triglyceride levels and reduced the risk of metabolic syndrome.

Summary

Triglycerides are a common type of fat in the body. The body needs various fats for energy, but triglyceride levels that are too high can increase the risk of heart disease.

If you have elevated triglycerides or risk factors and are concerned, there are several lifestyle interventions for both treatment and prevention. In some cases, a healthcare provider may prescribe medications.