Triglycerides – How to Lower Triglycerides

I’ve recently answered several questions related to triglycerides. These questions range from “What are triglycerides?” to “My triglycerides are 400, do I need to worry?” on to “Help, my triglycerides are 1200, how do I fix this?”

So, I’m going to answer all these questions here for those of you who are wondering, but haven’t asked.

What are triglycerides?

Triglycerides are a type of fat. Actually, they’re the most common type of fat in foods and in your body. When you eat foods containing fat and oil, such as butter, French fries, and chocolate chip cookies, the body takes the fat and stores it in your body as triglycerides. So, all those “fat cells” in your body are made up of triglycerides.

What do triglycerides have to do with cholesterol?

When you see your MD, he or she may order a “lipid panel” (lipid is a fancy term for fat). From the lipid panel you will learn your total cholesterol, HDL (good) cholesterol, LDL (bad) cholesterol, and triglycerides.

Total cholesterol = HDL + LDL + VLDL

Well, what in the world is VLDL? Not something you’ve probably seen or heard of before. VLDL is an acronym for Very Low Density Lipoproteins, another “bad” type of cholesterol. Triglycerides are used to calculate VLDL levels in your blood.

Triglycerides x 20% = VLDL (bad) cholesterol

Also, the liver uses triglycerides as fuel for cholesterol production. So, if you eat a high fat (triglyceride) diet, the liver will increase its’ production of cholesterol and put more cholesterol out into your blood.

What is a normal triglyceride level?

You want your triglycerides to be below 200 mg/dL. Borderline high triglycerides are from 200-500 mg/dL. Triglycerides are high risk above 500 mg/dL.

Some experts argue that 200 mg/dL is too high and that a normal level should be less than 150 mg/dL. The numbers I’ve listed above are the current guidelines from the National Cholesterol Education Program Expert’s Panel.

If your triglycerides are high your heart disease risk increases.

What you can do to lower triglycerides?

1. Limit simple sugars.

Unlike other types of cholesterol, triglycerides are affected by sugars you eat. You need to limit foods such as soft drinks, candy, baked goods, syrup, table sugar, jelly, and honey. A high intake of fruit juice can also raise triglyceride levels since juice contains a high content of natural sugars.

2. Limit alcohol.

If your triglycerides are borderline high or high risk, discuss your alcohol intake with your MD. My recommendation for borderline high (200-500 mg/dL) is to limit alcohol to no more than 1 drink per day for women, 2 drinks per day for men. One drink equals 12 ounces beer, 4 oz wine, or 1 ½ ounces liquor. If your triglyceride level is high risk (great than 500 mg/dL) I recommend NO alcohol. Again, discuss your situation with your MD.

3. Lose weight and/or maintain a healthy weight.

Many times weight loss alone will lower your triglycerides. Losing as little as 10% body weight could drop your triglycerides back to the normal range.

4. Choose a low-fat diet.

To achieve lower triglyceride levels, maintain a dietary intake of 30% or less of total calories coming from fat. A healthy diet for normal triglyceride levels should consist of whole grains, beans, fruits, vegetables, low-fat dairy, and lean meat.

5. Increase your physical activity.

Boosting your activity can lower your triglycerides up to 40%. If you’re not currently active, talk to your MD before starting an activity program. To reduce triglycerides, be physically active at least 30 minutes on 3 or more days each week. The more activity the better.

Triglycerides aren’t all bad. They provide efficient energy storage, cushion your organs, transport certain vitamins, and keep you warm by providing insulation. What’s important is to keep them under control!

Now, if you like this information and want to receive regular heart health and weight loss tips from dietitian Lisa Nelson, subscribe to The Heart of Health today!

Physical Activity – How much do you really need?

As I previously mentioned, The Health and Human Services Department sets physical activity guidelines after reviewing a good decades worth of research related to physical activity and health.

This report encompasses everyone from the age of 6 and up. Let’s go into a little more detail on the adult guidelines.

Adult Physical Activity Guidelines

1. All adults should avoid inactivity.
   Any type of activity is better than nothing. Adults who include activity as part of their everyday life gain some form of health benefit.
2. To see substantial health benefits, include at least 150 minutes (2 ½ hours) per week of moderate-intensity activity. If times a factor, you can see the same benefits by bumping up the intensity and being vigorously active 75 minutes (1 hr. 15 min.) each week.Yes, it is still okay to break your activity into chunks.For example, if your schedule doesn’t allow 30 minutes at the gym, you can include a 10 minute brisk walk during lunch break to count towards the goal of 150 minutes for the week. However, workout segments less than 10 minutes in length are not as beneficial.

   Also, the most benefit is seen by spreading your activity throughout the week. If you’re tempted to hit the gym for a power workout session on a Saturday for 2 ½ hours, that is not as beneficial as 30 minutes of activity 5 days out of the week. But, remember, any form/amount of activity is better than nothing!

3. If you want to take things to the next levels, more extensive health benefits are seen when activity is increased to 300 minutes (5 hours) per week of moderate intensity activity or 150 minutes of vigorous intensity aerobic activity.
4. Don’t forget strength training! You want to include all major muscle groups on two or more days each week. Especially beneficial as we age and see a decline in metabolism (and corresponding weight gain) if muscle mass is not maintained.

Now, don’t let yourself be overwhelmed and give up without even attempting to meet these guidelines. Activity does not have to be hard or expensive. You can walk your dog, go dancing, climb the stairs at work, mow the lawn, and go to the gym. There are many, many options available to get 2 ½ hours of physical activity every week.

All the best,

Lisa Nelson RD

Physical Activity – How much physical activity is recommended?

By now you know being heart healthy and losing weight go hand-in-hand with physical activity. If you want to lose weight and keep it off, you have to be regularly active. If you want to lower triglycerides you have to be active. If you want to raise HDL you have to be active.

The Health and Human Services Department sets physical activity guidelines after reviewing a good decades worth of research related to physical activity and health.

Here’s a quick review of the adult guidelines:

1. All adults should avoid inactivity.
2. To see substantial health benefits, include at least 150 minutes (2 ½ hours) per week of moderate-intensity activity. If times a factor, you can see the same benefits by bumping up the intensity and being vigorously active 75 minutes (1 hr. 15 min.) each week.
3. If you want to take things to the next levels, more extensive health benefits are seen when activity is increased to 300 minutes (5 hours) per week of moderate intensity activity or 150 minutes of vigorous intensity aerobic activity.
4. Don’t forget strength training! You want to include all major muscle groups on two or more days each week. Especially beneficial as we age and see a decline in metabolism (and corresponding weight gain) if muscle mass is not maintained.

All the best,

Lisa Nelson RD

Lower Cholesterol – Do you understand your lab results?

It’s very possible your MD orders lab work and you have no idea what or why you’re having blood drawn. Well, let’s clear up the confusion when it comes to your cholesterol labs.

The terms “lipid panel”, “lipid profile”, and “lipoprotein profile” are used interchangeably to order the same set of labs. To make reading this easier, I’m going to use “lipid profile” from here on out.

“Lipid” is simply a medical term for “fat”. A lipid profile measures fatty substances in your blood. Cholesterol is one type of fat.

When you eat food containing cholesterol or when your body produces cholesterol and releases it into your bloodstream, the cholesterol will attach to a protein. This package of cholesterol plus a protein is called a lipoprotein (lipid or fat plus protein). A lipid profile measures lipoprotein levels in your blood.

Lipid profiles include five components:

LDL – “bad” cholesterol
LDL (low-density lipoprotein) cholesterol carries mostly cholesterol, some protein, and minimal triglyercerides throughout your circulation. LDL should be less than 130 mg/dL, ideally less than 100 mg/dL.

VLDL – “bad” cholesterol
VLDL (very low-density lipoprotein) cholesterol contains minimal protein and mainly transports triglycerides. VLDL should be less than 40 mg/dL.

Triglycerides
Triglycerides are a type of fat in the blood, not a type of cholesterol. Triglycerides are frequently used to estimate VLDL (“bad”) cholesterol. Here’s the calculation: triglycerides divided by 5 equals VLDL cholesterol. Triglycerides should be less than 200 mg/dL, ideally less than 150 mg/dL.

HDL – “good” cholesterol
HDL (high-density lipoprotein) cholesterol removes cholesterol from your bloodstream and carries it back to the liver. I like to think of HDL as a vacuum cleaner, picking up cholesterol LDL leaves behind in your arteries, the more HDL the better. HDL should be greater than 40 mg/dL, ideally greater than 60 mg/dL.

Total cholesterol
Cholesterol is essential to bodily functions, such as building cells and producing hormones. However, too much cholesterol will build up on artery walls, form a plaque, and potentially “plug” the artery resulting in a heart attack or stroke. Total cholesterol is calculated from the above components (Total cholesterol = HDL + LDL + VLDL). Total cholesterol should be less than 200 mg/dL.

Do you see how if you only know your total cholesterol, you only have one piece of the lipid profile?

Now, sometimes your results will include ratios or a risk score. Here’s an explanation of what those numbers mean.

Risk Score
A risk score is based on you lipid profile results, sex, age, family history, and various other risk factors. If you have a high risk score for heart disease, it’s best to speak with your MD to evaluate your risk score.

Cholesterol:HDL Ratio
You want a low ratio of cholesterol to HDL. A ratio lower than 4.5 is good, but 2 or 3 is best. You can calculate your cholesterol to HDL ratio by dividing total cholesterol by HDL. For example, your total cholesterol is 195 and your HDL is 55. 195 divided by 55 equals a ratio of 3.5.

It’s actually not your total cholesterol that has the greatest impact on your heart disease risk. The ratio of total cholesterol to HDL is a critical factor. If your total cholesterol is less than 200, but your ratio is 5, you are still at increased risk for developing heart disease.

LDL:HDL Ratio
This ratio compares the amount of bad (LDL) cholesterol to your good (HDL) cholesterol levels. You want a ratio less than 3.5, ideally less than 2.5. To calculate your ratio, divide LDL by HDL. For example, your HDL is 55 and LDL is 100. 100 divided by 55 equals a ratio of 1.8.

Triglyceride:HDL Ratio
A low ratio of triglycerides to HDL is best, ideally less than 2. To calculate your triglyceride to HDL ratio, divide your triglycerides by your HDL. For example, your triglyceride level is 200 and your HDL is 55. 200 divided by 55 equals a ratio of 3.6.

Lipid profiles are commonly ordered to assess your heart disease risk. Your doctor or dietitian will use the results to determine the best treatment to reduce your risk.

A lipid profile is beneficial, because you know your “good” cholesterol level and “bad” cholesterol levels. The interventions that work best to raise HDL and lower LDL differ, so knowing all your numbers helps you make the most effective changes.

You’re probably wondering why a lipid profile isn’t always ordered versus simply checking your total cholesterol (and possibly HDL). Cost and time always play a part and if your risk for heart disease is low, then a quick and less expensive screening makes sense. If you are at increased risk, a more complete assessment (lipid profile) may be more appropriate. Everyone’s situation is unique, so it’s best to discuss what’s right for you with your MD.

Now, to receive regular heart health and weight loss tips from dietitian Lisa Nelson, subscribe to The Heart of Health today!

All the best,
Lisa Nelson RD

Mediterranean Diet to Reduce Heart Disease

I’m sure you’ve heard of the Mediterranean Diet and it’s link to heart health. The Mediterranean Diet emphasizes fruits, vegetables, whole grains, fish, and monounsaturated fats (olive oil).

Those that follow a Mediterranean Diet have a reduced there risk of developing heart disease and dying from a heart attack. Even those that have survived a heart attack and lived to adopt the Mediterranean Diet significantly reduced their risk of a second heart attack and other complications.

In an interesting twist, the native Mediterranean population has gradually adopted a more Western diet leading to negative results. The Mediterranean area has seen an income rise that’s resulted in extra dollars being spent on meat and saturated fat food sources. Over the past 4 decades the average calorie intake in the Mediterranean countries has increased ~30%. So, the once healthy Mediterranean countries are now seeing the weight epidemics the US is familiar with – 75% of the population overweight or obese in Greece, with over half of the population in Italy, Spain, and Portugal following suit. These countries are now supporting the “Mediterranean Diet” as a part of their cultural heritage they can not let die.

Here’s a quick breakdown of the characteristics common to a Mediterranean Diet:

• High intake of fruits and vegetables
• Select whole grains
• Consume healthy fats (canola and olive oil)
• Eat nuts in moderation
• Low red wine consumption
• Limit eggs to less than 4 times per week
• Consume little red meat
• Eat fish regularly

All the best,

Lisa Nelson, RD, LN
eNutritionServices

Be Heart Healthy – Switch to diet soda.

Do you drink a couple cans of regular soda each day? If so, make the switch to diet. Switching from 24 oz (two cans) of regular soda each day to diet soda will save you 280 calories/day and 78 grams of sugar! This change promotes weight loss (~1/2 pound/week) and triglyceride control.

I can “hear you” arguing with me that there’s no way you can tolerate the taste of diet soda. Well, there are now many products on the market comparable in taste to regular soda without the extra sugar and calories. Start experimenting until you find one you like. Or cut out soda all together and opt for water:)

Diet soda doesn’t eliminate the issue of carbonation and tooth decay or the possible link between caffeine and blood pressure. However, diet soda is the better choice in the long run for your heart health and weight loss goals.

All the best,
Lisa Nelson, RD
eNutritionServices

Your Checklist to Lower Cholesterol

Here’s a checklist of the top 8 things you must do if you want to successfully lower your cholesterol and keep it low.

Know your numbers

Have you had a lipid profile? Do you understand the numbers? If you are going to successfully lower cholesterol you need to know your numbers and what they mean. The most effective way to raise HDL is not necessarily the best way to lower LDL.

Evaluate your lifestyle

There are risk factors for high cholesterol that you can not control, such as age, gender, and family history, but there are factors you can control. For example, you can reduce risk by not smoking, increasing your activity, and losing extra weight.

Balance your fats

Reduce unhealthy saturated fats in your diet and replace them with heart healthy unsaturated fats. Total fat intake should be 30% or less of your total daily calories. Out of this 30%, saturated fat should be limited to 7%.

Be active

Physical activity lowers triglycerides and raises HDL (good) cholesterol. Shoot for 30 minutes 5 or more days a week. If you are not currently active, check with your MD before beginning an activity program.

Eliminate trans fats

You need to be food label savvy and watch out for trans fats. Trans fats raise LDL (bad) cholesterol, lower HDL (good) cholesterol, and raise triglycerides. Limit trans fats to 1% or less of your daily caloric intake.

Understand triglycerides

Triglycerides are impacted the most by your simple sugar and alcohol intake. If you are struggling with high triglycerides, you need to use a different strategy to get your cholesterol under control.

Increase dietary fiber

A high fiber diet is necessary for heart health. You need 25-35 grams of dietary fiber daily, especially soluble fiber. For every 1-2 grams of daily soluble fiber intake, LDL (bad) cholesterol is lowered 1%.

Add omega 3 fatty acids

For heart health and lower cholesterol, you want to improve the ratio of omega 3 to omega 6 fatty acids. Omega 3 fatty acids are involved in the regulation of heart rate, blood pressure, and blood clotting.

If you’re ready for regular heart health and weight loss tips for dietitian Lisa Nelson, sign up for The Heart of Health today and grab your copy of the special report “Stop Wasting Money – Take Control of Your Health” today!

A Heart Friendly Starbucks?

I may have some good news for Starbucks lovers. 

 

Normally, the high sugar, high fat, high calorie beverage and menu items offered by Starbucks were reasons to steer clear if you struggle to lower triglycerides, lower cholesterol, or shed extra pounds.  Starbucks is typically not the best place to grab a quick breakfast with a Frappuccinno, while scanning the daily paper. 

 

Simply selecting a Grande Frappuccino and Cranberry Orange Muffin would start your day with a whopping 850 calories and 30 grams of fat!

 

In the past Starbucks has not embraced the idea of offering more nutritious items.  They did remove trans fats and started offering nonfat milk this past year, but there is still plenty of room for improvement.

 

The good news is Starbucks has decided to revamp their breakfast menu to offer six heart friendly breakfast options.  The goal was a menu with fewer calories, more protein, more fiber, and more fruit.

 

New menu selections include:

 

Apple bran muffin – 330 calories, 8 grams of fat, 7 grams fiber

Baked berry stella – 280 calories, 9 grams of fat, 6 grams fiber

Power Protein plate with peanut butter – 330 calories, 16 grams fat, 5 grams fiber

Chewy fruit and nut bar – 250 calories, 10 grams fat, 4 grams fiber

Perfect oatmeal – 140 calories, 2.5 grams fat, 4 grams fiber

 

These new options provide reduced calories and fat grams, while boosting dietary fiber content.  All good moves if you are looking to be heart friendly.

 

You still need to use your head when choosing a beverage.  Starbucks is not removing its’ high calorie, fat, and sugar beverage options.  One of the best choices is a simple Caffe Americano (15 calories, 0 grams fat). 

 

So, if you enjoy the Starbucks ambiance, you’ll now be able to enjoy a heart healthy breakfast, too.  Hopefully, the taste of the new menu items lives up to the flavor of their coffee!

 

To receive regular heart health and weight loss tips from dietitian Lisa Nelson, subscribe to The Heart of Health ezine.

Do I need to be concerned about high HDL levels?

My LDL is 50, my HDL is 160 and my triglycerides 90.  Do I need to be concerned about my high HDL levels?

The above question is one I recently answered for a visitor to The Health Central Network.  I thought readers of this blog may be interested in the answer as well, so here it is. 

HDL is the good cholesterol and does not contribute to arterial plaque that leads to heart disease.  HDL actually does the opposite and reduces the plaque lining your artery walls.  A high level is a good thing and reduces your heart disease risk.  If taking medications, speak with your MD to double check whether your medication is playing a role.

With an HDL of 160, your total cholesterol is going to be over 200.  However, the high HDL level negates the negative of a total over 200.  You are doing fine, keep up the good work!

All the best,

Lisa Nelson, RD, LN

Lower Cholesterol