Triglycerides And Their Importance

Triglycerides May Be The Most Important Number To Know, At Least For Heart Health. If Triglycerides Are OK, Often The Other Heart Numbers Are OK Too.triglycerides-and-their-importance-triglyceride

Triglycerides are fat. Cells run on them. Some get into our body more or less directly from the food we eat. The liver produces a lot as well. Actually, triglycerides aren’t soluble in blood, so they need to be packaged in particles that are. The ones from our last meal are called chylomicrons, and are packaged by our intestines and sent into the bloodstream via a system that opens near the neck called the thoracic duct. (Imagine, think for a minute, why the body is designed in such a way that these fatty particles need to enter the blood stream near the neck rather than near the liver where they are produced.) Chylomicrons have only small amounts of cholesterol and are usually consumed by hungry cells within a couple of hours.

The liver makes triglycerides and also packages them into VLDL particles. Viewed from the outside, these are very similar to chylomicrons. Both have an outer layer of water soluble proteins, then a thick layer of triglycerides. The VLDL particle, however, has a center composed of cholesterol.

triglycerides-and-their-importance-pattern-AAs these VLDL and chylomicron particles circulate, hungry cells pluck off the triglycerides, Eventually, the triglycerides are picked away. There is little left of a chylomicron at this point, but the VLDL is now picked down to its cholesterol core. This particle, now a lot smaller, is renamed LDL, and is essentially a little ball of maybe 50% cholesterol, 30% fat. If a cell needs cholesterol, it will engulf this entire particle. Otherwise it continues to circulate. Various other processes will eventually take the particle out of circulation, or it may manage to get stuck behind an artery wall.

If triglycerides are high, the liver makes larger VLDL particles, and crucially, makes more of them as well. What is crucial about this, is that the amount of cholesterol the liver is going to put into circulation stays the same, so if it makes more VLDL particles, each one is going to get a smaller ration of cholesterol. Later on, when most of the triglycerides have been picked off, the result is a much smaller LDL particle—just what we do not want.

Why Would Triglycerides Be High?

What causes triglycerides to become high in the first place? Triglycerides are fat. It would seem obvious that eating a lot of fat must be the cause, but paradoxically, this is not the case.

The explanation is insulin. When high amounts of carbs are eaten, insulin goes up, ostensibly to deliver the glucose to hungry cells. Circulating insulin orders essentially every cell in the body: “Use glucose—do not use fat.” Thus, when insulin is high, cells stop using triglycerides. This causes triglycerides to pile up in the blood. Furthermore, the insulin tells the fat cells to store the triglycerides as fat, and not metabolize them away as heat. The insulin level is like a switch. High—store, low—burn. Re-read this post “The Grand Unified Theory of Fat” for a refresher on fat and glucose metabolism.

Oddly, this “high carbs causes high triglycerides” thing has been known since the 50’s, and that high triglycerides, in turn, cause heart disease has been known almost as long. Makes you wonder how the high carb dietary fad of the last quarter of the last century ever met medical muster. It’s done enormous harm.

What About a Diet High in Fat?

Eating a high fat diet doesn’t increase triglycerides. If triglycerides were elevated from a high carb diet, they will usually drop, and drop triglycerides-and-their-importance-GreatNewsfairly quickly. You will likely lose weight as well.

Adult onset diabetics can have fasting triglyceride levels of 500 or more. Over 150 is considered borderline high by most doctors. Actually, you should shoot for something under 100, preferably closer to 50. To get there, cut out sugar, cut out starch, cut out alcohol. Getting triglycerides below 100 usually will increase the size of the LDL particles, and thus reduce the amount getting behind the artery wall.

If triglycerides are low enough, LDL particle size will become Pattern “A.” But how low is low enough? This varies from person to person. Usually below 100 will do it, but some people need to get their triglycerides significantly lower. The only way to find the triglyceride “tipping point” is to measure, modify, and measure again.

Why Is the Triglyceride Number So Key?

Two main reasons, mentioned above.

First, if triglycerides are low, circulating glucose really couldn’t be all that high. So low triglycerides pretty much insures a stable sugar situation. And if sugar is stable, insulin will be stable too.

Second low enough triglycerides means the very desirable Pattern “A” cholesterol. And Pattern “A” means low heart disease risk.

But there’s no reason to use just one number. Measure them all! There are enough exceptions to these general rules that ‘measure them all’ is not overkill, it is just prudent.

How Low is “low”?

This varies from person to person. The only way to really know is to measure triglycerides and measure LDL cholesterol particle size. At some level, the particle size will flip to Pattern “A.” For some people it could be as high as 125 mg/dl, and others may have to get their triglycerides as low as 50 mg/dl.

To lower triglycerides, cut starch and cut alcohol.

  1 comment for “Triglycerides And Their Importance

  1. Jim
    June 26, 2015 at 7:21 am

    Nice concise representation.

    Can you tell me, when getting a lipid profile, is there one method that stands out above the rest?

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