Only my triglycerides are high. How do I fix this?

-Matt from Oregon

Triglyceride is a fancy word for fat. Whether the fat is stored or moving through the bloodstream, it is a triglyceride. Fat gets to our blood:

• From the foods we eat
• When released from our stored fat
• When the liver produces fat.

When we eat fat, it gets into our blood through the intestines. Depending on how much we eat and how much work our muscles are doing, we can burn it for energy or store it in our fat or liver. If cholesterol and triglycerides are measured without fasting, the absorbed fat will not have been cleared from your blood, and triglycerides could look high. Be sure to fast for at least 8, but preferably 12 hours before the test.

Excess calories get stored as fat. Too much sugar, starch, or protein, and it gets converted to fat, transported as triglycerides, and stored as fat.

When triglycerides reach the liver and fat cells, enzymes activate, moving them into the cells. Some people's enzymes do not perform this function properly, so triglycerides stay in the blood even if the person does not overeat. In diabetics, the enzymes are not working properly due to the diabetes. Sugar levels are too high and the excess sugar is converted into triglycerides. In either situation, triglycerides in the blood are high. You do not have to be overweight to have high triglycerides. (More information on reducing triglycerides when you are diabetic.)

The first step in reducing triglycerides is to control the balance of fat and carbohydrates in your diet and avoid overeating. If overweight, reduce calories and exercise regularly to lose the extra pounds. Try to keep each meal balanced with approximately:

• 25% protein
• 25% fat
• 50% complex carbohydrates.

Complex carbohydrates are starches that have fiber so they are absorbed slowly. Examples include vegetables, pears, apples, and legumes. These are the opposite of high glycemic carbohydrates, such as bananas, white flour, white potatoes, and white pasta. These break down into sugar quickly and the excess is converted into triglycerides and stored.

Even if you do all the right things, it is possible your triglycerides are still too high (above 150) because you genetically inherited an inability to clear them. In this case, you will need medication to help lower the value, particularly if your level of High Density Lipoprotein, also known as the good or protective cholesterol, is too low. High triglycerides lead to hardening of the arteries. Extremely high triglycerides, when numbers are in the thousands, can allow fat to deposit in other organs, and cause even more damage.

Eat the optimal amount of the right foods, maintain a healthy weight, and exercise regularly. Then, if necessary, work with your doctor for the proper medication to help.

John Messmer, MD Contributing Expert

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