and protease inhibitors used to treat
diac arrhythmias, improve visual
HIV.
acuity in preterm infants and has
Simple life style changes are highly
been used to improve cognitive
effective for lowering triglyceride levels.
and mental health. Adding fatty
AGE 17
Changes such as weight loss, exercise
fish to your diet at least twice a
and increased fiber intake all contrib-
week and/or supplementing with
ute to decreasing triglyceride levels. A
fish oil significantly improves tri-
diet with limited intake of simple sugars
glyceride levels.
Cardiac Risk Assessment
such as cakes, candy, cookies, chips
Optimal nutrition is paramount
OBER 2009 / P
and other processed foods is neces-
for lowering triglyceride levels.
Part 2: Triglycerides
sary to decrease triglycerides. A diet
Sufficient levels of chromium, cal-
OCT
Last month we talked about high calorie foods and saturated fats from
low in saturated fat is also effective.
cium, B vitamins and anti-oxidants
cholesterol and how it contributes meat, dairy products and processed
Saturated fat is found in animal prod-
are necessary to sustain a
to the development of coronary ar- foods. The more calories we eat (and
ucts such as meat and dairy. And of
Continued on p. 19
tery disease. I specifically discussed don’t burn off with physical activity), the
course avoiding all trans-fat in your diet
high density lipoprotein or HDL. HDL more triglycerides we produce. This ex-
is a must.
functions to move cholesterol mol- tra energy is stored as fat and levels
Not all fats are detrimental to your
ecules out of the plaque forming become higher in the blood stream.
health. Omega-3 fat found in fatty fish
H
&
cells and to the liver for disposal. It When levels are very high, a fatty liver
such as salmon, tuna, and sardines can
is thus known as “good” cholesterol. and/or pancreatitis—inflammation of
successfully lower triglyceride levels.
W
But there are several HDL subtypes the pancreas can develop.
Omega-3 intake may also prevent car-
and they are not equally beneficial. Those at particular risk for elevated
Subtype HDL2b is protective against triglycerides are diabetics, obese and
heart disease while subtype HDL3 is sedentary individuals, alcoholics, in-
not protective. Cardiac risk assess- dividuals with hypertension and those
ment should include total HDL levels with a family history. Individuals in
as well as HDL subtype levels. these risk groups should have their tri-
Neighbors
In addition, triglyceride levels glyceride levels measured at least once
should be evaluated. Evaluation of a year and treated aggressively if el-
triglyceride levels should not take a evated.
back seat to cholesterol measure- Various medications can also in-
ments. Elevated triglycerides in and crease levels of triglycerides. Most
of themselves are a risk factor for commonly, beta blockers and diuret-
developing coronary artery disease. ics used to treat high blood pressure,
Several epidemiological studies have estrogen therapy in women, tamoxifen
N
E
shown this association. Other stud- and birth control pills. Exogenous es- W
ies have shown elevated triglyceride trogen is thought to increase triglycer-
S
P
levels frequently occur with low lev- ide levels by increasing insulin resis- A
els of HDL. An observational study
P
tance and decreasing the clearance of
E
evaluating lipid panels in patients these fats by the liver. Birth control pills
R
with suspected heart disease found can decrease insulin sensitivity by 40%
a high ratio of triglycerides to HDL in association with increased fatty ac-
was the strongest predictor of heart ids, cholesterol and triglyceride levels.
disease. Other medications which affect triglyc-
Individuals with abnormal levels eride levels are prednisone, Accutane
of triglycerides are at risk not only for
vascular disease such as heart attacks
and strokes, but also cognitive im-
pairment (high levels of triglycerides
appear to be neurotoxic), abdominal
obesity and difficulty losing weight.
In an animal study conducted at St
Louis University School of Medicine,
it was shown that high triglycerides
blocked leptin from passing into the
brain. Leptin is a hormone secreted
by fat cells; when it passes into the
brain it signals us to stop eating. If S
our brains don’t receive this signal
S
E
we keep eating even when we are
N
full leading to a higher risk of weight
L
L
gain.
E
So what are triglycerides? Tri-
W
glycerides are molecules which trans-
d
port fat from the digestive system to
n
other cells. The liver produces triglyc-
a
erides when dietary fats are unavail-
H
T
able. However, most triglycerides re-
L
sult from dietary intake of sugar, high
A
E
H
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