Perhaps it is because I am getting older that I think cartoons are not what they used to be. I have five young children, all boys. Like any concerned parent I govern what they watch. I have found that some of the most detrimental shows on television are actually the cartoons because of the values, or lack of them, that they teach.
Fortunately some of the classics are still around. My favorite has always been that wascally wabbit Bugs Bunny and his trademark expression, “What’s up, Doc?” Unfortunately, for many of us the answer to the question, “What’s up, Doc?” is, “Your triglycerides.” Triglycerides are becoming increasingly important in heart health matters. In fact in the ‘Third Report of the National Cholesterol Education Program (NCEP)’, triglyceride testing is recommended as part of a complete cholesterol profile. In other words, it is recommended that doctors evaluate high cholesterol treatments in respect to a patient’s triglyceride levels.
So what’s up with triglycerides? Or perhaps we should phrase the question this way, “Why are my triglycerides so high?” If high triglycerides are really a serious health concern (and they are) then we are wise to be concerned if ours are high. Of course your doctor is the one to isolate the particular cause or causes of your elevated triglyceride levels. Or perhaps you do not have high triglycerides and are concerned to keep things that way. Either way let’s consider some of the things that influence triglyceride levels.
I enjoy backing into a subject so let’s begin with some causes that are not so common. The first grouping can be classified as medical conditions. These would include but are not limited to the following:
Hypothyroidism is one such condition. It occurs when the thyroid does not properly control metabolism resulting in fatigue, weakness, weight gain, cold intolerance as well as many other uncomfortable symptoms. It also tends to raise triglycerides.
Nephrotic syndrome is a serious kidney disease characterized by high levels of protein in the urine and low levels of protein in the blood. It also produces swelling around the eyes, feet and hands due to the retention of fluids. In addition to raising triglycerides it can also raise LDL cholesterol which is tied to coronary heart disease.
Several liver diseases can negatively affect triglyceride levels. One particular liver condition, known as fatty liver, involves the overproduction and accumulation of triglycerides and other fats in liver cells. Severe cases can result in liver cell death.
Familial hypertriglyceridemia refers to a group of rare genetic disorders resulting in high triglyceride levels. It occurs when the lever produces too much triglyceride and in severe cases can cause triglyceride levels in excess of 1,000 mg/dL and pancreatitis (acute or chronic inflammation of the pancreas).
Pregnancy is a not so rare medical condition that causes triglycerides to rise temporarily (usually in the third trimester). The preventive cure for pregnancy, abstinence, is readily available but must people find it a difficult pill to swallow.
Closely related to medical conditions are the medications we take to cure them. Some medications can negatively affect LDL and HDL cholesterols as well as triglycerides. Usually when a patient stops taking the medication his triglyceride levels return to what they were before taking the medication. If you are taking prescribed medicines ask your doctor if they can negatively affect cholesterol and triglycerides.
So much for the less common causes of elevated triglycerides. But now it is time to consider those causes which are usually to blame for our unhealthy condition. It is a short list beginning with diabetes.
Of course diabetes is a serious disease in many respects. In relation to heart disease it is treated as a risk factor equal to that of someone who has documented coronary heart disease. Persons with diabetes who experience a myocardial infarction (heart attack) have an unusually high death rate in either the short or long term. Therefore diabetics need to be very aggressive in lowering triglycerides and LDL cholesterol.
Obesity is next on the list for the most common causes of high triglycerides. Triglycerides are the primary fat in our bodies, the main constituent in our energy system. People who are overweight tend to have much higher levels of these fats. They also have higher LDL cholesterol levels which are perhaps even more serious.
It would not be appropriate to assume that obesity has the same cause in every case. There are many conditions (like hypothyroidism) which can attribute to uncontrollable weight gain. These conditions are beyond our present topic. But I do have to ask this question: Why is obesity on the increase? The United States is becoming fatter. I think most of us suspect that changes in lifestyle habits are the primary contributors to the increase in obesity.
At this point our subject matter takes a turn. The causes we have already discussed are in many cases beyond our control (pregnancy being an obvious exception). Diabetics do not choose to be diabetics. But interestingly enough as we approach the most common cause of rising triglycerides we find ourselves in territory where we do have control. Some causes of obesity are difficult to control. Some are not. These latter causes deserve our focus precisely because we can do something about them. We can get more exercise. It may not be easy or convenient but we can do something about our lethargy. We don’t get enough exercise because we choose not to. Lack of exercise attributes to triglyceride buildup and obesity. In short, we often have high triglycerides because we choose to.
And now we have arrived at the most common cause of elevated triglycerides. And it is also the most controllable. Drum roll please….it is diet. They say you are what you eat. I hope that is not true. I love catfish and it is a bottom feeder. But in respect to health it is often a true statement. Your diet dramatically affects your health. This is most assuredly true when it comes to triglycerides. Our bodies both take in triglycerides when we eat and manufacture triglycerides from the things we eat. That is how we make energy. But diets high in certain foods and low in others cause the body to create and store inordinate amounts of triglycerides. Top on the list is sugar. Simple sugar is easily converted into triglycerides. We were never created to consume the large amounts of processed sugar that have become commonplace in our culture. Other simple carbohydrates also function like sugar. To reduce your triglycerides stay away from simple sugar and carbohydrates and their kissing cousin, alcohol. Complex carbohydrates like whole grains are another matter. They convert to triglycerides much more slowly.
Since triglycerides are fats, a diet high in fat is also a bad idea. But when I mention fats I have in mind mostly saturated fats and of course anything that contains trans-fats. Some fats however should be consumed in large amounts in order to reduce triglycerides. These are polyunsaturated fats especially omega-3. Omega-3 (particularly from fish sources) is well documented to dramatically lower triglycerides. In fact the American Heart Association recommends 2 to 4 grams of omega-3 from DHA plus EPA every day for those trying to reduce triglycerides. That requires eating a whole lot of cold water fatty fish. You can also buy quality fish oil supplements. But buy from a trusted source to guarantee that you are getting what you are paying for and nothing more, such as mercury.
So what’s up with triglycerides? Now you know. The main thing that is up with triglycerides is poor dieting. Fortunately this is within our control. We can be healthier if we choose to be. It simply takes a little awareness and a whole lot of discipline. So the next time you say, “What’s up, doc?” maybe the response will not be, “Your triglycerides.” Maybe it will be, “Your health scores.”