High LDL and Low Triglycerides: Understanding the Lipid Paradox and Its Health Implications
What are the implications of high LDL cholesterol combined with low triglycerides. How does this lipid profile affect cardiovascular health. Can a healthy diet contribute to this unique cholesterol pattern. What are the potential causes and health effects of low triglyceride levels.
The Lipid Paradox: Decoding High LDL and Low Triglycerides
The combination of high LDL (Low-Density Lipoprotein) cholesterol and low triglycerides presents an intriguing lipid profile that challenges conventional wisdom about cardiovascular health. This unique pattern, often referred to as the “lipid paradox,” warrants a closer examination to understand its implications for overall health and disease risk.
Typically, high LDL levels are associated with an increased risk of heart disease, while low triglycerides are generally considered beneficial. However, when these two factors occur simultaneously, the interpretation becomes more complex. This article delves into the nuances of this lipid profile, exploring its potential causes, health implications, and dietary considerations.
Understanding Lipids: The Building Blocks of Cholesterol
Lipids are essential macronutrients that play crucial roles in the body. They include steroids, phospholipids, and triglycerides. Triglycerides, in particular, serve as both immediate and stored energy sources for the body.
When we consume more calories than our body needs for immediate energy, the excess is converted into triglycerides and stored in fat cells for future use. This process is a normal part of energy metabolism, but imbalances can lead to health concerns.
The Role of Triglycerides in Health
- Energy storage and utilization
- Hormone production
- Cell membrane structure
- Insulation and protection of organs
While high triglyceride levels are commonly associated with increased cardiovascular risk, low levels can also be a cause for concern in certain circumstances.
The LDL Conundrum: Not All Bad Cholesterol Is Created Equal
LDL cholesterol is often labeled as “bad” cholesterol due to its association with atherosclerosis and heart disease. However, recent research has revealed that the story is more complex than initially thought. LDL particles come in different sizes and densities, which can significantly impact their effect on cardiovascular health.
Two Types of LDL Particles
- LDL-A particles: Larger, less dense, and associated with lower heart disease risk
- LDL-B particles: Smaller, denser, and linked to increased heart disease risk
When high LDL levels occur alongside low triglycerides, it may indicate a predominance of LDL-A particles. This scenario could potentially be less harmful than having high levels of small, dense LDL-B particles.
Dietary Factors Influencing the High LDL, Low Triglyceride Profile
Diet plays a crucial role in shaping our lipid profile. Interestingly, a diet rich in healthy fats can contribute to the high LDL, low triglyceride pattern. How does this work?
Consuming healthy fats, such as those found in avocados, nuts, olive oil, and fatty fish, can lead to several beneficial changes in the lipid profile:
- Increase in HDL (High-Density Lipoprotein) cholesterol, often referred to as “good” cholesterol
- Transformation of small, dense LDL particles into larger, less harmful LDL-A particles
- Reduction in triglyceride levels
This dietary pattern may result in a lipid profile that shows high total LDL cholesterol but low triglycerides. While the high LDL number might seem concerning at first glance, the underlying composition of mostly large, buoyant LDL particles could actually indicate a lower cardiovascular risk.
The Impact of Very Low-Fat Diets on Triglyceride Levels
While low-fat diets have been promoted for weight loss and heart health, extremely low-fat diets can have unintended consequences on lipid profiles. How do very low-fat diets affect triglyceride levels?
Consuming a diet extremely low in fat can lead to abnormally low triglyceride levels. While this might seem beneficial, it’s important to remember that some dietary fat is essential for various bodily functions, including:
- Hormone production
- Nutrient absorption
- Brain function
- Cell membrane integrity
A balanced approach to fat consumption, focusing on healthy sources of fats, is generally recommended for optimal health and lipid profiles.
Fasting and Its Effects on Triglyceride Levels
Fasting has gained popularity as a potential health intervention, but how does it impact triglyceride levels? Research has shown that various fasting protocols can significantly reduce triglyceride levels.
A 2010 study found that alternate-day fasting over eight weeks led to a 32% reduction in triglyceride levels. Longer fasting periods may produce even more dramatic results, potentially leading to very low triglyceride levels in individuals who already have normal levels.
Types of Fasting and Their Impact on Triglycerides
- Intermittent fasting (16/8 method): Fasting for 16 hours each day
- Alternate-day fasting: Alternating between fasting days and normal eating days
- Extended fasting: Fasting for 24 hours or more
While fasting can have beneficial effects on lipid profiles, it’s crucial to approach it carefully and under medical supervision, especially for individuals with pre-existing health conditions.
Malnutrition and Its Impact on Lipid Profiles
Malnutrition, whether due to inadequate intake or overnutrition, can significantly affect lipid profiles. How does malnutrition influence triglyceride levels?
Severe undernutrition can lead to abnormally low triglyceride levels as the body depletes its fat stores. This condition is often accompanied by other health issues and should be addressed promptly.
Signs of Malnutrition
- Unintentional weight loss
- Muscle wasting
- Fatigue and weakness
- Compromised immune function
- Changes in skin, hair, and nail health
If low triglyceride levels are accompanied by these symptoms, it’s crucial to seek medical attention to address the underlying nutritional deficiencies.
Interpreting Lipid Panel Results: Beyond the Numbers
A standard lipid panel provides valuable information about various aspects of cholesterol and triglycerides. However, interpreting these results requires looking beyond simple numerical values. What factors should be considered when analyzing lipid panel results?
A comprehensive lipid panel typically includes:
- Total cholesterol
- LDL cholesterol
- HDL cholesterol
- Triglycerides
- Cholesterol/HDL ratio
- Non-HDL cholesterol
While these numbers provide important information, it’s crucial to consider them in the context of overall health, lifestyle factors, and other risk factors for cardiovascular disease.
Advanced Lipid Testing
In cases where the standard lipid panel reveals unusual results, such as high LDL with low triglycerides, advanced lipid testing may be recommended. These tests can provide more detailed information about:
- LDL particle size and number
- Apolipoprotein B levels
- Lipoprotein(a) levels
- Inflammatory markers
This additional information can help healthcare providers make more accurate assessments of cardiovascular risk and tailor treatment plans accordingly.
Lifestyle Modifications for Optimal Lipid Profiles
While genetic factors play a role in determining lipid profiles, lifestyle choices can significantly impact cholesterol and triglyceride levels. What are some effective strategies for maintaining a healthy lipid profile?
Dietary Approaches
- Emphasize whole, unprocessed foods
- Include a variety of fruits and vegetables
- Choose lean proteins and plant-based protein sources
- Incorporate healthy fats from sources like olive oil, avocados, and nuts
- Limit refined carbohydrates and added sugars
- Consider Mediterranean or DASH diet patterns
Physical Activity
Regular exercise can have profound effects on lipid profiles, including:
- Increasing HDL cholesterol
- Reducing triglycerides
- Improving insulin sensitivity
- Promoting weight management
Aim for at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week, along with muscle-strengthening activities at least twice a week.
Stress Management
Chronic stress can negatively impact lipid profiles. Incorporate stress-reducing techniques such as:
- Meditation and mindfulness practices
- Yoga or tai chi
- Deep breathing exercises
- Regular sleep patterns
- Engaging in hobbies and social activities
When to Seek Medical Advice for Unusual Lipid Profiles
While lifestyle modifications can often improve lipid profiles, there are situations where medical intervention may be necessary. When should you consult a healthcare provider about your lipid levels?
- Consistently abnormal lipid panel results despite lifestyle changes
- Family history of premature cardiovascular disease
- Presence of other cardiovascular risk factors (e.g., hypertension, diabetes)
- Symptoms of cardiovascular disease (e.g., chest pain, shortness of breath)
- Extremely low triglyceride levels accompanied by other health concerns
A healthcare provider can perform a comprehensive assessment, considering your overall health status, family history, and other risk factors to determine the most appropriate course of action.
The Future of Lipid Research: Personalized Approaches to Cardiovascular Health
As our understanding of lipid metabolism and cardiovascular health continues to evolve, researchers are exploring more personalized approaches to risk assessment and treatment. What emerging trends are shaping the future of lipid management?
Genetic Testing and Precision Medicine
Advances in genetic testing are allowing for more tailored approaches to lipid management. Genetic variants associated with lipid metabolism can help identify individuals at higher risk for cardiovascular disease, even when their lipid panel results appear normal.
Microbiome Research
The gut microbiome plays a crucial role in lipid metabolism. Ongoing research is investigating how modulating the gut microbiome through diet, probiotics, or other interventions might influence lipid profiles and cardiovascular health.
Novel Biomarkers
Researchers are exploring new biomarkers that may provide more accurate assessments of cardiovascular risk. These include:
- Apolipoprotein profiles
- Inflammatory markers
- Oxidative stress indicators
- Endothelial function markers
As these areas of research progress, we may see more sophisticated and individualized approaches to lipid management and cardiovascular disease prevention.
In conclusion, the combination of high LDL cholesterol and low triglycerides presents a complex lipid profile that requires careful interpretation. While traditionally viewed as contradictory indicators of cardiovascular health, emerging research suggests that this pattern may not always signify increased risk. Factors such as LDL particle size, dietary habits, and overall health status must be considered when evaluating the implications of this lipid profile.
Maintaining a healthy lifestyle, including a balanced diet rich in healthy fats, regular physical activity, and stress management, remains crucial for optimal lipid profiles and cardiovascular health. For individuals with persistent lipid abnormalities or additional risk factors, consultation with a healthcare provider is essential to develop a personalized approach to cardiovascular risk management.
As our understanding of lipid metabolism continues to evolve, we can look forward to more nuanced and individualized strategies for assessing and managing cardiovascular health. This progress holds the promise of more effective prevention and treatment of cardiovascular disease, ultimately leading to improved health outcomes for individuals with diverse lipid profiles.
High LDL, Diet, Symptoms, Dangers, and More
Lipids, also referred to as fats, are one of the three macronutrients that are an essential part of the diet. There are various types of lipids, including steroids, phospholipids, and triglycerides. Triglycerides are a type of lipid that the body can use for both immediate and stored energy.
When you eat a meal, your body uses the nutrients from that meal as energy or fuel. However, if you eat a meal with too much energy (too many calories), this excess energy gets converted into triglycerides. These triglycerides are stored in fat cells for use at a later time.
The most common concern about triglycerides is high triglyceride levels.
High levels of triglycerides in the blood may contribute to atherosclerosis, the clogging and hardening of the arteries. Because of this, high triglyceride levels may increase your risk of heart disease, heart attack, or stroke.
Low triglyceride levels may be a health concern as well. Let’s look at how low triglycerides may affect your health and how to prevent and treat related problems.
The most common blood test used to check your triglyceride levels is called a lipid panel. A standard lipid panel will test for the following:
- total cholesterol
- LDL (“bad”) cholesterol
- HDL (“good”) cholesterol
- triglycerides
- cholesterol/HDL ratio
- non-HDL cholesterol
Your doctor will use a lipid panel to determine if your triglyceride levels are within normal range.
Normal triglyceride levels are
There is no current range for low triglyceride levels. However, if your triglyceride levels are very low, this may indicate an underlying condition or disease.
A healthy diet
We know that an unhealthy diet can cause high triglycerides, while a healthy diet generally leads to low triglycerides.
One interesting note is that sometimes low triglyceride levels can occur with high LDL levels (which often indicate a higher heart disease risk). If low triglyceride levels lower heart disease risk, but high LDL levels increase it, what can cause this inconsistency?
There are two types of LDL particles that should be taken into account when calculating heart disease risk:
- LDL-A particles are larger, less dense, and lower your risk.
- LDL-B particles are smaller, denser, and increase your risk.
When you have low triglyceride levels but high LDL levels, it could indicate that you have a diet filled with healthy fats.
Healthy fats will not only cause an increase in good cholesterol (HDL) but can also change the type of the LDL particles in the blood. Therefore, those high LDL levels may not actually be a bad thing.
Instead, it is more likely that they are LDL particles that have become larger and less dense from the intake of healthy fat. Low triglycerides and high HDL levels in the blood will generally support this idea.
A very low-fat diet
Low-fat diets aren’t necessarily unhealthy. Research has shown that low-fat diets can be an effective way to lose weight. However, anything done on an extreme scale can be dangerous, and very low-fat diets are no exception to the rule.
People on low-fat diets who are consuming very little fat may have lower triglyceride levels. With fat being an essential part of human metabolism, it is important to consume at least some fat — preferably, the healthy kind.
Long-term fasting
Fasting is the abstinence of food and drink, and for some people it’s one of the ways in which they improve their health. Fasting can have many health benefits, from lowering blood sugar and lipid levels to aiding in weight loss.
In a small 2010 study, researchers found that in people who partook in alternate-day fasting (a type of intermittent fasting) over eight weeks, triglyceride levels were lowered by roughly 32 percent.
A longer period of fasting may produce more dramatic results. For those with already normal levels, this could potentially lead to very low triglyceride levels.
Instead of fasting for long periods of time, or fasting every other day, a shorter stint of intermittent fasting may be just as effective, without lowering your levels too much. This could mean fasting for 8 or 16 hours each day, rather than skipping food entirely for 24 hours.
Malnutrition
Malnutrition occurs when the body is not getting enough of, or alternately too much of, certain nutrients. According to the World Health Organization, more than 2.3 billion adults worldwide experience malnutrition in some form.
Undernutrition can lead to deficiencies in important nutrients, including macronutrients such as lipids. Some symptoms of malnutrition include:
- weight loss, fat loss, and muscle mass loss
- hollow cheeks and eyes
- a protruding, or swollen, stomach
- dry and brittle hair, skin, or nails
- emotional symptoms, such as depression, anxiety, and irritability
If someone is experiencing severe undernutrition, their triglyceride levels may be well below the normal range. Undernutrition is best treated with increased food intake and, in some cases, supplementation of vitamins and minerals.
Malabsorption
Malabsorption is a condition in which the small intestine is unable to properly absorb the nutrients from food. Causes of malabsorption may include damage to the digestive tract, diseases affecting the digestive tract, or even certain drugs.
For people who experience malabsorption, the body may not be able to properly absorb carbohydrates, proteins, or fats.
There are many symptoms of malabsorption. However, fat malabsorption can lead to a condition called steatorrhea. Steatorrhea is a major indicator that your body isn’t absorbing fats properly. You may notice:
- pale and foul-smelling stools
- stools that are bulkier and float
- grease or fat in your stools
- drops of oil or fat in the water surrounding your stools
People who have trouble absorbing fats may have low triglyceride levels. Treatment for steatorrhea involves addressing underlying conditions that may be causing malabsorption with medication and lifestyle changes.
Hyperthyroidism
The thyroid gland plays a crucial role in regulating metabolism. In people with an overactive thyroid (hyperthyroidism), regular metabolic processes can be greatly affected. Some of the symptoms of hyperthyroidism include:
- an enlarged thyroid gland, called a goiter
- unintentional weight loss and appetite changes
- alterations in heart rate
- thinning of the skin and hair
- cognitive changes, such as increased anxiety or nervousness
One of the biggest indicators of hyperthyroidism is unintentional weight loss. Generally, this weight loss occurs regardless of food intake.
This means that the body is always using up more energy than that person is consuming. People with hyperthyroidism may have low levels of triglycerides due to the increased use of these triglycerides for fuel.
Blood tests that measure levels of thyroxine and thyroid-stimulating hormone may be used to diagnose hyperthyroidism. It’s generally treated with medication and lifestyle changes.
Cholesterol-lowering drugs
According to a 2015 report from the Centers for Disease Control and Prevention, roughly “78.1 million Americans were already taking or are eligible for cholesterol-lowering medication.” Cholesterol medication, or lipid-lowering drugs, are one of the ways in which people can get their cholesterol levels under control.
There are many different types of lipid-lowering medications, including statins, PCSK9 inhibitors, and more. Statins, fibrates, and omega-3 fatty acid ethyl esters are three types of lipid-lowering drugs that are known to lower triglyceride levels.
If you’re concerned that your cholesterol-lowering drugs are causing your triglyceride levels to drop too low, consider speaking with a doctor to switch medications.
Low triglyceride levels are generally not dangerous. In fact, research supports the idea that low triglyceride levels can offer certain health benefits.
In one 2014 study, researchers found that lower non-fasting triglyceride levels were associated with a reduction in all-cause mortality in almost 14,000 study participants.
Another smaller 2017 study found that low triglyceride levels were linked to improved brain function in older adults without dementia.
However, incredibly low triglyceride levels may be linked to other conditions, as mentioned above. Some of these conditions in and of themselves may be dangerous, so it becomes important to treat the underlying condition that’s causing low triglycerides.
The best treatment for low triglycerides is to find and treat the underlying cause. For some conditions, such as malnutrition, it may be as simple as making dietary changes. For other conditions, such as malabsorption and hyperthyroidism, medication and lifestyle changes may be necessary.
If low triglyceride levels are the result of not getting enough fat in the diet, here are some suggestions for healthy dietary practices:
- Total dietary fat intake should be anywhere from 20–35 percent of total calories for the average person not on a low-fat diet.
- Monounsaturated and polyunsaturated fats should make up the majority of fat consumed in the diet, as these are the most heart healthy.
- Saturated fats and cholesterol should be limited, and artificial trans fats should never be consumed.
Keeping your triglycerides within the normal range is relatively easy with a well-rounded diet. The American Heart Association (AHA) recommends the following dietary and lifestyle changes to keep your heart healthy and your triglyceride levels normal:
- Keep your calories within normal range for your age, gender, and activity level.
- Eat a varied diet that includes all the major food groups, especially fruits, vegetables, and heart-healthy oils.
- Avoid overeating foods that contain empty calories, as these can be stored as fat.
If you’re concerned that your triglyceride levels are low for another reason, such as an underlying condition, reach out to your doctor. They can use a lipid test, among other medical tests, to find the root cause of your low triglyceride levels.
High LDL, Diet, Symptoms, Dangers, and More
Lipids, also referred to as fats, are one of the three macronutrients that are an essential part of the diet. There are various types of lipids, including steroids, phospholipids, and triglycerides. Triglycerides are a type of lipid that the body can use for both immediate and stored energy.
When you eat a meal, your body uses the nutrients from that meal as energy or fuel. However, if you eat a meal with too much energy (too many calories), this excess energy gets converted into triglycerides. These triglycerides are stored in fat cells for use at a later time.
The most common concern about triglycerides is high triglyceride levels.
High levels of triglycerides in the blood may contribute to atherosclerosis, the clogging and hardening of the arteries. Because of this, high triglyceride levels may increase your risk of heart disease, heart attack, or stroke.
Low triglyceride levels may be a health concern as well. Let’s look at how low triglycerides may affect your health and how to prevent and treat related problems.
The most common blood test used to check your triglyceride levels is called a lipid panel. A standard lipid panel will test for the following:
- total cholesterol
- LDL (“bad”) cholesterol
- HDL (“good”) cholesterol
- triglycerides
- cholesterol/HDL ratio
- non-HDL cholesterol
Your doctor will use a lipid panel to determine if your triglyceride levels are within normal range.
Normal triglyceride levels are
There is no current range for low triglyceride levels. However, if your triglyceride levels are very low, this may indicate an underlying condition or disease.
A healthy diet
We know that an unhealthy diet can cause high triglycerides, while a healthy diet generally leads to low triglycerides.
One interesting note is that sometimes low triglyceride levels can occur with high LDL levels (which often indicate a higher heart disease risk). If low triglyceride levels lower heart disease risk, but high LDL levels increase it, what can cause this inconsistency?
There are two types of LDL particles that should be taken into account when calculating heart disease risk:
- LDL-A particles are larger, less dense, and lower your risk.
- LDL-B particles are smaller, denser, and increase your risk.
When you have low triglyceride levels but high LDL levels, it could indicate that you have a diet filled with healthy fats.
Healthy fats will not only cause an increase in good cholesterol (HDL) but can also change the type of the LDL particles in the blood. Therefore, those high LDL levels may not actually be a bad thing.
Instead, it is more likely that they are LDL particles that have become larger and less dense from the intake of healthy fat. Low triglycerides and high HDL levels in the blood will generally support this idea.
A very low-fat diet
Low-fat diets aren’t necessarily unhealthy. Research has shown that low-fat diets can be an effective way to lose weight. However, anything done on an extreme scale can be dangerous, and very low-fat diets are no exception to the rule.
People on low-fat diets who are consuming very little fat may have lower triglyceride levels. With fat being an essential part of human metabolism, it is important to consume at least some fat — preferably, the healthy kind.
Long-term fasting
Fasting is the abstinence of food and drink, and for some people it’s one of the ways in which they improve their health. Fasting can have many health benefits, from lowering blood sugar and lipid levels to aiding in weight loss.
In a small 2010 study, researchers found that in people who partook in alternate-day fasting (a type of intermittent fasting) over eight weeks, triglyceride levels were lowered by roughly 32 percent.
A longer period of fasting may produce more dramatic results. For those with already normal levels, this could potentially lead to very low triglyceride levels.
Instead of fasting for long periods of time, or fasting every other day, a shorter stint of intermittent fasting may be just as effective, without lowering your levels too much. This could mean fasting for 8 or 16 hours each day, rather than skipping food entirely for 24 hours.
Malnutrition
Malnutrition occurs when the body is not getting enough of, or alternately too much of, certain nutrients. According to the World Health Organization, more than 2.3 billion adults worldwide experience malnutrition in some form.
Undernutrition can lead to deficiencies in important nutrients, including macronutrients such as lipids. Some symptoms of malnutrition include:
- weight loss, fat loss, and muscle mass loss
- hollow cheeks and eyes
- a protruding, or swollen, stomach
- dry and brittle hair, skin, or nails
- emotional symptoms, such as depression, anxiety, and irritability
If someone is experiencing severe undernutrition, their triglyceride levels may be well below the normal range. Undernutrition is best treated with increased food intake and, in some cases, supplementation of vitamins and minerals.
Malabsorption
Malabsorption is a condition in which the small intestine is unable to properly absorb the nutrients from food. Causes of malabsorption may include damage to the digestive tract, diseases affecting the digestive tract, or even certain drugs.
For people who experience malabsorption, the body may not be able to properly absorb carbohydrates, proteins, or fats.
There are many symptoms of malabsorption. However, fat malabsorption can lead to a condition called steatorrhea. Steatorrhea is a major indicator that your body isn’t absorbing fats properly. You may notice:
- pale and foul-smelling stools
- stools that are bulkier and float
- grease or fat in your stools
- drops of oil or fat in the water surrounding your stools
People who have trouble absorbing fats may have low triglyceride levels. Treatment for steatorrhea involves addressing underlying conditions that may be causing malabsorption with medication and lifestyle changes.
Hyperthyroidism
The thyroid gland plays a crucial role in regulating metabolism. In people with an overactive thyroid (hyperthyroidism), regular metabolic processes can be greatly affected. Some of the symptoms of hyperthyroidism include:
- an enlarged thyroid gland, called a goiter
- unintentional weight loss and appetite changes
- alterations in heart rate
- thinning of the skin and hair
- cognitive changes, such as increased anxiety or nervousness
One of the biggest indicators of hyperthyroidism is unintentional weight loss. Generally, this weight loss occurs regardless of food intake.
This means that the body is always using up more energy than that person is consuming. People with hyperthyroidism may have low levels of triglycerides due to the increased use of these triglycerides for fuel.
Blood tests that measure levels of thyroxine and thyroid-stimulating hormone may be used to diagnose hyperthyroidism. It’s generally treated with medication and lifestyle changes.
Cholesterol-lowering drugs
According to a 2015 report from the Centers for Disease Control and Prevention, roughly “78.1 million Americans were already taking or are eligible for cholesterol-lowering medication.” Cholesterol medication, or lipid-lowering drugs, are one of the ways in which people can get their cholesterol levels under control.
There are many different types of lipid-lowering medications, including statins, PCSK9 inhibitors, and more. Statins, fibrates, and omega-3 fatty acid ethyl esters are three types of lipid-lowering drugs that are known to lower triglyceride levels.
If you’re concerned that your cholesterol-lowering drugs are causing your triglyceride levels to drop too low, consider speaking with a doctor to switch medications.
Low triglyceride levels are generally not dangerous. In fact, research supports the idea that low triglyceride levels can offer certain health benefits.
In one 2014 study, researchers found that lower non-fasting triglyceride levels were associated with a reduction in all-cause mortality in almost 14,000 study participants.
Another smaller 2017 study found that low triglyceride levels were linked to improved brain function in older adults without dementia.
However, incredibly low triglyceride levels may be linked to other conditions, as mentioned above. Some of these conditions in and of themselves may be dangerous, so it becomes important to treat the underlying condition that’s causing low triglycerides.
The best treatment for low triglycerides is to find and treat the underlying cause. For some conditions, such as malnutrition, it may be as simple as making dietary changes. For other conditions, such as malabsorption and hyperthyroidism, medication and lifestyle changes may be necessary.
If low triglyceride levels are the result of not getting enough fat in the diet, here are some suggestions for healthy dietary practices:
- Total dietary fat intake should be anywhere from 20–35 percent of total calories for the average person not on a low-fat diet.
- Monounsaturated and polyunsaturated fats should make up the majority of fat consumed in the diet, as these are the most heart healthy.
- Saturated fats and cholesterol should be limited, and artificial trans fats should never be consumed.
Keeping your triglycerides within the normal range is relatively easy with a well-rounded diet. The American Heart Association (AHA) recommends the following dietary and lifestyle changes to keep your heart healthy and your triglyceride levels normal:
- Keep your calories within normal range for your age, gender, and activity level.
- Eat a varied diet that includes all the major food groups, especially fruits, vegetables, and heart-healthy oils.
- Avoid overeating foods that contain empty calories, as these can be stored as fat.
If you’re concerned that your triglyceride levels are low for another reason, such as an underlying condition, reach out to your doctor. They can use a lipid test, among other medical tests, to find the root cause of your low triglyceride levels.
Low cholesterol is associated with a high risk of stroke in women
Lowering low-density cholesterol (LDL) levels reduces the risk of heart attacks and stroke, with an ideal value of less than 100 mg/dL. But can this level be too low? A new study has found that women with LDL levels of 70 mg/dL and below are twice as likely to have a hemorrhagic stroke than women with LDL levels of 100-130 mg/dL. LDL is called “bad” cholesterol because it can lead to fat buildup in the arteries. The study also showed that women with the lowest triglyceride levels had a higher risk of developing hemorrhagic stroke compared to women with elevated triglyceride levels.
Hemorrhagic strokes, also known as hemorrhages, are much less common than ischemic strokes, which block blood flow to the brain. They are much more difficult to treat and, as a result, are much more likely to be fatal.
“Strategies to lower cholesterol and triglycerides, such as diet or statin therapy, are being used to prevent cardiovascular disease,” study author Pamela Rist said. “But our study shows that for women, very low values of these parameters can also be dangerous. Women initially have a higher risk of stroke than men, in part because they live longer, so it is important to identify ways to reduce these risks.”
The study involved 27937 women aged 45 years and older. All of these women were included in the Women’s Health study, in which they measured total cholesterol, LDL, HDL and triglycerides. The researchers then analyzed the records to determine how many women had strokes. On average, over 19 years of observation, scientists identified 137 such women.
Stroke occurred in 9 of 1069 women with cholesterol levels of 70 mg/dL or lower (0.8%), compared with 40 of 10067 with cholesterol levels of 100-130 mg/dL (0.4%). After controlling for other factors that may have affected the development of a stroke (age, smoking, high blood pressure, treatment with cholesterol-lowering drugs), the researchers found that patients with very low LDL levels were 2.2 times more likely to have a bleeding stroke.
Also, 34 of 5714 women (0.6%) with the lowest triglyceride levels had a stroke, compared with 29 of 7989 women (0.4%) with the highest triglyceride levels. After adjusting for other factors that can also increase the risk of stroke, the researchers found that those with the lowest triglyceride levels were twice as likely to bleed.
No difference was found for total cholesterol and HDL cholesterol.
“Women with very low LDL cholesterol or low triglycerides should be further screened for other risk factors for stroke in order to reduce the chance of hemorrhagic stroke,” said Pamela Rist. “Furthermore, more research is needed to determine how to reduce the risk of hemorrhagic stroke in women with very low LDL and low triglyceride levels.”
One of the limitations of this study was that cholesterol and triglyceride levels were measured only once, at the start of the study. In addition, a large number of women have already reached menopause at the time of the initial measurement, which makes it impossible to accurately determine whether this fact affects the relationship between cholesterol and triglyceride levels and the development of bleeding.
Expert opinion: Hemorrhagic stroke is an acute violation of cerebral circulation with rupture of blood vessels and hemorrhage in the brain. According to statistics, it is among the top five pathologies ending in death. Despite the fact that this study left more questions than answers, this work can serve as a starting point for a more detailed study.
Triglycerides
Triglycerides are fats, one of the main sources of energy for body cells. An increase in their level increases the risk of heart and vascular disease, as well as the risk of developing acute pancreatitis.
Synonyms Russian
Blood lipids, neutral fats, TG.
Synonyms English
TG, Trig, Triglycerides.
Test method
Colorimetric photometric method.
Units
mmol/l (millimoles per litre).
What biomaterial can be used for research?
Venous blood.
How to properly prepare for an examination?
- Do not eat for 12 hours before the test.
- Avoid physical and emotional stress and do not smoke for 30 minutes prior to the examination.
General information about the study
Triglycerides are fats that are the main source of energy for the body. Most of the triglycerides are found in adipose tissue, but some of them are in the blood, providing energy to the muscles. After a meal, triglyceride levels rise as the body converts energy that is not needed now into fat. Triglycerides are absorbed in the intestines and, transported through the blood, are deposited in adipose tissue in reserve. Between meals, they are burned, releasing energy for the body.
Since triglycerides are insoluble in water, they are carried in the blood with a protein in the form of a complex called lipoprotein. There are several types of lipoproteins that differ in the proportions of their components:
- very low density lipoproteins (VLDL),
- low density lipoproteins (LDL),
- high density lipoproteins (HDL).
Most triglycerides in the body are carried by very low density lipoproteins (VLDL).
An increase in triglycerides increases the risk of developing cardiovascular diseases, although their causes are not fully understood. There are a number of factors contributing to this: decreased physical activity, overweight, smoking, alcohol abuse, and diabetes.
In addition, triglycerides significantly increase the risk of developing an acute inflammation of the pancreas – acute pancreatitis.
What is research used for?
- To assess the risk of developing atherosclerosis and problems with the heart and blood vessels. Atherosclerosis is the process of plaque growth inside the vessels, which can restrict blood flow or completely block the lumen of the vessel.
- To monitor the effectiveness of a reduced animal fat diet and monitor blood lipid levels after administration of triglyceride and cholesterol (cholesterol) lowering drugs.
When is the test ordered?
- Together with a total cholesterol test or as part of a lipid profile that also includes LDL-C, VLDL-C, HDL-C, triglycerides and atherogenic index. A lipid profile is recommended for all adults over 20 years of age at least once every 5 years.
- At routine check-ups or more frequently (several times a year) if the person is prescribed a low-fat diet and/or is taking triglyceride and cholesterol-lowering medications. In these cases, it is checked whether the target lipid level is reached and, accordingly, whether the risk of cardiovascular diseases is reduced.
- It is especially important to check triglycerides in diabetics, as fluctuations in sugar levels increase triglycerides.
- If one or more risk factors for cardiovascular disease are present in the patient’s lifetime:
- smoking,
- age (men over 45, women over 55),
- high blood pressure (140/90 mmHg and above),
- high cholesterol or cardiovascular disease in other family members (heart attack or stroke in the closest male relative under 55 years of age or female under 65 years of age),
- ischemic heart disease, myocardial infarction or stroke,
- diabetes,
- overweight,
- alcohol abuse,
- intake of large amounts of food containing animal fats,
- low physical activity.
- If a child in the family had a history of high cholesterol or heart disease at a young age, it is recommended to take a cholesterol test for the first time between the ages of 2 and 10 years.
What do the results mean?
Reference values (normal triglycerides):
Clinical guidelines 1 , level
“Diagnostics and correction of lipid metabolism disorders for the prevention and treatment of atherosclerosis. Russian guidelines, VII revision. 2020”.
“2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk”.
Interpretation of the results should be made taking into account other analyzes included in the lipid profile.
Causes of high triglyceride levels (hypertriglyceridemia)
Hypertriglyceridemia may be the result of a hereditary predisposition or excessive dietary intake of animal fats. Most people with high cholesterol have some degree of both.
Other causes of high triglycerides must be ruled out before starting treatment:
- alcoholism,
- chronic inflammation of the kidneys leading to nephrotic syndrome,
- chronic renal failure,
- decreased thyroid function (hypothyroidism),
- poorly treated diabetes mellitus,
- pancreatitis,
- myocardial infarction – in this case, elevated levels may persist for up to several months,
- gout.
Low triglyceride levels (hypotriglyceridemia) are not of particular clinical significance. May occur under the following conditions:
- hereditary hypolipoproteinemia,
- increased thyroid function (hyperthyroidism),
- intestinal malabsorption,
- chronic obstructive pulmonary disease,
- cerebral infarction.
What can influence the result?
Triglyceride levels may remain significantly (up to 5-10 times) elevated even several hours after a meal.
Blood samples taken on an empty stomach at different times may also vary. In some people, triglyceride levels change by 40% within one month. This phenomenon is called biological variation and reflects the normal fluctuations in cholesterol metabolism in the body. As a result, a single measurement does not always reflect the “usual” level of triglycerides, so a retake of the analysis is sometimes required.
Increase triglyceride levels:
- fat-rich foods,
- drinking alcohol,
- pregnancy (to be tested at least 6 weeks after delivery),
- oral contraceptives, cholestyramine, furosemide, veroshpiron, cordarone, corticosteroids.