If you've been told you have high triglycerides - too much fat in your bloodstream - you're not alone. It's estimated that one in four Canadians has an unhealthy triglyceride level, which is linked with heart disease, heart attack, stroke and diabetes.
The good news: High triglycerides, in large part, can be corrected though diet, weight loss and physical activity.
According to a scientific statement issued this month by the American Heart Association, lifestyle changes can lower blood triglycerides by as much as 50 per cent. The researchers came to this conclusion after analyzing more than 500 international studies from the past 30 years.
Triglycerides are a type of fat carried in the blood. When you eat, calories that are not needed right away are converted to triglycerides and stored. When you need energy between meals, hormones prompt fat cells to release triglycerides into the bloodstream.
You can have excessive levels of triglycerides in your bloodstream if you regularly eat more calories than you need - especially sugar and fat calories.
High triglycerides are thought to contribute to the hardening and thickening of artery walls, and as a result increase the risk of cardiovascular disease. Studies suggest that elevated triglycerides are more strongly tied to heart risk in people with lower levels of HDL (good) cholesterol and in those with Type 2 diabetes.
Obesity, lack of exercise, poor diet and alcohol consumption can increase blood triglycerides. High triglycerides also occur in people with poorly controlled diabetes and kidney disease.
Triglycerides are measured as part of a lipid panel, a series of blood tests that measures triglycerides as well as the major forms of cholesterol (total cholesterol, LDL cholesterol, HDL cholesterol). You'll be asked to fast for 12 hours for an accurate measurement.
A normal triglyceride result is less than 1.7 millimoles per litre of blood; borderline high 1.8 to 2.2 mmol/L; high 2.3 to 5.6 mmol/L; very high 5.7 mmol/L and above.
Although the normal cutoff for triglycerides is set at 1.7 mmol/L, the AHA is recommending a new optimal level of less than 1.13 mmol/L.
Many people with elevated triglycerides can reduce their level without medication. However, people with very high triglycerides generally will require medication since high levels may cause pancreatitis (inflammation of the pancreas).
The following strategies can help you significantly lower blood triglycerides and reduce your future risk for heart disease.
Lose excess weight
If you're overweight, cutting calories can lower triglycerides. Study after study has demonstrated that triglycerides are markedly affected by body weight and body fat.
People with a normal weight (body mass index under 25) are far more likely to have healthy triglyceride levels than those who are overweight (BMI 25 to 29.9) or obese (BMI 30 or greater). Having excess fat stored around the abdomen is also related to higher triglyceride levels.
BMI is calculated by dividing your weight in kilograms by your height in metres squared. You can use an online calculator to determine your BMI.
Cut refined carbohydrates
Too much added sugar and too many refined (white) starchy foods can increase triglycerides. Added sugars are found in soft drinks and sweets and also a surprising number of everyday foods such as breakfast cereals, salad dressings, frozen dinners, pasta sauces, soy milk - even peanut butter and bread.
Read nutrition labels. Limit added sugars to fewer than 100 calories per day (25 grams or 6 teaspoons) for women and 150 calories (37 grams or 9 teaspoons) for men. (Four grams of sugar is equivalent to one teaspoon.)
Drink no more than 36 ounces of sugar-sweetened beverages per week (e.g. pop, iced tea, lemonade, fruit drinks, sports drinks). Ideally, avoid these products.
Choose higher-fibre whole grain foods instead of refined carbohydrates. These include oats, 100 per cent whole grain breads and crackers, brown rice, quinoa and whole wheat pasta. Studies suggest that increasing fibre helps lower triglycerides in people with Type 2 diabetes.
This simple sugar is found in table sugar (sucrose), honey and high-fructose corn syrup. It's also found in fruit and vegetables.
Consuming too much fructose enhances fat production in the liver and leads to large increases in blood triglycerides.
Limit processed foods made with fructose.
Choose fruits that are lower in fructose such as cantaloupe, grapefruit, oranges, strawberries, peaches, nectarines and bananas. Vegetables lower in fructose include butternut squash, Brussels sprouts, broccoli, carrots, leaf lettuce, sweet potatoes, okra, spinach and red and white potatoes.
Choose healthier fats
Emphasize heart-healthy monounsaturated fats found in olive oil, peanut oil, canola oil, avocado, almonds and hazelnuts.
Reduce saturated fat by opting for lean meats and low-fat dairy products. Avoid processed foods made with trans fats.
Take fish oil
A daily intake of 2 to 4 grams of DHA (docosahexaenoic acid) plus EPA (eicosapentaenoic acid) combined - the omega-3 fatty acids in fish - has been shown to lower triglycerides by up to 30 per cent.
Most fish-oil capsules provide 300, 500 or 600 milligrams of DHA plus EPA combined. Liquid fish oil often contains 1,300 milligrams of DHA and EPA per teaspoon.
A daily intake of two grams of EPA and DHA can be obtained by taking two fish-oil capsules per day and eating 12 ounces of salmon per week.
As little as one standard drink a day can elevate blood triglycerides by spurring the liver to produce more fat.
If you drink, reduce your intake to no more than one alcoholic drink per day (5 ounces of wine, 1.5 ounces of spirits or 12 ounces of beer). People with very high triglycerides should avoid alcohol completely.
Leslie Beck, a Toronto-based dietitian at the Medcan Clinic, is on CTV's Canada AM every Wednesday. Her website is lesliebeck.com.