Triglyceride – The Neglected Fat

This article is Part 2 of my earlier  article “What is Cholesterol- The Good and the Bad”

While people are aware of Cholesterol and know that it can be harmful if present  in excess in the blood, few know about Triglycerides and their potentially harmful effects.

For a long time the role of triglycerides in the causation of heart disease was uncertain. Their nature and function is now better understood.

When the doctor measures your cholesterol, he also asks for a Triglyceride level.

What are Triglycerides

Triglycerides are a type of Fat, formed from one molecule of Glycerol, combined with three Fatty Acids. They come from the food we eat as well as being produced in the body. See my Article– What is all the Fuss about Fats”

The Fatty Acids can be either saturated, mono-unsaturated or poly unsaturated.

Saturated fatty acids typically occur in fats of animal origin, including dairy foods and fat in meat.  

monounsaturated fatty acids occur in plant fats, such as , Olive and Canola oil, and nuts such as macadamia.

polyunsaturated fatty acids are of two main types: omega-3’s, which occur in fish oils  and omega-6’s which are present in plant

oils such as  safflower and sunflower seeds

The type and proportion of fatty acids determines  the physical properties and appearance of the the triglyceride . For example cheese and butter are solid at room temperature while olive oil, safflower and canola are usually liquid.

When we ingest Fat in our diet, the digestive process called lipolysis breaks down the triglycerides into glycerol and fatty acids which are transported to the small intestine. In the wall of the small intestine there are cells called enterocytes. The fatty acids are absorbed into these cells and  they are re-formed into triglycerides and combined with cholesterol (VLDL) and proteins into particles called chylomicrons . These chylomicrons are excreted  from the cells, collected and transported via the Lymphatic System before they enter the blood stream via the large vessels near the heart. They are then used by various tissues for energy or taken up by fat cells for storage.

The Function of Triglycerides

The fat tissue under the skin of animals, birds and fish is mainly made of triglyceride and is essential for life ; it is

– part of the heat regulating system. It insulates the body against heat loss

– provides energy for metabolism and various bodily functions.                                              

Whaling is a very topical subject at the moment in the world-wide press. In the 1800’s, the whalers were very aware  of the importance and value of the fat under the skin of whales. This ” blubber”, which is mainly made of triglycerides, serves to insulate the whale against the cold and provide energy for its metabolism.

Blubber was melted down and transported in barrels to Europe where it provided the oil for lighting and heating for many years.

How is Triglyceride Measured

In humans it is possible to find the type and measure of fats ingested in the everyday diet by taking a biopsy of the sub-cutaneous fat and analyzing its fatty acid content.

Normally your Doctor will check your blood triglyceride level, when checking your Cholesterol. This is done after an over-night fast   ( ideally at least 12 hours ) . This is necessary for consistency in testing , because soon after a meal the blood triglyceride level will be high due to absorption from fatty food. The level will remain high for several hours.

Because, Alcohol, certain medications and over-the- counter products and supplements may affect your Triglyceride level, it is important to make certain that your Doctor knows exactly what you are taking.  It may be necessary to stop these for a short period prior to a test. But remember NEVER stop taking prescribed medication unless advised to do so by your Doctor.

Drugs that can increase triglyceride measurements include beta blockers, cholestyramine, oestrogens, protease inhibitors, retinoids, certain anti psychotics, and birth control pills.

Drugs that can decrease triglyceride measurements include Vitamin C (ascorbic acid), asparaginase, clofibrate, fenofibrate, fish oil, gemfibrozil, nicotinic acid, and statin medications.

The National Heart Foundation of Australia make the following recommendations:

The suggested target levels for blood cholesterol are:
– LDL-cholesterol <2.0 mmol/L
– HDL-cholesterol > 1.2 mmol/L
– Triglycerides <1.5 mmol/L

in the absence of any other risk factors. If other diseases are present the recommendation is for an even lower level

Why should we be concerned about Triglycerides.

Triglycerides play an important role in diseases such as Obesity, Diabetes and Heart Disease.

The metabolism of Triglycerides(TG) is intimately linked to that of Cholesterol, both LDL and HDL.  Changes in Triglyceride levels can  affect LDL (bad cholesterol) and HDL  levels. This is especially so in relation to HDL – the “good cholesterol”.  When there is a rise in triglyceride there tends to a fall in HDL which is not good . When TG is low the HDL tends to be high  – this is good.  Therefore it is important for the Doctor to consider each of these fats together. For a long time this was not the case and triglycerides were the ” forgotten fats”.

  • A raised TG can have an effect on certain clotting factors in the blood. This can increase the tendency for thrombosis to occur and an increase in the risk of heart attack.
  • There are Familial diseases in which TG and Cholesterol are raised. These result in heart disease at an early age.
  • Under-active thyroid disease (hypothyroidism ) can result in obesity, elevated Lipids  and heart disease
  • Raised Triglycerides may be one of the first signs of Diabetes.

I would recommend that you look at my article on Cholesterol, for a more details regarding HDL and LDL

There are many excellent books available on the subject discussed and related topics at—–

Premiere

 

Also check out Dr Al Sears excellent Krill Oil product, Ultra-omegano”  and the section, “Heart Health” by clicking on this Link – “ Can Your Stinky Fish Oil Do This? ‘

Conclusion

We have seen that  ‘Triglyceride – The Neglected Fat’, has an important role in the causation of Heart Disease and Diabetes particularly but, is also implicated in other potentially serious medical conditions.

In my next article I will deal with some of the important Solutions to the problem of Hyper-triglyceridaemia and how we can bring about change.

Doctor  Bill

What is CHOLESTEROL–The Good and the Bad – Part 1

We have all heard of Cholesterol. We are bombarded with advertising warning us of the dangers associated with an elevated blood Cholesterol and  the importance of lowering our Cholesterol. Many foods have labels advertising Low or No cholesterol content.The terms Light or Extra light are used on packaging to persuade us to buy a particular brand when often they have nothing to do with cholesterol levels. No doubt your Doctor has advised you to have your cholesterol checked. But what exactly is it ?

What is Cholesterol ?

Cholesterol is a white fatty substance found in our blood. It is a naturally occuring fat in humans and other animals. The liver produces about 1 gram of cholesterol per day, which is all the body requires. The body needs cholesterol to make  certain hormones , vitamin D , bile acids, cell membranes and nerve sheaths. Bile acids are essential for digestion and absorption of fats from our intestines.

Question:- Well then, if Cholesterol is necessary for many normal bodily functions, why is it a problem?

Answer:- The answer lies in both the type and quantity of cholesterol in the blood.

Researchers at Framingham near Boston in the USA were among the first to show the relationship between elevated levels of cholesterol and heart disease. Other researchers in California in the USA  found that there were different types of cholesterol which had different functions

How does Cholesterol function in our body?

Cholesterol in the body  rarely exists as pure cholesterol, because it is not soluble in water -and therefore blood. Instead cholesterol molecules  attach themselves to certain types of tiny transport proteins called Lipoproteins.

Two main types of lipoproteins are the carriers of cholesterol and will be the ones we discuss:-

(1)  Low Density lipoproteins  ( LDL ) carry about two thirds , while most of the remainder is attached to

(2)  High Density Lipoprotein ( HDL )

1. Low Density Lipoproteins ( LDL ):- LDL  transports cholesterol to the tissues. The problem arises when there is damage to the inner layer of the wall of an artery particularly in the heart or brain. The earliest sign of damage to an artery is the appearance of “fatty streaks”. These are yellow patches  on the inner wall of the artery which are stuffed with cholesterol. These plaques can increase in size and gradually lead to blockage of arteries, a condition called atherosclerosis. If this occurs in the heart blood vessels, a heart attack ( coronary occlusion) occurs or if  in the brain , a stroke. LDL  is often referred to as ” BAD cholesterol”

Normal Artery

Fatty Streak

Established Cholesterol Plaque

Cholesterol Plaque

 

Narrowed Artery

The discovery of the relationship between LDL cholesterol and heart disease was made byDr Joseph Goldstein and his colleague   Dr  Michael Brown at the Texas Health Science Centre in Dallas USA in the 1970’s. They discovered that human cells have LDL receptors which remove  cholesterol from the blood stream.  The lack of these receptors is the cause of familial hypercholesterolaemia, a severe form of high cholesterol which leads to the development of heart disease at any early age.  Their finding led to the development of the Statin Drugs which are commonly used today in the management of high cholesterol.

They received The Nobel Prize in 1985 for their work.

2. High Density Lipoprotein (HDL):- HDL on the other hand is referred to as GOOD cholesterol. It helps to clear the arteries by removing cholesterol from the artery wall and other tissues and carrying it to the liver to be  converted to other substances or removed from the body through the bile.

Investigations have shown that this reverse transport mechanism has a protective effect and therefore reduces the risk of heart disease.

Recent studies have also shown that HDL has other important functions. It has Anti-oxidant and anti-inflammatory properties which help protect the lining of the blood vessels.

If the lining of the blood vessels are damaged, the cells produce a sticky substance .Certain cells from the blood can adhere to the damaged cell wall, so leading to the development of plaque and consequently atherosclerosis. It appears that HDL can inhibit the secretion of the “sticky” substance and so reduce inflammation.

Factors causing an increase in LDL:-

1. Genetic Factors such as Familial Hyperlipidaemia

2. Diet: Ingestion of foods high in Cholesterol, increased intake of foods containing saturated ( animal ) fats and foods containg Trans Fats

3. Alcohol excess, may increase the production of another low density lipoprotein called VLDL. This  leads to a high cholesterol level and the collection of another type of fat called Triglyceride.

4. Impaired Liver function as a result of alcohol  excess , or Illicit drug use leading to hepatits B and C

5. Overweight

6.  Diabetes

7. Hormone imbalance, such as an under-functioning  Thyroid (Hypothyroidism)

8. Pregnancy and Breast Feeding: Hormone changes which occur during pregnancy and breast feeding may lead to abnormally high cholesterol and Triclyceride levels. Therefore the lady’s diet needs to be monitored carefully by her doctor, while bearing in mind the need for adequate supplies of nutrients and energy.

9.  Post menopausal women are at higher risk of developing high cholesterol levels and therefore heart disease.  This is a result of the falling oestrogen levels due to gradually declining function of the ovaries. Oestrogen has some protective effect on the wall of arteries.

10. Chronic kidney disease

11. Certain Medications, such as , the Contraceptive Pill, and thiazide diuretics,  those used to treat fluid retention and high blood pressure

Factors contributing to a fall in HDL:-

1. Genetic Factors –  certain rare diseases

2. Cigarette smoking.

3. Lack of Physical exercise

4. Obesity

5. Male Hormones – Testosterone excess in women with a condition called Polycystic Ovary Disease

Conclusion: So we have discussed  ” What is Cholesterol ” , we have found that there are different types of Cholesterol and  learned a little of the way they function.

We now know that HDL cholesterol is Good and has a protective effect in our body and the level needs to be high.

We see that the villain  is LDL  cholesterol and a low HDL. We  have discussed the many reasons why the level of LDL may be high.

I would recommend that you investigate the product ” Cholesterol Support ” by clicking on the Dr Sears banner below.

In Part 2, I will discuss that other Fat, Triglyceride and what we can do to solve the problems of  the condition called Hyperlipidaemia.

Doctor Bill