Lifestyle changes can lower high triglycerides

DEAR DOCTOR K: I have healthy cholesterol levels, but my triglyceride level is high. What are triglycerides? And how dangerous is it to have high levels of them?

DEAR READER: Triglycerides are a type of fat. They are important because they provide energy the body needs. Our bodies convert food we eat into triglycerides. They get bundled together into small packages and travel in the blood.

Blood triglyceride levels rise rapidly right after we eat. Levels drop over the next few hours. The blood carries the packages of triglycerides to our cells, where they provide energy. Triglycerides that aren’t immediately needed for energy are transported to fat cells for storage.

So, you need triglycerides. But high levels of triglycerides in the blood are not good for the arteries. People with high levels have a higher risk of stroke and heart disease. This is particularly true for women after menopause.

Although some doctors may disagree, I think your blood cholesterol levels are a more important influence on your health than your blood triglyceride levels. High levels of total cholesterol and of LDL cholesterol (the so-called “bad” cholesterol) probably put you at higher risk than high levels of triglycerides. But this is no reason to ignore high levels if you have them.

You’re more likely to have high triglycerides if you are obese, drink too much alcohol or eat a diet high in saturated fats. High triglyceride levels also run in families. Although we don’t yet understand the details, your genes are likely to affect your triglyceride levels. Some people appear to be born with genes that cause their triglyceride levels to be high. They have to work harder than other people to keep their triglycerides down. Other lucky people appear to be born with genes that protect them from having high levels.

Various medical conditions, including poorly controlled diabetes and chronic kidney or liver disease, can increase your risk for high triglycerides. So can certain medications such as prednisone, thiazide diuretics and some beta blockers.

I recommend you try to lower your triglycerides to a normal level, below 150 milligrams per deciliter. Lifestyle changes are perhaps the most powerful treatment available. Adopt a diet that emphasizes whole grains, fruits, vegetables and healthy fats. Also, get at least 30 minutes of moderate- to vigorous-intensity exercise most days. And keep your alcohol intake to a minimum.

We have a lot more information on treating high triglycerides in our Special Health Report called “What to Do About High Cholesterol.” You can find out more about it at my website.

If lifestyle changes don’t work, or if your triglyceride levels are very high, you may need medication. Triglyceride-lowering medications include niacin and fibrates.

Your doctor will determine whether you need medication. Even if you do, you almost surely will need to make lifestyle changes, too. Work with your doctor to figure out the right prescription for you.