What Are Triglycerides?

Introduction

LDL cholesterol, HDL cholesterol, and triglycerides are all terms related to high cholesterol, that lead to serious health problems, like the development of cardiovascular coronary diseases. What are they? And what are the core differences between them?

High cholesterol is defined as having excess fatty substances (cholesterol) in your body. This usually occurs from consuming a high-fat diet and unhealthy meals, while some cases are hereditary. Having high cholesterol can only be detected via lab blood tests, the sooner the detection the better to save people from developing serious heart problems.¹

LDL(low-density lipoprotein) cholesterol is known as the ‘bad’ cholesterol.  When its levels increase in the body, it will lead to the formation of plaque, thus causing cardiovascular complications. On the other hand, HDL (high-density lipoprotein) cholesterol is called the ‘good’ cholesterol. As its levels rise in the body, it protects patients from developing strokes or any type of heart problem.²

Triglycerides

Triglycerides are chemical compounds, which are made of lipids, types of fat that circulate in blood. They mainly originate from the fat found in food that gets consumed, such as butter, different types of oils, ghee, and extra calories from unhealthy meals. They get stored in the fat cells of the body as a result of unused calories, and they get released whenever the body needs energy.³

Importance of triglycerides in the body

In order for the body to develop, grow, and function normally, it requires fat and lipids. Triglycerides are essential for all ages including infants and the elderly as they are a concentrated source of fat and energy equivalent to about 9 kcal/g.⁴

Composition of triglycerides

Triglycerides belong to an organic chemical group called esters. They are formed when three fatty acids, the building blocks of fat in our bodies, of one or more kinds are linked to glycerol, a triol (type of alcohol).⁵ 

Triglycerides take their names from the fatty acids that are attached in their structure. For instance, the 16 and 18-carbon fatty acids, better known as palmitic acid and stearic acid, respectively, are two of the most commonly found fatty acids. In animals, up to 30% of body fat is composed of palmitic acid. It makes up between 5 and 50% of the lipids in vegetable fats; palm oil contains a high concentration of it. Stearic acid comprises a significant amount of lipids in ruminant tallow and can be found in high concentrations in certain vegetable oils, such as cocoa and shea butter. 

Alpha-linolenic acid (an omega-3 fatty acid) and linoleic acid (an omega-6 fatty acid) are not synthesised by many mammals. However, the synthesis of other essential omega-3 and omega-6 fatty acids, as well as cellular functions depends on those fatty acids. Thus, they are known as essential fatty acids because eating is the only way to obtain them. Many mammals only occasionally require the omega-6 and omega-3 fatty acids, which are produced in the body from their parent fatty acids and are obtained from linoleic acid and alpha-linolenic acid, respectively. These levels are not always required to ensure optimal development or health.

The most extensively distributed fatty acid is oleic acid, which is found in all oils and fats to some degree. In oils including sunflower, peanut, palm, and olive, saponification yields this acid as the main component.⁶

Sources of triglycerides

Naturally, the most common source of triglycerides is from the food we eat, which can come from a plant source like coconut oil and palm oil, or from an animal origin like milk caproic acid. Since there is a high demand for triglycerides, they can be synthesised through a chemical reaction that involves the presence of a catalyst.⁴

Health implications

Levels of cholesterol and triglycerides are detected using blood tests that should be done every 5 years, however, if there is a family history of dyslipidemia or other complications, then the blood tests should be conducted more frequently.³

Normal levels vs. elevated levels

Triglycerides typically have a value of less than 150 mg/dL in healthy persons. A value of 151 to 200 mg/dL is regarded as borderline high; a value of 201 to 499 is deemed high; and a value of 500 and above is considered very high (and raises the risk of pancreatitis, an inflammation of the pancreas gland). An increasing body of research indicates that elevated triglyceride levels, unrelated to cholesterol levels, may increase the risk of cardiovascular disease.³ 

Relationship of triglycerides with other health conditions 

There is a composite of factors that will lead to abnormal levels of triglycerides in the body, mainly due to the lack of activity, consuming an unhealthy diet, and drinking excessive amounts of alcohol. The prevalence of having high triglyceride levels will increase with the presence of thyroid problems, diabetes, liver diseases, kidney diseases, and obesity. Unfortunately, there are several medications for certain conditions that can elevate the levels of triglycerides, such as HIV, breast cancer, and hypertension treatments.³

Some patients are more prone to developing high levels of triglycerides than others, for instance, if they come from specific ethnicities like South Asians, or if they have genetic diseases such as lipid metabolism disorder where the body isn’t capable of breaking down fats.³

Importantly, elevated cholesterol and triglyceride levels in the body can cause the development of atherosclerosis, as it evolves slowly due to the buildup of fat in the arteries. Atherosclerosis is considered a serious event, because of the damage of many arteries of the heart, brain, kidneys, arms, legs, and pelvis. It is the key factor in restricting blood flow in the body, leading to the formation of blood clots and sometimes disabilities.

Treatment and prevention

To lower your cholesterol levels, it is best to start with lifestyle modifications to get triglyceride levels back within the normal range. This may include eating healthily, striving for a healthy weight by increasing whole and unprocessed grains in the diet, reducing the intake of processed carbs, meats, and fat, and exercising frequently. Additionally, quitting smoking and lowering the consumption of alcohol will help in shifting the body towards a healthier state.³

A variety of medications may be prescribed by healthcare professionals or GPs to regulate or reduce triglyceride levels in the blood.³

• Fibrates reduce the amount of triglycerides. It is also possible to use these medications to reduce high cholesterol.
• Concentrated omega-3 fatty acids are used for the treatment of triglyceride levels of 150 mg/dL or more. Unlike omega-3 dietary supplements, which are not approved by the FDA to treat individuals with elevated triglyceride levels, these medications are manufactured differently.
• Statins are the most popular medications for treating high blood cholesterol, which can also be used to reduce blood triglyceride levels. The most famous ones are Atorvastatin and Rosuvastatin.
• Ezetimibe is another medication that lowers cholesterol and can be used to flush the blood of triglycerides.

Summary

Triglycerides are chemical structures having glycerol with 3 fatty acids, they could be found in nature or manufactured. They have lots of benefits in medicine due to the fatty acid moiety, but if the levels exceed the normal range, then health issues will arise causing cardiovascular problems that could affect the whole body. 

Nowadays, due to our busy lifestyles, unconsciously we forget to take good care of ourselves and maintain our health conditions. For instance, if exercise performance is applied on a regular basis, then the chance of developing any type of metabolic disease will decrease. Rarely do we identify patients with one disease, people now are suffering a combination of cardiometabolic diseases that are interconnected. For example, diabetic patients have high cholesterol and triglyceride levels in their bodies. The key to better health is to monitor the well-being of the state with healthcare professionals to maintain a brighter life for you and those who care about you.