What Is Triglyceride? What’s the Normal Range, and How to Lower Triglycerides?

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Translation from Chinese to English

Health is the most important wealth in life, so most people regularly undergo medical check-ups to ensure that their health is not in jeopardy. Triglycerides, commonly seen in blood lipid reports, are vital indicators of health. But what exactly are triglycerides, and what role do they play in our health? This article aims to explore these questions.

What Are Triglycerides?

Triglycerides (also known as triacylglycerols or simply TG) are a type of fat found in the human body. They serve as an energy reserve in the body and subcutaneous fat helps maintain body temperature and protect against external impacts.

Structurally, they are composed of one molecule of glycerol and three molecules of fatty acids (as seen in the diagram).

Where Do Triglycerides Come From in the Body?

1. Through Dietary Intake

   Fats in the food we consume are digested and absorbed primarily in the small intestine with the help of bile.

2. Endogenous Synthesis

   Any excess dietary nutrients that the body does not use may be transformed into triglycerides in the liver and stored in fat tissues. Triglycerides are mainly present in fat tissues and the bloodstream.

What Is the Normal Range for Triglycerides?

Currently, both national and international standards consider a triglyceride level of <150 mg/dL as the normal range. However, lower is not always better; there is an ideal range, typically recommended between 40 and 149 mg/dL. A value between 150 and 199 mg/dL is considered borderline, where symptoms may not yet be present, but it can increase the cardiovascular burden and lead to insulin resistance. When the level reaches 200-499 mg/dL, the risk of heart attacks significantly increases, and the incidence of diabetes rises. Triglyceride levels exceeding 500 mg/dL dramatically increase the chances of acute pancreatitis, which may progress to pancreatic cancer.

Symptoms of High Triglycerides

Are there any symptoms that can help us identify the warning signs of high triglycerides?

Unfortunately, except for specific symptoms caused by primary familial hypertriglyceridemia or high chylomicronemia, such as hepatosplenomegaly, eruptive xanthomas, etc., most patients with high triglycerides do not have noticeable symptoms initially.

💡Even when symptoms do occur, they are usually due to related complications, such as chest tightness, chest pain, unilateral weakness, difficulty breathing, etc., and by that time, the disease has usually progressed to the middle or late stage.

Since symptoms only appear in the middle or late stages of the disease, our strategy for these types of diseases should be “active prevention” rather than passive waiting for treatment.

How to Lower Triglyceride Levels

Here, we’ll divide methods into two categories: non-pharmacological and pharmacological based on the content of a retrospective article.

1. Non-Pharmacological Options

   • Increasing the intake of marine sources of polyunsaturated fatty acids (e.g., fish oil) can reduce triglycerides by 5-10%.
   • Achieving a 5-10% weight loss may result in a 20% reduction in triglycerides.
   • Combining the use of the Mediterranean and low-fat diet has the potential to reduce triglycerides by 10-15%.

💡The key points for implementing the Mediterranean diet are as follows (source: Health Promotion Administration, Ministry of Health and Welfare, Taiwan):

1. Replace refined starches with whole grains.
2. Consume a variety of vegetables in adequate amounts.
3. Eat a variety of fruits in adequate amounts.
4. Consume dairy products in moderation.
5. Include legumes and soy products in the diet.
6. Use olive oil as the primary source of fat.
7. Include a moderate amount of nuts daily.
8. Choose high-quality protein sources and consume poultry, fish, etc.
9. Limit the consumption of red and fatty meats.
10. Reduce the frequency of consuming sweets.

For more information, you can read this article on recommended fish oil brands in 2023.

Pharmacological Options

• Fibric Acids
  Recent research has shown that fibric acid medications can reduce triglycerides by approximately 20-50% by activating the liver’s Peroxisome proliferator-activated receptorα (PPARα).
• Nicotinic Acid (Niacin)
  Niacin, a B-complex vitamin (vitamin B3), may work by inhibiting the breakdown of triglycerides in adipose tissue, reducing the release of triglycerides into the bloodstream. Niacin can also reduce the liver’s synthesis of triglycerides.
• Statins
  By inhibiting the key enzyme HMG-CoA reductase, statins block the pathway of cholesterol synthesis, ultimately reducing cholesterol production and triglycerides by approximately 7-30%.
• Cholesterol Absorption Inhibitors
  These drugs directly inhibit cholesterol absorption and can reduce triglycerides by around 5-11%.
• Omega-3 Fatty Acids
  Omega-3 fatty acids, found in fish oil (EPA and DHA), are as effective as medications in reducing triglycerides, with better safety. According to literature, the intake of omega-3 fatty acids and the reduction in triglycerides show a dose-response relationship. [3]

💡How much should be consumed to achieve a triglyceride-lowering effect? According to the American Heart Association’s recommendations, an intake of 1g/day (EPA+DHA) can reduce the incidence of coronary heart disease, and clinical studies have found that 80% of EPA+DHA has better absorption rates. [4]

Notes on Triglycerides

Dietary Considerations:

1. Reduce the intake of animal fats, fried foods, and trans fats.
2. Limit the consumption of refined sugars, such as Western-style cakes, bread, and candied fruits.
3. Reduce the consumption of sugary beverages, including bubble tea.
4. Pay special attention to the intake of high-fructose fruits, as fructose is more potent in converting to triglycerides than sucrose or glucose.
5. Limit alcohol consumption. Many studies on alcohol’s impact on triglycerides suggest that alcohol intake reduces fatty acid oxidation and increases the activity of lipid synthesis enzymes.
6. Incorporate regular physical activity into your routine.

Most media outlets emphasize the health risks associated with cholesterol but often overlook the significance of another blood lipid, triglycerides. This article aims to provide a better understanding of triglycerides.

Please note that this information is provided for educational purposes, and individuals with concerns about their triglyceride levels or medications should consult a healthcare professional for personalized guidance and treatment.

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