High triglycerides
High blood triglycerides are a medical condition known as hypertriglyceridemia; this is a form of hyperlipidemia (dyslipidemia) characterized by the excessive increase of triglycerides in the blood (> 200mg / dl).
Having high triglycerides significantly increases the risk of heart attack, but its statistical importance has not yet been completely differentiated from that of hypercholesterolemia (high cholesterol), which is often (but not necessarily) accompanied. Ultimately, hypertriglyceridemia is a dyslipidemia that favors the event of acute ischemic heart disease, due to:
- REDUCTION OF FIBROLSOLIC EFFICIENCY (increased potential for blood clotting)
- PREPARATION FOR THROMBOSIS
- DIRECT CORRELATION WITH LDL IPERCOLESTEROLEMIA
- DIRECT CORRELATION WITH REDUCTION OF HDL CHOLESTEROL
Drug therapy for high triglycerides (fibrates, gemfibrozil) significantly decreases the risk of unfortunate events, confirming what the above statistical correlation between cardio-ischemic events and high triglycerides suggests.
Causes of high triglycerides
Among the causes of the onset of hypertriglyceridemia, the primary and secondary ones are distinguished.
Primary or familial hypertyliglyceridemia (type IV and V) is a primitive, genetically transmitted, autosomal dominant disease; it is frequently associated with obesity and reduced glucose tolerance, which contribute to increased coronary risk and acute pancreatitis.
In contrast, the secondary increase in blood triglycerides, INDEPENDENT from the genetic heritage, is determined by one or more environmental, behavioral and associated comorbidity factors:
- Food abuse and obesity: alcohol abuse, unbalanced diet (especially carbohydrate excess simple) and poorly distributed in meals (over-abundant meals)
- Diabetes Mellitus not properly treated
- Nephrotic syndrome
- Kidney failure
- Intake of corticosteroid and estrogen drugs
Diet
As anticipated, high triglycerides can be the consequence of inappropriate eating habits and lifestyle; obesity is the fruit of food abuse (sometimes related to psychic disorders), generally extended to all high-calorie foods and to sugary or alcoholic beverages, and aggravated by the inadequacy of overall physical activity. It is possible to define that food abuse, on the whole, favors the imbalance of meals (reducing its frequency to the advantage of hypercaloricity), determining an ineffective, inefficient or inappropriate metabolic response.
Excess calories, above all from sugars, determine the excessive increase in blood sugar levels; this hyperglycemia, which consequently induces hyperinsulinemia (excess of INSULIN), in the sedentary subject (and especially in the obese and / or in the insulin-resistant) favors the INCORRECT metabolization of nutrients, which (due to the anabolic and lipogenic effect insulin) inexorably undergo conversion to fatty acids;
in practice, it is possible to affirm that food abuse is related to hyperglycemia, consequently to hyperinsulinemia, and favors the synthesis of fatty acids determining the onset of high triglycerides in plasma.
Furthermore, we remind you that ethyl alcohol, although NOT being a nutrient as it is NOT DIRECTLY involved in energy production, provides 7kcal per gram; it contributes to the caloric amount of the meal, determines an insulin stimulus comparable to that of simple carbohydrates and to be metabolized MUST undergo the biochemical conversion to fatty acids.
It can be seen that ALSO alcohol abuse contributes significantly to the elevation of blood triglycerides.
There are also nutrients useful for the reduction of blood triglycerides ; this is the case of the omega-3 essential fatty acids, or alpha linolenic acid (18: 3 ALA), eicosapentaenoic acid (20: 5 EPA) and docosahexaenoic acid (22: 6 DHA). The foods that contain them are above all: blue fish (herring, sardine, mackerel, lanzardo, alaccia, needlefish, bonito, tuna, alice, salmon, "cod" etc.) and vegetable or fish oils (linseed oil, of soy, walnut, blackcurrant, rapeseed etc; cod liver oil). EPA and DHA perform numerous functions useful for the prevention of coronary heart disease; among these we recall a DIRECT effect on
- REDUCTION: of blood triglycerides, of the hepatic synthesis of VLDL, of blood density, of arterial pressure, of fibrinogenemia, of the platelet aggregation potential;
- HDL INCREASE (?);
- STRENGTHENING of fibrinolysis;
- INHIBITION of PDGFc synthesis (determining factor in the pathogenesis of atherosclerosis).
The essential fatty acids of the omega3 family are fundamental in the dietary treatment of high triglycerides and in the reduction of associated complications and comorbidities.
At the same time, the defect in dietary fiber (especially soluble) can aggravate the condition of high triglycerides in the blood; it is able to modulate the absorption of nutrients favoring the attenuation of the glycemic curve and reducing lipogenesis; therefore, guaranteeing a fiber quota of 30g per day is an excellent precaution for reducing blood triglycerides.
Ultimately, the recommendations to prevent and treat high triglycerides are:
- Avoid eating or overeating sweet foods, sugary drinks and alcoholic beverages
- Avoid excessive portions of predominantly carbohydrate foods: pasta, bread, rice, polenta, and all other cereals with respective derivatives
- Divide the daily calories into at least 5 meals a day, and avoid consuming generally too large portions
- Promote the consumption of foods containing essential fatty acids of the omega3 family, in particular DHA and EPA
- Promote the achievement of the share of dietary fiber (about 30g / day)
- Promote ESPECIALLY the physical exercise in correspondence of the post-prandial glycemic peak (walk or ride after 120'-150 'from the meal).
Bibliography:
- Clinical treatment and surgical therapy . Volume I - F. Mazzeo - Piccin - page 318
- Branwvald Heart Diseases . Treatise on cardiovascular medicine. Volume I - DP Zipes, P. Libby, RO Bonow, E. Brawnvald - Elsevier Masson - pag 1031
- Post infarction and associated diseases . Volume I - A. Zangara - Piccin - pag 73
- Reasoned medical therapy - A. Zangara - Piccin - pag 599
