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High Blood Triglycerides

by Dr. Thomas K. Lo

Lowering your triglyceride level can improve your health. Triglycerides are a type of fat, also called a lipid, that occurs in the blood. Any calorie your body does not convert to energy right away is turned into triglycerides. Those lipid triglycerides then get stored in fat cells and are used as energy later. Like most fats, if you eat more calories than you burn, it could lead to high triglyceride levels. Triglycerides contain double the amount of energy as compared to both carbohydrates and proteins, which also supply energy to the body.

Triglycerides, HDL & LDL

Triglycerides and cholesterol are different types of lipids found in your blood. While cholesterol builds cells and supports certain hormones, triglycerides give your body energy by storing excess calories. High triglyceride levels can increase your risk of stroke or heart attack by thickening artery walls and hardening arteries. Triglycerides can even cause pancreatitis. Many times, high triglycerides go hand in hand with other medical conditions such as obesity, type 2 diabetes, hypothyroidism, and metabolic syndrome.

Being physically inactive, eating foods high in certain fats and sugars, and drinking too much alcohol may increase blood triglycerides. Some medicines used to treat breast cancer, high blood pressure, HIV, and other conditions may increase triglyceride levels in the blood.

Lipid panels measure total cholesterol, which include HDL “good” (high-density lipoprotein) cholesterol, which works to remove LDL “bad” (low-density lipoprotein) cholesterol, which can build up in the arteries and cause blockage in blood vessels and triglyceride levels in your blood.

Factors That Can Raise Triglycerides and What May Help Lower Triglycerides

Factors that can raise your triglyceride level include eating more calories than you burn off, especially if you eat a lot of sugar; being overweight or obese; cigarette smoking; excessive alcohol use; certain medicines; some genetic disorders; thyroid disease; poorly controlled type 2 diabetes; metabolic disease; and liver or kidney disease.

Triglyceride levels are measured in milligrams per deciliter (mg/dL). The guidelines for triglyceride levels are normal if less than 150mg/dL, borderline high is between 151 to 199 mg/dL, high levels are 200 to 499 mg/dL, and considered very high if above 500 mg/dL.

Case-control studies have shown that high triglycerides are an independent cardiovascular disease risk factor. Also, a recent study concluded that in younger persons, the highest levels of triglycerides corresponded with a four times greater risk of heart disease and stroke risk compared to similar patients in the study who had the lowest levels of triglycerides. (Tirosh et al, Ann Intern Med 2007).

The American Heart Association (AHA) recommends changes in lifestyle habits as the main therapy for high triglycerides. You should focus on fiber-rich complex carbohydrates, such as vegetables and whole grains, low sugar fruits, and unsweetened dairy instead of simple sugars. 

All people, whether or not they have high triglycerides, should limit their intake of added sugars. If a person has high triglycerides, it is especially important to limit daily calories from added sugar to no more than 5 percent to 10 percent (no more than 100 calories for most women and no more than 150 calories per day for most men). Sugar has no nutritional value other than to provide calories. Added sugars are sugars and syrups that are added to foods or beverages during processing or preparation. They do not include naturally occurring sugars such as those found in milk (lactose) and fruits (fructose). For those people above 150 mg/dL triglycerides, limit fructose and emphasize more vegetables and fruits that are lower in fructose. People who consume large amounts of beverages with added sugars tend to consume more calories overall and tend to gain weight. Currently, it is estimated that soft drink consumption alone accounts for one third of added sugars intake in the U.S. diet. Those with triglycerides outside the normal range should limit fructose consumption to 50 to 100 grams per day, because fructose raises triglycerides.

The type of carbohydrates that you eat makes a difference. Foods that contain high amounts of simple sugars, especially fructose, raise triglyceride levels. Trans fats raise triglycerides, while omega-3 fats found in fatty fish and avocados lower triglyceride levels.

Alcohol in high amounts increases triglyceride levels in some people. In individuals with very high triglycerides, abstinence from alcohol is best.

If you are overweight and lose weight, it will result in a 20 percent decrease in triglycerides—the magnitude of decrease in triglycerides are directly related to the amount of weight lost.

Physical activity plays an important role in lowering triglycerides. The effects that physical activity has on triglyceride levels vary depending upon baseline triglyceride level, level of intensity, caloric expenditure, and duration of activity. Try to get at least 30 minutes of moderate-intensity physical activity on five or more days, for a total of at least 150 minutes per week.  

Visceral fat is strongly associated with insulin resistance (an inability of the body to use insulin to convert food into energy) and high levels of triglycerides. Visceral fat lies deep inside the abdomen, near the waistline surrounding the abdominal organs. The best way to lose this fat is to lose excess weight by eating a healthy diet, along with getting regular physical activity. Physical activity helps reduce abdominal fat and preserve muscle during weight loss. Also, lowering your stress level helps with losing visceral fat.

Substituting carbohydrates for fats may raise triglyceride levels and may decrease HDL “good” cholesterol in some people. So keep healthy dietary fat to 25-35 percent of total diet. A statement released by the National Heart, Lung and Blood Institute, panel on detection, evaluation, and treatment of high blood cholesterol in adults, suggests that very high intakes of carbohydrates (greater than 60 percent of total calories) are accompanied by a rise in triglycerides. Lower intakes (e.g., 50 percent of calories) should be considered for persons with metabolic syndrome who have elevated triglycerides or low HDL “good” cholesterol.

So, what is metabolic syndrome? It is a cluster of easily measured metabolic factors, which occur together. It occurs when a person has three or more of the following five factors: elevated waist circumference, elevated triglycerides, reduced HDL cholesterol, elevated blood pressure, elevated fasting glucose. Metabolic syndrome develops in the setting of excess calories and a sedentary lifestyle with underlying causes being obesity and insulin resistance. Most studies show that the metabolic syndrome is associated with an approximate doubling of heart disease and stroke risk and a five times greater risk for developing type 2 diabetes. Lifestyle modifications are important to reducing risk from the metabolic syndrome, since they improve all of the components of the metabolic syndrome.

   If you are struggling with health issues, call the Advanced Chiropractic & Nutritional Healing Center at 240-651-1650 for a free consultation. Dr. Lo uses Nutritional Response Testing® to analyze the body to determine the underlying causes of ill or non-optimum health. The office is located at 7310 Grove Road #107, Frederick, MD. Check out the website at www.doctorlo.com.

The Sunshine Vitamin

by Dr. Thomas K. Lo, Advanced Chiropractic

Vitamin D, sometimes called the “sunshine vitamin,” is produced in your skin in response to sunlight. It is a fat-soluble vitamin in a family of compounds that includes vitamins D-1, D-2, and D-3.

Your body produces vitamin D naturally when directly exposed to sunlight. You can also get it through certain foods and supplements to ensure adequate levels of the vitamin in your blood.

Vitamin D has several important functions. Perhaps the most vital are regulating the absorption of calcium and phosphorus and facilitating normal immune system function. Getting a sufficient amount of vitamin D is essential for normal growth and development of bones and teeth, as well as improved resistance against certain diseases.

If your body does not get enough vitamin D, you are at risk of developing bone abnormalities such as soft bones (rickets in children and osteomalacia in adults) or fragile bones (osteoporosis). Muscles need it to move, nerves need it to carry messages between the brain and every body part, and the immune system needs vitamin D to fight off invading bacteria and viruses.

How Much Vitamin D Do I Need?

The amount of vitamin D you need each day depends on your age. Average daily-recommended amounts are listed in micrograms (mcg) and International Units (IU). Life Stage Recommended Amount: Birth to 12 months—10 mcg (400 IU); Children 1–13 years—15 mcg (600 IU); Teens 14–18 years—15 mcg (600 IU); Adults 19–70 years—15 mcg (600 IU); Adults 71 years and older—20 mcg (800 IU); Pregnant and breastfeeding women—15 mcg (600 IU).

What Foods Provide Vitamin D?

Very few foods naturally have vitamin D. Fortified foods provide most of the vitamin D in American diets.

Fatty fish such as salmon, tuna, and mackerel are among the best sources. Beef liver, cheese, and egg yolks provide small amounts, and mushrooms also provide some vitamin D. Almost all of the U.S. milk supply is fortified with 400 IU of vitamin D per quart, as are many of the plant-based alternatives such as soymilk, almond milk, and oat milk. Foods made from milk, like cheese and ice cream, are usually not fortified.

Can I Get Vitamin D From The Sun?

The body makes vitamin D when the skin is directly exposed to the sun, and most people meet at least some of their vitamin D needs this way. Skin exposed to sunshine indoors through a window will not produce vitamin D. Cloudy days, shade, and having dark-colored skin cuts down on the amount of vitamin D the skin makes.

People who avoid the sun or who cover their bodies with sunscreen or clothing should include good sources of vitamin D in their diets or take a supplement. Recommended intakes of vitamin D are set on the assumption of little sun exposure.

Am I Getting Enough Vitamin D?

Because vitamin D can come from sun, food, and supplements, the best measure of one’s vitamin D status is blood levels of a form known as 25-hydroxyvitamin D. In general, levels below 30 nmol/L (12 ng/mL) are too low for bone or overall health, and levels above 125 nmol/L (50 ng/mL) are probably too high. Levels of 50 nmol/L or above (20 ng/mL or above) are sufficient for most people.

By these measures, some Americans are vitamin D deficient, and almost no one has levels that are too high. In general, young people have higher blood levels of 25-hydroxyvitamin D than older people, and males have higher levels than females. By race, non-Hispanic blacks tend to have the lowest levels, and non-Hispanic whites the highest. The majority of Americans have blood levels lower than 75 nmol/L (30 ng/mL).

Certain other groups may not get enough vitamin D. These include breastfed infants, because human milk is a poor source of the nutrient. Breastfed infants should be given a supplement of 400 IU of vitamin D each day. Older adults, because their skin doesn’t make vitamin D when exposed to sunlight as efficiently as when they were young, and their kidneys are less able to convert vitamin D to its active form. People with dark skin have trouble because their skin has less ability to produce vitamin D from the sun. People with disorders such as Crohn’s disease or celiac disease who don’t handle fat properly, because vitamin D needs fat to be absorbed. Obese people, because their body fat binds to some vitamin D and prevents it from getting into the blood.

What Are Some Effects Of Vitamin D On Health?

Vitamin D is being studied for its possible connections to several diseases and medical problems, including diabetes, hypertension, bone disorders, cancer, and autoimmune conditions such as multiple sclerosis.

As we age, millions (mostly women, but men, too) develop, or are at risk of, osteoporosis, a condition in which bones become fragile and may fracture if one falls. It is one consequence of not getting enough calcium and vitamin D over the long term. Supplements of both vitamin D3 (at 700–800 IU/day) and calcium (500–1,200 mg/day) have been shown to reduce the risk of bone loss and fractures in elderly people aged 62–85 years. Many men and women supplement vitamin D (and calcium) as part of an overall plan to prevent or treat osteoporosis.

Can Vitamin D Be Harmful?

Yes, when amounts in the blood become too high. Signs of toxicity include nausea, vomiting, poor appetite, constipation, weakness, and weight loss. It can cause confusion, disorientation, and problems with heart rhythm. Excess vitamin D can also damage the kidneys.

The daily upper limit for vitamin D is 25 mcg to 38 mcg (1,000 to 1,500 IU) for infants; 63 mcg to 75 mcg (2,500 to 3,000 IU) for children one to eight years; and 100 mcg (4,000 IU) for children nine years and older adults, and pregnant and lactating teens and women. Vitamin D toxicity almost always occurs from overuse of supplements. Excessive sun exposure does not cause vitamin D toxicity because the body limits the amount of this vitamin it produces.

Are There Any Interactions With Vitamin D That I Should Know About?

Like most dietary supplements, vitamin D may interact or interfere with other medicines or supplements you might be taking. Here are some examples:

Prednisone and other corticosteroid medicines to reduce inflammation impair how the body handles vitamin D, which leads to lower calcium absorption and loss of bone over time.

Both the weight-loss drug orlistat (brand names Xenical® and Alli®) and the cholesterol-lowering drug cholestyramine (brand names Questran®, LoCholest®, and Prevalite®) can reduce the absorption of vitamin D and other fat-soluble vitamins (A, E, and K).

Both phenobarbital and phenytoin (brand name Dilantin®), used to prevent and control epileptic seizures, increase the breakdown of vitamin D and reduce calcium absorption.

Tell your doctor, pharmacist, and other healthcare providers about any dietary supplements and medicines you take.

If you are struggling with health issues, call the Advanced Chiropractic & Nutritional Healing Center at 240-651-1650 for a free consultation. Dr. Lo uses Nutritional Response Testing® to analyze the body to determine the underlying causes of ill or non-optimum health. The office is located at 7310 Grove Road #107, Frederick, MD. Check out the website at www.doctorlo.com.