Home > Food and Drink, Heart Health, Nutrition > Triglyceride Heart Risk

Triglyceride Heart Risk

November 25, 2013 Written by JP       [Font too small?]

For years, I’ve been telling my clients and physician friends that the current obsession with cholesterol levels is way out of focus. In my opinion, high LDL (aka “bad”) cholesterol is more likely than not a very small contributor to the current epidemic of cardiovascular disease. On the other hand, elevated triglycerides appear to be a far better marker for lifestyle choices which probably affect heart disease and stroke risk. Fortunately, a few, simple dietary changes can lower high triglycerides and significantly improve cardiovascular wellness. Best of all, lowering hypertriglyceridemia often doesn’t require any medications or supplements.

Triglycerides are a form of fat that is contained in blood. Elevated levels of blood triglycerides (over 150 mg/dL) have been implicated in a higher risk of cardiovascular disease and all-cause mortality. In fact, a recent review of 61 studies found that the risk of death increased incrementally in relation to the amount of triglycerides present in blood samples of over 1,000,000 study participants. Simply put, the higher the level of triglycerides, the greater the incidence of cardiovascular and overall mortality.

Interestingly, conventional medicine frequently employs a distinctly natural approach to managing hypertriglyceridemia: high dosage, prescription fish oil. However, many people with high triglycerides may want to consider dietary interventions prior to (or in conjunction with) prescription or supplemental fish oil therapy. The medical literature informs that eating plenty of green leafy vegetables, nuts and oily fish can dramatically lower blood triglycerides. What’s more, if you consistently replace high glycemic carbohydrates (refined, starchy and sugary foods) with fatty fish, greens and nuts, your triglycerides levels will likely plummet. If additional support is required, losing excess weight and regular aerobic exercise can further affect triglyceride concentrations and improve your overall lipid profile. Best of all, these three nutritional strategies tend to support virtually every aspect of wellness without side effects.

My Top 3 Green Leafy Vegetables: Kale, Spinach and Swiss Chard

Dosage: 2 or more servings daily

My Top 3 Nuts: Almonds, Pistachios and Walnuts

Dosage: 1 – 3 ounces daily

My Top 3 Fish: (Wild) Black Cod, Sardines, Wild Alaskan Salmon

Dosage: 2 – 5 servings weekly

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

To learn more about the studies referenced in today’s column, please click on the following links:

Study 1 - Effects of Blood Triglycerides on Cardiovascular and All-Cause Mortality (link)

Study 2 - Lifestyle Modifications for Treatment of Hypertriglyceridemia (link)

Study 3 – Habitual Diets Rich in Dark-Green Vegetables Are Associated with (link)

Study 4 - Effects of Total and Green Vegetable Intakes on Glycated Hemoglobin … (link)

Study 5 - Effect of Ketogenic Mediterranean Diet w/ Phytoextracts and Low (link)

Study 6 – Inclusion of Atlantic Salmon in the Chinese Diet Reduces Cardiovascular (link)

Study 7 - Inclusion of Fish or Fish Oil in Weight-Loss Diets for Young Adults ... (link)

Study 8 - Benefits of Salmon Eating on Traditional & Novel Vascular Risk Factors (link)

Study 9 - A Randomized Trial of the Effects of an Almond-Enriched, Hypocaloric (link)

Study 10 - Pistachio Nuts Reduce Triglycerides & Body Weight by Comparison to (link)

Natural Ways to Lower Triglycerides

Source: Curr Cardiol Rep. 2011 Dec;13(6):544-52. (link)

Bookmark and Share

Related Posts:

Tags: , ,
Posted in Food and Drink, Heart Health, Nutrition

11 Comments & Updates to “Triglyceride Heart Risk”

  1. charles grashow Says:

    “In my opinion, high LDL (aka “bad”) cholesterol is more likely than not a very small contributor to the current epidemic of cardiovascular disease.”

    Why so?

    Also-what is your opinion on LDL-P/ApoB?

  2. JP Says:

    Hi Charles,

    IMO, overemphasizing the importance of LDL cholesterol is much like counting the number of $1 bills in a wallet and, based on the value, trying to extrapolate one’s financial status. It’s a micro issue that has been inappropriately magnified.

    My best advice is not to rely on any one test to guide your cardiovascular wellness protocol. Having said that, blood pressure and sugar are important and can be easily monitored. Daily stress management and exercise almost certainly help. So too does constructive social interaction and volunteerism. Eating a Mediterranean-style diet, particularly one low in carbohydrates, has been proven to reduce various (likely) risk factors for CVD (blood pressure, blood sugar, inflammation, LDL cholesterol, triglycerides, waist circumference, etc.). So, rather than relying heavily on conventional and “up-and-coming” tests, I typically recommend adopting diet and lifestyle approaches which are associated with improved cardiovascular function and mortality.

    A few relevant links:






    Be well!


  3. charles grashow Says:


    Your thoughts on this from Dr Thomas Dayspring


    Let’s get rid of the nonsense seen all over the internet that atherosclerosis is an inflammatory disease, not a cholesterol disease. That is baloney-with the reality being that it is both. One cannot have atherosclerosis without sterols, predominantly cholesterol being in the artery wall: No cholesterol in arteries – no atherosclerosis. Plenty of folks have no systemic vascular inflammation and have atherosclerotic plaque. However clinicians have no test that measures cholesterol within the plaque – it is measured in the plasma. It is assumed, that if total or LDL-C or non-HDL-C levels are elevated the odds are good that some of that cholesterol will find its way into the arteries, and for sure there, are many studies correlating those measurements with CHD risk. Yet, we have lots of patients with very low TC and LDL-C who get horrific atherosclerosis. We now recognize that the cholesterol usually gains arterial entry as a passenger inside of an apoB-containing lipoprotein (the vast majority of which are LDLs) and the primary factor driving LDL entry into the artery is particle number (LDL-P), not particle cholesterol content (LDL-C). Because the core lipid content of each and every LDL differs (how many cholesterol molecules it traffics) it takes different numbers of LDLs to traffic a given number of cholesterol molecules: the more depleted an LDL is of cholesterol, the more particles (LDL-P) it will take to carry a given cholesterol mass (LDL-C). The usual causes of cholesterol depleted particles are that the particles are small or they are TG-rich and thus have less room to carry cholesterol molecules. Who has small LDLs or TG-rich LDL’s? – insulin resistant patients! After particle number endothelial integrity is certainly related to atherogenic particle entry: inflamed endothelia have inter-cellular gaps and express receptors that facilitate apoB-particle entry. So the worse scenario is to have both high apoB and an inflamed dysfunctional endothelium. Is it better to have no inflammation in the endothelium – of course! But make no mistake the driving force of atherogenesis is entry of apoB particles and that force is driven primarily by particle number not arterial wall inflammation: please see Ira Tabas, Kevin Jon Williams, Jan Borén. Subendothelial Lipoprotein Retention as the Initiating Process in Atherosclerosis Update and Therapeutic Implications Circulation. 2007;116:1832-44.


  4. JP Says:

    Hi Charles,

    I agree that endothelial integrity and insulin resistance both factor into CVD. Other likely factors include hypertensive-related damage, imbalanced omega-3/6 fatty acids, oxidized cholesterol and many more. However, rather than focusing on the latest and greatest markers and tests, I think it’s preferable to pursue dietary and lifestyle choices which tend to promote various aspects of wellness including connective tissue integrity, insulin sensitivity, low systemic inflammation and beyond.

    A recent case in point:


    Be well!


  5. JP Says:

    Update: Low carb diets are an effective way to lower triglycerides …


    Ann Intern Med. 2014 Sep 2;161(5):309-18. doi: 10.7326/M14-0180.

    Effects of low-carbohydrate and low-fat diets: a randomized trial.

    BACKGROUND: Low-carbohydrate diets are popular for weight loss, but their cardiovascular effects have not been well-studied, particularly in diverse populations.

    OBJECTIVE: To examine the effects of a low-carbohydrate diet compared with a low-fat diet on body weight and cardiovascular risk factors.

    DESIGN: A randomized, parallel-group trial. (ClinicalTrials.gov: NCT00609271).

    SETTING: A large academic medical center.

    PARTICIPANTS: 148 men and women without clinical cardiovascular disease and diabetes.

    INTERVENTION: A low-carbohydrate (<40 g/d) or low-fat (<30% of daily energy intake from total fat [<7% saturated fat]) diet. Both groups received dietary counseling at regular intervals throughout the trial.

    MEASUREMENTS: Data on weight, cardiovascular risk factors, and dietary composition were collected at 0, 3, 6, and 12 months.

    RESULTS: Sixty participants (82%) in the low-fat group and 59 (79%) in the low-carbohydrate group completed the intervention. At 12 months, participants on the low-carbohydrate diet had greater decreases in weight (mean difference in change, -3.5 kg [95% CI, -5.6 to -1.4 kg]; P = 0.002), fat mass (mean difference in change, -1.5% [CI, -2.6% to -0.4%]; P = 0.011), ratio of total-high-density lipoprotein (HDL) cholesterol (mean difference in change, -0.44 [CI, -0.71 to -0.16]; P = 0.002), and triglyceride level (mean difference in change, -0.16 mmol/L [-14.1 mg/dL] [CI, -0.31 to -0.01 mmol/L {-27.4 to -0.8 mg/dL}]; P = 0.038) and greater increases in HDL cholesterol level (mean difference in change, 0.18 mmol/L [7.0 mg/dL] [CI, 0.08 to 0.28 mmol/L {3.0 to 11.0 mg/dL}]; P < 0.001) than those on the low-fat diet.

    LIMITATION: Lack of clinical cardiovascular disease end points.

    CONCLUSION: The low-carbohydrate diet was more effective for weight loss and cardiovascular risk factor reduction than the low-fat diet. Restricting carbohydrate may be an option for persons seeking to lose weight and reduce cardiovascular risk factors.

    Be well!


  6. JP Says:

    Update: Fish oil may reduce damage caused by heart attack …


    “WEDNESDAY, March 4, 2015 (HealthDay News) — High doses of omega-3 fatty acids may protect against further damage in heart attack patients, a preliminary study suggests.

    The research included 374 heart attack survivors who received standard treatment and took either a 4-gram prescription-only dose of omega-3 fatty acids each day or a placebo. The researchers said that people probably couldn’t get that level of omega-3 fatty acids from diet alone. To illustrate how large a dose that is, the researchers noted that 4 grams of omega-3 fatty acids is the equivalent of eating 8 ounces of salmon.

    Using MRIs, the patients’ hearts were scanned two weeks, four weeks and six months after their heart attack.

    Compared to those taking the placebo, patients taking the omega-3 capsules had lower levels of inflammation and were 39 percent less likely to show deterioration of heart function. There was also less thickening or scarring of the areas of the heart that were not directly damaged during the heart attack. This thickening, also known as fibrosis, often develops when the surviving heart muscle works harder to compensate for the damaged tissue, according to the researchers.”

    Be well!


  7. JP Says:

    Update 04/28/15:


    J Nutr. 2015 Apr 22. pii: jn203190.

    Cranberry Juice Consumption Lowers Markers of Cardiometabolic Risk, Including Blood Pressure and Circulating C-Reactive Protein, Triglyceride, and Glucose Concentrations in Adults.

    BACKGROUND: Cardiometabolic risk is the risk of cardiovascular disease (CVD), diabetes, or stroke, which are leading causes of mortality and morbidity worldwide.

    OBJECTIVE: The objective of this study was to determine the potential of low-calorie cranberry juice (LCCJ) to lower cardiometabolic risk.

    METHODS: A double-blind, placebo-controlled, parallel-arm study was conducted with controlled diets. Thirty women and 26 men (mean baseline characteristics: 50 y; weight, 79 kg; body mass index, 28 kg/m2) completed an 8-wk intervention with LCCJ or a flavor/color/energy-matched placebo beverage. Twice daily volunteers consumed 240 mL of LCCJ or the placebo beverage, containing 173 or 62 mg of phenolic compounds and 6.5 or 7.5 g of total sugar per a 240-mL serving, respectively.

    RESULTS: Fasting serum triglycerides (TGs) were lower after consuming LCCJ and demonstrated a treatment × baseline interaction such that the participants with higher baseline TG concentrations were more likely to experience a larger treatment effect (1.15 ± 0.04 mmol/L vs. 1.25 ± 0.04 mmol/L, respectively; P = 0.027). Serum C-reactive protein (CRP) was lower for individuals consuming LCCJ than for individuals consuming the placebo beverage [ln transformed values of 0.522 ± 0.115 ln(mg/L) vs. 0.997 ± 0.120 ln(mg/L), P = 0.0054, respectively, and equivalent to 1.69 mg/L vs. 2.71 mg/L back-transformed]. LCCJ lowered diastolic blood pressure (BP) compared with the placebo beverage (69.2 ± 0.8 mm Hg for LCCJ vs. 71.6 ± 0.8 mm Hg for placebo; P = 0.048). Fasting plasma glucose was lower (P = 0.03) in the LCCJ group (5.32 ± 0.03 mmol/L) than in the placebo group (5.42 ± 0.03 mmol/L), and LCCJ had a beneficial effect on homeostasis model assessment of insulin resistance for participants with high baseline values (P = 0.035).

    CONCLUSION: LCCJ can improve several risk factors of CVD in adults, including TGs, CRP, glucose, insulin resistance, and diastolic BP.

    Be well!


  8. JP Says:

    Update 05/18/15:


    Nutrition Research – May 13, 2015

    Paleolithic nutrition improves plasma lipid concentrations of hypercholesterolemic adults to a greater extent than traditional heart-healthy dietary recommendations

    Recent research suggests that traditional grain-based heart healthy diet recommendations, which replace dietary saturated fat with carbohydrate and reduce total fat intake, may result in unfavorable plasma lipid ratios, with reduced high-density lipoprotein (HDL) and an elevation of low-density lipoprotein (LDL) and triacylglycerols (TG). The current study tested the hypothesis that a grain-free Paleolithic diet would induce weight loss and improve plasma total cholesterol (TC), HDL, LDL and TG concentrations in non-diabetic adults with hyperlipidemia to a greater extent than a grain-based heart healthy diet, based on the recommendations of the American Heart Association. Twenty volunteers (10 male, 10 female) aged 40 to 62 years were selected based on diagnosis of hypercholesterolemia. Volunteers were not taking any cholesterol-lowering medications and adhered to a traditional heart healthy diet for four months, followed by a Paleolithic diet for four months. Regression analysis was used to determine whether change in body weight contributed to observed changes in plasma lipid concentrations. Differences in dietary intakes and plasma lipid measures were assessed using repeated measures ANOVA. Four months of Paleolithic nutrition significantly lowered (P < 0.001) mean TC, LDL, and TG and increased (P < 0.001) HDL, independent of changes in body weight, relative to both baseline and the traditional heart healthy diet. Paleolithic nutrition offers promising potential for nutritional management of hyperlipidemia in adults whose lipid profiles have not improved after following more traditional heart healthy dietary recommendations.

    Be well!


  9. JP Says:

    Update 05/28/15:


    Nutrition, Metabolism and Cardiovascular Diseases – May 13, 2015

    The triglyceride-lowering effect of supplementation with dual probiotic strains, Lactobacillus curvatus HY7601 and Lactobacillus plantarum KY1032: reduction of fasting plasma lysophosphatidylcholines in nondiabetic and hypertriglyceridemic subjects

    Background and Aims: This study evaluated the triglyceride (TG)-lowering effects of consuming dual probiotic strains of Lactobacillus curvatus (L. curvatus) HY7601 and Lactobacillus plantarum (L. plantarum) KY1032 on the fasting plasma metabolome.

    Methods and Results: A randomized, double-blind, placebo-controlled study was conducted on 92 participants with hypertriglyceridemia but without diabetes. Over a 12-week testing period, the probiotic group consumed 2 g of powder containing 5 x 109 colony-forming units (cfu) of L. curvatus HY7601 and 5 x 109 cfu of L. plantarum KY1032 each day, whereas the placebo group consumed the same product without probiotics. Fasting plasma metabolomes were profiled using UPLC-LTQ-Orbitrap MS. After 12 weeks of treatment, the probiotic group displayed a 20% reduction (p = 0.001) in serum TGs and 25% increases (p = 0.001) in apolipoprotein A-V (apoA-V). At the 12-week follow-up assessment, the following 11 plasma metabolites were significantly reduced in the probiotic group than the placebo group: palmitoleamide, palmitic amide, oleamide, and lysophosphatidyl choline (lysoPC) containing C14:0, C16:1, C16:0, C17:0, C18:3, C18:2, C18:1, and C20:3. In the probiotic group, changes (△) in TG were negatively correlated with △ apoA-V, which were positively correlated with △ FFA. In addition, △ FFA was strongly and positively correlated with △ lysoPCs in the probiotic group but not the placebo group.

    Conclusions: The triglyceride-lowering effects of probiotic supplementation, partly through elevated apoA-V, in borderline to moderate hypertriglyceridemic subjects showed reductions in plasma metabolites; fatty acid primary amides and lysoPCs (NCT02215694; http://www.clinicaltrials.gov).

    Be well!


  10. JP Says:

    Updated 09/03/15:


    Food Nutr Res. 2015 Aug 19;59:27651.

    Effect of a high intake of cheese on cholesterol and metabolic syndrome: results of a randomized trial.

    BACKGROUND: Cheese is generally rich in saturated fat, which is associated with increased risk for cardiovascular diseases. Nevertheless, recent reports suggest that cheese may be antiatherogenic.

    OBJECTIVE: The goal of this study was to assess whether intake of two types of Norwegian cheese, with widely varying fat and calcium content, might influence factors of the metabolic syndrome and serum cholesterol levels differently.

    DESIGN: A total of 153 participants were randomized to one of three groups: Gamalost(®), a traditional fat- and salt-free Norwegian cheese (50 g/day), Gouda-type cheese with 27% fat (80 g/day), and a control group with a limited cheese intake. Blood samples, anthropometric measurements, blood pressure, and questionnaires about lifestyle and diet were obtained at inclusion and end.

    RESULTS: At baseline, there were no differences between the groups in relevant baseline characteristics, mean age 43, 52.3% female. After 8 weeks’ intervention, there were no changes in any of the metabolic syndrome factors between the intervention groups compared with the control group. There were no increases in total- or LDL cholesterol in the cheese groups compared with the control. Stratified analysis showed that those in the Gouda group with metabolic syndrome at baseline had significant reductions in total cholesterol at the end of the trial compared with control (-0.70 mmol/L, p=0.013), and a significantly higher reduction in mean triglycerides. In the Gamalost group, those who had high total cholesterol at baseline had a significant reduction in total cholesterol compared with control (-0.40 mmol/L, p=0.035).

    CONCLUSIONS: In conclusion, cholesterol levels did not increase after high intake of 27% fat Gouda-type cheese over 8 weeks’ intervention, and stratified analysis showed that participants with metabolic syndrome had reduced cholesterol at the end of the trial.

    Be well!


  11. JP Says:

    Updated 09/23/15:


    Metabolism. 2015 Jul 30.

    Effects of pistachios on the lipid/lipoprotein profile, glycemic control, inflammation, and endothelial function in type 2 diabetes: A randomized trial.

    OBJECTIVE: The health benefits of regular nut consumption have been well-documented; however, effects on cardiovascular risk in diabetes are emerging. This study examined the effects of daily pistachio consumption on the lipid/lipoprotein profile, glycemic control, markers of inflammation, and endothelial function in adults with type 2 diabetes.

    MATERIALS/METHODS: We enrolled 30 adults (40-74years) with well-controlled type 2 diabetes (mean glycated hemoglobin 6.2%) in a randomized, crossover, controlled feeding study. After a 2-week run-in period, participants consumed nutritionally-adequate diets with pistachios (contributing 20% of total energy) or without pistachios for 4weeks each, separated by a 2-week washout. We assessed fasting lipids/lipoproteins, glycemic measures (while fasted and during a 75g oral glucose tolerance test), inflammatory markers, and endothelial function after each diet period.

    RESULTS: Total cholesterol and the ratio of total to HDL cholesterol were significantly lower (p<0.05) following the pistachio diet (4.00mmol/L and 4.06mmol/L, respectively) compared to the control diet (4.15mmol/L and 4.37mmol/L, respectively). Triglycerides were significantly lower (p=0.003) following the pistachio diet (1.56mmol/L) compared to the control diet (1.84mmol/L). There were no treatment differences in fasting glucose and insulin, but fructosamine was significantly lower (p=0.03) following the pistachio diet (228.5μmol/l) compared to the control diet (233.5μmol/l). Inflammatory markers and endothelial function were unchanged.

    CONCLUSION: Daily pistachio consumption can improve some cardiometabolic risk factors in adults with well-controlled type 2 diabetes. Our findings support recommendations that individuals with diabetes follow healthy dietary patterns that include nuts.

    Be well!


Leave a Comment

To prove you're a person (not a spam script), type the security word shown in the picture. Click on the picture to hear an audio file of the word.
Click to hear an audio file of the anti-spam word