Triglyceride [TG] reducing diet

  Our body needs fat for its structural integrity and healthy functioning. But high levels of total blood cholesterol in general and triglycerides in particular raises your risk of heart disease. Therefore it is very important to keep cholesterol and triglycerides at optimum levels.

Triglycerides (TG) are lipids or fats conformed by three fatty acids attached to a glycerol molecule and their main function is to store energy as fat in the adipose tissue [fat tissues] of the body.

Triglycerides are either produced by liver or they reach the body through diet.

Hypertriglyceridemia or high TG is defined as a state with fasting serum TG of 150 mg/dL (1.7 mmol/L) or higher. The TG elevation is the most common form of dyslipidemia or cholesterol abnormality in the adults and it is associated with tremendous risk for the heart diseases.

Causes of high  Triglycerides [TG]

Triglycerides [TG] increase may result from genetic as well as environmental factors.

 Common secondary causes of raised TG include:

·       Obesity

·       Uncontrolled diabetes

·       Excess intake of alcohol

·        High saturated fat

·        High refined sugar and high caloric diet

·       Smoking

·        Metabolic syndrome

·        Hypothyroidism or underactive thyroid

·        Diabetes mellitus

·        Kidney disorders

·        Cushing’s syndrome

·        Pregnancy

·        Acromegaly

·        Drugs (thiazides, beta blockers, steroid hormones and others.

 What is the risk associated with high TG levels?

Hypertriglyceridemia or high TG levels increases your risk of cardiovascular disease particularly, if your triglycerides  goes above 200 mg/Dl.    It is associated with tremendous risk for the heart diseases.

Insulin resistance is a condition of the body in which the insulin produced by the body is incapable of lowering blood sugar levels. It is associated with an increased risk of both atherosclerotic clot formation and progression to type 2 diabetes. 

Insulin resistance may also lead to an elevation of very low-density lipoprotein triglyceride, a reduction in high-density lipoprotein cholesterol, and triglyceride-enriched low-density lipoprotein.

Elevated triglycerides cause a reduction in the heart protecting high-density lipoprotein level as well as the generation of small, dense low-density lipoproteins which increases the risk for cardiovascular diseases; these processes are mediated by cholesteryl ester transfer protein.

How to lower triglycerides levels?

Dietary and lifestyle changes can make a huge difference in lowering triglycerides and keeping you healthy. The drugs causing TG elevation must be replaced with better remedies. Totally avoid alcohol abuse and smoking in a gradual way.

Manage diseases such as diabetes, thyroid dysfunction, Cushing syndrome etc. with appropriate intervention if any of these is causing the rise.

Avoid:

·       Alcohol

·       saturated fats such as butter, ghee, margarine etc. 

·       Simple (refined) carbohydrates such as white flour[ Maida].

·        Added sugars.

Include foods such as:

Fruits ,vegetables, grains, plant proteins ,lean meat, dairy products. The dietary components have definite role in managing TG levels. The composition of the diet, total calories ingested, food quality, and adherence to dietary patterns may have an impact on lipid profile test which reveals the Triglyceride level also.

A] Dietary fiber

Fiber is part of the plant-based foods. Dietary fiber is commonly classified as soluble and insoluble.

This includes cellulose, non-starch polysaccharides, pectins, hydrocolloids, fructo-oligosaccharides, lignin, beta-glucans, and resistant starch .

Include foods such as whole grain cereals, legumes , fruits, and vegetables with higher fiber content.

Whole grains are the main source of insoluble fiber; however, they are also composed of soluble fiber

According to a study higher intake of whole grain cereal foods was related to a greater reduction in serum TG levels[3].

The research studies recommend increasing consumption of whole grains in the diet and the replacement of refined grains. Another study points out that inclusion of dietary fiber from oats in the diet can be a valid strategy to prevent the onset of CVD [4].

B] Life style modifications

In addition to dietary changes certain life style modifications are suggested to keep TG under control such as regular exercise, physical activity and avoiding frequent snacking.

C]Nutritional intervention or diet

The  consumption of omega-3 supplements and the Mediterranean Diet are the best documented nutritional interventions for the reduction of TG[5].

Omega-3 is a safe nutrient with considerable evidence in favor of its effect on reducing TG concentrations in patients with metabolic disorders and diseases [6].

D] Consumption of plant sterols

   Less than 1.5 g/day of plant sterols [found in plant foods] improves TG and LDL cholesterol levels [7].

Plant sterols can decrease TG concentration through blocking the absorption of fatty acids in the intestinal lumen as well as by modulating liver producing triglycerides. Legumes, vegetable oils, nuts, cereals, and seeds are likewise sources of plant sterols.

E] Consume more nuts& seeds

The evidence suggests that a diet enriched with nuts, mixed nuts, peanuts, and almonds could be useful for the reduction of TG, whereas cashews appear to have no effect on this biomarker. Flaxseeds also help to reduce TG.

F] Carbohydrates lowering 

Decreasing carbohydrate consumption from 20–50 g per day initially and then gradually increasing it (120–150 g/per day) is an intervention that has proven beneficial for TG levels.

Role of Mediterranean diet in reducing triglycerides

  The Mediterranean diet includes  foods such as fruits, leguminous vegetables, nuts and seeds, fish, vegetables, and whole grains, Greek yogurt, low-fat cheese (ricotta, cottage cheese), extra virgin olive oil, and reduces the consumption of sugar, processed foods, red meat, and sugary drinks.

 The Mediterranean diet is rich in antioxidants, fiber, vitamins and minerals, polyphenols, monounsaturated fatty acids MUFA, and omega-3 polyunsaturated fatty acids;

It has therefore been proposed as a dietary model with great effect in managing triglycerides and other lipoproteins .The reduction in TG levels related to the Mediterranean diet has been evidenced in several studies. The diet helps in reducing bad LDL cholesterol as well.

In nutshell Mediterranean diet is helpful in protecting against heart diseases from atherosclerotic plaque deposition.

Role of Paleolithic diet in managing triglycerides

The type of diet in the Paleolithic period was proposed, according to the historical context and geographical location. This dietary pattern includes lean meat, poultry, fish, seafood, fruits, nuts, berries, seeds, vegetables, and water; the “non-Paleolithic” foods were legumes, cereals, sugar, salt, processed foods, and dairy products.

Paleolithic nutrition offers promising potential for nutritional management of hyperlipidemia in adults [10].

References

1.    https://pubmed.ncbi.nlm.nih.gov/33046451/

2.    https://pubmed.ncbi.nlm.nih.gov/11143762/

3.    https://pubmed.ncbi.nlm.nih.gov/33612630/

4.    https://pubmed.ncbi.nlm.nih.gov/32138344/

5.    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8912493/

6.    https://pubmed.ncbi.nlm.nih.gov/27913872/

7.    https://pubmed.ncbi.nlm.nih.gov/31413246/

8.    https://pubmed.ncbi.nlm.nih.gov/29229363/

9.    https://pubmed.ncbi.nlm.nih.gov/33082244/

10.           https://pubmed.ncbi.nlm.nih.gov/26003334/