Over the years much has been written about the dangers of high cholesterol leading to an increased risk of heart disease, stroke and other health conditions. The role triglycerides play in these conditions has been overlooked.
Triglycerides make up about 95% of your body's fat and are the chemical form in which most body fats exist. The fat produced from triglycerides is used for energy production, provides your body's organs with insulation, and is a central component in the structure of cell membranes. Unused triglycerides are transferred to fat cells for storage. When energy is needed, hormones can cause the release of the stored fats. When the body's production of triglycerides gets too high the blood triglyceride levels will also increase. This thickens and sludges the blood, decreasing blood flow. Excess triglycerides increase the risk of stroke, heart attacks, fatty liver, pancreatitis and obesity.
Since triglycerides are part of a serum lipid blood test, and lipids are fats circulating in the blood, most people assume high fat diets increase triglycerides. They are surprised to learn sugars , refined grains, and fruit sugars are the biggest culprits causing elevated triglycerides
High blood sugar levels lead to high triglycerides levels. Sugars and refined grains stimulate insulin production. Insulin stimulates the liver to produce triglycerides. Triglycerides in the blood are not made from dietary fats but made in the liver from excess sugar which has not been used for energy. Eating more calories than your body can use for energy contributes to higher triglycerides.
This chart shows the average blood sugar measurements of a normal healthy adult:
Category
|
Fasting Value
|
Eating Value
|
Minimum
|
Maximum
|
2 hrs after consuming Glucose
|
Normal
|
70 mg
|
100 mg
|
Under 140 mg
|
Early Diabetes
|
101 mg
|
126 mg
|
140 mg – 200 mg
|
Established Diabetes
|
Over 126 mg
|
|
Over 200 mg
|
Contributing to high triglycerides are obesity, increased alcohol intake, low activity level, diabetes, pre diabetes with insulin resistance, low thyroid function, liver and kidney disease, and eating more calories than your body uses.
Medications which can cause increased blood triglycerides are beta-blockers for high blood pressure, diuretics, some steroids, drugs used to test HIV, the newer classes of antipsychotic drugs, Tamoxifen, retinoids, cyclosporin, birth control pills and estrogens.
The chart below outlines national guidelines for triglyceride levels:
TRIGLCERIDES LEVEL
|
CLASSIFICATION
|
Less than 150 mg/dL
|
Normal
|
150 to 199 mg/dL
|
Borderline-high
|
200 to 499 mg/dL
|
High
|
500 mg/dL
|
Very high
|
The major contributor to high triglyceride levels is diet. And most often, with my patients (who are eating healthfully and trying to take care of themselves) the culprit is fruit juice. The major contributor in those who are less health conscious is alcohol intake, high fructose corn syrup, other sugars, and white flour products.
Americans are eating more sugar than ever before according to research conducted by Dr. Richard Johnson a professor of medicine at the University of Colorado.
The average person in the 1700’s ate 4 lbs of sugar a year. Today 25% of us consume over ½ lb of added sugar daily adding up to 180 lbs. per year! This is why 1 in 4 Americans is either pre-diabetic or has type II diabetes.
The two main sources of dietary sugar are high fructose corn syrup (HFCS) and table sugar.
What surprises many is that consuming high levels of fructose can absolutely devastate your biochemistry and physiology. We are not evolved to handle high levels of sugar and especially high levels of fructose. Fructose is metabolized differently than glucose in a way that creates more fat, higher triglycerides, more non-alcoholic fatty liver disease, and more obesity. High fructose corn syrup literally packs your organs in fat.
For most of human history individuals consumed an average of 15 grams of fructose daily, mostly in the form of whole fruits and vegetables.
The commercial production of fructose began in 1969. High fructose corn syrup (HFCS) was developed and since it was less expensive it was used as the sweetener for more than 50 % of our processed foods. It is added to soft drinks, most processed drinks, baked goods, breads, crackers, peanut butter, mayonnaise, sauces, ketchup, salad dressings, candies, jams, jellies, breakfast cereals, and almost all processed foods of any kind. Other high fructose sources are honey, fruit juice and table sugar (which is half glucose and half fructose).
Statistics are hard to find, but the current average daily fructose consumption info ranges from 38-80 grams. Adolescents and children are in the higher intake ranges when calculated as a percent of total diet.
Why is excess fructose such a culprit, even worse than glucose? Because the 2 are metabolized differently. Glucose is used by and metabolized in all body cells. It is an energy provider for your brain, muscles, and all body organs. Fructose is not a direct source of energy for your muscles and brain although many producers claim it is.
Glucose is your body's primary fuel source because it is the easiest type of fuel to break down and convert into energy. Your brain consumes more energy than any other organ and runs most efficiently on the energy produced by glucose. The amino acid, glutamine, is a back up brain fuel.
Fructose is not so easily converted to energy. It goes through different and more complicated metabolic processes in the liver. You can see details on the
difference in glucose and fructose metabolism if you like such details.
To learn how much fructose you and family members are eating, go to see the
foods highest in fructose and
groups of high fructose foods. You will be surprised when you check these links. BE SURE TO KEEP YOUR DAILY FRUCTOSE INTAKE NO HIGHER THAN 50 GRAMS AND PREFERABLY HALF THAT MUCH.
Ideally you would get all your fructose from fruits and vegetables, but that is extremely difficult in todays world. It is better to cut back your fructose consumption by eliminating the junk fructose and then eating it as natural fruits. Fruits contain antioxidants, vitamin C, potassium, fiber and other healthy ingredients. Even though fruits are beneficial, you should still be careful with your consumption, as your intake can still easily be too high. So please, carefully add your fruits based on the table below.
FRUIT
|
SERVING SIZE
|
GRAMS OF FRUCTOSE
|
Limes
|
1 medium
|
0
|
Lemons
|
1 medium
|
0.6
|
Cranberries
|
1 cup
|
0.7
|
Passion fruit
|
1 medium
|
0.9
|
Prune
|
1 medium
|
1.2
|
Apricot
|
1 medium
|
1.3
|
Guava
|
2 medium
|
2.2
|
Date (Deglet Noor style)
|
1 medium
|
2.6
|
Cantaloupe
|
1/8 of med. melon
|
2.8
|
Raspberries
|
1 cup
|
3.0
|
Clementine
|
1 medium
|
3.4
|
Kiwifruit
|
1 medium
|
3.4
|
Blackberries
|
1 cup
|
3.5
|
Star fruit
|
1 medium
|
3.6
|
Cherries, sweet
|
10
|
3.8
|
Strawberries
|
1 cup
|
3.8
|
Cherries, sour
|
1 cup
|
4.0
|
Pineapple
|
1 slice (3.5" x .75")
|
4.0
|
Grapefruit, pink or red
|
1/2 medium
|
4.3
|
Boysenberries
|
1 cup
|
4.6
|
Tangerine/mandarin orange
|
1 medium
|
4.8
|
Nectarine
|
1 medium
|
5.4
|
Peach
|
1 medium
|
5.9
|
Orange (navel)
|
1 medium
|
6.1
|
Papaya
|
1/2 medium
|
6.3
|
Honeydew
|
1/8 of med. melon
|
6.7
|
Banana
|
1 medium
|
7.1
|
Blueberries
|
1 cup
|
7.4
|
Date (Medjool)
|
1 medium
|
7.7
|
Apple (composite)
|
1 medium
|
9.5
|
Persimmon
|
1 medium
|
10.6
|
Watermelon
|
1/16 med. melon
|
11.3
|
Pear
|
1 medium
|
11.8
|
Raisins
|
1/4 cup
|
12.3
|
Grapes, seedless (green or red)
|
1 cup
|
12.4
|
Mango
|
1/2 medium
|
16.2
|
Apricots, dried
|
1 cup
|
16.4
|
Figs, dried
|
1 cup
|
23.0
|
Triglyceride levels can be monitored, and should be kept as low as possible to insure good health.
NATURAL SUPPLEMENTS TO HELP MAINTAIN HEALTHY TRIGLYCERIDE LEVELS
The American Heart Association has recommended 2-4 grams daily of omega-3-fatty acids, such as fish oil to help stabilize triglycerides. There is a prescription medication for the treatment of high triglycerides, called Lovaza. It is an omega 3 acid ethly ester. Lovaza is much more expensive than the over the counter fish oil.
For detailed tables showing more content of fructose in different foods see Dr. Johnson”s book
The Sugar Fix.
Please see Dr. Slagle’s newsletter on natural & artificial sweeteners, for more information.