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Triglycerides

Episodes

Posted on April 15th 2024 (about 1 year)

Dr. Rhonda Patrick explores collagen peptides, high-dose niacin and vitamin B6, avoiding nano- and microplastics in her latest Q&A.

Posted on May 21st 2022 (about 3 years)

In this clip, Dr. Dominic D'Agostino discusses how ketones affect exercise performance.

Posted on April 2nd 2022 (about 3 years)

In this clip, Dr. Krauss talks about LDL numbers that are considered high risk.

Topic Pages

  • Sugar-sweetened beverages (SSBs)

    Fructose-rich SSBs accelerate hepatic de novo lipogenesis, augmenting very-low-density lipoprotein secretion and raising plasma triglycerides.

News & Publications

  • Metabolic syndrome is a cluster of conditions that includes hypertension, high blood glucose, excess abdominal fat, and abnormal blood lipids. Having metabolic syndrome markedly increases a person’s risk of cardiovascular disease, type 2 diabetes, and stroke. A recent meta-analysis found that taurine supplementation improves conditions associated with metabolic syndrome.

    Researchers analyzed the findings of 25 studies (with more than 1,000 participants) investigating links between taurine supplementation and metabolic syndrome. They also explored the effects of taurine dose and examined secondary outcomes of taurine supplementation, including body composition, lipid profile, and blood glucose control.

    They found that taurine doses ranged from 0.5 to 6 grams, with study durations ranging from five days to one year. On average, taurine supplementation reduced systolic blood pressure by 4 mmHg, diastolic blood pressure by 1.5 mmHg, fasting blood glucose by 6 milligrams per deciliter, and triglycerides by 18 milligrams per deciliter. The researchers did not observe an effect on high-density lipoprotein cholesterol. The reduction in diastolic blood pressure and fasting blood glucose was dose-dependent, with higher doses eliciting more robust effects.

    These findings suggest that taurine supplementation improves factors associated with metabolic syndrome. Interestingly, other research shows that an acute bout of exercise increases blood taurine levels, providing a mechanistic link between exercise and better metabolic health.

  • Coronary artery disease, a cardiovascular condition characterized by the gradual buildup of plaque within the heart’s arteries, is the third leading cause of death worldwide, claiming the lives of nearly 18 million people each year. A recent meta-analysis found that omega-3 fatty acids reduced the risk of dying from cardiovascular disease by 18 percent and myocardial infarction (heart attack) by 23 percent, underscoring omega-3s' effectiveness as an adjunct therapy for coronary artery disease.

    The investigators analyzed the findings of 12 studies involving more than 29,000 people with coronary artery disease. The various studies lasted between one and five years and used both eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), marine forms of omega-3 fatty acids. Doses ranged between 0.84 and 3.46 grams daily for EPA + DHA and between 1.8 and 4 grams daily for EPA alone.

    The analysis revealed that omega-3s reduced the risk of premature death from all causes by 10 percent, cardiovascular disease by 18 percent, myocardial infarction by 23 percent, sudden cardiac death by 33 percent, and hospitalization for heart failure or unstable angina pectoris (chest pain caused by lack of blood flow to the heart) by 25 percent in patients with coronary artery disease. These effects were strongest among patients receiving EPA only and those with high triglycerides.

    These findings suggest that omega-3s, especially EPA, reduce the risk of cardiovascular disease, particularly among people with high triglycerides. Triglycerides play critical roles in the pathophysiology of coronary artery disease. Elevated triglyceride levels often accompany other conditions, such as obesity, diabetes, and high LDL (“bad”) cholesterol, further exacerbating the risk of developing coronary artery disease. Learn about the early research showing omega-3s' effects on reducing triglycerides.

  • Triglycerides, the most common type of fat in the body, serve as a vital energy source and aid in absorbing fat-soluble vitamins. However, elevated levels of triglycerides, often associated with unhealthy dietary habits and certain metabolic conditions, have been linked to an increased risk of atherosclerosis, cardiovascular disease, and other metabolic disorders. Now, findings from a recent study suggest that higher triglyceride levels reduce the risk of dementia by as much as 18 percent.

    Researchers drew on data from more than 86,000 healthy older adults enrolled in the UK Biobank and ASPREE studies. They measured the participants' triglyceride levels and assessed different aspects of their cognition, such as memory, language, and reasoning. Then, they determined the effects of triglyceride levels on these cognitive measures.

    They found that participants with higher triglyceride levels (normal to high-normal) were 18 percent less likely to develop dementia and experienced a slower decline in their overall cognitive abilities over time than those with lower triglyceride levels. Those with the highest levels of triglycerides were 36 percent less likely to develop dementia than those with the lowest levels. These results were consistent even after considering other factors that could affect the outcomes.

    These findings suggest that higher triglyceride levels protect against dementia, counter to current thinking about triglycerides. They also highlight the need for further investigation to understand whether this link is causal and whether components of triglycerides benefit cognitive function.

  • From the article:

    Metabolic syndrome has emerged as a major public health concern, affecting 30% to 60% of postmenopausal women worldwide.

    […]

    The cross-sectional study included 616 postmenopausal women aged 49 to 86 years who were not taking estrogen and vitamin D/calcium supplements at the beginning of the trial. It concluded there was a positive correlation between vitamin D and estradiol.

    Specifically, higher vitamin D was associated with a favorable lipid profile, blood pressure, and glucose level. Estradiol was negatively associated with cholesterol, triglycerides, and blood pressure. These results suggest a synergistic role of vitamin D and estradiol deficiency in developing metabolic syndrome in postmenopausal women.

    View full publication

  • From the article:

    All 95 men in the studies (ages 34 to 69 years) had the metabolic syndrome. To receive this diagnosis, patients must have three of the following five risk factors: increased waist circumference (abdominal fat), low HDL (“good”) cholesterol, high triglycerides (fats in the blood), high blood pressure, and high blood sugar.

    The first study showed that testosterone treatment significantly reduced waist circumference, total cholesterol, LDL (“bad”) cholesterol, triglycerides, and body mass index (a measure of body fat). Treatment also increased “good” cholesterol. Improvements were progressive over 12 months, indicating that benefits may continue past a year, Saad said.

    In the second study, the researchers divided the patient population into three groups by age: less than 57 years, 57 to 63 years, and more than 63 years. They found that the oldest men had similar improvements in metabolic risk factors to the youngest men.

    Additionally, the investigators looked at the degree of testosterone deficiency before treatment. This beginning level of testosterone deficiency did not predict the beneficial outcome, they found. Men whose subnormal testosterone levels were not as low as the others had similar improvements in metabolic risk factors to men with the lowest levels, according to Saad.

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  • From the article:

    “When indicated, testosterone treatment is both essential and safe in elderly patients with symptomatic late onset hypogonadism, or testosterone deficiency,” said study lead author Aksam A. Yassin, M.D., Ph.D., Ed.D., chairman of the Institute of Urology & Andrology in Norderstedt-Hamburg, Germany. “Further analysis is needed to confirm if our findings are due to a direct effect of restoring physiologic testosterone levels.”

    Specifically, investigators found that the prevalence of metabolic syndrome dropped from 56 to 30 percent after 57 months of treatment with testosterone-replacement medication to regulate hormone levels. In addition, triglycerides, and levels of blood sugar and pressure significantly decreased, while the average waist circumference shrank by 11 centimeters.

    Beginning in 2004, investigators collected data from 261 patients with late-onset hypogonadism, characterized by both low testosterone levels and sexual dysfunction, at three centers in Germany. Patients received 1,000 milligrams of a long-acting testosterone drug, called undecanoate, on the first day of the study, at week six, and then every three months.

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  • From the aricle:

    Peterson and team then examined prevalence of nine chronic conditions, including type 2 diabetes, arthritis, cardiovascular disease, stroke, pulmonary disease, high triglycerides, hypercholesterolemia, hypertension and clinical depression.

    The researchers studied the prevalence of multimorbidity, or when two or more of the chronic conditions were present, among three age groups (young, middle-aged and older men) with and without testosterone deficiency. They found that low total testosterone [<300 ng/dL] was associated with multimorbidity in all age groups – but it was more prevalent among young and older men with testosterone deficiency.

    “We also found a large dose-response relationship between the age-specific low total testosterone and moderate total testosterone levels and multimorbidity, even after adjusting for obesity and muscle strength capacity,” Peterson says. “Which means that men should be concerned about declining total testosterone, even if it has not reached a level to warrant a clinical diagnosis (<300 ng/dL [10.4 nmol/L]).”

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  • From the article:

    Together, these results suggest that the link between heart disease and depression cannot be explained by a common genetic predisposition to the two diseases. Instead, it implies that something about an individual’s environment – such as the risk factors they are exposed to – not only increases their risk of heart disease, but at the same time increases their risk of depression.

    […]

    Of these common biomarkers, they found that triglycerides (a type of fat found in the blood) and the inflammation-related proteins IL-6 and CRP were also risk factors for depression.

    Both IL-6 and CRP are inflammatory markers that are produced in response to damaging stimuli, such as infection, stress or smoking. Studies by Dr Khandaker and others have previously shown that people with elevated levels of IL-6 and CRP in the blood are more prone to develop depression, and that levels of these biomarkers are high in some patients during acute depressive episode. Elevated markers of inflammation are also seen in people with treatment resistant depression. This has raised the prospect that anti-inflammatory drugs might be used to treat some patients with depression. Dr Khandaker is currently involved in a clinical trial to test tocilizumab, an anti-inflammatory drug used for the treatment of rheumatoid arthritis that inhibits IL-6, to see if reducing inflammation leads to improvement in mood and cognitive function in patients with depression.

    While the link between triglycerides and coronary heart disease is well documented, it is not clear why they, too, should contribute to depression. The link is unlikely to be related by obesity, for example, as this study has found no evidence for a causal link between body mass index (BMI) and depression.

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  • From the article:

    Data from several genome-wide association studies were used to gauge genetic associations to lifestyle and cardiometabolic risk factors. […] According to the analysis:

    -A genetic predisposition for insomnia was associated with a 24% increased risk for intracranial aneurysm and aneurysmal subarachnoid hemorrhage.

    -The risk for intracranial aneurysm was about three times higher for smokers vs. non-smokers.

    -The risk for intracranial aneurysm was almost three times higher for each 10 mm Hg increase in diastolic blood pressure (the bottom number in a blood pressure reading).

    -High triglyceride levels and high BMI did not demonstrate an increased risk for intracranial aneurysm and aneurysmal subarachnoid hemorrhage.

    View full publication

  • Metabolic diseases, such as type 2 diabetes, cardiovascular disease, and non-alcoholic fatty liver disease (NAFLD), represent a major public health burden. Dietary factors such as excess sugar intake are associated with greater metabolic disease risk; however, it is unclear how different types of sugars (e.g., glucose, fructose, or sucrose) differentially impact metabolic health. In this report, researchers investigated the effects of sugar-sweetened beverages on fatty acid synthesis, blood triglycerides, and hepatic insulin resistance in healthy males.

    Following the consumption of glucose, the pancreas secretes insulin into the bloodstream so that insulin-sensitive organs such as the liver, skeletal muscle, and adipose tissue can transport glucose into their cells. Excess sugars are converted to fats in the liver via a process called de novo lipogenesis and then stored in adipose tissue; however, as fat levels in adipose tissue rise (i.e., overweight and obesity), fat accumulates in the liver leading to the development of NAFLD. Fructose, the main sweetener found in sugar-sweetened beverages, does not require insulin to be absorbed and is preferentially taken up by the liver, accelerating NAFLD development independent of weight gain.

    The authors recruited 94 healthy lean males (average age, 23 years) and assigned them to consume beverages sweetened with moderate amounts of either glucose, fructose, or sucrose (a sugar that contains both glucose and fructose) in addition to their normal diet for seven weeks. The beverages contained an amount of sugar found in about two cans of non-diet soda. The researchers assigned a fourth group of participants to consume their normal diet with no added sugar-sweetened beverages. They assessed fatty acid and triglyceride synthesis by the liver and whole-body fat metabolism.

    Daily consumption of beverages sweetened with fructose and sucrose, but not glucose, led to a twofold increase in the production of free fatty acids in the liver. Fructose intake did not increase triglyceride production in the liver or whole-body fat metabolism. Participants from all four groups consumed about the same amount of calories, and while body weight tended to increase for all groups, this relationship was only statistically significant for the group consuming glucose-sweetened beverages. Glucose and insulin tolerance did not change with sugar-sweetened beverage consumption.

    The investigators concluded that consumption of beverages sweetened with fructose and sucrose increased free fatty acid production in the liver. While they did not observe changes in other metabolic markers such as insulin tolerance, they hypothesized that the alterations in fat production by the liver pave the way for metabolic disease development.

  • Sugar-sweetened beverages are among the leading contributors to sugar intake among people living in the United States. Examples of sugar-sweetened beverages include regular soda (not sugar-free), sports drinks, energy drinks, and coffees, teas, and waters that contain added sugars. Data from a new study indicate that sugar-sweetened beverage consumption is associated with dyslipidemia.

    Dyslipidemia is a condition in which blood levels of lipids (such as cholesterol or triglycerides) are abnormal. It is recognized as one of the primary risk factors for cardiovascular disease. Most dyslipidemias are characterized by high plasma cholesterol or triglycerides (or both), or low HDL cholesterol. Nearly half of all adults living in the United States have some form of dyslipidemia.

    The study involved more than 6,700 people enrolled in two different cohorts of the Framingham Heart Study. At various time points during the study, the participants provided complete medical histories, underwent physical exams, and completed lab tests to assess total cholesterol, HDL cholesterol, and triglyceride levels. They also completed questionnaires about their lifestyles and diet, including beverage intake. Participants were followed for an average of 12.5 years.

    The data revealed that consuming more than 12 ounces of sugar-sweetened beverages per day increased the risk of having high triglycerides by 53 percent and having low HDL cholesterol by 98 percent. Consuming low-calorie sweetened beverages (e.g., “diet” drinks) or up to 12 ounces of 100 percent fruit juice was not associated with dyslipidemia.

    These findings suggest that consumption of sugar-sweetened beverages increases the risk of dyslipidemia and underscores the role of nutrition in reducing risk factors that contribute to cardiovascular disease.

  • Cardiovascular disease is the number one cause of death worldwide, claiming the lives of more than 17 million people every year. A recent meta-analysis and systematic review suggests that quercetin may exert protective effects to reduce the risk of cardiovascular disease.

    Quercetin is a flavonol compound found in a wide variety of fruits and vegetables, including onions, apples, tea, and lettuce. Epidemiological data suggest that quercetin exerts protective effects against cardiovascular diseases, cancer, and other chronic diseases due to its anti-inflammatory actions.

    The analysis investigated the effects of quercetin intake on several risk factors for cardiovascular disease, including lipid profiles, blood pressure, and glucose levels. It was based on findings from 17 randomized controlled trials involving nearly 900 participants who took a standardized quercetin extract.

    The results of the analysis indicated that quercetin intake reduced systolic and diastolic blood pressures by approximately 3.09 mmHg and 2.86 mmHg, respectively. Quercetin intake did not appear to influence blood lipid profiles or glucose levels. However, a sub-group analysis demonstrated that longer trials of quercetin intake (8 weeks or more) had favorable effects on participants' HDL cholesterol and triglyceride levels.

    These findings suggest that quercetin may be useful in the clinical setting for the management of risk factors associated with cardiovascular disease.

  • Cardiovascular disease is the number one cause of death of people living in the United States (US). Having elevated (abnormal) triglyceride levels may contribute to atherosclerosis, which increases the risk of cardiovascular disease. The US Food and Drug Administration has approved the use of a drug to reduce the risk of cardiovascular events in adults who have elevated triglyceride levels.

    The drug, called Vascepa (icosapent ethyl), reduces blood triglyceride levels by one-third when accompanied by low-fat, low-cholesterol dietary modification. It has been shown to reduce the rate of heart attacks, strokes, and other cardiovascular events by 25 percent compared to a placebo.

    Candidates for Vascepa therapy must have triglyceride levels of 150 milligrams per deciliter or higher. They should also have established cardiovascular disease or type 2 diabetes and two or more additional cardiovascular disease risk factors.

    The active ingredient in Vascepa is eicosapentaenoic acid, a type of omega-3 fatty acid derived from fish oil. The drug, which is taken orally, has demonstrated a safety profile similar to placebos. Adverse events associated with Vascepa include atrial fibrillation and increased risk of bleeding. People who are allergic to fish or shellfish may be at risk for allergic reactions to Vascepa.

  • More than a third of adults living in the United States have metabolic syndrome, a constellation of conditions that includes abdominal (central) obesity, high blood pressure, high fasting plasma glucose, high serum triglycerides, and low high-density lipoprotein levels. People who have metabolic syndrome are at increased risk of developing diabetes and heart disease. A new study suggests that time-restricted eating may reduce this risk.

    Time-restricted eating is a form of daily fasting that aligns eating and fasting cycles to the body’s innate 24-hour circadian system. People who practice time-restricted eating typically eat during an 8- to 12-hour daytime window and fast during the remaining 12 to 16 hours.

    This study involved 19 adults (average age, 59 years) who had metabolic syndrome. Most of the participants were obese, took a statin or antihypertensive drug, and had poor blood glucose control. They followed a time-restricted eating pattern that allowed them to eat during a 10-hour daytime window with a 14-hour overnight fast for 12 weeks. No overt attempt to change physical activity or diet quality or quantity was required.

    At the end of the study, participants exhibited reduced waist circumference and body fat, lowered blood pressure, and improvements in lipid profiles and blood glucose control. These findings suggest that time-restricted eating may have potential as an adjunct to current therapies to treat metabolic syndrome.

  • A high dose of fish oil (4g/day) lowered triglyceride levels by 20-30% in people with high triglycerides according to an analysis of 17 randomized controlled trials reviewed by the scientific advisory council at the American Heart Association.

    “In analyzing the current scientific data, the advisory panel found:

    •For most people with high triglycerides (200 to 499 mg/dL), prescription doses of omega-3 fatty acids using drugs with either EPA+DHA or EPA alone can reduce triglyceride by 20 to 30%.

    •Contrary to common perception, the formula that contains both EPA and DHA does not increase the “bad” form of cholesterol (LDL-C) among most people with high triglyceride levels (200-499 mg/dL). However, when the drug is given to people with very high triglyceride levels at 500 mg/dL or greater, LDL-C may increase.

    •The panel’s review found that prescription omega-3 fish oil is effective in reducing triglyceride levels regardless of whether people are on statin therapy.

    •In a recent large, randomized placebo-controlled study called REDUCE-IT, researchers found that the EPA-only medication combined with statin medication resulted in a 25% reduction in major cardiovascular events (heart attack, stroke and cardiovascular death) among people with high triglycerides."

  • Time-restricted eating (TRE), a ketogenic diet, and exercise improved cognitive function and markers of metabolism including triglycerides, VLDL, and HbA1c in a 71-year-old woman with ApoE4 that has mild Alzheimer’s disease and metabolic syndrome (case study).

    This is an interesting proof of principle study showing that implementing a nutrition protocol purposed at raising plasma ketones through fasting (TRE) a ketogenic diet and physical exercises can compensate for insulin resistance and the ApoE4 gene in a mild Alzheimer’s patient experiencing cognitive impairment.

    The APOE4 gene is the largest risk factor for Alzheimer’s disease besides age itself.

    To learn more check out this episode highlight of Dr. Dale Bredesen talking about time-restricted eating and a ketogenic diet in the context of Alzheimer’s disease in people with and without ApoE4.

    Episode: https://youtu.be/PWZbeq6MCKU

  • Exercising while fasted induces adaptations to mitochondria in muscle and adipose tissue including increased fatty acid metabolism that is blunted by pre-exercise feeding (meta-analysis of 46 clinical studies).

    Exercising in a fasted state increased the release of fatty acids stored in adipose tissue and the use of them for energy in muscle and adipose tissue (ie. fat burning). It also increased the use of intramuscular triglycerides over glycogen in muscle tissue. Exercise while fasted also caused mitochondria to increase gene activity in genes related to fatty acid metabolism making them more efficient as using fat for energy. These adaptations were blunted by pre-exercise feeding.

    Pre-exercise feeding did enhance performance in long-duration exercise (> 60 minutes) but had no effect on aerobic training shorter than 60 minutes. Pre-exercise feeding also slightly enhanced anaerobic exercise (ie. run until exhaustion) but had no effect on high-intensity interval training.

  • Supplementation with the omega-3 EPA (4g/day) reduced cardiovascular-related death by 25% in people with high triglycerides on statins compared to those taking a placebo (randomized, double-blind, placebo-controlled trial in 8,179 people from around the world).

    The supplement used in this study was a highly pure EPA and the placebo was mineral oil. There has been some concern that the mineral oil may have had adverse effects on lipids since the placebo was associated with a 6% increase in LDL; however, that increase would only translate to a 4% increased heart attack risk. Furthermore, a similar study in Japan using 4g/day of EPA showed a 19% reduction in cardiovascular-related death but there was no placebo control.

    Additionally, the effects of the highly purified EPA might be independent of lipid-lowering effects. EPA also decreases inflammation, has effects on blood thinning and cell membrane fluidity…any of these might affect sudden cardiac death.

  • FTA

    … a clinical trial in 60 overweight (BMI > 25), healthy adults, aged 40-60 years. After initial screening, the subjects were randomized into four groups with 15 per group. The four groups received, respectively, placebo, omega-3 fatty acid, probiotic VSL#3, or both omega-3 and probiotic, for 6 weeks. […] The probiotic (VSL#3) supplemented group had a significant reduction in total cholesterol, triglyceride, LDL, and VLDL and had increased HDL (P < 0.05) value. VSL#3 improved insulin sensitivity (P < 0.01), decreased hsCRP and favorably affected the composition of gut microbiota. Omega-3 had a significant effect on insulin sensitivity and hsCRP but had no effect on gut microbiota. The addition of omega-3 fatty acid with VSL#3 had a more pronounced effect on HDL, insulin sensitivity and hsCRP. Table showing statistics of the study.

  • A small clinical trial finds that eating later in the day (12 pm to 11 pm) increased weight gain, raised insulin, fasting glucose, cholesterol, and triglyceride levels compared to eating earlier in the day (8 am to 7 pm).

    In the small study, each of the nine healthy weight adults underwent each of the two conditions: daytime eating (three meals and two snacks between 8 a.m. and 7 p.m.) for eight weeks and delayed eating (the same three meals and two snacks eating from noon to 11 p.m.) for eight weeks after a 2-week washout period. This is a small trial and needs to be repeated but is in line with another study that showed when healthy adults eat meals that are identical for breakfast, lunch, or dinner, the postprandial glucose increase is lowest after breakfast and highest after dinner even though the meals were 100% identical.

    For more on meal timing and time-restricted eating…check out my podcasts with the experts, Dr. Satchin Panda and Dr. Ruth Patterson on youtube and iTunes.

  • The probiotics also lowered triglycerides, VLDL, and markers of insulin resistance. There was no cognitive improvement in the placebo group.

    The participants took 2 billion Bifidobacterium bacteria per day, which is a pretty small quantity of probiotics. It is likely that the probiotics are working through multiple mechanisms such as lowering inflammation and increasing neurotransmitters. Other studies have shown that gut bacteria are able to modulate the levels of GABA, norepinephrine, serotonin, dopamine, and acetylcholine through the gut-brain axis.

    I spoke with the gut experts, Drs. Justin and Erica Sonnenburg, about the importance of the gut microbiome in human health and the various foods (ie. fermentable fiber and other prebiotics) that provide our gut bacteria with the food they need to thrive. Here is the interview (also available on iTunes and Sticher): https://www.youtube.com/watch?v=gOZcbNw7sng