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Cholesterol (cont.)

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What causes elevated triglyceride levels?

High triglyceride blood levels (hypertriglyceridemia) may be genetic or they may be acquired. Examples of inherited hypertriglyceridemia disorders include mixed hypertriglyceridemia, familial hypertriglyceridemia, and familial dysbetalipoproteinemia.

Hypertriglyceridemia can often be caused by nongenetic factors such as obesity, excessive alcohol intake, diabetes mellitus, kidney disease, and estrogen-containing medications such as birth control pills.

How can elevated blood triglyceride levels be treated?

Diet is the first step in treating hypertriglyceridemia. A low-fat diet, regular aerobic exercise, loss of excess weight, reduction of alcohol consumption, and stopping cigarette smoking may be enough to control triglyceride levels in the blood. In patients with diabetes, meticulous control of elevated blood glucose is also important.

When medications are necessary, fibrates (such as Lopid), nicotinic acid, and statin medications can be used. Lopid not only decreases triglyceride levels but also increases HDL cholesterol levels and LDL cholesterol particle size. Nicotinic acid lowers triglyceride levels and increases HDL cholesterol levels and the size of LDL cholesterol particles.

Statins are effective for decreasing triglyceride and LDL cholesterol levels and, to a lesser extent, elevating HDL cholesterol levels.

What are cholesterol-lowering foods?

A healthy diet that minimizes cholesterol intake is a good first step in using food to decrease cholesterol levels in the blood. Extra lean meats, skim milk, and vegetable-based "butter-like" substitutes may help decrease LDL levels in the bloodstream.

In addition to diet, exercise, and weight loss, there are foods that may help in lowering and rebalancing the cholesterol -- increasing HDL (the good) and decreasing LDL (the bad).

  • Increasing soluble fiber in the diet helps decrease both total cholesterol and LDL cholesterol. Sources include oatmeal, oat bran, and a variety of vegetables and fruits: beans, apples, pears, barley, and prunes. The goal is to eat 5 to 10 grams of soluble fiber a day (a cup of oatmeal has 4 grams of fiber and an apple contains 3 grams).
  • Olive oil acts as an antioxidant to decrease LDL levels and does not affect levels of good HDL cholesterol.
  • Foods fortified with plant sterols and stanols decrease cholesterol absorption in the intestine. They can be found in cereal, margarines, and yogurts. Read labels to discover which foods are fortified with these beneficial plant compounds. Sterols and stanols may also be found as a dietary supplement.
  • Soy and foods containing soy products may help decrease LDL levels.
  • Nuts are healthy. Almonds, hazelnuts, peanuts, pecans, pine nuts, pistachios, and walnuts may be helpful in decreasing cholesterol levels. However, nuts are high in calories and should be eaten in moderation. Also, one should avoid nuts covered with salt or sugar.
  • Certain fish contain omega-3 fatty acids that lower cholesterol levels. The American Heart Association recommends at least 2 to 3 servings per week in the diet. Fatty fish that are helpful include salmon, halibut, mackerel, trout, herring, and sardines. It's best to grill or bake fish and to avoid frying.
Medically Reviewed by a Doctor on 3/13/2014

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