Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Cholesterol levels facts
- What is cholesterol?
- What are LDL and HDL cholesterol?
- What determines the level of LDL cholesterol in the blood?
- Does lowering LDL cholesterol prevent heart attacks and strokes?
- How can LDL cholesterol levels be lowered?
- What are "normal" cholesterol blood levels?
- What are the 2013 ACC/AHA Guidelines?
- Why is HDL the good cholesterol?
- What are LDL/HDL and total/HDL ratios?
- How can levels of HDL cholesterol be increased?
- What are triglycerides and VLDL?
- Do high triglyceride levels cause atherosclerosis?
- What causes elevated triglyceride levels?
- How can elevated blood triglyceride levels be treated?
- What are cholesterol-lowering foods?
- What medications are available to lower cholesterol, lipids, and triglycerides?
- Is lowering LDL cholesterol enough?
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.
Tips to keep it under control.