'SURPRISING' New Recommendations on Triglycerides by American Heart Association

A new scientific statement raises the threshold for pharmacologic treatment of hypertriglyceridemia.

I just received AHA Guidelines for Hypertriglyceridemia and was shocked to read the new guidelines for Treatment protocol in High Triglycerides. I am not sure whether this will work in Indian Patients too or not because Lifestyle and Diet for Indians will definitely reflect a different picture of this protocol. I think this has to be reviewed again at our own clinical experiences with our patients. Let's see how it gonna work over here.

I've been surprised at the lack of fanfare surrounding the American Heart Association's recently published scientific statement on triglycerides and cardiovascular disease (CVD). The attention it did receive focused on the lower fasting triglyceride level that is now considered optimal: <100 mg/dL. In my opinion, the real headline was the committee's important statements in support of less drug treatment — in particular, the recommendation for a substantial increase in the triglyceride level that should trigger consideration of pharmacologic therapy.

After a careful review of the recent literature, the committee concluded that pharmacologic therapy should not be started until a patient's fasting triglyceride level is 500 mg/dL (in contrast to the Adult Treatment Panel's recommendation of 200 mg/dL). See the figure, which also appears on page 2308 of the AHA statement.

The AHA committee also explicitly acknowledges (on page 2297) that "the independence of triglyceride level as a causal factor in promoting CVD remains debatable. Rather, triglyceride levels appear to provide unique information as a biomarker of risk, especially when combined with low HDL-C and elevated LDL-C." This clear statement — together with the new, higher threshold for initiating drug treatment — represents a remarkable change.

(Source: Publication on AHA Guidelines 2011)

Triglycerides are Bad for the Heart

You hear a lot of talk about cholesterol and how bad it is for your heart, but not much is heard about triglycerides – another blood fat that can have harmful effects when levels are too high.

High triglyceride levels in the blood can lead to weight gain and obesity and other diet-related diseases. So, diet and exercise are both vital components in controlling triglyceride levels and maintaining good health.

In a recent publication of the Journal of the American Heart Association, researchers found that exercise and diet can reduce triglyceride levels by 20% to 50%.

“The good news is that high triglycerides can, in large part, be reduced through major lifestyle changes,” said Michael Miller, M.D., chair of the statement committee and professor of medicine in epidemiology and public health and director of the Center for Preventive Cardiology at the University of Maryland School of Medicine in Baltimore.

“In contrast to cholesterol, where lifestyle measures are important but may not be the solution, high triglycerides are often quite responsive to lifestyle measures that include weight loss if overweight, changes in diet and regular physical activity.”

These findings are based on an analysis of 500 studies across the globe that were conducted over the past 30 years. The researchers found that to reduce the amount of triglycerides in your blood, you need to make some real life changes to your diet and lifestyle. This means reducing:

• Added sugar to less than 5 percent to 10 percent of calories consumed – about 100 calories per day for women and 150 calories per day for men.
• Fructose from both processed foods and naturally occurring foods – less than 50 to 100 grams per day
• Saturated fat to less than 7 percent of total calories
• Trans fat to less than 1 percent of total calories; and
• Alcohol, especially if triglyceride levels are higher greater than 500 mg/dL

The researchers conclude that most sugars are consumed through sugary drinks and that cutting down on these will greatly affect your waistline and your health. Other dietary changes include eating more fresh fruits and vegetables, high fiber whole grains and unsaturated fats like Omega-3 that offer countless health benefits.

Exercise will also help in reducing the amount of triglycerides in the bloodstream. As little as 30 minutes a day of some form of exercise that will elevate your heart rate is enough to get your health back on track.

“Triglycerides are an important barometer of metabolic health,” said Neil J. Stone, M.D., co-chair of the statement and professor of medicine in the Feinberg School of Medicine at Northwestern University in Chicago. “When the clinician sees an elevated triglyceride level, there needs to be an important conversation about risk factors and the need to eat less, eat smarter, and to move more on a daily basis to improve triglycerides and the metabolic profile.”

The statistics show that 31% of American adults have unhealthy levels of triglycerides and these numbers are increasing among young adults.

Supplementing your diet with a high quality protein powder can help control cravings and provide the body with a clean energy source. Eating a protein with every meal helps keep you feeling fuller for longer and so the temptation to overeat is reduced.

Courtesy: NATSECRETAN - WORDPRESS BLOG