High Triglycerides (Part 2) – Who Has It?

Another video in the series on
hypertriglyceridemia. What? Wait a minute. What is that? “Hyper” meaning too many;
“triglycerides” meaning fat. It’s the stuff you have on saddlebags, the subcutaneous
fat. But the biochemist has this. Think this picture up in the right. A
glycerol molecule holding three fatty acids together…that’s what that big fat
storage is. What’s inside fat cells? We did another video just recently where we
looked at what tends to cause it. Well we’re going to talk about that a little
bit today and where you see it, how common is it, and here’s some basic step. Standard
definitions for hypertriglyceridemia. Normal – less than 150. You know I’d rather
not see them that high but that’s the lab normal that you see in medical
standards these days. Borderline high is 150 to 200. High is 200 above. And then
you can get them very very high 500 and high. Now where do you see this and how
often is it? Well you can see it from genetic factors, especially with the
really high (the 250 and 500 and above), those are usually genetic problems. But
you see it really commonly as we age. You see it with gender. You see it with men.
You see it with lower educational status, lower socioeconomic status, for poorer
folks. In other words, guess what? It tends to mimic insulin resistance. You see it
with increased obesity as well. Let’s actually, take a look at some of this. So
again, as you see, you’ve got the glycerol molecule holding three fatty acids
together. Here are a couple of different charts off the internet showing the men
and women by age. And as you see with women, you tend to have it 10 percent, 5
percent or less up until age 30, 40, even 50. But with men in the 30s and even in
the 40s, you start getting up 25, 30 percent or more. Just like with men, you
tend to see men… heavier men are more likely to have metabolic syndrome or
insulin resistance. And guess what? Men are more likely to have a positive
calcium score. All of these things just go hand in hand.
Insulin resistance, positive calcium score, increased weight, increased
obesity, aging. That’s why they call it metabolic syndrome. As we get into our
60s, 20% of men have it, starts to come down a little bit. Anybody has any
questions – why that might be the case? Some of that may be due to how
common is high triglyceride. Also, it depends on the ethnicity. Again, with the
cut-points that this group is using, they’re seeing a prevalence or a common
factor of 30 percent in non-Hispanic whites, 30 percent
in non-Hispanic blacks, down to about 15 to 20 percent in Mexican-Americans over
35%. So again, you see some very interesting variations with it. There’s
substantial risk once you start getting into the standards of medicine. They
start looking… we start looking at the risks associated with triglycerides. And
yes, there’s significant risks associated with elevated triglycerides even if
you’re able… even if you don’t have significant LDL levels. Again that that’s
where the standards are going is. You know from watching this chart, I don’t
get that focused on LDL levels anyway. Half the people that have a heart attack,
stroke have normal LDL. But in the standards of medicine, they still tend to
be focused a little bit too much on LDL. Now I will focus on triglycerides. One
thing I haven’t covered yet in this short video is treatments. As you will
hear multiple times through this series, there’s a big considered to be
breakthrough treatment. It was discussed in a New England Journal article in
January of 2019. Icosapent ethyl. It’s a big new drug. It’s supposed to be a
blockbuster. But the reality is it’s sort of like bionic or souped-up fish oil
DHA and EPA, and we can get fish oil in our diet. You can’t get it as a souped-up
and bionic icosapent ethyl, but you don’t have to pay as much for that
either. One of the things that this all of this tends to avoid and forget and
neglect is the vast majority of us that have high triglycerides can impact that
by impacting our insulin resistance, cutting the carbs in our diet. If you’ve
made it this far, thank you for your interest. Hello my name is Ford Brewer. I
started my career over three decades ago as an emergency room doc. The
experience was very frustrating because the majority of things that
brought people into the ER like heart attack and stroke or things that should
have been prevented. So I went to John Hopkins to get training in prevention. I
ended up running the program there. Since then, I’ve trained dozens of docs and
supervised hundreds of docs. And even more importantly helped
thousands of patients prevent heart attack and stroke and dementia rather
than waiting for the devastation and the consequences in hoping for cures that
just don’t work. Join us in Louisville on November 8th and 9th. We have an event
there. It’s a two-day like a boot camp in heart attack and stroke prevention. If
you’d like, you can also get all of the labs and arterial scan. You’ll learn new
things that you just don’t did from most docs in terms of the real causes of
heart attack and stroke, like how do I measure plaque, how do I know if I have
cardiovascular inflammation, the true causes of heart attack and stroke, and
what’s the most common cause of it. I’ll give you a hint: they’re cardiovascular
information and how do I prevent that, how do I manage that. Thank you.

18 thoughts on “High Triglycerides (Part 2) – Who Has It?

  1. i am not over weight. but with trying low carb losing 3 kilograms my triglycerides dropped from 147 to 93 and HDL of 40 to 56 . the ratio 4 drop to 1.6 and working on inflammation . thanks to good doctor . life style life style…..

  2. Thanks for the VDO Dr. Brewer, always very interesting and educational. Would you be able to explain the following: I eat a high carb diet, primarily whole foods, mediterranean type of diet. I am 55, length 6.3, weight 181 pounds and approx. 14% body fat (do a lot of HITT and resistance training). Although my high carb diet, I have a rather low Triglyceride level of around 50 mg/dl (HDL=50 and LDL=150). Do you have any potential explanation for this? Thanks!

  3. I cut my trigyclycerides from 135 to 55 by cutting carbs to less than 20 per day alone in just a couple of months. My HDL went from 65 to 115. I was able to go off 3 blood pressure meds. My understanding is that triglycerides are made up of VLDL which then interacts with the other blood lipids and creating more LDL. My understanding is that when triglycerides are low LPa is low because there is LDL overall, especially whe eating low carb. The LDL may even be lower or higher than the number because it is not a measurement, but derived from a formula that assumes SAD diet carbohydrate levels and other nprms that may not apply. At any rate, it the HDL and Tryglycerides that tell the biggest part of the story. That makes sense to me and I take additional niacin only on the weekends now and only in smaller amounts 500mg of niacinamide. I haven't had any more blood tests since I lost 50 more pounds since then and limited my meals to once or sometimes twice a day. It is amazing that low carb and fasting can bring so many benfits for absolutely free.

  4. Another great video! Thanks! What do you like to see for a Triglyceride level? I have had 5 bypasses 15 years ago and my Triglycerides for as long as I've been keeping records ~20 years run in the high 80's low 90's and it doesn't seem to matter that now I'm mostly whole food plant-based which has really helped my total cholesterol ~110 but has done nothing for my HDL and Triglyceride levels. Thanks again for your videos!

  5. Once again, thank you! I very much appreciate your content on Trigs. I wonder how the efficacy of that new drug was in the trials? I hope the claims are not all based on relative risk

  6. You need to address the following question: What non-dietary treatments impact insulin levels? Which supplements affect them? Which prescription drugs affect them?

  7. Thank you for covering this issue. I've been treating my triglycerides for 28 years. I was lucky and had a blood profile performed at 29 and had triglycerides around 400+. I was not over weight and non diabetic. It took years trying to get my LDL lower. Never worked, so they concentrated on my tryglicerides. I finally developed Diabetes during a year that I was not regular in getting my blood tests and my fasting blood sugar was 600 with 5,000 triglycerides. Still not over weight by much at that time. While treating the diabetes my tryglicerides became more under control and my blood sugars were good.

    Then 25 years from my diagnosis I had a Plaque Fracture in my heart and had to get a stent. I've been diligently working on my Grilled and Green/Primitive diet. Thank you very much for these videos.

  8. Age group 60- and on, could be due to radical lifestyle change, eating habits? I mean it's the age of retirement, meaning you suddenly face less stress, you spend more time walking in nature than sitting in office, you eat less and maybe homemade stuff and not the company cantene mass-fast lunch from under quality substances, different lifestyle and sleeping-waking habits, and so on… These are radical lifestyle changes in someones life, letting time to watch its own body's signs, not doing compensation-eating on false-hunger feel or to ease stress.

  9. Triglycerides and cholesterol levels are directly correlated. if you manage to bring down the Triglycerides, HDL will come down too but, LDL may not move at all.

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