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A Nutritional Approach to Triglycerides
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An Interview with Track Your Plaque Expert Nutritionist Gay Riley, MS, RD, CCN


Triglycerides are an ingredient that your body can use to make a number of unwanted lipoprotein particles.  Fortunately, triglycerides are among the most susceptible fats to dietary manipulation. In this Special Report, we interview Track Your Plaque expert in nutrition, Gay Riley, MS,RD, CCN on her unique approach to her patients with high triglycerides.

TYP: Triglycerides are responsible for creating an entire panel of undesirable lipid and lipoprotein particles in blood that cause coronary plaque growth, like small LDL particles, VLDL, and even a drop in HDL.

In your approach using Medical Nutrition Therapy, do you advise your patients to choose specific foods to reduce triglycerides? Are there specific foods to avoid that raise triglycerides?

Gay Riley: Elevated serum triglycerides are usually associated with insulin resistance, or the ineffectiveness of insulin to reduce blood sugar. Increased circulating insulin levels cause multiple problems with blood chemistry and homeostasis. One of the major problems is hardening of the arteries and plaque build up in the vessels. Because of this, dietary carbohydrate needs to be controlled.

Reduction and avoidance of high sugar, refined, processed, and packaged foods, alcohol, and sugary beverages is recommended. Adding more fresh produce (a useful rule-of-thumb is two vegetables for every fruit), high fiber carbohydrates like green leafy vegetables, tomatoes, and other non-starchy vegetables, berries, citrus, and melon.

Starchy vegetables that are not white, like beans, lentils, sweet potato, and acorn squash are good choices. Mono and polyunsaturated oils from natural nuts, plants, different oils such as olive, canola, sesame, peanut, etc and fatty cold water fish are equally important.
The cellular membrane phospholipid layer is made up of the fats we eat and should be fluid and permeable. Bad diets high in sugar, saturated and trans-fats cause the membrane to become hard and impermeable to nutrients that need to move freely in and out of the cell, thus insulin resistance. The more of the good fats you eat, the more permeable the cellular membrane becomes allowing for healthy metabolism of sugar in the blood.

Good fats also create an anti-inflammatory condition in the blood by producing more anti-inflammatory hormones like prostaglandins. Saturated and trans-fats, on the other hand, produce more inflammatory prostaglandins, which creates a hyper-inflammatory state leading to conditions like high blood pressure, heart disease, and a host of other medical problems.
Green leafy vegetables and citrus fruit increase blood pH and lower blood acidity. This is extremely important to total health. That is why we nutritionists run the vegetable/fruit issue into the ground.

Whole grains and fiber are important for slowing the absorption of carbohydrate into the blood and keeping blood sugar and insulin at a steady state. In other words, fibers smooth out blood sugar―no peeks and valleys in insulin and blood sugar.

For correcting hypertriglyceridemia or high triglycerides, a diet with 50% carbohydrate, 20% protein, and 30% fat is a recommended starting point. Depending on the individual, the carbohydrate recommendations could be even lower.

TYP: Are there differences among various carbohydrate foods and their effects on triglycerides? Is this a matter of glycemic index?

Gay Riley: There is evidence that supports the use of the glycemic index to control blood sugar and insulin levels. The higher the food is on the index, the higher and faster it causes insulin blood levels to rise. So trying to eat foods with a glycemic index of 50 or lower is a good idea. (Go to http://www.glycemicindex.com for more information on glycemic index, including an extensive database of glycemic indexes of various foods assembled by the world expert on the subject, Dr. Jennie Brand-Miller.)

TYP: How effective is weight loss for reduction of high triglycerides?

Gay Riley: It can be highly effective if insulin resistance is reduced, the food choices I mentioned are incorporated into the diet, and daily EXERCISE and activity is practiced. If you use a pedometer, 15,000 steps a day is effective for weight loss. Most of us get in 500–3000 steps. If insulin resistance is not treated, weight loss can be impossible.

TYP: Have you found any specific nutritional supplements useful to help control either insulin resistance and/or high triglycerides?


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