- and help prevent atherosclerosis
On a global scale, atherosclerosis is the leading cause of death due to heart failure or stroke. Atherosclerosis causes symptoms such as breathing difficulty, calf pain, impotence, and poor memory as a result of organs and tissues not getting enough blood and oxygen. Because the condition develops slowly and many people are not even aware of its presence before it is too late, early prevention is vital. According to a study that is published in the science journal Circulation, four grams of fish oil daily can lower levels of triglycerides, a blood lipid that is considered to be more harmful than cholesterol. It is also important to address the indirect causes of elevated triglyceride levels such as overweight, metabolic syndrome and type 2 diabetes. Consuming too many carbohydrates may even cause fatty liver and result in excess triglyceride production. On the other hand, triglycerides also have health properties, which we will take a closer look at for clarity.
Coronary occlusion is the leading cause of death worldwide. The atherosclerosis develops in several stages, and evidence suggests that elevated triglyceride levels is a far more dangerous risk factor than having too much cholesterol. Besides, atherosclerosis can develop independently of hypercholesterolemia but we will get back to that. Like cholesterol, triglycerides are circulating lipids in the bloodstream. Studies show that if triglyceride levels exceed 200 mg/dl, it may lead to atherosclerosis and increase the risk of many unpleasant symptoms or even death following cardiac arrest or stroke. Elevated triglyceride levels can also cause pancreatitis.
Fish oil lowers triglyceride levels, and it is important to get the right amount
Four grams of fish oil daily can lower triglyceride levels by 20-30 percent in most cases where treatment is required. It is also safe to take fish oil together with cholesterol-lowering statins, according to a scientific study by the American Heart Association (AHA), where 17 randomized, controlled, clinical studies were analyzed. In these studies, fish oil was given to individuals with elevated triglyceride levels, and the scientists concluded that it takes four grams per day to obtain the optimal effect.
Fish oil contains omega-3 fatty acids, namely EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), but science has not been able to determine which of these two fatty acids has the triglyceride-lowering effect. A previously published, randomized, placebo-controlled study named REDUCE-IT demonstrated that EPA in combination with statins lowered the risk of heart failure and stroke by 25 percent, which is most likely because EPA has an anti-inflammatory effect (inflammation is the common thread in atherosclerosis.)
The U.S Food and Drug Administration (FDA) has approved fish oil as a prescription drug for treating very high triglyceride levels (over 500 mg/dl). Elevated triglyceride levels are quite common among Americans, Europeans, and other populations that also have a high rate of overweight and type 2 diabetes. It is therefore relevant to look at what triglycerides are and why levels of this type of blood lipid go up in people that have problems with controlling their weight and blood sugar.
Facts about healthy and harmful triglycerides
Dietary fat is mainly found as triglycerides in plant oils, fish oils, and animal fat. Triglycerides are also present in the body’s fat stores. Triglycerides resemble a large E. The “back” is a vertical glycerol molecule, and the three horizontal “legs” that are attached to it are fatty acids. The fatty acids in each triglyceride “leg” can be either saturated or unsaturated. In other words, it is the fatty acid composition in each triglyceride that determines whether it is good or bad for our health.
Once the triglycerides have been absorbed by the intestine, they are carried with the blood in larger fat particles called chylomicrons. When the chylomicrons are broken down, the triglycerides inside are converted into glycerol and free fatty acids. The “E” is taken apart, in other words, so that the different free acids are able to carry out their many tasks throughout the body. Some of the free fatty acids are used to fuel brain and muscle tissue. The two free omega-3 fatty acids, EPA and DHA, are incorporated in all cell membranes and have a wide array of physiological functions. If there is an imbalance between EPA and the free omega-6 fatty acid called AA (arachidonic acid), it can easily set the stage for inflammation, atherosclerosis, and different lifestyle-related diseases.
It is also important to note the fact that the levels of the different lipids in our blood does not necessarily correspond with the lipid content in the food we eat. For example, non-alcoholic fatty liver disease (NAFLD) plays an important yet overlooked role in type 2 diabetes and metabolic syndrome, and these conditions are characterized by elevated levels of triglycerides and cholesterol, insulin resistance, hypertension, and enlarged waist circumference.
What started the ”fat fright”?
In 1953, a researcher named Ancel Keys published an article that triggered the whole fat fear and the witch hunt against cholesterol, but he conveniently forgot to mention important data, which did not fit into the hypothesis about dietary lipids and cholesterol increasing your risk of heart failure. New dietary guidelines were supported by the American presidential candidate, George McGovern in 1977, and the fat fright was here to stay. However, this sudden favoring of carbohydrates in the diet and the fear of fat has been a catastrophe for public health. In 1972, the British professor, John Yudkin, revealed that too much dietary carbohydrate is damaging for your health, but he was ignored by the health authorities and the food industry, simply because his viewpoint was a threat to their business interests. Today, more and more scientists are inclined to agree with Yudkin.
The link between carbohydrate intake and endogenous triglyceride production
For nearly 50 years, the general public and diabetics have been advised to stick with a low-fat diet with plenty of bread, potatoes, fruit, and other carbohydrate sources. However, the carbohydrate abundance can burden the liver, especially fructose from sugar, soft drinks, juice, fruit, and commonly used sweeteners like corn syrup and HFCS (High-Fructose Corn Syrup). When the liver is flooded with fructose, the fructose is converted into triglycerides and cholesterol by way of process called lipogenesis. The liver turns into a virtual fat factory because of the many carbohydrates in the diet. This condition is known as non-alcoholic fatty liver disease (NAFLD) and can develop into type 2 diabetes and the early stage of the disease known as metabolic syndrome, both of which have become increasingly common.
If you suffer from elevated triglyceride levels and non-alcoholic fatty liver, it is imperative that you eat a healthier diet with fewer carbohydrates, more protein and more healthy fats, especially fish oil.
Oily fish or fish oil supplements
It is a good idea to include fish in your diet several times per week. At least half of the intake should be oily fish such as anchovies, herring, or free-range salmon because these fish are particularly rich in omega-3 fatty acids (EPA and DHA). Preferably choose fish from pure waters and beware that predatory fish such as tuna contains more mercury because it is at the top of the food chain. A herring fillet contains around 1 gram of fish oil, while a free-range salmon steak contains around 3-4 grams. Farmed fish has a lower omega-3 content because they do not have a natural diet. According to the new study, optimal triglyceride lowering is obtained with four grams of fish oil each day, which means that a fish oil supplement is a convenient option for many people, especially for those who dislike the taste of fish. For normal protection of the cardiovascular system, two grams of fish oil daily is sufficient. Fish oil preparations based on free fatty acids have superior bioavailability. Also, make sure to choose a product that is within the safety threshold of the health authorities in terms of peroxide value and content of environmental toxins.
Ann C. Skulas-Ray et al. Omega-3 fatty Acids for the Management of Hypertriglyceridemia: A Science Advisory From the American Heart Association. Circulation 2019
American Heart Association. Prescription omega-3 fatty acid medications effectively lower high triglycerides. ScienceDaily. 2019
Fructose Consumption, Lipogenesis, and Non-Alcoholic Fatty Liver Disease. Nutrients 2017
Bispebjerg Hospital. Færre kulhydrater forbedrer type-2 diabetikeres evne til at regulere blodsukkeret. Nyhedsbrev 10. august 2019
Mads J Skytte et al. A Carbohydrate-reduced high-protein diet improves HbA1c and liver fat content in weight stable participants with type 2 diabetes: a randomized trial. Diabetologica. 2019
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