Nutrition Made Simple! | What Your TRIGLYCERIDE Levels Mean | New Trial @NutritionMadeSimple | Uploaded December 2022 | Updated October 2024, 2 hours ago.
Triglycerides are often misunderstood. We look at new evidence on triglyceride lowering and heart disease. An overview of the value and caveats of trigliceryde levels
New trial on triglyceride lowering. triglyceride-lowering drug vs placebo. participants: high triglycerides, low HDL-cholesterol. LDL-cholesterol was low, only triglycerides were high
fibrate reduced triglycerides. HDL-cholesterol went up by 5%
no significant change in risk of cardiovascular events (heart attack, stroke or death). why wasn’t risk lower if triglycerides came down?
Lipids like triglycerides and cholesterol are carried in our bloodstream in lipoproteins like LDL and VLDL. VLDLs carry mostly triglycerides, LDLs carry mostly cholesterol. in cardiovascular research risk follows number of lipoproteins, not lipid level. so cholesterol and triglycerides are markers
usually the higher the cholesterol and triglycerides, the more lipoproteins. VLDLs and LDLs are cousins. VLDLs can turn into LDLs. both carry ApoB
the fibrate didn't reduce apoB so risk didnt go down, regardless of what happens to triglycerides or cholesterol. fibrates lower VLDLs (which carry mostly TGs). So both triglycerides and their carriers go down. But it raises large LDLs
VLDLs were reduced by being converted into LDLs. Reducing triglycerides by transforming one ApoB lipoprotein, VLDLs, into another, LDLs, is not helpful
Other trials: lowering triglycerides without lowering apoB doesnt help
genetics: triglyceride levels have little if any effect on cardiovascular risk when we account for ApoB
raising HDL-cholesterol doesn´t help; triglycerides and HDL-cholesterol combined play small if any role in cardiovascular risk accounting for apoB; people with good triglycerides and HDL-cholesterol can still have plaque in their arteries
triglycerides associate with risk at population level; higher triglycerides associate with higher risk; lowering them doesn’t necessarily lower risk
high triglycerides reflect overweight, diabetes etc. changing triglycerides directly doesnt necessarily do much
markers vs makers. triglycerides, HDL-cholesterol (tracks well with risk but changing HDL-c directly makes little difference), LDL-cholesterol
triglycerides/HDL-cholesterol, total cholesterol/HDL-cholesterol, reflect obesity, diabetes but higher HDL-cholesterol genetically doesn´t affect risk
triglycerides can come down without change to apoB
high triglycerides: chances are i´m overweight or diabetic; if triglycerides come down due to weight loss, they reflect positive change
very high triglycerides can be bad news besides heart disease. pancreatitis and fatty liver.
don´t ignore high triglycerides. but don’t assume lower triglycerides mean lower heart disease risk; also can’t assume low triglycerides mean safety. could still have determinants of cardiovascular risk out of whack, like high blood pressure or high ApoB
fibrates reduce triglycerides and VLDLs yet risk wasn´t lower
Connect with me:
Facebook: facebook.com/DrGilCarvalho
Twitter: twitter.com/NutritionMadeS3
Animations: Even Topland @toplandmedia
References:
1-nejm.org/doi/full/10.1056/NEJMoa2210645
2-jamanetwork.com/journals/jamacardiology/article-abstract/2786334
3-jamanetwork.com/journals/jama/article-abstract/2768850
4-jamanetwork.com/journals/jama/article-abstract/2722770
5-nejm.org/doi/full/10.1056/NEJMe2213208
6-pubmed.ncbi.nlm.nih.gov/33870931
7-link.springer.com/book/10.1007/978-1-59745-533-6
8-elifesciences.org/articles/58361#s3
9-ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.119.041998
10-jamanetwork.com/journals/jama/article-abstract/2722770
11-journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003062
12-ncbi.nlm.nih.gov/pmc/articles/PMC4103514
13-academic.oup.com/ije/article/50/3/893/5948819
14-sciencedirect.com/science/article/pii/S0735109717412320
15-academic.oup.com/eurheartj/article/41/1/111/5556353
16-academic.oup.com/eurheartj/article/42/47/4791/6362485
Disclaimer: The contents of this video are for informational purposes only and are not intended to be medical advice, diagnosis, or treatment, nor to replace medical care. The information presented herein is accurate and conforms to the available scientific evidence to the best of the author's knowledge as of the time of posting. Always seek the advice of your physician or other qualified health provider with any questions regarding any medical condition. Never disregard professional medical advice or delay seeking it because of information contained in Nutrition Made Simple!.
#NutritionMadeSimple #GilCarvalho
0:00 New trial on Triglyceride lowering
1:21 Triglycerides vs Lipoproteins
3:55 Conclusion of the trial
5:24 LDL particle size
6:30 Big picture
7:50 Markers vs Makers
10:27 Ratios
11:36 Value of Triglycerides
13:02 Improving health as a whole
Triglycerides are often misunderstood. We look at new evidence on triglyceride lowering and heart disease. An overview of the value and caveats of trigliceryde levels
New trial on triglyceride lowering. triglyceride-lowering drug vs placebo. participants: high triglycerides, low HDL-cholesterol. LDL-cholesterol was low, only triglycerides were high
fibrate reduced triglycerides. HDL-cholesterol went up by 5%
no significant change in risk of cardiovascular events (heart attack, stroke or death). why wasn’t risk lower if triglycerides came down?
Lipids like triglycerides and cholesterol are carried in our bloodstream in lipoproteins like LDL and VLDL. VLDLs carry mostly triglycerides, LDLs carry mostly cholesterol. in cardiovascular research risk follows number of lipoproteins, not lipid level. so cholesterol and triglycerides are markers
usually the higher the cholesterol and triglycerides, the more lipoproteins. VLDLs and LDLs are cousins. VLDLs can turn into LDLs. both carry ApoB
the fibrate didn't reduce apoB so risk didnt go down, regardless of what happens to triglycerides or cholesterol. fibrates lower VLDLs (which carry mostly TGs). So both triglycerides and their carriers go down. But it raises large LDLs
VLDLs were reduced by being converted into LDLs. Reducing triglycerides by transforming one ApoB lipoprotein, VLDLs, into another, LDLs, is not helpful
Other trials: lowering triglycerides without lowering apoB doesnt help
genetics: triglyceride levels have little if any effect on cardiovascular risk when we account for ApoB
raising HDL-cholesterol doesn´t help; triglycerides and HDL-cholesterol combined play small if any role in cardiovascular risk accounting for apoB; people with good triglycerides and HDL-cholesterol can still have plaque in their arteries
triglycerides associate with risk at population level; higher triglycerides associate with higher risk; lowering them doesn’t necessarily lower risk
high triglycerides reflect overweight, diabetes etc. changing triglycerides directly doesnt necessarily do much
markers vs makers. triglycerides, HDL-cholesterol (tracks well with risk but changing HDL-c directly makes little difference), LDL-cholesterol
triglycerides/HDL-cholesterol, total cholesterol/HDL-cholesterol, reflect obesity, diabetes but higher HDL-cholesterol genetically doesn´t affect risk
triglycerides can come down without change to apoB
high triglycerides: chances are i´m overweight or diabetic; if triglycerides come down due to weight loss, they reflect positive change
very high triglycerides can be bad news besides heart disease. pancreatitis and fatty liver.
don´t ignore high triglycerides. but don’t assume lower triglycerides mean lower heart disease risk; also can’t assume low triglycerides mean safety. could still have determinants of cardiovascular risk out of whack, like high blood pressure or high ApoB
fibrates reduce triglycerides and VLDLs yet risk wasn´t lower
Connect with me:
Facebook: facebook.com/DrGilCarvalho
Twitter: twitter.com/NutritionMadeS3
Animations: Even Topland @toplandmedia
References:
1-nejm.org/doi/full/10.1056/NEJMoa2210645
2-jamanetwork.com/journals/jamacardiology/article-abstract/2786334
3-jamanetwork.com/journals/jama/article-abstract/2768850
4-jamanetwork.com/journals/jama/article-abstract/2722770
5-nejm.org/doi/full/10.1056/NEJMe2213208
6-pubmed.ncbi.nlm.nih.gov/33870931
7-link.springer.com/book/10.1007/978-1-59745-533-6
8-elifesciences.org/articles/58361#s3
9-ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.119.041998
10-jamanetwork.com/journals/jama/article-abstract/2722770
11-journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003062
12-ncbi.nlm.nih.gov/pmc/articles/PMC4103514
13-academic.oup.com/ije/article/50/3/893/5948819
14-sciencedirect.com/science/article/pii/S0735109717412320
15-academic.oup.com/eurheartj/article/41/1/111/5556353
16-academic.oup.com/eurheartj/article/42/47/4791/6362485
Disclaimer: The contents of this video are for informational purposes only and are not intended to be medical advice, diagnosis, or treatment, nor to replace medical care. The information presented herein is accurate and conforms to the available scientific evidence to the best of the author's knowledge as of the time of posting. Always seek the advice of your physician or other qualified health provider with any questions regarding any medical condition. Never disregard professional medical advice or delay seeking it because of information contained in Nutrition Made Simple!.
#NutritionMadeSimple #GilCarvalho
0:00 New trial on Triglyceride lowering
1:21 Triglycerides vs Lipoproteins
3:55 Conclusion of the trial
5:24 LDL particle size
6:30 Big picture
7:50 Markers vs Makers
10:27 Ratios
11:36 Value of Triglycerides
13:02 Improving health as a whole
