[Kim Jaeho's Life Story] <272> If Your Triglyceride Levels Keep Rising

One of the most frequently flagged issues during health checkups is dyslipidemia, which includes hyperlipidemia-a condition characterized by high levels of total cholesterol and triglycerides in the blood-as well as low levels of high-density lipoprotein (HDL) cholesterol, commonly referred to as "good cholesterol."

Dyslipidemia, including hyperlipidemia, often presents without noticeable symptoms, making it easy to overlook its dangers. However, when dyslipidemia develops, cholesterol accumulates on the walls of blood vessels, forming plaques that narrow or block the arteries, leading to atherosclerosis. Over time, atherosclerosis can progress to serious conditions such as angina, myocardial infarction, and stroke, which are major causes of death if left untreated.

According to the National Health Information Portal of the Korea Disease Control and Prevention Agency, citing data from the Korean Society of Lipid and Atherosclerosis, the prevalence of dyslipidemia in Korea in 2022 was 40.2%. This means that as many as two out of every five adults are affected by dyslipidemia. But why does dyslipidemia occur?

After our bodies digest food and absorb nutrients used for energy metabolism, most of these nutrients are supplied to all cells in the form of blood glucose. Any energy that remains unused by the cells is converted in the liver into glycogen-a type of carbohydrate-and triglycerides for storage. These reserves are then used as energy sources when nutrient supply becomes insufficient.

Among these energy reserves, glycogen is stored in the liver and muscles. Each gram of glycogen stores 4 kcal of energy, with about 500 grams stored for short-term use-enough to last for a day. Glycogen is used first when needed.

Triglycerides, on the other hand, are stored in fat cells under the skin and around internal organs. Each gram of triglyceride stores 9 kcal of energy, making it an efficient long-term energy reserve. For an average person, the amount of stored triglycerides is sufficient to sustain normal life for about a month on water alone. Storing triglycerides in excess of this amount leads to obesity.

Triglycerides are composed of one molecule of glycerol (a type of alcohol) and three fatty acid molecules. Most of the fats we consume in our diet are in the form of triglycerides. When we consume excessive calories, especially from carbohydrates such as sugar or alcohol, the liver converts the surplus calories, alcohol, and sugar into triglycerides for storage in fat cells, to be used later as needed.

When we eat foods containing triglycerides, they are absorbed in the small intestine. Blood triglyceride levels begin to rise about 30 minutes after a meal and reach a peak that is 5 to 10 times higher than fasting levels after 4 to 6 hours. Therefore, to obtain an accurate measurement of blood triglyceride levels, it is necessary to fast for 12 hours before testing.

The blood triglycerides measured during health checkups reflect both dietary fats and those produced by the liver, making up the largest proportion of blood lipids. Normal blood triglyceride levels are less than 150 mg/dL. Levels between 150 and 199 mg/dL are considered borderline, 200 to 499 mg/dL are classified as high risk, and 500 mg/dL or more are considered very high risk.

Elevated blood triglycerides promote the production of low-density lipoprotein (LDL) cholesterol, which is harmful to vascular health, and accelerate the breakdown of high-density lipoprotein (HDL) cholesterol, which is beneficial. As a result, high blood triglyceride levels increase the risk of atherosclerosis and, over time, raise the likelihood of cardiovascular diseases such as angina, myocardial infarction, and stroke.

Therefore, individuals with hypertriglyceridemia-elevated blood triglyceride levels-must lower their triglyceride concentrations below the standard threshold. The best strategy for both prevention and management is to correct unhealthy lifestyle habits that contribute to high triglyceride levels.

Factors that raise blood triglycerides include diets high in saturated fats, processed or refined carbohydrates (including sugar), certain diseases or medications that elevate triglycerides, lack of physical activity, smoking, and excessive alcohol consumption. Diseases that can raise triglyceride levels include diabetes, liver disease, kidney disease, obesity, inflammatory diseases, and thyroid disorders. Medications that can increase triglycerides include diuretics, corticosteroids, beta-blockers, and some HIV drugs.

To prevent and treat hypertriglyceridemia, it is necessary to improve the unhealthy lifestyle habits that cause it. Among various poor habits, diets high in saturated fats and processed or refined carbohydrates (including sugar) are particularly decisive factors in raising blood triglyceride levels and must be addressed.

However, it is not easy to change habits such as consuming diets high in saturated fats and processed or refined carbohydrates (including sugar). As a result, many people are tempted to rely on medications for hyperlipidemia as recommended by their physicians instead of making lifestyle changes. In such cases, there is something important to keep in mind.

Medications for hyperlipidemia mainly work by inhibiting cholesterol synthesis in the liver, blocking cholesterol absorption, or promoting cholesterol breakdown to improve blood lipid profiles. Statins are the most widely used class of these drugs. Statins are HMG-CoA reductase inhibitors that block the activity of the enzyme required for cholesterol synthesis in the liver, thereby lowering blood cholesterol levels.

While statins can temporarily lower blood triglyceride concentrations, relying solely on medication does not address the underlying causes of dyslipidemia. As a result, triglyceride levels only drop while the medication is effective and rise again when its effect wears off. This is not a cure, and side effects such as muscle pain and elevated liver enzymes may occur.

Since some causes of hypertriglyceridemia-such as medications that raise triglyceride levels-cannot always be discontinued, and diseases that raise triglycerides cannot always be cured at once, a strategic approach is needed. In such situations, creating an optimal environment for your body's own healing mechanisms is the core strategy of the Newstart program (refer to Life Story, Part 6).

The first of the eight components of Newstart is to consume a wide variety of plant-based foods, including fruits, vegetables, and grains, in a balanced and unprocessed form, avoiding selective eating. It is also important to reduce the intake of sugar, processed or refined carbohydrates, saturated and trans fats, salt, and alcohol, which can cause many health problems if consumed in excess. Practicing the other Newstart principles-exercise, water, sunlight, temperance, fresh air, rest, trust, and love-is equally important.

Independent researcher