Excess Carbohydrates Cause Elevated Triglycerides

Overweight patients commonly have elevations of their small LDL cholesterol and triglycerides as well as decreases of their HDL cholesterol; all of these changes  correlate with an increased risk of heart attacks.   This pattern is collectively known as atherogenic dyslipidemia and is associated with the narrowing of arteries called atherosclerosis.

This pattern of cholesterol and triglyceride abnormalities is also associated with insulin resistance and is a major feature of the metabolic syndrome.  Weight loss has been shown to improve these abnormalities as well as the insulin resistance that often occurs at the same time.

Dietary carbohydrates, especially simple sugars, can produce these cholesterol/triglyceride changes because of the effect they directly have on metabolism of triacylglycerols, a fatty molecule that is commonly contained within triglycerides

Carbohydrate Reduction Improves Artherogenic Dyslipidemia

A reduction in carbohydrate intake has been reported although many studies have examined only the effects of extremely low carbohydrate intakes of 20 grams per day or less.  These low levels of carbohydrate intakes are commonly associated with the Atkins diet.

Reductions in dietary carbohydrate intake results in a decrease in plasma triglycerides by 25-50% within one to a few months (see table 3 of this paper).  Additionally, HDL cholesterol (the good cholesterol) levels will increase of 10-20% is the same amount of time.

Eating lower carbohydrates can sometimes result in a higher fat intake.  There is no evidence that higher fat intake with a lower carbohydrate diet are harmful.  Most studies show little to no increase in LDL cholesterol (the bad cholesterol) despite relatively high dietary contents of saturated fat and dietary cholesterol.

Additionally, the type of LDL molecule that is produced changes with decreased carbohydrate diets.  There is a small, dense type of LDL molecule that is the most dangerous form in regards to contributing to heart disease.  A reduction in carbohydrates transforms these small LDL cholesterol molecules into large fluffy, LDL cholesterol molecules which are believed to have much less heart disease forming potential.

Reduce Carbs to Lower Triglycerides

Many studies show that extreme carbohydrate reductions result in decreased triglyceride levels.  Well, you don’t have to be on an Atkins diet (less than 20 grams per day) to realize the triglyceride-lowering benefits of low carbohydrate diets.

As shown in a recent study, placing men on a diet with 26% carbohydrates resulted in reductions in blood triglyceride concentrations with a reduction in carbohydrate intake.  This equals  about 150 grams per day for an average man and 130 grams per day for an average woman.

The reduction in triglyceride levels was seen in patients who didn’t have significant weight loss.  This underscores that it is the reduction in carbohydrates not weight loss per say that results in improvements of the triglyceride levels.  Interestingly, a decrease in saturated fat (animal fat) intake did not result in additional reductions in triglycerides.  This study adds to the mounting evidence that carbohydrate intake , not fat, is responsible for elevations of triglycerides.

So, if you have elevated triglycerides or low HDL cholesterol levels, try to reduce your intake of carbohydrates to less than 125-150 grams per day.  The lower you go the more potent effect but if you can only get to 150 grams per day initially, you’ll start seeing improvements.  The vast majority of my patients with elevated triglycerides can discontinue their medications within a month or 2 after reducing the carbs to less than 100 grams per day consistently.

Why Does My Doctor Advised Still Advise Me To Eat Low Fat If It’s All About The Carbs?

I can’t answer this in a way that applies to all physicians, nurse practitioners or dieticians who still recommend low fat diets strategies.  All I can say is that there are many individuals in medicine who seem to quit reading the scientific literature much once they go into practice.

Medical journals have been full of papers discussing the growing understanding of insulin resistance and its effects not only on triglycerides but high blood pressure, diabetes and heart disease as well.  There are probably many different reasons why they aren’t staying abreast with this material.  But regardless, if they don’t know that a reduction is carbohydrates will reduce your triglycerides, they will simply prescribe you a pill rather counsel you on your diet.

Excessive Carbohydrates Are Poisonous

So you need to take it upon yourself to improve your health and they single most powerful thing almost everyone could do is reduce their carbohydrate intake to less than 100 grams per day.  Try to make sure the carbs you do eat come from vegetables and fruits.

Don’t worry about counting calories or about eating fat as the hunger suppressing effects of carbohydrate reduction will cause you to naturally eat less calories and total fat as well.

Avoid eating low fat foods since these often contain more carbohydrates.  Be cautious of low sodium foods because some of these also have had more carbohydrates added in an effort to boost the flavor.  You might even download a copy of my Science of Hunger Guide for some additional tips on reducing your hunger (and your weight) without focusing on calories.

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Patrick Nemechek, D.O.

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