Wednesday, April 2, 2014

The Nutrition Debate #197: Triglycerides and alcohol consumption

Somebody said to me recently that he had been told by his doctor that his triglycerides were “high” because he drank alcohol (1 very dry martini) almost every day. I replied that I had never read that alcohol consumption caused elevated triglycerides, so, in my never ending “search for the truth,” I decided to look into it.

First question: how high is considered “high” triglycerides? The conventional range on most lab reports puts the “in range” value at <150mg/dL. Several popular medical advice, web-based resources also suggest that a fasting triglyceride level from 150 to <200mg/dL is considered “borderline,” from 200 to 500mg/dL is “high” and >500mg/dL “very high.”

(There doesnt, however, appear to be a low value below which your triglycerides should not fall. I was interested in this since my own values have dropped from 137mg/dL average to 49mg/dL average from almost the beginning of my Very Low Carb adventure, ranging as low as 22. My most recent triglycerides were 34mg/dL. More on how to do that here.)

I have heard of people with triglycerides as high as 300 and 500mg/dL. Of course, that is something that you and your doctor would want to address; but if you eat a Standard American Diet (which most people do), should you be worried if your triglycerides are in the range of 200mg/dL? Personally, I think not. But, if you have “borderline” triglycerides, what is the likely cause and what can you do about it? Again, I suggest you read this link, and take 2 grams of fish oil daily.

Triglycerides are fats. A triglyceride is a compound consisting of three (3) fatty acid molecules combined with a glycerol molecule. They are formed in the liver from fatty acids produced there, they circulate in the blood, and from there they are deposited in your bodys fat cells for storage. Together, they are a stable source of dense energy that you carry around with you for a time when there is no quick energy to be obtained from ingested carbohydrates or stored carb energy (glycogen) in the liver and muscles. It is then that your circulating insulin drops (in people with a healthy metabolism) and the triglycerides stored in body fat break up and cross over into the blood to be used for energy.

So, a Google search of the popular web sites for “triglycerides and alcohol consumption” produced a lot of what appeared to be mostly derivative advice from the Cleveland Clinic: “Follow your doctor's advice regarding alcohol. Alcohol increases triglyceride levels for some individuals. If you have high triglycerides and do consume alcohol…” (emphasis on “some” added by me).This advice, in other words, to those with other than a generic predisposition to VERY HIGH triglycerides – to lower your triglycerides, lower your consumption of alcohol – is based on an association and an assumption.

But what is the mechanism by which alcohol consumption raises triglycerides? Heres what I found: “Alcohol is calorie rich. So overconsumption of alcohol will inevitably elevate triglycerides.” (#1); “Alcohol consumption can raise triglyceride blood levels by causing the liver to produce more fatty acids.” (#2); “Now, whats the connection between drinking alcohol and high triglyceride levels? Its all about calories! Alcohol is full of calories (its also full of sugar) and any extra calories turn into triglycerides. The triglycerides are then stored in your body as fat. This means that high alcohol consumption can increase your triglyceride levels.” (#3).

So, “alcohol is full of calories,” and as these [ethyl alcohol] calories contain no “nutrients,” they are considered “empty” calories. Empty calories are therefore “extra” calories, and “extra calories turn into triglycerides.” Thats all there is to it! Thats the relationship between alcohol and triglycerides! Extra (because theyre empty) calories become triglycerides in your blood, and then they become body fat! But its all immaterial in this instance, because the person with whom I was discussing this doesnt have “high” triglycerides. His last three lab tests were 123, 209 and 161mg/dL, respectively.

I suppose I should also check the medical literature in the scientific journals, not just the popular sites that tend to oversimplify (and often give very bad advice, such as, with respect to dietary fats and cholesterol). But theres no hint anywhere that the consumer-based medical advice, IF you have HIGH triglycerides, is other than simply to eliminate calories, because extra calories make triglycerides, and the “best” calories to eliminate are the so-called empty calories.

From a purely nutritional perspective, I cant disagree with that. The best calories to eat for their nutritional value are nutrient dense foods. They include saturated fats and cholesterol (animal protein from fatty meats, eggs and cold-water fish); and whole, unprocessed low-carbohydrate vegetables roasted in olive oil or tossed in butter. Ill drink to that!
And, if you DO have “borderline” triglycerides (150-200mg/dL), try taking 2-3 grams of fish oil daily to lower them.

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