Retrospective #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 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: what is considered “high” triglycerides? The range on most lab reports puts the “in range” value at <150mg/dL. Several popular web-based, medical advice 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 is not, however, 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, up to 2002, to 49mg/dL average from almost the beginning of my Very Low Carb adventure begun in 2002, ranging as low as 22. My most recent triglycerides were 34mg/dL.)

I’ve heard of people with triglycerides as high as 300 and 500mg/dL. That is something that you and your doctor would want to address; but, should you be worried if your triglycerides are <200mg/dL? Well, lets see.

Triglycerides are fats, a compound consisting of three (3) fatty acid molecules with a glycerol backbone. They are formed in the liver from fatty acids produced there, they circulate in the blood, from where they are used for energy or stored in your fat cells. Either way, 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 level 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 advice derived 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…” Excepting those with a rare genetic predisposition to VERY HIGH triglycerides, this advice from the Cleveland Clinic – to lower your triglycerides, lower your consumption of alcohol – appears to be based on an association.

But is there a mechanism by which alcohol consumption causes high triglycerides? Here’s what I found: “Alcohol is calorie rich. So, overconsumption of alcohol will inevitably elevate triglycerides”; “Alcohol consumption can raise triglyceride blood levels by causing the liver to produce more fatty acids.” So, that’s the connection between drinking alcohol and high triglyceride levels? It’s all about the calories! Alcohol is full of calories, and any extra calories from alcohol turn into triglycerides, but alcohol is absorbed thru the stomach (not the intestine) and burned first. This means that high alcohol consumption can increase your triglyceride levels, briefly, after imbibing.

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.” It seems that’s the Cleveland Clinics rationale for the relationship between alcohol and triglycerides! Extra calories become triglycerides in the blood. But it’s all immaterial in this instance, because the person with whom I was discussing this DOESN’T HAVE “high” triglycerides. His last three lab tests were 123, 209 and 161mg/dL, 164mg/dl average.

Popular sites offering medical advice tend to oversimplify. But there’s no hint anywhere that the Cleveland Clinic’s 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 can’t disagree with that. The best calories, for their nutritional value, are in nutrient-dense, real food. That includes saturated fats and cholesterol (animal protein from fatty meats, cold-water fish and eggs); and whole, unprocessed low-carbohydrate vegetables roasted in olive oil or tossed in butter.

And, if you DO have “borderline” triglycerides (150-200mg/dL), try taking 2 grams of fish oil daily to lower them.