Triglycerides are the Ringo Starr of lipids: essential, but not a primary concern

When it comes to the myriad risk factors that can contribute to heart disease, few things top LDL cholesterol. A true bodily evildoer, this bad-boy lipid hogs all the media attention as a potential cardiac killer.

Meanwhile, triglycerides quietly accumulate in your bloodstream, systematically forming fat in your cells and wondering what havoc they must wreak to garner some notice. Triglycerides, in a way, are the Ringo Starr of lipids — essential to keeping the beat but hardly worth a second thought.

Sure, a few studies have confirmed that elevated triglyceride levels can be a strong predictor of cardiac trouble, stroke and heart disease. Left unchecked, they sometimes can result in acute pancreatitis, a life-threatening inflammatory condition.

"Triglycerides are sometimes referred to as the "forgotten fat" because we hear less about them than cholesterol," said Mary Etta Dunaway of the Diabetes Center of Southeast Missouri Hospital.

But the so-called "bad cholesterol" — low-density lipoprotein, to be technical — remains of foremost concern to doctors because considerably more solid information exists, according to Kaiser Permanente Sacramento endocrinologist Dr. Laura Hoffman. With triglycerides, "The data is less firm."

That doesn't mean, however, that people should just ignore their triglycerides.

National Cholesterol Education Program guidelines state that triglyceride levels should remain below 150 milligrams per deciliter. But some physicians, including those at the Mayo Clinic, recommend 100 milligrams. Levels between 200 and 500 are considered high and might merit aggressive intervention. Dunaway said their goals at the Diabetes Center are to keep triglycerides below 150.

"Elevated triglyceride levels should be treated with diet and exercise," Dunaway said. "If target goals cannot be achieved, medication may be added by the physician."

Losing just 10 pounds and avoiding alcohol will help.

Diet is also crucial: Avoiding excessive refined carbohydrates, saturated fats and hydrogenated oil. As with treating cholesterol, try to consume omega 3 fatty acids (fish oils, for instance) and nuts and flax products. Niacin in vitamin B3 also has been shown to help.

One reason why triglycerides are not top-of-mind is that there are no obvious symptoms. In extreme and rare cases, Hoffman said, the body will break out in a rash. Most often, though, a patient might not notice any initial adverse health effects.

Many of Hoffman's patients have both elevated LDL and triglyceride levels. In such cases, she said, "as long as their triglycerides aren't dangerously high, we'll focus on LDL cholesterol first. We have better evidence that treating LDL will yield better outcomes."

See, triglycerides just can't get no respect.

Features editor Chris Harris contributed to this report.