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Journalism of Courage
When it comes to heart health, cholesterol and triglycerides are often mentioned together. While both are types of fats (lipids) in the blood, they serve different purposes and impacts on the body. Misconceptions about these lipids can lead to confusion about diet, lifestyle and medical treatment.
Myth 1: Cholesterol and Triglycerides Are the Same Thing
Fact: Cholesterol and triglycerides are different types of lipids with unique roles in the body. Cholesterol is a waxy, fat-like substance that is essential for building cell membranes, producing hormones (such as estrogen and testosterone), and making vitamin D. It is produced by the liver and is also obtained from animal-based foods like meat, dairy and eggs.
Triglycerides, on the other hand, are the body’s main form of stored fat. They are made from excess calories consumed in the diet, particularly from carbohydrates and fats. When you eat more calories than your body needs, the liver converts them into triglycerides and stores them in fat cells for later energy use.
Myth 2: High Cholesterol and High Triglycerides Mean the Same Risk for Heart Disease
Fact: While both can contribute to cardiovascular disease, they do so in different ways. High levels of low-density lipoprotein (LDL) cholesterol, often called “bad” cholesterol, can lead to plaque build-up in arteries, increasing the risk of atherosclerosis (hardening of the arteries), heart attack and stroke.
High triglyceride levels can also contribute to heart disease but they primarily indicate that the body is processing fats inefficiently. Excess triglycerides in the bloodstream are often linked to conditions like obesity, insulin resistance and metabolic syndrome, all of which increase the risk of cardiovascular disease.
Myth 3: If My Cholesterol Levels Are Normal, I Don’t Need to Worry About Triglycerides
Fact: Even with normal cholesterol levels, high triglycerides can be a risk factor for heart disease.
It is possible to have normal LDL and HDL (high-density lipoprotein, or “good” cholesterol) levels while having high triglycerides. Elevated triglycerides are associated with inflammation, insulin resistance, and an increased risk of type 2 diabetes. Doctors now recognize that triglyceride levels are an independent risk factor for heart disease and should not be ignored.
Myth 4: The Same Diet Changes Affect Both Cholesterol and Triglycerides
Fact: While there is some overlap, dietary strategies differ. To lower LDL cholesterol, focus on reducing saturated and trans fats found in fried foods, processed snacks, and fatty cuts of meat. Increase fibre intake through whole grains, legumes, fruits, and vegetables. Get healthy fats from sources like nuts, seeds, olive oil, and fatty fish.
To lower triglycerides, focus on reducing added sugars and refined carbohydrates (such as white bread, sugary drinks, and sweets), as excess sugar is converted into triglycerides. Limit alcohol consumption, as alcohol significantly raises triglyceride levels. Maintain a healthy weight and engage in regular physical activity, which helps burn excess triglycerides for energy.
Myth 5: Medication for High Cholesterol Also Treats High Triglycerides
Fact: Different medications target cholesterol and triglycerides differently. Statins, the most common cholesterol-lowering drugs, primarily reduce LDL cholesterol and have a mild effect on triglycerides. However, if triglycerides are very high, doctors may prescribe fibrates, Omega-3 fatty acid supplements, or niacin, which specifically lower triglyceride levels.
(Dr Rakesh Gupta, Senior Consultant, Internal Medicine, Indraprastha Apollo Hospitals, Delhi)
