Triglycerides: Why do they matter?

Triglycerides are an important measure of heart health. Here's why triglycerides matter — and what to do if your triglycerides are too high.

You know your body mass index (BMI) is a little high. You're also keeping an eye on your blood pressure and cholesterol level. Now your doctor suggests lowering your triglycerides, too. If you didn't even realize you had triglycerides, take heart. The same lifestyle choices that promote overall health can help lower your triglycerides, too.

What are triglycerides?

Triglycerides are a type of fat found in your blood. When you eat, your body converts any calories it doesn't need to use right away into triglycerides. The triglycerides are stored in your fat cells. Later, hormones release triglycerides for energy between meals. If you regularly eat more calories than you burn, you may have high triglycerides (hypertriglyceridemia).

What's the difference between triglycerides and cholesterol?

Triglycerides and cholesterol are separate types of fat that circulate in your blood. Triglycerides provide your body with energy, and cholesterol is used to build cells and certain hormones. Since triglycerides and cholesterol can't dissolve in blood, they circulate throughout your body with the help of protein packages called lipoproteins.

What's considered normal?

A simple blood test can reveal whether your triglycerides fall into a healthy range.

Normal — Less than 150 milligrams per deciliter (mg/dL)
Borderline high — 150 to 199 mg/dL
High — 200 to 499 mg/dL
Very high — 500 mg/dL or above

Why do high triglycerides matter?

Although the exact mechanism is unclear, high triglycerides may contribute to hardening of the arteries (atherosclerosis) or thickening of the artery walls — which increases the risk of stroke, heart attack and heart disease.

High triglycerides often accompany other conditions known to increase the risk of heart disease and stroke as well, including obesity and metabolic syndrome — a cluster of conditions that includes too much fat around the waist, high blood pressure, high triglycerides, high blood sugar and abnormal cholesterol levels.

Sometimes high triglycerides are a sign of poorly controlled diabetes, low levels of thyroid hormones (hypothyroidism), liver or kidney disease, or the use of certain medications. High triglycerides can also result from rare genetic conditions.

What's the best way to lower triglycerides?

Healthy lifestyle choices are key.

Lose excess pounds. If you're overweight, losing the excess pounds can help lower your triglycerides. Motivate yourself by focusing on the benefits of losing weight, such as more energy and improved health.
Consume fewer calories. Remember that excess calories are converted to triglycerides and stored as fat. Reducing your calories will reduce triglycerides.
Avoid sugary foods. Simple carbohydrates, such as sugar, can cause a sudden increase in insulin production. This can increase triglycerides.
Limit your cholesterol intake. Aim for no more than 300 milligrams of cholesterol a day — or less than 200 milligrams if you have heart disease. Avoid the most concentrated sources of cholesterol, including organ meats, egg yolks and whole milk products.
Choose healthier fats. Avoid saturated fat and instead choose healthier monounsaturated fat, found in olive, peanut and canola oils. In addition, eat fish high in omega-3 fatty acids — such as mackerel and salmon — instead of red meat.
Avoid alcohol. Alcohol is high in calories and sugar and has a particularly potent effect on triglycerides. Even small amounts of alcohol can promote high triglyceride levels.
Exercise regularly. Aim for at least 30 minutes of physical activity on most or all days of the week. Regular exercise can boost "good" cholesterol while lowering "bad" cholesterol and triglycerides. Take a brisk daily walk, swim laps or join an exercise group.

It's also important to control diabetes and high blood pressure, if you have those conditions.

What about medication?

If healthy lifestyle changes aren't enough to control high triglycerides, your doctor may recommend medication. Cholesterol medications known as fibrates (such as fenofibrate or gemfibrozil) and nicotinic acids (such as niacin) are often effective for lowering triglycerides. If you also have low high-density lipoprotein (HDL) or "good" cholesterol or high low-density lipoprotein (LDL) or "bad" cholesterol, your doctor may prescribe cholesterol-lowering statins or a combination of a statin and a fibrate or nicotinic acid.

If your doctor prescribes medication to lower your triglycerides, take the medication as prescribed. And remember the significance of the healthy lifestyle changes you've made. Drug therapy can help — but lifestyle matters, too.

source: http://www.mayoclinic.com/health/triglycerides/CL00015

Alzheimer's stages: How the disease progresses

Alzheimer's disease can last more than a decade. See what types of behaviors are common in each of the stages as the disease progresses.

Alzheimer's disease typically develops slowly and causes a gradual decline in cognitive abilities, usually over a span of seven to 10 years. It eventually affects nearly all brain functions, including memory, movement, language, behavior, judgment and abstract reasoning.

Dividing the progression of Alzheimer's disease into stages can help you plan for the future, but remember that not everyone will experience the same symptoms or progress at the same rate. While each individual is different, the progression of his or her disease can be roughly divided into three categories — mild, moderate and severe.

Mild Alzheimer's disease

People in the early stages of Alzheimer's may experience memory loss, lapses of judgment and subtle changes in personality. They often have decreased attention span and less motivation to complete tasks. In addition, they may resist change and new challenges, and get lost even in familiar places.

While everyone occasionally forgets words or names during conversations, in people with mild Alzheimer's this problem occurs with increasing frequency. They may substitute or make up words that sound like or mean something like the forgotten word. They sometimes even avoid talking to keep from making mistakes and appear subdued or withdrawn — especially in socially or mentally challenging situations.

They may also put things in very odd places. For example, a wallet may end up in the freezer, or clothes may go into the dishwasher. They may ask repetitive questions or hoard things of no value. When frustrated or tired, they may become uncharacteristically angry.

Moderate Alzheimer's disease

In the middle stage of Alzheimer's, people can't organize thoughts or follow logical explanations. They lose the ability to follow written instructions and often need help choosing proper clothing for the season or occasion. Eventually, they'll require help getting dressed because their confusion may cause them to put their pajamas on over their daytime clothes or their shoes on the wrong feet. They may also have episodes of urinary or fecal incontinence.

It's usually during this stage that people start having problems recognizing family members and friends. They may mix up identities — thinking a son is a brother or that a spouse is a stranger. They may become confused about where they are and what day, season or year it is. They become unable to recall their address or phone number.

Because they lack of judgment and tend to wander, people with moderate Alzheimer's disease aren't safe on their own. They may exhibit restless, repetitive movements in late afternoon, or continually repeat certain stories, words or motions, such as tearing tissues.

Personality changes are common and can include:

Accusations of infidelity or stealing
Threats and cursing
Inappropriate behavior, such as kicking, hitting, biting, screaming or grabbing

Severe Alzheimer's disease

People in the last stage of Alzheimer's require help with all their daily needs. They lose the ability to walk without assistance and then the ability to sit up without support. They are usually incontinent and may no longer speak coherently. They rarely recognize family members. Swallowing difficulties can cause choking, and they may refuse to eat.

How long?

The rate of progression varies widely among individuals. For some, severe dementia occurs within five years of diagnosis. For others, it can take more than a decade. On average, people with Alzheimer's live for eight to 10 years after diagnosis. Some live as long as 20 years. Most people with Alzheimer's don't die of the disease itself, but of pneumonia, a urinary tract infection or complications from a fall.

source: http://www.mayoclinic.com/health/alzheimers-stages/AZ00041

Your Doc Is In

Friday, February 8, 2008

Triglycerides affect Heart Health