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Medical Forum / General / Nutrition / November 2004Do all carbs cause high triglycerides, or only the hi-glycemic ones? (Was: high dietary cholesterol = high blood cholesterol?)
Re: Do all carbs cause high triglycerides, or only the hi-glycemic ones? Daniel and Susan wrote: "Does not" "DOes so" "Does not" "Does so" Daniel, Susan, I usually enjoy both your posts. I'd really like to see some citations on this subject. The little bit of Googling and PubMed searching I've done has not turned up any review articles that address this specific point, and it's really easy to get led astray by limited animal studies. I've managed to knock my own triglycerides down from the 190's to 115. Mostly that's been by going to < 50g carb/d, just about all of it low-glycemic. Which is great improvement, but it's still not quite as good as I'd like. You both agree that carb restriction has a role in cutting triglycerides. When you've done as much you can along those lines, (and already doing what one can on weight loss and exercise) what's the next best plan of attack for lowering triglycerides? Adam Becker 5'10", T2 diabetes, 177lbs, 49 yrs Metformin 1000mg/d, D&E > Re: Do all carbs cause high triglycerides, or only the hi-glycemic > ones? [quoted text clipped - 22 lines] > 5'10", T2 diabetes, 177lbs, 49 yrs > Metformin 1000mg/d, D&E Have you tried fish oils? I guess that quite large doses are required to get the expected results. Jan Hi there, too much of something ALWAYS has a bad effect... so.. if u dont eat too much of something... u wont get the bad effects.. even when u eat pure transfatty acid :P cu Michi >Re: Do all carbs cause high triglycerides, or only the hi-glycemic >ones? [quoted text clipped - 22 lines] >5'10", T2 diabetes, 177lbs, 49 yrs >Metformin 1000mg/d, D&E >>I'd really like to see some citations on this subject. Susan replied > They're on Medline, in every cite comparing high carb with lower carb. Well, Medline wanted a credit card. But I searched at PubMed on triglycerides low.carbohydrate glycemic and got 6 hits. Only one of them seemed relevant. "Long-term effect of varying the source or amount of dietary carbohydrate on postprandial plasma glucose, insulin, triacylglycerol, and free fatty acid concentrations in subjects with impaired glucose tolerance."; Wolever TM, Mehling C. http://tinyurl.com/4s4nf Changes in 0-8-h mean plasma triacylglycerols in the 3 treatment groups differed significantly: -0.14, 0.04, and 0.18 mmol/L, respectively, with the high-GI, MUFA, and low-GI diets. So for triglycerides, Wolevar actually finds the low-glycemic index meals WORSE than high-GI or high-fat. (Somebody help me here - I'm reading triacylglycerols to be just another way of measuring triglycerides. Am I mistaken?) Googling, of course, I also find articles like: http://www.medicinenet.com/cholesterol/page5.htm Q: How can elevated blood triglyceride levels be treated? A: The first step in treating hypertriglyceridemia is a low fat diet. In http://tinyurl.com/6w9p2 SK Fried seems to be saying that carbs don't effect triglycerides very much in normal subjects, but that they have an outsize effect on triglycerides in subjects with the metabolic syndrome. And for such subjects, hi-GI meals have a larger effect than lo-GI meals. (The wording in the abstract is somewhat confusing.) "In terms of the long-term effects of diets high in sugars on the risk of cardiovascular disease, available epidemiologic evidence indicates no association of sugars or total carbohydrate intake per se, but high dietary glycemic load is associated with higher serum triacylglycerol concentrations and greater risk of coronary heart disease in women." > Changes in 0-8-h mean plasma triacylglycerols in the 3 treatment > groups differed significantly: -0.14, 0.04, and 0.18 mmol/L, [quoted text clipped - 3 lines] > reading triacylglycerols to be just another way of measuring > triglycerides. Am I mistaken?) AFAIK triacylglycerols is the correct scientific name of triglycerides - TG. BTW, in fasting state TG is almost same thing as VLDL - basically fat created by liver from mostly carbs. Postprandial, it is VLDL + chylomicrons - fat coming directly from food. Mirek Mirek said: >in fasting state TG is almost same thing as VLDL - basically fat >created by liver from mostly carbs. Postprandial, it is VLDL + >chylomicrons - fat coming directly from food. Mirek, thanks, that helps. Let me see if I've got it right: Postprandially, the liver packages dietary fat as chylomicrons. These circulate in the blood and get taken up by adipose or whatever tissue needs it. This goes relatively quickly, so after an overnight fast, it's gone. Postprandially, carbohydrate goes many places; much gets stored in the liver as glycogen. During fasting, some is released as blood glucose. The liver converts other glycogen to fat (entirely saturated?) and packages it with cholesterol into VLDL. This is a more-or-less steady process; it keeps going until the liver's glycogen stores are largely depleted, which can take a long time. Right so far? The fasting levels of VLDL will depend mainly on two sets of factors - how fast the liver is producing VLDL and how quickly the tissues take up VLDL. The liver production rate will depend, inter alia, on how rich/depleted its glycogen stores are. Tissue absorption will depend, inter alia, on metabolic need and on insulin levels. Still on track? Did I get the major factors right? Finally, during fasting, once the liver's glycogen stores are depleted, adipose tissue starts packaging fat into VLDL and putting it into the blood. Similar story to hepatic VLDL. ------ Rightly or wrongly, I've put this story together from a bunch of different posts and web articles. I've hunted quite a bit for a FAQ or article that tells this whole story in one place - preferably with good diagrams - but no luck. Anybody got a pointer? Thanks Adam Becker > Postprandially, the liver packages dietary fat as chylomicrons. These No, they are created in intestines, AFAIK. > circulate in the blood and get taken up by adipose or whatever tissue > needs it. This goes relatively quickly, so after an overnight fast, [quoted text clipped - 6 lines] > process; it keeps going until the liver's glycogen stores are largely > depleted, which can take a long time. I think that liver starts converting glucose as long as BG is too high - but in the end it is the same thing... Mirek > Mirek said: > >in fasting state TG is almost same thing as VLDL - basically fat [quoted text clipped - 4 lines] > > Postprandially, the liver packages dietary fat as chylomicrons. Chylomicrons are formed by the intestines and then released into the lymphatic system, before being dumped into the blood near the heart. > These > circulate in the blood and get taken up by adipose or whatever tissue > needs it. This goes relatively quickly, so after an overnight fast, > it's gone. Chylomicrons only last a few minutes in the blood, before the remnants are absorbed by the liver. > Postprandially, carbohydrate goes many places; much gets stored in the > liver as glycogen. During fasting, some is released as blood glucose. > The liver converts other glycogen to fat (entirely saturated?) and > packages it with cholesterol into VLDL. This is a more-or-less steady > process; it keeps going until the liver's glycogen stores are largely > depleted, which can take a long time. I doubt the liver wastes any glycogen making fat. If glycogen stores are full, then excess glucose will certainly go to fat, but AFAIK glycogen isn't broken down just to make fat. > The fasting levels of VLDL will depend mainly on two sets of factors - > how fast the liver is producing VLDL and how quickly the tissues take > up VLDL. Tissues don't take up VLDL, they just strip it of (some of) its cargo (mostly TGs), turning it into IDL. > The liver production rate will depend, inter alia, on how > rich/depleted its glycogen stores are. Tissue absorption will depend, > inter alia, on metabolic need and on insulin levels. VLDL is more likely to be released when fat is needed by the tissues, so the tissue lipoprotein lipase that removes fatty acids from it is likely to be active at the time. > Finally, during fasting, once the liver's glycogen stores are > depleted, adipose tissue starts packaging fat into VLDL and putting it > into the blood. Similar story to hepatic VLDL. When fasting, adipose tissue releases free fatty acids, which are carried by the blood protein albumin to the rest of the body including the liver. They are then burnt for energy or incorporated into TGs in VLDL. Adipose tissue doesn't make VLDL, it just receives deliveries from it. MattLB >Daniel, Susan, I usually enjoy both your posts. I'd really like to >see some citations on this subject. They're on Medline, in every cite comparing high carb with lower carb. Even Ornish mentions TGL being high on his diet, due to high carb consumption, then tries to laugh off the risk as if it doesn't matter. > The little bit of Googling and >PubMed searching I've done has not turned up any review articles that >address this specific point, and it's really easy to get led astray by >limited animal studies. All you have to do is google up any studies comparing high carb to low carb (but be careful what definition of low carb is, sometimes its 4-50%!) of calories. Then look at the impact of triglycerides. >I've managed to knock my own triglycerides down from the 190's to 115. > Mostly that's been by going to < 50g carb/d, just about all of it [quoted text clipped - 7 lines] >5'10", T2 diabetes, 177lbs, 49 yrs >Metformin 1000mg/d, D&E Fish oil, in high doses, is well established to lower TGLs. If you're on any other antithrombotic meds, or have clotting issues, discuss with a doctor, though. Susan > Re: Do all carbs cause high triglycerides, or only the hi-glycemic > ones? == Simple carbs (by measurement) raise VLDL triglycerides, but not refined or complex carbs, or alcohol. All carbs, regardless of their glycemic index, including alcohol, have the potential to raise total triglycerides, however whether they do depends on a long list of (dietary) interactions, including liver, hormonal, and other functions. |
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