Dear Sue and Jennifer:

What can I do nutritionally to lower my triglycerides? My doctor wants to put me on medications, but I would like to try diet and exercise first. (I walk one to three miles almost daily.) Please help! Thanks,
-- Sandy

Dear Sandy:

Thank you for your question. Though your concerns about the necessity for medication are specific, so many of us are trying to cut down on our intake of triglycerides (fats) that your question presents a great opportunity for me to list important facts that can help everyone have a healthier diet.

First, a little background: Triglycerides are the most plentiful lipids in our body and our diets, and they are the body's most highly concentrated form of chemical energy.

Depending on their chemical structure, triglycerides can be saturated, monounsaturated or polyunsaturated.

• Saturated fats occur mostly in animal tissues and a few plant products and include cocoa butter, palm oil and coconut oil.
• Monounsaturated fats include olive oil and peanut oil.
• Polyunsaturated fats include corn, safflower, sunflower, soybean, cottonseed and sesame oils.

Although many factors contribute to atherosclerosis (fatty plaque deposits formed in the walls of arteries), people who eat a diet high in saturated fats run a greater risk of developing it than people who eat a diet lower in saturated fats and cholesterol.

Some fat-reducing facts and guidelines:

1. Make sure that fat provides no more than 30 percent of your calories and that you eat no more than 300mg of cholesterol each day.
2. Your liver processes the fat you eat. If you eat more than your body needs for energy, the excess will be stored as body fat.
3. If you eat too many of any kind of calorie -- carbohydrates, proteins or fats -- your body turns them into triglycerides, which circulate in the bloodstream and are deposited in body-fat stores.
4. Your blood-triglyceride level increases whenever you eat, but other factors can also affect your level, such as alcohol intake, certain medications, recent exercise, diet, menstrual cycle and hormones.
5. High blood levels of triglycerides are linked with heart disease, although they are not a guarantee you will develop heart disease. Other factors such as smoking, obesity and high blood pressure increase the chance.
6. Substitute fish, poultry or vegetables for red meat as often as possible.
7. Cut down on fat-laden dairy products like whole milk, butter and cheese -- or substitute fat-free cheese, cottage cheese and yogurt and skim milk, -- and increase your intake of fresh fruits and vegetables.
8. Complex carbohydrates and fiber help lower blood triglycerides. Eat lots of whole grains, whole-wheat bread and whole-wheat pasta. Whole-grain cereals like Shredded Wheat and All Bran are good, as are dried beans and fruits and vegetables of all types (but preferably fresh).
9. One of the best diet therapies for high triglycerides is seafood. Studies have shown that fish oils from, for example, clams, oysters, crab and salmon, drive triglycerides down dramatically. Try to have at least one or two fish or seafood meals each week.
10. Other good meal ingredients are bean soups, whole-grain pastas with low-fat sauces, fruit salads, vegetable salads (all light on oil), whole-grain cereal, whole-grain bagels and fruits.
11. Try to avoid refined sugar, excessive alcohol, refined flours and fruit juices, as they contribute to high blood triglycerides.
12. Keep up the good work staying active, because exercise is extremely important. Continue your walking, and try snowshoeing or cross-country skiing for variety.
13. If you smoke, STOP!
14. If you are overweight, try shedding a few pounds. Often, just lowering your weight can lower your triglycerides.

If you would like further help, ask your doctor to refer you to a registered dietitian in your area. It may be helpful to have someone review your current diet and then make more specific recommendations based on your likes, dislikes and lifestyle.

Lots of luck. We commend you for trying to resolve the problem the natural way, with proper diet and exercise, and we hope that this method works for you.

Sincerely,
Jennifer Schiano and Sue Gilbert