Triglycerides and Lipids: Overview, Health Implications, and Management

Triglycerides (TGs)

Esters of glycerol + 3 fatty acids; most common body fat.

Exogenous triglycerides

Obtained from diet.

Endogenous triglycerides

Synthesized by liver from other molecules.

Chylomicrons

Lipoproteins that carry dietary triglycerides.

Normal fasting TG

<150 mg/dL.

Hypertriglyceridemia

TG > 150 mg/dL.

High triglycerides

200-499 mg/dL.

Pancreatitis risk

TG ≥500 mg/dL or 1000 mg.

Hyperlipidemia

Elevated levels of lipids (fats) in the blood, which includes triglycerides.

Health implications of high TG

Increased risk for cardiovascular diseases and pancreatitis.

Management - dietary interventions

Reduce alcohol consumption, achieve healthy weight, healthy diet (low sugar, high fiber), choose healthy fats (unsaturated fats), avoid trans fats and hydrogenated oils.

Management - lifestyle modifications

Quit smoking, increase physical activity, achieve healthy weight, reduce alcohol consumption.

Fibrates

Medications such as Fenofibrate and Gemfibrozil.

Statins

Medications such as Atorvastatin.

Fish oil/Lovaza

A supplement used for managing triglyceride levels.

Niacin

A supplement that affects blood clotting; use with caution.

Cholesterol

Fat-like substance that supports cell membranes.

Fatty acids

Building blocks of fat that give energy, build cells, create hormones, and support brain and nerve health.

Saponification

Turning fat into soap using a strong base (commonly NaOH).

Role of lipids in the brain

Build and maintain cell membranes, form myelin sheaths, support brain signaling, store energy for brain cells, protect and repair neurons.

Brain lipids

Structure + insulation + signaling + energy + protection.

LDL ('Bad') cholesterol

Contributes to plaque; normal LDL: <100 mg/dL.

HDL ('Good') cholesterol

Anti-atherogenic; 40-60 mg/dL males, 40-65 mg/dL females.

Thyroid hormones

Regulate LDL clearance.

Unsaturated Fatty Acids (Omega-3)

Beneficial for heart and brain, reduces inflammation.

Saturated Fatty Acids

Linked to heart disease.

Lipids

Insoluble in water.

Triglycerides

React with a strong base (like NaOH) to produce soap (fatty acid salts) and glycerol.

Glycerin

Special name of the glycerol produced during soap-making.

Cholesterol in the Brain

Major lipid in brain, concentrated in white matter.

Sphingolipids & Phospholipids

Maintain myelin.

Omega-3 fatty acids (DHA)

Essential for brain function.

ApoE

Related to cholesterol metabolism; ApoE4 increases Alzheimer's disease risk.

Neurofibrillary tangles

Twisted fibers of protein inside neurons.

Amyloid plaques

Extracellular deposits of beta-amyloid protein that interfere with neuron communication.

Neuronal loss

Death of neurons in key brain areas leading to memory loss.

Age as a risk factor for Alzheimer's

Higher risk of Alzheimer's because the brain becomes more vulnerable to damage over time.

Patient safety interventions

Soft foods, remove confusing decorations, support daily activities to prevent accidents.

Lovaza (Omega-3)

Lowers very high triglycerides.

Fish oil

Natural source of DHA; helps reduce triglycerides and supports heart and brain health.

Niacin (vitamin B3)

Lowers LDL ('bad') cholesterol and raises HDL ('good') cholesterol.

Liquid Oils

Unsaturated; vegetable oils; liquid at room temperature.

Solid Fats

Saturated; animal fats like butter/lard.