Studies have shown that elevated triglyceride levels can increase risks for cardiovascular disease (CVD), stroke, and premature cardiovascular death. The American Heart Association also notes that high levels of triglycerides have been linked to type 2 diabetes and fatty liver disease. For adults with elevated triglycerides, experts have recommended several therapeutic lifestyle changes, including:
- Increased physical activity.
- Weight loss.
- Optimal nutrition-related practices.
- Smoking cessation.
“These lifestyle modifications can be very effective in lowering triglyceride levels in adults,” says Margaret D. Carroll, MSPH. Studies also suggest that medications like statins, omega-3 fatty acids, and other therapies may be helpful in lowering triglyceride levels.
A Look Across Time
In an NCHS Data Brief, Carroll and colleagues examined recent trends in the percentage of adults aged 20 and over in the United States with elevated triglyceride levels, which was defined as 150 mg/dL or higher. The authors examined data from the National Health and Nutrition Examination Surveys (NHANES) 2001–2004, 2005–2008, and 2009–2012. NHANES provides cross-sectional surveys that are designed to monitor the health and nutritional status of the non-institutionalized U.S. population.
Overall, triglyceride levels have dropped significantly across many demographic groups in the past decade, including both men and women, according to study results (Figure).
The percentage of all adults aged 20 and over with elevated triglyceride decreased from about 33% during 2001–2004 to approximately 25% during 2009–2012. Triglyceride levels also declined in overweight and obese men and women throughout the study period.
Among people aged 60 and older, large decreases were seen in the percent of people with elevated triglyceride levels. For men in this age group, there was a decrease from nearly 40% in 2001-2004 to nearly 25% in 2009-2012. In women 60 years and older, over 44% had high triglyceride in 2001-2004, but this figure dropped to about 31% in 2009-2012.
For adults aged 40 to 59, a decreasing trend was seen in men and women from 2001–2004 to 2009–2012. For adults aged 20 to 39, the percentage of men with elevated triglycerides did not change significantly, but notable changes were seen among women in this age range. The percentage of women in this youngest age group with elevated triglycerides declined from nearly 22% during 2001–2004 to slightly less than 15% during 2009–2012.
“Levels of elevated triglyceride levels dropped from about 40% to 28% in Mexican-American women during the study period,” says Carroll. “However, there were no significant improvements in elevated triglyceride levels seen in Mexican-American men. For non-Hispanic white adults, declining trends were observed in both men and women, but no change was observed in the percentage of non-Hispanic black men or women with elevated triglycerides.”
During the entire study period, the percentage of adults with elevated triglyceride levels was consistently lower in non-Hispanic black adults than in non-Hispanic white or Mexican-American adults. “This finding supports what has been documented in previous studies,” Carroll adds. Research has suggested that a possible explanation for this phenomenon is that levels of lipoprotein lipase are higher among blacks than whites.
Research has shown that several factors affect triglyceride levels, including a sedentary lifestyle, increased body weight, and cigarette smoking. Other efforts that may lower triglyceride levels include reducing intake of simple carbohydrates, trans-fatty acids, and alcohol. Monounsaturated and polyunsaturated fatty acids and marine-based omega-3 products may reduce triglyceride levels, according to published research.
The study by Carroll and colleagues did not speculate about the causes of the shift in triglyceride levels, but it is possible that several factors may be at play. These include a smaller percent of adults who smoke cigarettes, the decline in plasma concentrations of trans-fatty acids, and the increased percent of adults taking cholesterol-lowering medications.
Some clinical trials have shown that triglyceride levels can drop between 10% and 30% when patients with elevated triglycerides use statin monotherapy. However, more studies are necessary to definitively demonstrate the benefits of statins on reducing triglyceride levels.
Readings & Resources (click to view)
Carroll MD, Kit BK, Lacher DA. Trends in elevated triglyceride in adults: United States, 2001–2012. NCHS Data Brief. 2015:198. Hyattsville, MD. National Center for Health Statistics. Available at: www.cdc.gov/nchs/data/databriefs/db198.htm.
Miller M, Stone NJ, Ballantyne C, et al. Triglycerides and cardiovascular disease: a scientific statement from the American Heart Association. Circulation. 2011;123:2292-2333.
Summer AE, Finley KB, Genovese DJ, Criqui MH, Boston RC. Fasting triglyceride and the triglyceride-HDL cholesterol ratio are not markers of insulin resistance in African Americans. Arch Intern Med. 2005;165:1395-1400.
Vesper HW, Kuiper HC, Mirel LB, Johnson CL, Pirkle JL. Levels of plasma trans-fatty acids in non-Hispanic white adults in the United States in 2000 and 2009. JAMA. 2012;307:562-563.