In India, whenever a patient goes for a lipid test, the results mostly revolves around low HDL, high triglyceride levels, LDL, Non HDL. This is  true in most of the cases. The intricacies of cholesterol, triglycerides, LDL, HDL, Non HDL look like  zombies looming around to the general public. The reports are common in our society, but we are not close to the basic understanding of the terms. 

Cholesterol is an integral part of the body. The major content of our brain is cholesterol. The membranes, hormones, metabolism are fueled and guarded by cholesterol. 

The darker shades attached with cholesterol are because of its association mainly to heart disease. Cholesterol is associated with diabetes, obesity, thyroid and many other diseases. 

Let's unravel the mystery of cholesterol. Total cholesterol is the sum up of all the elements, i.e. LDL, HDL, VLDL, Triglycerides. The causes of high cholesterol can be genetic, familial, lifestyle, obesity and some rare illnesses.

Significance of  individual components of cholesterol

Total cholesterol - Sum up of all the elements of cholesterol (HDL, LDL, VLDL, Triglyceride)

HDL - High-density lipoprotein is the only cholesterol, which is required towards the higher side. Higher is better,  it is a protective cholesterol against heart disease, stroke. The values are roughly 40 in males and 50 in females.

LDL – Low-density lipoprotein is the bad cholesterol, principally responsible for heart disease and stroke, lower is better.

VLDL- Is the intermediary metabolic product of cholesterol metabolism.

Triglyceride- This normally high in Indians. It is a marker of prediabetes, resistance to insulin hormone , and is also increases in thyroid illnesses. There is a familial association with high triglyceride levels. Till date there is no head to head association of an increase in triglyceride levels with heart disease, stroke.It is a marker for the coming illness.

HDL/LDL ratio this is commonly being reported . By now it  is very clear  HDL is good and LDL is bad cholesterol ,so higher the ratio it is better for the patient.

Small dense LDL - is relatively a new marker discussed in the medical world , this is a very bad cholesterol mostly associated with heart disease.

After this brief appraisal for lipids, let's talk about triglyceride and its control. Whenever you have high levels of triglyceride there is  nothing to be alarmed . As we had talked about  earlier, this is a marker of the coming illness. It is mostly not causing the disease but its rise is a red herring for us. The normal levels of this type are around 150 and in our country mostly it is around 200-300.

Why control Triglycerides?

We need to control our triglyceride levels to prevent diseases like swelling of the pancreas gland i.e Pancreatitis. The chances of developing this serious illness are mostly when we have very high levels i.e more than 500. Whenever the levels are above 400, the treatment in terms of medicines should start. There is a consensus in the medical world for treatment when triglycerides are above 400.

What should be done ,when it is in between 150 to 400 ?

Get the test done empty stomach, avoid heavy carbohydrate diet or boozing a night before the test.

If values are high in spite of these precautions? 

The three steps of triglyceride control i.e DEW

Diet- Diet should be low in carbs i.e less of chapattis, chaval, sugar in tea, sweets, and namkeen. Avoid eating namkeen, apply less of ghee in chapattis, can avoid egg yolk, have more of salads and soups. The old age wisdom of our forefathers can be applied i.e have less quantity of carbs per meal. 

Exercise – Regular exercise in the form of brisk walking, yoga, aerobics, a treadmill can be done. It helps in losing weight and also helps in controlling triglyceride levels.

Weight loss- the cumulative effect of the above-mentioned efforts lead to weight loss. Weight loss helps in controlling the triglyceride levels.

The DEWs of wisdom has now landed on the morning grass. We should embrace it for good health and a healthy future. If after all these efforts the levels are above 400, we need to take an opinion of a physician and can be put on medicines.