Seeing an increase in serum triglycerides is often a cause for concern as this is one of the first signs of metabolic syndrome and/or insulin resistance. Metabolic syndrome describes a cluster of 5 signs/markers that when 3 or more are present, increases the risk of cardiovascular diseases. An elevated triglyceride of over 1.69mmol/L being one of them (American Heart Association, 2023).

In a healthy person, triglycerides are taken away from the blood and rediverted to areas of the body to exert its beneficial effects. The rest that is not immediately needed by the body is then stored away for later use.

This picture of elevated blood triglycerides is often part of a larger metabolic problem and generally points towards some form of insulin resistance. A great way to understand what is happening here is to think of our blood vessels as the motorway/highway. Our vast network of blood vessels running throughout our body is the motorway that carries travellers (carbs and fats) to their city of destination (muscle, liver, adipose tissue).

In an optimal world, we want the travellers to come off the motorway effectively and efficiently when they reach their destinations but when we have insulin resistance present, it’s as if the slip roads coming off the motorway entering the major cities are blocked off, creating high amounts of congestion and traffic.

The congestion and build up on the motorway then result in car accidents, car honking and general damage. Similarly, a build up of glucose and fats in the blood vessels results in inflammation and damage to the vessels which results in increased blood pressure amongst other things.

So, what was the cause of this all in the first place?

One way to look at it is that there were too many cars on the motorway entering the major cities with no cars leaving the other way. This results in the gradual overpopulation of the major cities which leads to the eventual shutdown of the slip roads to prevent any more cars entering as the cities couldn’t accept or handle any more.

Likewise, when there is an excess of calories going into the body (chronically), without enough coming out or being burned for energy, the ‘major cities’ (adipose, muscle and liver) become more and more saturated and full of carbs and fats.

Over time, the mechanisms behind the ‘entry’ point to the adipose, muscle and liver become dysfunctional, leading to a build-up in the blood. Given enough time, this can become dangerous.

There are other reasons outside of the typical energy excess that leads to the under clearance of blood fats.

For example, a slow thyroid (hypothyroidism) can inhibit lipoprotein lipase activity, which is a key enzyme used to break down triglycerides in the blood to be used as energy (Mavromati & Jornayvaz, 2021).

Chronic psychological stress could also be part of this picture as our catecholamines like adrenaline and noreadrenaline release fatty acids into the bloodstream, again, for energy, as part of our fight or flight response (Anni et al, 2021).

From a dietary perspective, it is generally the increased consumption of refined carbohydrates/sugars that can lead to increased triglycerides as this eating pattern usually results in an excess of energy intake. (Kelly et al, 2023)

Excessive consumption of alcohol can also raise triglyceride levels as this pushes up VLDL (very low density lipoprotein) production by the liver, which is one of the main carrying vehicles for triglycerides in the blood. Alcohol also seems to inhibit lipoprotein lipase activity as well, an enzyme that helps with the metabolism of fats (Van de Wiel, 2012).