Vu Vincent Nguyen

Hun 3230 (Monday/Wednesday 12pm-1:15pm)

Triglycerides and Cardiovascular Disease

When speaking to others on the topic of triglycerides, the first thing typically to come to
their mind is chemistry or a big blank. Well, this text should be able to clear up any
misconceptions of the word. Included in this document, will be information that will thoroughly
define triglycerides, its role as a nutrient, the process in which it goes through to be
metabolized, and the association between triglycerides and cardiovascular disease.
According to Lawrence1, the term lipid is synonymous to the word fat, although, fat is
technically considered to be a triglyceride or triglycerides that solidify at room temperature.
Lipids are referred to as oily or fatty biological substances that arent dissolvable in water. They
can be comprised of fatty acids, triglycerides, phospholipids, steroids (cholesterol), and the less
commonly known terpenes. Lawrence1 explains the structure of triglycerides; fatty acids are the
simplest lipids that are typically components of triglycerides. There are four different types,
Stearic, Oleic, Linoleic, and Elaidic acid. They consist of approximately eighteen carbon atoms,
along with hydrogen and oxygen atoms, but can differ in the presence of double bonds, the
number of double bonds, and the configuration of the bonds. When the carbon atoms are all
connected by single bonds, this means the molecule has the maximum number of hydrogen
atoms, making it saturated. As soon as one of those hydrogen atoms are kicked out to form a
carbon-carbon double bond the molecule is unsaturated. One carbon-carbon double bond
makes the molecule monounsaturated and polyunsaturated fatty acids have more than one
double bond. Lawrence1(p18), states that configuration of the double bonds determine if the
molecule is cis or trans. Cis means both parts of the carbon chain extend from the same side of
the double bond, whereas, with trans, the chains extend from different sides of the double
bond.

Now that the foundation of triglycerides are explained, Lawrence1, presents what
triglycerides are composed of, which are, fatty acids and another molecule, glycerol. Glycerol,
also known as, glycerin, is a three carbon molecule with an alcohol group (an oxygen and
hydrogen atom). Three fatty acid groups attach to the glycerol molecule via the alcohol
molecule. When a triglyceride is formed from an unsaturated fatty acid, making an unsaturated
fat, the missing hydrogen atoms create empty spaces between the fatty acid chains, allowing
movement along the molecule and causing fluidity. Unsaturated fats can be found in vegetable
oil. Triglycerides that are composed of saturated and trans unsaturated fatty acids are more
compact and stack tightly together. They are typically more solid at room temperature and can
be found in margarine or shortening. This in turn makes it a saturated fat. Lawrence1 states that
it is more efficient to store energy in the form of triglycerides that in the form of carbohydrates
or proteins.
In a book by Wood2, his text further explains sources of triglycerides and, where and
how this molecule is digested and absorbed. Dietary fats, triglycerides, can be found from a few
sources. Animal sources would be meat, poultry, fish, dairy, and eggs. Fat-rich plant sources
would come from nuts and seeds, as well as, oils used to prepare a meal.
The process in which a triglyceride goes through to be absorbed in the body is
demonstrated by Wood2; after passing through the stomach and entering the upper portion of
the small intestine, stomach acid, bile salts, and digestive enzymes known as lipases intiate the
breakdown of triglycerides into fatty acids and glycerol. These lipases are produced in the
pancreas and the bile salts are secreted by the gallbladder and produced by the liver. The free

fatty acids are then absorbed by cells that line the small intestines and then reassembled as
triglycerides and formed into chylomicrons. They then, end up in the blood stream via the
lymphatic system draining the intestines. These chylomicrons in the bloodstream exchange
their triglycerides for cholesterol from high-density lipoproteins. Further down the stream
another enzyme, lipoprotein lipase, found in muscle, heart, adipose tissue, and other non-liver
tissue, also strip the triglyceride in the chylomicron of its fatty acids. When the triglyceride and
apolipoprotein is taken from the chylomicron, it arrives at the liver for uptake as a chylomicron
remnant.
So what are the roles of triglycerides? Gropper and Smith3, triglycerides are stored as
body fat in the form of triacylglycerols, a form of highly concentrated energy. They account for
nearly 95% of dietary fat. The other classifications of lipids, sterols and steroids, phospholipids,
and glycolipids arent technically triglycerides but, they are in the same category. Sterols are
commonly seen as cholesterol and are a precursor for steroids. They are important components
of cell membranes, especially in nerve tissue. Phospholipids have several roles and are seen on
blood-borne lipid particles like chylomicrons, important components of cell or organelle
membranes to facilitate the passage of materials, and serve as a source of physiologically active
compounds. Glycolipids are similar to phospholipids where their physiological role is mainly
structure.
Fazios4 book explains the relationship between triglycerides and cardiovascular disease.
First, Fazio4 explains the importance of triglycerides and lipid transport in the body. The
ingesting of a meal changes the concentration of triglycerides in blood plasma, depending on

the need by the body. The necessary step of the active pancreatic lipase to dismantle the
triglyceride into its components, fatty acid, and glycerol is crucial for the molecules to cross the
cellular membrane to be reassembled. Once reassembled triglycerides are put into
chylomicrons and held together by a structural protein called apolipoprotein B. The liver then
starts the endogenous lipid cycle where it uses excess fatty acid to create triglycerides and
contain them in large lipoproteins called very-low-density-lipoprotein (VLDL). But unlike
chylomicrons remnants that disappear after being stripped of its triglyceride, VLDLs dont
disappear and continue to be the infamous LDL, low-density-lipoprotein. These fatty acids
released by VLDL and triglycerides induce an inflammatory response to atheroma. The previous
source, Gropper and Smith3 explains the relationship between lipids and cardiovascular disease
a little more thoroughly. Gropper and Smith3 state, Atherosclerosis is a degenerative disease
of vascular endothelium. The principle players are in the atherogenic process are cells of the
immune system and lipid material, primarily cholesterol and cholesteryl esters. In addition to
genetics of apolipoproteins the lipid related response to dietary intervention can be a factor to
atherosclerosis, which is caused by the accumulation of lipid material in the lumen of the blood
vessel and is progressively occluded.
There were a couple articles that had the idea; there were certain types of triglycerides
that impacted heart disease in a positive or negative manner. Willett5 stated, Trans fatty acids
from partially hydrogenated vegetable oils have clear adverse effects and should be eliminated.
Modest reductions in cardiovascular heart disease rates by further decreases in
saturated fat are possible if saturated fat is replaced by a combination of poly- and monounsaturated fat, and the benefits of polyunsaturated fat appear strongest. This means that

trans fat should be cut out from the diet to decrease the risk of heart disease and saturated fat
is replaced with mono and poly saturated fat, you will benefit in reducing the risk of heart
disease. In a journal6 it suggested that reducing saturated fat by reducing and/or modifying
dietary fat reduced the risk of cardiovascular events by 14% supports the pervious statement.
To conclude, as a dietary professional, knowing the importance and hazards of
triglycerides is essential to a good practice. Willett5, there are fats, such as, trans fats that
should be eliminated from the diet because of the disease risk associated with it. On the other
hand, Willett4, there are fats that can be consumed to benefit health such as, polyunsaturated
fats. Gropper and Smith3, knowing the importance of fat and how it contributes to numerous
physiological functions including, energy reserves, making up cell s structure and membranes,
means you cant simply cut out fat from your diet to lose weight. This type of information along
with the references used in the paper allows dietetic practice to efficiently take a client and
regulate their triglyceride levels to reduce their chance of cardiovascular disease through a
sound diet.

References
1) Lawrence G. The Fats Of Life : Essential Fatty Acids In Health And Disease [e-book].
New Brunswick, N.J.: Rutgers University Press; 2010. Available from: eBook Collection
(EBSCOhost), Ipswich, MA. Accessed October 14, 2013.Title: How Fat Works
Author: Wood, Philip A.Date: 2006 (EBSCO)
2) Wood P. How Fat Works [e-book]. Cambridge, Mass: Harvard University Press; 2006.
Available from: eBook Collection (EBSCOhost), Ipswich, MA. Accessed October 14,
2013.
3) Sareen S. Gropper. Jack L. Smith Advanced Nutrition and Human Metabolism 6th
edition; 2013. Wadsworth, Cengage Learning. Accessed October 14, 2013
4) Fazio S. Contemporary Diagnosis And Management Of Hypertriglyceridemia [e-book].
Newtown, Penn: Handbooks in Health Care Co; 2009. Available from: eBook Collection
(EBSCOhost), Ipswich, MA. Accessed October 14, 2013. Dietary fats and coronary heart
disease
5) Willett W. Dietary fats and coronary heart disease. Journal Of Internal Medicine [serial
online]. July 2012;272(1):13-24. Available from: Academic Search Complete, Ipswich,
MA. Accessed October 14, 2013.
6) Hooper L, Summerbell C, Smith G, et al. Reduced or modified dietary fat for preventing
cardiovascular disease. Cochrane Database Of Systematic Reviews [serial online].
2012;(5)Available from: Science Citation Index, Ipswich, MA. Accessed October 14,
2013.
7) International Weekly Journal of Science Web Site. http://www.nature.com. Accessed
October 14, 2013