Triglycerides, often overshadowed by cholesterol, are critical indicators of cardiovascular and metabolic health. Beyond their role in energy storage, elevated triglyceride levels are strongly linked to increased risk of heart disease, inflammation, and metabolic disorders.

At Superpower, we believe that the standard reference range for triglycerides is overly permissive, potentially allowing silent risks to go un-diagnosed. Grounded in robust scientific evidence, we've defined a more stringent optimal range that better supports long-term health and reduces the risk of chronic disease.

Key Points

• "Normal" Isn’t Optimal: Triglyceride levels below 150 mg/dL, considered "normal," may still carry significant risks for cardiovascular disease, metabolic dysfunction, and chronic inflammation.
• The Inflammatory Impact: Triglyceride levels above 100 mg/dL can amplify systemic inflammation, driving the silent progression of chronic diseases like atherosclerosis and metabolic syndrome.
• Redefining Optimal: Research indicates that maintaining triglyceride levels within a lower and stricter range can optimize metabolic health, reduce cardiovascular risk, and promote longevity.
  • Conventional Range - Less than 150 mg/dL
  • Optimal Range - 70-85 mg/dL

What Are Triglycerides?

Triglycerides are the most common form of fat in our bodies. Tri-glycerides act as energy packets, each made up of three fatty acid chains attached to a glycerol backbone – hence the name "tri-glycerides." These fatty acids can be saturated, unsaturated, or a mix of both, providing a versatile energy source.

We get triglycerides from two sources: our diet and our liver. When we eat fat- or carbohydrate-rich foods, our body breaks them down into fatty acids and glucose, respectively. The intestines absorb these nutrients and package the fatty acids with protective proteins, creating parcels called chylomicrons. Chylomicrons transport these dietary triglycerides through the bloodstream, delivering them to tissues that need immediate energy or to fat cells for storage.

Our liver also produces "homemade" triglycerides. Excess glucose from carbohydrate-rich foods is either stored in the liver as glycogen or converted into fatty acids. These fatty acids are then packaged into triglycerides by the liver and released into the bloodstream as very low-density lipoprotein (VLDL) particles. VLDL particles circulate throughout the body, delivering triglycerides to tissues. This process underscores the direct link between carbohydrate intake and the production of triglycerides in the body. Therefore, there is a direct link between your carbohydrate consumption and triglyceride level.

Why Should You Care About Triglycerides?

Triglycerides are more than just stored energy; they are a significant risk factor for cardiovascular disease, independent of other factors like cholesterol.

Elevated triglycerides directly contribute to vascular problems. VLDL particles, which carry triglycerides can get stuck in your vessel walls. Once stuck, they can trigger inflammation, leading to plaque buildup that narrows the vessel and can cause heart attacks or strokes.  High triglycerides also promote the release of substances that further inflame and damage blood vessels.

Beyond heart health, excess triglycerides can lead to widespread inflammation in the body, contributing to chronic diseases. They can accumulate in organs like the liver and pancreas, leading to conditions like fatty liver disease and pancreatitis.

High triglycerides also disrupt other aspects of cholesterol balance. HDL, the "good" cholesterol, normally helps protect your heart by removing cholesterol from arteries. However, when HDL interacts with triglyceride-rich VLDL particles, it swaps its cholesterol for triglycerides, making it heavier and quickly removed from the bloodstream. Meanwhile, LDL, the "bad" cholesterol, becomes smaller and denser when it absorbs triglycerides from VLDLs. This smaller, denser LDL is more likely to penetrate artery walls and contribute to plaque formation.

The combination of high triglycerides, low HDL, and small, dense LDL is common in people with Type 2 diabetes and is a key feature of metabolic syndrome, which is often linked to insulin resistance and blood vessel problems.

Additionally, as triglycerides build up in fat cells, the body produces more leptin, a hormone that regulates hunger and metabolism. However, in obesity, often associated with high triglyceride levels, leptin resistance can develop. Fat tissue rich in triglycerides can also convert male hormones into estrogen, potentially disrupting hormone balance. Paradoxically, as triglyceride levels rise, the body produces less adiponectin, a hormone that normally helps control blood sugar and reduce inflammation.

What is the Conventional Reference Range?

The conventional reference range for triglycerides is typically categorized as follows:

• Normal: Less than 150 mg/dL (1.7 mmol/L)
• Borderline: 150 to 199 mg/dL (1.7 to 2.2 mmol/L)
• High: 200 to 499 mg/dL (2.3 to 5.6 mmol/L)
• Very high: 500 mg/dL or higher (5.7 mmol/L or higher)

The conventional ranges, derived from population averages, are designed to identify high cardiovascular risk rather than define optimal health. Recent research suggests these ranges may be too lenient, allowing silent progression of cardiometabolic and inflammatory issues even within "normal" levels.

What is The Superpower Optimal Range for Triglycerides?

At Superpower, we recommend a more stringent optimal range for triglycerides:

• Superpower Optimal Range: 70-85

Our range is rooted in population studies and clinical research that have shown decreased cardiovascular risk and improved metabolic health at these lower levels.

Why is The Conventional Range for Triglycerides Problematic?

Triglyceride levels below 150 mg/dL are often labelled as "normal" or "optimal". However, emerging evidence suggests this threshold may not be sufficient to minimize risk.

The current threshold may not adequately protect against cardiovascular disease. Research shows that triglyceride levels at or above this threshold are strong predictors of atherosclerosis, stroke, and heart failure, even in high-risk patients on medication ^[1-4]. Elevated triglycerides are also linked to early-onset cardiovascular disease, high blood pressure, metabolic syndrome, and type 2 diabetes ^[5-7], emphasizing the importance of maintaining lower levels from a young age for long-term heart health.

Additionally, triglyceride levels above 150 mg/dL are associated with an increased risk of non-Alzheimer dementia, further expanding the range of potential health risks, including stroke ^[3].

Elevated triglycerides are closely linked to systemic inflammation, a major driver of atherosclerosis and cardiovascular disease ^[8]. Even conventionally "normal" triglyceride levels are associated with increased inflammatory markers, such as C-reactive protein and fibrinogen ^[9-12]. Research shows that lowering triglycerides helps reduce markers of inflammation ^{[13, 15]}.

Additionally, spikes in triglycerides can impair the anti-inflammatory function of HDL ("good" cholesterol), reducing its ability to protect against vascular inflammation, which may accelerate the progression of heart disease ^[15].

Triglyceride levels below 100 mg/dL appear more favorable for metabolic health ^[16]. Levels above this threshold often coincide with a more harmful mix of fats in the blood which includes more small, dense LDL particles ("bad" cholesterol) and less HDL ("good" cholesterol) ^{[1, 17- 20]}. This mix is strongly linked to plaque buildup in arteries and cardiovascular disease.

Supporting this, a long-term study found that triglyceride levels between 100-150 mg/dL were associated with higher mortality from all causes compared to lower levels, suggesting that what is currently considered "normal" still carries significant health risks ^{[21, 22]}.

Lastly, the current "normal" range for triglyceride levels is misleading. It's set near the 75th percentile for men and even higher for women [23]. Defining "normal" with a threshold that places a significant portion of the population, especially women, in a higher risk category, rather than reflecting a true average or healthy range, is problematic.

Supporting evidence from research studies

Even moderately elevated triglyceride levels are associated with an increased risk of adverse health outcomes. Our recommendation for a lower optimal triglyceride range is rooted in extensive research suggesting significant health benefits at these levels.

Cardiovascular Health:

Multiple studies have demonstrated a strong link between lower triglyceride levels and lower risk of heart-related issues. Individuals with triglyceride levels below 89-100 mg/dL have the lowest risk of heart attacks and other serious heart-related problems ^{[24, 25]}. For every ~85 mg/dL reduction in triglyceride levels, the risk of these issues decreases by approximately 14% ^[26]. This protective effect is observed even in patients with existing heart conditions ^[27].

To prevent harmful triglyceride spikes after eating, which are known to contribute to heart disease risk, it's recommended to keep fasting triglyceride levels below 100 mg/dL ^[28].

At Superpower, we recognize that triglyceride levels alone don't fully reflect cardiovascular risk. Current research indicates that the number of apoB-containing lipoproteins is a more accurate indicator. This understanding guides our comprehensive approach to lipid management and cardiovascular risk assessment.

Metabolic Health

Lower triglyceride levels are strongly associated with improved metabolic health ^[29]. Research consistently shows that individuals with triglyceride levels below 100 mg/dL have better insulin sensitivity reducing the risk of developing insulin resistance, lower risk of metabolic syndrome, and a decreased likelihood of developing type 2 diabetes ^[29-31].

Keeping triglycerides below 100 mg/dL helps the body better regulate blood sugar levels. Interestingly, the relationship between triglycerides and metabolic health is bidirectional! While lower triglycerides improve metabolic function, lifestyle changes that enhance metabolic health, such as weight loss, often lead to reduced triglyceride levels ^[32].

Inflammation and Endothelial Function

Triglyceride levels below 100 mg/dL are associated with reduced inflammation, a key factor in many chronic diseases ^[16]. These lower levels correlate with better function of the endothelium (the inner lining of blood vessels), crucial for preventing atherosclerosis and cardiovascular events ^[33]. Research indicates that as triglyceride levels decrease, the body's inflammatory burden progressively lessens, suggesting a dose-dependent relationship ^[34].

Cognitive Health

Elevated triglycerides are recognized as a risk factor for brain health ^[35]. Studies link high triglycerides to neurodegeneration and increased cognitive decline risk, especially in people with metabolic syndrome ^{[21, 22, 35, 36]}.  Research shows triglyceride levels ≥150 mg/dL correlate with increased risk of cognitive impairment, while levels below 100 mg/dL are associated with lower risk ^[37-38].

Long-term Health Outcomes

Long-term studies show significant benefits of lower triglyceride levels. A 22-year follow-up found better survival rates in patients with levels below 100 mg/dL ^[21]. Genetic studies support this, suggesting that lifelong low triglyceride levels are linked to reduced all-cause mortality ^{[40, 41]}.

Not All Triglycerides Are Equal

The type of carbohydrates or fat you consume can affect your triglyceride levels.

Simple, easily-digested sugars cause your intestines to release more chylomicrons and your liver to pack more triglycerides into VLDL particles, increasing your triglyceride levels in your bloodstream. Therefore, diets high in glycemic load and glycemic index are associated with elevated blood triglycerides.

Saturated fats, usually solid at room temperature, can raise LDL cholesterol and cardiovascular risk. Unsaturated fats, considered heart-healthy, offer benefits: monounsaturated fats may improve cholesterol and reduce inflammation, while polyunsaturated fats, especially omega-3s, can lower triglycerides and have anti-inflammatory effects. A diet favoring unsaturated fats over saturated fats can improve your triglyceride profile and overall cardiometabolic health. ^{[42, 43]}.

The Key Takeaway

Emerging research underscores the importance of maintaining triglyceride levels within a stricter range of 70-85 mg/dL to optimize your heart and metabolic health. While conventional guidelines label levels below 150 mg/dL as "normal," evidence suggests that this threshold may leave you vulnerable to silent, long-term damage. Elevated triglycerides are strongly linked to inflammation, cardiovascular disease, and metabolic dysfunction—even within what's considered the "normal" range.

At Superpower, we advocate for a proactive approach, focusing on achieving lower triglyceride levels to protect against the insidious effects of high triglycerides. By aiming for this optimal range, you can significantly improve your lipid profile, reduce your risk of heart disease, and support long-term metabolic health.