Dr. Bianco we can walk through these obviously number one being being overweight or obese so that’s really the biggest driver of elevated triglycerides and in fact cardiovascular risk in our society these days things change over time we could argue the 1950s maybe smoking was more prevalent but that’s decrease in our society compared to those times so as I mentioned triglycerides are basically food its energy so an overabundance of energy leads the body to produce a higher level of particles filled with triglyceride which again leads to the Cascade events right so most of and interesting li there are people that we term metabolically obese and some of you may be this or see this which are people who have a metabolism of someone very overweight but for some reason they don’t really they don’t actually deposit the energy in their belly fat so don’t gain weight so there could be relatively thin people who have this metabolic abnormality yeah but most of the time it’s seen with being overweight right so if you think of triglycerides sugar and fats packaged together to be delivered to our cells for energy too much energy raises triglycerides so if one’s able to lose weight and and eliminate or decrease the prevalence of obesity we should have a decrease in triglycerides and I do want to make a follow-up point that I mentioned the triglyceride themselves is not necessarily the problem it’s what causes your triglycerides to go up becomes the problem right and what causes the triglycerides to come down decreases the problem so the trick let’s try going up and down our markers of the risk of inflammation plaques that’s why we look at them and use them and try to lower them but going back to the original point the most prevalent reason for elevated triglycerides in our society now is being overweight or an abundance of energy and compound that with physical inactivity correct so so decreasing activity compounds the absorption of energy and decreasing utilization of energy when people are physically active it does more than burn calories it changes the metabolism it enhances the delivery of these particles delivering triglycerides to the cells where it can be burned less physical activity you have more of these particles floating around where they can get into the arteries so remember it’s where they’re going that determines your risk so being in active further enhances the inflammatory process the risk of elevating triglycerides being physically active can burn your triglycerides as well as enhance your body’s ability to utilize me you