How to Lower Triglycerides: Food, Habits and Treatment

01Basics

What triglycerides are

MedlinePlus and NHLBI explain that triglycerides are a type of fat (lipid) and the most common fat in the body. They come from foods, especially butter, oils and other fats, and from extra calories the body does not need right away. These calories are converted into triglycerides and stored in fat cells, then released for energy between meals.

Mayo Clinic notes that triglycerides and cholesterol are different lipids: triglycerides store unused calories and provide energy, while cholesterol is used to build cells and certain hormones. Both are usually measured in the same blood test, often called a lipid panel or lipid profile.

02Results

Understanding your result

The three sources use the same categories for adults:

• healthy: below 150 mg/dL (1.7 mmol/L)
• borderline high: 150 to 199 mg/dL
• high: 200 to 499 mg/dL
• very high: 500 mg/dL or above

NHLBI adds that a healthy level for children and teens aged 10 to 19 is below 90 mg/dL. On fasting, Mayo Clinic says you need to fast before the test for an accurate measurement, while NHLBI says you may be asked to fast for several hours. Follow the instructions given with your test.

03Risk

Heart risk and very high levels

High triglycerides usually cause no symptoms, NHLBI explains, but if they are not controlled they can increase the risk of coronary heart disease and stroke. Mayo Clinic says they may contribute to hardening of the arteries, and are often a sign of related conditions such as obesity and metabolic syndrome, a cluster that includes excess waist fat, high blood pressure, high blood sugar and low HDL cholesterol.

Very high levels, above 500 mg/dL, can cause acute pancreatitis, according to NHLBI and Mayo Clinic. NHLBI notes that extremely high levels, above 1,500 mg/dL, can cause a syndrome with stomach pain, swelling of the liver and spleen and memory problems. Very high results need prompt medical follow-up, not just waiting to see if lifestyle changes work.

04Causes

Other conditions and medicines to review

The sources list health conditions that can raise triglycerides: type 2 diabetes or prediabetes, especially when poorly controlled, low thyroid hormone levels (hypothyroidism), kidney or liver disease, overweight and obesity, and some genetic conditions. Smoking, excess alcohol and eating more calories than you burn, especially from sugar, also raise them.

Mayo Clinic lists medicine groups that can raise triglycerides as a side effect, including diuretics, estrogen and progestin, retinoids, steroids, beta blockers, some immunosuppressants and some HIV medicines. NHLBI adds some medicines for breast cancer and, rarely and usually mildly, for high blood pressure. Never stop these on your own: ask your doctor whether any of your medicines could be playing a role.

05Sugar

Cutting added sugar and refined carbohydrates

Mayo Clinic says simple carbohydrates, such as sugar and foods made with white flour or fructose, can increase triglycerides, and that regularly eating more calories than you burn, particularly from high-carbohydrate foods, can lead to high levels. MedlinePlus likewise recommends limiting sugar and refined foods.

In practice, this means looking at sugary drinks, sweets, pastries and white-flour products, and replacing some of them with whole foods. Extreme diets are not necessary; consistent changes matter more.

06Fats

Choosing healthier fats

Mayo Clinic recommends trading saturated fat, found in meats, for healthier plant fats such as avocado, nuts and olive and canola oils, choosing fish rich in omega-3 fatty acids such as mackerel or salmon instead of red meat, and avoiding trans fats and hydrogenated oils. MedlinePlus also advises switching from saturated fats to healthier fats, and NHLBI recommends heart-healthy foods.

For more on overall eating patterns that support blood lipids, see our guides on a diet for lowering cholesterol and the worst foods for high cholesterol.

07Habits

Alcohol, activity and other habits

All three sources advise limiting alcohol. Mayo Clinic explains it is high in calories and sugar and has a particularly strong effect on triglycerides; people with severe or very high levels may be advised to avoid alcohol completely.

Mayo Clinic recommends at least 30 minutes of physical activity on most or all days, which can also raise HDL cholesterol, and suggests building activity into daily tasks. NHLBI recommends asking your provider what level of activity is right for you, as well as quitting smoking, managing stress and getting enough good-quality sleep.

08Weight

Weight goals and prescription treatment

Mayo Clinic says that in mild to moderate hypertriglyceridemia, cutting calories can reduce triglycerides, and NHLBI recommends aiming for a healthy weight. Weight goals should be set individually with a professional, since not everyone needs to lose weight.

If lifestyle changes are not enough, the sources describe several prescription options: fibrates, which lower triglycerides; statins, mainly for cholesterol, which can also lower triglycerides; prescription omega-3 fatty acids; and niacin, which should only be taken with medical advice because of interactions and side effects. NHLBI notes that more than one medicine may be needed for very high levels. Mayo Clinic says people whose levels stay very high may be referred to a specialized lipid clinic.

09Sources

Where the sources differ

Fasting. Mayo Clinic says fasting is needed for an accurate measurement; NHLBI says you may be asked to fast and also refers to non-fasting levels above 175 mg/dL as a risk marker.

Fish oil. Mayo Clinic says prescription fish oil contains more active fatty acids than many over-the-counter supplements, which may not be effective. NHLBI says prescription omega-3 products are made differently from supplements, which are not approved to treat high triglycerides.

Statins. Mayo Clinic presents statins mainly for people who also have unhealthy cholesterol, blocked arteries or diabetes; NHLBI says they can also be used to lower triglycerides. The choice is made by the prescriber.

10Summary

In summary

Triglycerides are a blood fat; below 150 mg/dL is healthy, and high levels raise heart and stroke risk, while very high levels can cause pancreatitis. Extra calories from sugar and refined carbohydrates, alcohol, inactivity, excess weight, some conditions and some medicines can raise them.

Everyday steps you can take: cut sugar and refined foods, choose healthier fats and fish, limit alcohol, stay active and do not smoke. Medicines, medicine reviews and fasting instructions are for your prescriber. In our nutrition practice in Bilbao we help adults adapt their eating to their lipid results (consultations are in Spanish).