Diagnosed with High Triglycerides? 6 Things That Help

When it comes to heart health, cholesterol gets all the attention. But there’s another blood test that speaks volumes about your heart health: triglycerides. 

Triglycerides are a type of fat in your bloodstream. We get them from eating fat-containing foods, like butter and oils. However, they can also increase as a result of consuming extra calories or lots of sugar.  While triglycerides are a source of energy for your body, elevated levels can put you at risk for health problems. “Elevated triglyceride levels increase the risk of developing atherosclerotic cardiovascular disease, including heart attacks, strokes and chronic inflammation of the blood vessels,” says cardiologist Khanh-Van Tran, M.D., Ph.D. Very high triglyceride levels can also increase your risk for acute pancreatitis, which can be life-threatening, she adds. “Because of these risks, patients should treat the diagnosis seriously and work to lower their triglyceride levels.”

As alarming as this may sound, high triglycerides are extremely common. According to the National Heart, Lung and Blood Institute, 1 in 4 American adults have this condition. So, we asked cardiologists what to do to lower triglycerides, and this is what they told us.

1. Minimize Sugary Foods

Even though triglycerides are fats, eating too much sugar can also elevate them. If you have high triglycerides, defined as 150 to 500 mg/dL, your health care provider may strongly urge you to reduce your consumption of added sugars. Ideally, someone with high triglycerides would keep their added sugars “to basically nothing,” says cardiologist Gregory Katz, M.D. Added sugars are found in large quantities in cookies, cakes, doughnuts, candy, soda, sweet tea, and sugary lattes and coffee drinks. 

If you’re wondering how to minimize added sugars, a great first step is reading the Nutrition Facts panel on food packages. In addition, try some simple swaps, like drinking plain or sparkling water and unsweetened tea or coffee in lieu of sugar-sweetened beverages. You can also choose plain yogurt over flavored versions or opt for unsweetened cereal.

What about natural sugars from fruit? The answer depends on how high your triglycerides are. If your triglycerides are less than 500 mg/dL, the American College of Cardiology says you can safely eat three to four servings of fruit per day. You can also eat this amount if your numbers fall between 500 and 999 mg/dL, provided you avoid high glycemic index fruits, like bananas, watermelon, mangoes and pineapple. However, if your triglycerides exceed 1,000 mg/dL, the ACC recommends limiting fruit to one serving per day and working with a registered dietitian to develop an individualized eating plan to help lower your numbers.

2. Avoid Alcohol

One of the best things you can do to lower triglycerides is avoiding alcohol, says Katz. If your numbers fall between 150 and 500 mg/dL, your health care provider may give you the go-ahead to drink moderately depending on your overall health. Moderately means women should not exceed one drink per day, and men should have no more than two drinks. However, if you have very high triglyceride levels (defined as above 500 mg/dL), experts advise abstaining from alcohol entirely. 

That said, it can be tough to cut back or give up alcohol. So, speak with your health care provider, who can point you toward resources that support you in the journey to stop drinking or cut back. 

3. Try the Mediterranean Diet 

If there’s one eating pattern that Tran recommends, it’s the Mediterranean diet. In addition to lowering triglycerides, this heart-healthy eating plan has been shown to reduce “harmful” LDL cholesterol and raise “good” HDL cholesterol. It has also been linked to more stable blood glucose levels, which may protect against diabetes. Plus, research has found it may promote weight loss and help reduce stubborn belly fat (aka visceral fat).

The Mediterranean diet is surprisingly flexible. It’s rich in vegetables, fruits, whole grains, legumes, nuts, seeds and olive oil. It also contains small amounts of fish, eggs and dairy, with a little poultry. At the same time, it limits ultra-processed foods, red meat, added sugars and sodium. Despite its name, you can customize it to fit with cultural food preferences and traditions. So, there are lots of ways to make it work for you.

4. Work in Aerobic Exercise

All exercise is good for your heart. But if you want to lower triglycerides, think moderate to vigorous aerobic exercise. This type of exercise uses up triglycerides for fuel, naturally removing them from your bloodstream. 

Pairing aerobic exercise with a nutritious, balanced eating pattern can have an additional benefit, and that’s helping you reach a healthy body weight. “Aerobic exercise and weight loss have also been shown to reduce liver triglyceride content and improve insulin sensitivity, which further helps lower circulating triglyceride levels,” says Tran. The combo is so powerful that losing 5% to 10% of your body weight in combination with exercise can reduce triglycerides by 20%. 

The key is regular, consistent exercise. Aim for 150 minutes per week of moderate-intensity activity, like brisk walking, leisurely biking, gardening or dancing. Alternatively, you can do 75 minutes per week of vigorous aerobic exercise, such as running, swimming, jumping rope or fast cycling.

5. Treat Underlying Health Issues

Various health conditions can increase your risk for high triglycerides. “In addition to weight loss, healthy eating and regular exercise, it’s crucial to identify and address secondary causes, such as uncontrolled diabetes, hypothyroidism, certain medications and excessive alcohol use,” says Tran. Managing these can lead to significant improvements in your triglycerides, she says. For instance, if you’re living with diabetes or metabolic syndrome, better blood sugar management may lower your triglycerides while also improving blood glucose levels. 

6. Take Medication, If Needed

If your fasting triglyceride levels are consistently at or above 500 mg/dL, your health care provider will likely consider medication alongside lifestyle changes, says Tran. For levels above 1,000 mg/dL, medication may be even more strongly recommended. However, before your health care provider writes a prescription, they will typically want to determine if an underlying medical condition is contributing to your elevated numbers, such as uncontrolled diabetes or kidney disease, says Tran. If medications are indicated, they may include statins, fibrates or prescription omega-3 fatty acids.

It can be encouraging to know that you may not always require medication. Katz points out that lifestyle changes have a profound impact on your need for triglyceride-lowering medication. “Sometimes medications are needed for life, sometimes people are able to come off of the medications [by] adjusting their diet, alcohol consumption and activity levels,” he says. 

Our Expert Take

Finding out you have high triglycerides may come as a surprise. However, high triglycerides are extremely common. Because these blood fats can raise the risk for heart disease and stroke, it’s important to do what you can to reduce your numbers. Cardiologists say lifestyle changes, such as limiting sugar, following a Mediterranean diet, avoiding alcohol, getting regular aerobic exercise and taking any prescribed medications, can all help lower triglyceride levels. Treating underlying health issues that can contribute to elevated triglycerides—like type 2 diabetes—is also essential.

That said,  the goal isn’t to reduce your triglyceride levels for your next blood test. It’s making lifestyle changes that you can follow every day. That’s why extreme diet and exercise programs that feel unsustainable to you are best avoided, says Katz. “Even if they lower the levels temporarily, they are tough to stick with long-term,” he says. Instead, the trick is to find those small, sustainable changes that work for you over the long haul.