High Triglycerides: What They Mean for Your Heart and How to Lower Them
If a recent blood test showed high triglycerides, you’re not alone. Two experts explain what causes elevated levels and share tips to lower them.
When you have blood work done at an annual physical or cardiologist appointment, there is one result that deserves special attention: triglycerides.
Triglycerides are a type of fat in your blood that your body uses for energy. After you eat, your body converts excess calories into triglycerides, which are either used right away or stored in fat cells for later. The liver also makes triglycerides, so they’re an important part of how your body fuels everyday activities.
“Triglycerides mostly come from the foods we eat, especially those high in sugar and fat,” says Gabrielle Gambino, a senior clinical dietitian who specializes in heart failure at NewYork-Presbyterian/Weill Cornell Medical Center. “When we eat a little too much, the triglycerides start to tick up in the blood. The more triglycerides are in our blood, the more inflammation we start to see in our body.”
That inflammation can affect your health over time, causing harm to your arteries, liver, and pancreas, and raising your risk for serious health issues like pancreatitis, blood clots, stroke, and heart disease.
So while triglycerides are essential for energy, keeping them in check is key.
“Fortunately, triglycerides are often very sensitive to lifestyle measures, such as reducing added sugars, alcohol, and weight loss if needed, and increasing aerobic activity,” says Dr. Jessica M. Peña, a cardiologist at NewYork-Presbyterian/Weill Cornell Medical Center. “For people with a rare condition that causes severely elevated triglycerides, we also now have two therapies recently approved by the FDA.”
Health Matters spoke to Dr. Peña and Gabrielle about triglycerides and how to lower your levels.
Why did my doctor say my triglycerides are high?
Dr. Peña: Your doctor may tell you that your triglycerides are high if the number is over 150 milligrams per deciliter (mg/dL) when you’ve been fasting, or over 175 mg/dL if you haven’t fasted. If the level is higher than normal, your doctor will often repeat the test after you’ve fasted for 8 to 12 hours to confirm the results. Mild to moderate increases in triglycerides (between 150 and 500 mg/dL) are quite common.
What causes high triglycerides?
Dr. Peña: The main causes of high triglycerides include:
- Dietary factors, such as a high fat diet, refined carbohydrates, and excessive alcohol
- Certain medications
- Genetic predisposition or conditions
- Chronic diseases, such as diabetes, obesity, and kidney disease
- Pregnancy
What to Eat to Lower Triglycerides
- Limit added sugar: If a food label says, “added sugar,” that’s usually not good for you. “It’s just extra sugar your body doesn’t need,” says Gabrielle. “Instead, look for foods that haven’t been overly processed.”
Research shows that fructose (a sugar naturally found in fruits) can raise triglyceride levels, and it may surprise some people to learn that fruit juice can increase levels due to its high sugar content. “It’s basically a straight shot of sugar into the body,” says Gabrielle. “So I tell patients to try to avoid sugary drinks.” On the other hand, whole fruit helps lower triglycerides because it contains fiber. - Add fiber: Fiber helps clear out the triglycerides in our body like a garbage disposal. “It reduces the amount of fat you absorb, keeps sugar levels from getting too high, and clears the arteries,” says Gabrielle. To add fiber to your diet, try foods like whole grains, beans, broccoli, cauliflower, seeds, nuts, leafy greens and whole fruits. Also, look for starchy foods low in fiber and replace them (for example, whole grain rice instead of mashed potatoes).
“The daily fiber recommendation is 25 to 30 grams of fiber a day, which can feel like a lot, so I usually tell patients to start with about a fistful of whole grains at lunch or dinner,” says Gabrielle. - Replace saturated fats with omega-3 fats: Cutting back on foods high in saturated fat — like dairy, red meat and chicken — and replacing them with plant-based, omega-3 fats can make a big difference. Omega-3s help drive down triglyceride levels, and studies show they can even help our genes process triglycerides in a different way, so more fat is used for energy which keeps the arteries clearer. They’re also not as inflammatory as saturated fats. “Fish is a really good source of omega 3s, especially fatty fish; I usually tell patients to have two servings a week,” says Gabrielle. “Other options are kale, black beans, flaxseed oil, and brussels sprouts.”
Do I have to stop drinking alcohol if I have high triglycerides?
Dr. Peña: If you have a mild to moderate elevation of triglycerides, it’s best to limit alcohol — so less than one drink per day for women and two drinks per day for men. If your triglyceride levels are severely elevated (over 1,000 mg/dL), it’s important to abstain from alcohol, since it can increase your health risks.
If I have high triglycerides, can I still eat eggs?
Gabrielle: The old advice to avoid eggs if you have high triglycerides is outdated. Studies now show that genetics are a factor with cholesterol-laden foods, so a lot of patients aren’t as sensitive as they think to eggs. Don’t be afraid to eat an egg every so often, if you like them.
Will I need medication to lower my triglycerides?
Dr. Peña: When triglycerides are over 1000 mg/dL, the risk of pancreatitis goes up as well. At that point, treatment usually includes a very low‑fat diet, abstinence from alcohol, and medication to lower triglyceride levels and prevent pancreatitis.
For people with milder but persistent elevations in triglycerides, doctors may recommend medications to reduce the risk of cardiovascular disease, such as statins.
How to Stick to a Low-Triglyceride Diet
- Set personal goals: Choose just one or two diet goals each month, instead of trying to switch your diet all at once. “We are human and have our favorite things, and lifestyle changes can be really unsettling,” says Gabrielle. “Try not to be hard on yourself and slowly work towards a new type of eating pattern.”
- Use trackers, but only if they help: “Some people are numbers-driven, and they like tracking their food or fiber intake with an app, smart watch or fitness wearable,” says Gabrielle. “But patients can get hooked on the numbers and become stressed.” Instead of trackers, another option is to simply track your food intake by looking at your plate. For example, look at the serving size of whole grains at lunch or dinner for one month, and the next month, double it and see how you feel.
- Cook healthy recipes: Some simple swaps and changes in how you prepare meals will benefit you in the long run. For example, you can aim to make smaller portions or use the oven or air fryer instead of frying foods in oil. Some easy recipes include grain-based salads that have nuts, seeds, and fruit; turkey burgers instead of high-saturated fat burgers; and salmon cooked in the oven.
How quickly do you see an improvement in triglyceride levels?
Dr. Peña: Depending on the cause of the triglyceride elevations, we can see very fast reductions, even in a matter of days and weeks.
Gabrielle: It’s different for everybody, but I would start following diet guidelines and stick with them for at least six months and see how you’re feeling. I’ve seen some really good improvements.