How to Lower Triglycerides
Lower triglycerides naturally with less added sugar, regular exercise, fatty fish, modest weight loss, and less alcohol, plus the healthy ranges and the level at which to see your doctor first.
You will end up with five changes to start this week, the healthy ranges to read your result against, and the number at which to see your doctor before going it alone.
High blood triglycerides are very common, and the National Heart, Lung, and Blood Institute says up to one in four adults are affected. If you just got bloodwork back and your doctor circled a number you did not expect, you are not alone.
Triglycerides are fats in your blood. They come from the fats you eat and from extra calories your body does not need right away, which your body stores as triglycerides in fat cells for later. That is a perfectly normal process. The problem starts when levels stay high because you are consistently taking in more fuel than you burn, especially from sugar and refined carbs.
Lifestyle changes carry more weight here than they do for cholesterol. Announcing the American Heart Association's 2011 statement on triglycerides, its chair said that lifestyle measures matter for cholesterol but may not be the solution, while high triglycerides are often quite responsive to them.
Cut added sugars and refined carbs
When you eat more sugar and refined carbohydrates than your body needs for immediate energy, the liver converts the excess into triglycerides through a process called de novo lipogenesis. Fructose is especially problematic because the liver converts it into fat more readily than glucose. Start by eliminating sugary drinks like soda, sweetened juice, and energy drinks. Then cut back on white bread, white rice, pastries, and anything with high-fructose corn syrup. Replace them with whole grains, brown rice, and fiber-rich vegetables. The American Heart Association puts the ceiling at 6 teaspoons of added sugar a day for women, which is 25 grams, and 9 teaspoons for men, which is 36 grams. The same page explains why the drinks come first on this list. Sugar-sweetened beverages are about 24% of all the added sugar in the American diet, more than any other single source. For fruit, pick the lower-fructose ones the American Heart Association's 2011 triglyceride statement names, such as cantaloupe, grapefruit, strawberries, peaches, and bananas.
Good to know: Swap soda for water or unsweetened tea. If you keep some sugary drinks while you cut back, the 2011 triglyceride statement's ceiling is 36 ounces a week on a 2,000-calorie diet, which is three 12-ounce cans.
Exercise most days of the week
Aim for at least 150 minutes of moderate-intensity aerobic exercise per week. That breaks down to about 30 minutes of brisk walking, cycling, or swimming 5 days a week. The American Heart Association's 2011 triglyceride statement puts the drop from exercise at 20% to 30%. The drop is largest when your triglycerides start above 150 mg/dL, the activity is moderate to intense, and you also eat fewer calories. Add two full-body strength training sessions on top of that. Regular aerobic exercise trains your muscles to burn fat more efficiently as fuel. A single session also blunts the rise in triglycerides after your next meal. A 2013 review in Sports Medicine found this takes a session that burns roughly 500 to 600 calories, such as a long brisk walk, and that the effect lasts only about 2 days. That is why exercising most days matters more than any single workout. If you are not currently active, start with 20 minutes of brisk walking and build from there.
Good to know: By the CDC's rule of thumb, you are at moderate intensity when you can still talk but not sing. Walking at that pace counts toward the 150 minutes.
Eat more omega-3 fatty acids
Eat fatty fish like salmon, mackerel, sardines, or herring at least twice per week. That is the American Heart Association's recommendation of 2 servings of fish a week, particularly fatty fish, with a serving being 3 ounces cooked. Omega-3 fatty acids (specifically EPA and DHA) reduce the liver's production of VLDL particles, which are the main carriers of triglycerides in your blood. They also raise the activity of lipoprotein lipase, the enzyme that clears triglycerides from those particles, as the American Heart Association's 2011 statement describes. The NHLBI says concentrated omega-3 fatty acids are available by prescription for triglyceride levels of 150 mg/dL or above, and that these are made differently from omega-3 dietary supplements, which are not FDA-approved to treat high triglycerides. So do not treat fish oil from the supplement aisle as a stand-in for the prescription product. If you do not eat fish, plant sources like walnuts, flaxseeds, and chia seeds provide ALA (a precursor to EPA and DHA), though the conversion rate in the body is low. Talk to your doctor before starting any supplement.
Lose a small amount of weight
If you are carrying extra weight, you do not need to hit your high school number. Aim for a 5% to 10% reduction in body weight. For a 200-pound person, that is just 10 to 20 pounds. Excess body fat, especially visceral fat around the abdomen, drives insulin resistance. When your cells resist insulin, the liver ramps up its production of VLDL triglyceride particles. Losing weight improves insulin sensitivity and reduces that output. The American Heart Association's 2011 scientific statement on triglycerides puts the drop from a 5% to 10% weight loss at about 20%. It lists losing excess weight among the lifestyle changes that together can lower triglycerides by 20% to 50%.
Good to know: If your triglycerides stay high after you lose weight, ask your doctor to look for another cause. The NHLBI lists diabetes, kidney disease, liver disease, and thyroid disease among the conditions that raise triglycerides, along with some medicines, including some breast cancer and HIV treatments.
Limit or cut out alcohol
Keep alcohol to no more than one drink a day for women and two for men. Alcohol adds calories that your body readily turns into triglycerides, and the effect grows with the amount you drink. The American Heart Association's 2011 statement estimates that 1 ounce of pure alcohol a day goes with triglycerides 5% to 10% higher than in nondrinkers. It also reports an exaggerated rise when heavy drinking comes with a meal high in saturated fat. Above 500 mg/dL, stop drinking entirely. The NHLBI says your provider may recommend exactly that, and it warns that levels that high raise the risk of acute pancreatitis.
Start from your number. If it is 500 mg/dL or higher, talk to your doctor before making changes on your own, because that is the range where acute pancreatitis becomes a real risk and medication may be needed right away. If it is from 150 to 499, start today with the drinks in step 1 and the walking in step 2, work through the other steps, and ask your doctor when to recheck. The 2026 ACC/AHA Guideline on the Management of Dyslipidemia retires and replaces the 2018 guideline on the management of blood cholesterol, and it covers high cholesterol, high triglycerides, and elevated lipoprotein(a) together. So ask about your whole lipid panel at that visit, not only the triglyceride line. For the other numbers your doctor will look at, our guides on how to lower cholesterol and how to lower blood pressure take the same step-by-step approach.
Questions we get asked about this
Answers from experience, not a textbook.
Avoid or minimize sugary drinks (soda, sweetened juices, energy drinks), baked goods and pastries, candy, white bread, white pasta, white rice, fried foods, red and processed meats, and anything with high-fructose corn syrup. Limit alcohol, and stop drinking entirely if your triglycerides are above 500 mg/dL. These foods either contain added sugars that the liver converts directly into triglycerides or are calorie-dense and contribute to excess calorie intake. Replace them with whole grains, vegetables, legumes, fatty fish, nuts, and olive oil.
Part of the effect shows up by the next day. One long exercise session lowers the triglyceride rise after your next meal, as step 2 explains. For your fasting number, we could not find a published week-by-week timeline. The American Heart Association's 2011 statement gives a size instead. Its summary says intensive lifestyle change can lower triglycerides by 50% or more. That means losing excess weight, cutting added sugar, eating unsaturated fats in place of saturated and trans fats, eating more fatty fish, and getting regular aerobic exercise, all together. Ask your doctor when to recheck, since the interval depends on how high your starting number was.
No. Triglycerides and cholesterol are both lipids found in your blood, but they are different substances with different functions. Triglycerides store unused calories and provide energy between meals. Cholesterol is used to build cell membranes, produce hormones, and aid digestion. They are measured together in a standard lipid panel and both contribute to cardiovascular risk, but they require different management strategies. You can have high triglycerides with normal cholesterol or vice versa.
The NHLBI's categories for adults are healthy below 150 mg/dL, borderline high from 150 to 199, high from 200 to 499, and very high at 500 and above. For children and teens ages 10 to 19, healthy is below 90 mg/dL. A recent meal raises triglycerides, which is the rise the exercise in step 2 blunts, so you may need to fast for 9 to 12 hours before the blood draw, according to MedlinePlus, and your provider will tell you if you do. Prepare for a recheck the same way you prepared for the first test, so the two numbers compare fairly.
Not always. Lifestyle changes come first, and whether they are enough depends on how high your level is and what is driving it, so the decision is your doctor's. Above 500 mg/dL, see your doctor before relying on lifestyle changes alone, because of the pancreatitis risk, and the NHLBI notes that more than one medicine may be needed at very high levels. The medicines it lists are fibrates, prescription omega-3 fatty acids, statins, and ezetimibe paired with a healthy diet.
Heart Health Fundamentals
How to Lower Blood Pressure
How to Lower Cholesterol
How to Check Your Heart Rate
How to Lower Triglycerides
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