Elevated Triglycerides have been linked to heart disease, heart attacks, strokes, and diabetes. Elevated Triglycerides are also associated with obesity and are often elevated in those who are obese. People with diabetes are at an increased risk, since high levels of Triglycerides are a part of the pathophysiology of diabetes. In fact, the two most important risk factors for heart disease are Triglycerides and high Cholesterol.
The triglycerides are a blood fat that acts as a storage site for fat. Your triglycerides should be in the low to moderate range. High triglycerides are associated with increased risk of heart disease and stroke as well as liver and pancreatic problems.
2. Limit sugar, refined carbohydrates and excess alcohol
Should I follow a keto diet to lower my triglycerides? Not necessary. Cutting down on sugar, refined carbohydrates and alcohol may be enough to lower your levels.
As mentioned earlier, any calorie surplus can lead to an increase in triglycerides. However, the most likely sources of extra calories are excess sugar, refined carbohydrates and alcohol.
One reason for the rise in triglyceride levels could be that carbohydrates and sugar are the two most consumed foods. However, another reason may be that fructose (a component of sugar) and alcohol are more likely to cause liver fattening, which can increase triglyceride levels.
One study reports that just replacing sugary drinks with water lowers triglyceride levels.
Another study found that reducing alcohol consumption lowers blood triglyceride levels.
Other factors, such as. B. Incipient obesity and insulin resistance may increase the likelihood that carbohydrate consumption will increase triglyceride levels.
If you are overweight or insulin resistant, reducing carbohydrates should be necessary. However, there is evidence that most people with high triglycerides – even those of normal weight – benefit from reducing their intake of sugar, refined carbohydrates and alcohol.
3. Some people respond better to a low fat diet
For people with very high triglyceride levels (defined as greater than 1000 mg/dL or 11.2 mmol/L), there is reason to believe that in some situations a low-fat diet is as good or better than a low-carbohydrate diet.
One study found that people with triglycerides below 400 mg/dL (4.5 mmol/L) responded best to a low-carbohydrate diet, while those with triglycerides above 400 mg/dL (4.5 mmol/L) responded best to a low-fat diet.
However, in some cases, a decrease in triglyceride levels has been observed with a diet low in carbohydrates and high in fat.
It is important to know the cause of the elevated triglycerides, as this may affect the proposed dietary treatment. If a person has a genetic cause, such as. B. a family history of chylomicronemia or lipoprotein lipase deficiency, a low-fat diet may be more effective.
Other than these extreme examples, there is no evidence that a low-fat diet is better than a low-carbohydrate diet for lowering high triglyceride levels.
4. Eat to lose weight
Losing just 3 pounds can result in an average 15 mg/dL reduction in triglycerides.
In the LookAHEAD study, a randomized trial of a low-fat, low-calorie diet, the average reduction in triglycerides was only 12 mg/dL (0.13 mmol/L).
However, the reduction was greater in participants who lost more weight. For example, people who lost more than 15% of their body weight in the LookAHEAD study had an average triglyceride reduction of 70 mg/dL (0.8 mmol/L). Conversely, 25% of participants who did not lose weight did not see their triglyceride levels decrease.
5. Fiber
Fiber can also lower triglyceride levels. But the effect of fiber on your health may depend more on the carbohydrate content of your diet.
A randomized study found that in participants on a high-carbohydrate diet, a reduction in fiber intake increased triglyceride levels by 45%. The addition of dietary fiber lowered triglyceride levels to initial levels.
A smaller observational study found a clear association between higher fiber intake and lower triglyceride levels. But in a study like this, it’s hard to control the overall quality of the diet. High-fiber, high-carb diets are probably better than low-fiber, high-carb diets in many ways.
An intervention study with fiber supplements showed no improvement in triglyceride levels in participants. This suggests that the effects of dietary fiber are related to the overall quality of the diet rather than the presence of the fiber itself.
The main lesson is to avoid refined carbohydrates and sugar. If you are on a high carbohydrate diet, make sure it is also high in fiber.
6. Eat more fish
Eating fish and taking omega-3 fatty acid supplements can significantly lower triglyceride levels.
In a randomized study, people who ate 270 grams of salmon twice a week reduced their triglyceride levels by an average of 28 mg/dL (0.32 mmol/L).
This triglyceride-lowering effect comes on top of the many other potential health benefits of fish consumption.
For information on omega-3 supplements and their effect on triglyceride levels, see the Supplements section below.
4. Exercise to lower triglycerides
Summary
While any physical activity can have health benefits, high-intensity exercise and strenuous resistance training are best for lowering triglycerides.
While diet probably has the biggest impact on triglyceride levels, exercise can also lower them. But not all types of training produce equally promising results.
To lower triglycerides, it is best to train at a higher intensity.
There are several ways to define high intensity training. Usually more than 85% of the maximum heart rate is achieved. However, a more useful definition is the level of physical activity at which you can no longer carry on a conversation, or the level that you can only sustain for a few minutes.
Resistance training with moderate weights and a high number of repetitions can also help lower triglyceride levels. If you lift lighter weights, the effect is less.
Does this mean that low intensity training has no health benefits? No, of course not. As we mentioned in our comprehensive guide to exercise, any form of exercise has many health benefits.
Even if you don’t get to the point where exercise affects your triglyceride levels, don’t let that discourage you. Continue to maintain your muscles, strengthen your bones and build your fitness step by step.
5. Use of triglyceride preparations
The data show that diet and exercise are practical approaches to lowering triglyceride levels. For some people, however, lifestyle changes are not enough. In that case, it may be helpful to talk to your doctor about dietary supplements.
Disclaimer:. Any medicine or dietary supplement can have unintended side effects or interactions with other medicines. The following information is provided for informational purposes only and does not constitute medical advice. You should always consult your personal physician before starting, stopping, or changing the dosage of any supplement or medication.
Here is a list of possible options.
- Niacin: 2,000 to 3,000 mg per day
- Berberine: 500 mg twice a day
- Fish oil : Eicosapentaenoic acid (EPA) 2 to 4 grams per day (docosahexaenoic acid, or DHA, doesn’t seem to have much effect).
- Curcumin: 80 to 100 mg per day
- Fenugreek: 10 grams per day
6. Takes medication to lower triglycerides
Summary
Many supplements and medications can lower triglyceride levels. Doses of 3 to 4 grams of fish oil (EPA only) may be the best choice for reducing cardiovascular events and the risk of death.
However, most medications and even supplements can have significant side effects. Always consult your doctor before starting any new supplements or medications.
In addition to supplements, some studies show that certain medications can lower triglyceride levels. The medication recommendations are designed to reduce the risk of pancreatitis and cardiovascular disease.
The evidence for the idea that lowering triglyceride levels with drugs can protect the heart is mixed. Many individual studies show no benefit, but a meta-analysis of several studies indicates a small benefit.
Ask your doctor if any of these medications are right for you:
Statins are the most commonly prescribed class of cholesterol-lowering drugs and have a low cholesterol-lowering effect, ranging from a 10% reduction at low doses to 30% at high doses.
Fibrates – Drugs such as gemfibrozil can lower triglyceride levels by 30-50%. These medicines should be used with caution when taken together with statins or warfarin, as interactions may occur. People with a history of gallstones are better off not taking fibrates.
Although fibrates lower triglycerides, it is not clear whether they reduce cardiac events or the risk of death.
Prescription Niacin – Niacin can reduce triglyceride levels by up to 30%. Niacin may cause liver disease and worsen insulin resistance or blood sugar control in type 2 diabetics. People with stomach ulcers are better off not taking niacin.
Although niacin lowers triglyceride levels, it is not known whether it lowers the risk of heart disease or death.
Omega-3 fatty acids – these are available over the counter (as supplements) and by prescription. The prescription version is generally higher dosed and contains pure EPA.
Studies on different doses of omega-3 show a 20-50% reduction in triglyceride levels.
Most studies show that a dose of 3 to 4 grams is the most effective treatment.
According to a large 2019 study, people who took 4 grams of EPA fish oil (in the form of ethylicosapent) saw their triglyceride levels drop by 21% over five years (from 216 mg/dL to 170 mg/dL).
More importantly, cardiovascular events decreased by 5% and mortality by 0.9%.
7. Risk of elevated triglycerides
Summary
High triglycerides increase the risk of coronary heart disease and pancreatitis.
High triglycerides can lead to two major health problems: an increased risk of heart disease and an increased risk of pancreatitis (acute and severe inflammation of the pancreas).
Increased risk of heart disease
Medical science consistently proves that people with high triglycerides are more prone to heart disease. This is not surprising, as high triglyceride levels are also correlated with other cardiac risk factors such as insulin resistance, metabolic syndrome and small, more atherogenic LDL particles.
Observational studies show that the risk of myocardial infarction is three times higher (1-3% over 10 years) in people with triglyceride levels above 265 mg/dL (3.0 mmol/L) compared to those with lower levels.
Another study reported an increased risk for statin-treated patients if their triglycerides were higher than 175 mg/dL (2 mmol/L).
Studies comparing the effects of high triglycerides on cardiovascular risk suggest that they may be as important as or more important than high LDL cholesterol.
One study has shown that gene mutations that lower triglycerides have the same benefit in terms of reducing heart disease risk as gene mutations that lower LDL.
Other studies have shown that high triglycerides and the ratio of triglycerides to HDL cholesterol (high-density lipoprotein) are associated with smaller LDL particles and progressive coronary heart disease, whereas high LDL cholesterol shows no significant correlation.
More recently, a review of the PREDIMED study found that triglycerides greater than 150 mg/dL (1.69 mmol/L) and residual cholesterol (triglyceride-rich particles such as VLDL and intermediate-density lipoprotein (IDL)) have a greater predictive value for heart disease risk than LDL.
However, the evidence for drug treatment of triglycerides does not show a sustained benefit. A meta-analysis of randomized trials (the highest level of evidence) showed that lowering triglycerides with medication can reduce the risk of heart disease. But not all studies agree.
In fact, many studies have shown no improvement in the risk of heart disease or death.
Can a lifestyle that helps lower triglycerides have a greater effect than drugs?
In theory, lifestyle interventions may have a greater effect because they address the underlying cause of elevated triglycerides that cannot be treated with drugs. However, no comparative tests have been carried out.
Increased risk of pancreatitis
Very high triglycerides are the third most common risk factor for pancreatitis, but only account for 4% of cases. Gallstones and alcoholism are much more common, about 70% of all cases.
People with triglyceride levels above 1,000 mg/dL (11.2 mmol/L) have a 5% chance of developing pancreatitis, while levels above 2,000 mg/dL (22.5 mmol/L) increase to 10-20%. In comparison, the risk of pancreatitis in the general population is only 0.5%.
8. Summary
High triglycerides are a serious medical problem associated with an increased risk of heart disease and pancreatitis. They are also common in obesity, insulin resistance and other metabolic disorders.
Fortunately, this can be remedied. You can actively help lower triglycerides by following a low-carb diet, avoiding sugar and excessive alcohol consumption, and exercising.
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Frequently Asked Questions
How do you lower triglycerides quickly?
There are many ways to lower triglycerides quickly. Some of the most common methods include: Losing weight Eating a low-fat diet Exercising regularly Taking a statin drug There are many ways to lower triglycerides quickly. Some of the most common methods include: Losing weight Eating a low-fat diet Exercising regularly Taking a statin drug
What are the best foods to eat to lower triglycerides?
The best foods to eat to lower triglycerides are those that are high in fiber, such as vegetables, fruits, and whole grains.
What is the main cause of high triglycerides?
The main cause of high triglycerides is obesity.
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