How can you reduce triglycerides?

Lower your levels to the healthy range to reduce your risk of heart disease, Type 2 diabetes, and more.

WRITTEN BY

Stephanie Eckelkamp

REVIEWED BY

Dr. Robert Lustig

UPDATED: 19 Sep 2024

PUBLISHED: 19 Sep 2024

🕗 9 MIN READ

Like cholesterol, triglycerides aren’t inherently bad. When our bodies need energy, fat cells can break down stored triglycerides and release free fatty acids and glycerol that can be burned as fuel by energy-demanding tissues like skeletal muscle. But when circulating triglyceride levels become dangerously elevated (150 mg/dL and above is considered high), they become a risk factor for heart attack, stroke, and heart disease. 

There are two main reasons for this: The breakdown of triglyceride-rich particles leaves behind remnant particles rich in LDL cholesterol that are easily oxidized and can promote arterial plaque buildup. Epidemiological research suggests that triglycerides are independently associated with increased inflammation, further promoting atherosclerosis risk. High triglycerides have also been associated with Type 2 diabetes, insulin resistance, and fatty liver disease, all components of metabolic syndrome.

What are triglycerides?

Triglycerides are one of the primary energy carriers in your body and help you use fat for energy. At a molecular level, triglycerides are a type of lipid (which is a kind of fat) consisting of three fatty acids attached to a glycerol molecule. 

We get some triglycerides from food that contain dietary fat. After these fats are digested into fatty acids, they can be resynthesized into triglycerides in the intestine and travel through the bloodstream (along with cholesterol) as a component of lipoproteins called chylomicrons for several hours following a meal. While traveling through the bloodstream, these chylomicrons interact with an enzyme called lipoprotein lipase that allows them to deposit their triglyceride load into various cells, such as muscle cells to be burned for energy and fat cells to be stored (in fact, the bulk of our adipose or fat tissue is triglycerides). Once they’re relatively depleted of triglycerides, these chylomicron remnants make their way to the liver, where their remaining lipid components are recycled and repackaged into very low-density lipoprotein, or VLDL particles.

Our liver can also make triglycerides from carbohydrates and send them into the bloodstream (as a component of very low-density lipoprotein, or VLDL, particles). Excess glucose in the bloodstream gets converted into fatty acids and subsequently triglycerides. Over time, this can contribute to elevated circulating triglycerides, increased fat storage, and increased risk for heart disease. 

If your blood work indicates high triglycerides, lifestyle changes may help reduce your numbers to a healthy level—even by as much as 50 percent or more. Try the evidence-based strategies below to bring your triglycerides back down.

1. Don’t overdo it on carbs

Excess carbs can drive up triglycerides. Indeed, carbs, and especially sugar, are more closely correlated with high triglycerides than other macronutrients. High-carb diets—characterized as having more than 55 percent of their daily calories from carbs—have been shown to increase the liver’s production of triglycerides and VLDL particles (which transport triglycerides in blood) and reduce the clearance of VLDL from the bloodstream. And high sugar diets increase triglyceride levels rapidly. 

There are a few reasons for this: 

1. Your body breaks down carb-containing foods into glucose. This glucose goes to the liver, where it’s released into the bloodstream or stored as glycogen. Once the liver’s glycogen stores are full, however, the excess glucose gets converted into fatty acids and then triglycerides. Because the liver has limited storage capacity for triglycerides, these triglycerides are packaged into VLDL particles and released into the bloodstream, raising levels. 
2. Some research suggests that refined sugars enhance dietary fat absorption, increasing triglyceride secretion into the bloodstream. The sweet molecule fructose is more likely to be turned into fat in the liver and then packaged as triglyceride.
3. Overconsumption of carbs—particularly refined carbs and sugars—contributes to insulin resistance, which is associated with elevated triglycerides. One potential mechanism: Insulin resistance decreases activity of the enzyme lipoprotein lipase, which normally allows cells to offload and transport triglycerides from the circulation. 

Fortunately, plenty of research shows that reducing total carbohydrate intake can quickly lower triglyceride levels. In a 2017 study, people with high triglycerides who replaced the refined carbohydrates and sugars in their diets with a combination of unsaturated fats and protein (of equal caloric value) lowered triglycerides by 18.5 percent in three weeks. Insulin sensitivity also improved. 

And you may not have to go super low-carb to benefit. In a 2020 meta-analysis of 12 randomized trials, low-carb diets—containing less than 40 percent of calories from carbs—led to significant reductions in blood triglycerides. 

Various factors (including age, sex, activity level, and body composition goals) influence how many carbs you should eat. In general, for optimizing metabolic health, 40 percent or less of daily calories from carbohydrates is beneficial for most, and a tighter range of 30 percent or less may be even better, according to registered dietitian Stephanie Greunke, MS, RD. That works out to less than 200 grams and 150 grams, respectively, on a 2,000-calorie-per-day diet. 

2. Eat more fiber

Scale back on refined carbs and sugars (think: sodas, juices, sweeteners, flour-based products, and other highly processed foods), but don’t skimp on unrefined, fiber-rich carbs. While a high-carb intake in the absence of fiber raises triglycerides, research suggests that when fiber increases proportionally with overall carbohydrate intake, triglyceride levels remain relatively stable. And when fiber consumption increases without increasing overall carbohydrate intake, triglyceride levels actually fall. 

Some experts, including cardiologist Steven Nissen, MD, have even said that high triglycerides may be reflective of a fiber-deficient diet for some people. A 2019 study supports this idea. The more fiber that people with overweight or obesity reported eating, the lower their triglyceride levels. 

There are at least two reasons that fiber may help lower triglycerides. First, soluble fiber forms a thick gel in the GI tract that allows it to bind to fat and decrease its absorption, which, in turn, may reduce triglyceride levels. Second, fiber slows glucose absorption into the bloodstream and is associated with decreased insulin resistance—a good thing, as insulin resistance is independently correlated with high triglycerides.

Good sources of fiber include:  

• Nonstarchy vegetables: broccoli, Brussels sprouts, carrots, cauliflower
• Seeds and nuts: chia, flax, almonds, pistachios
• Legumes: beans, lentils, chickpeas, peas
• Fruits: berries, oranges, pears, avocados
• Whole grains: quinoa, oats

For optimal metabolic health, most Levels advisors recommend aiming for 50 grams of fiber per day. 

3. Up your omega-3s

If you lower your carb intake, chances are you’ll increase your fat intake. And to optimize triglycerides, the types of fats you focus on could make a difference. Several sources recommend swapping out saturated fats in favor of monounsaturated fats, omega-3 polyunsaturated fats, and omega-6 polyunsaturated fats. 

Research appears particularly strong for omega-3s. Several studies have shown that consuming omega-3-rich fatty fish such as salmon, mackerel, and sardines may improve your overall blood lipid profile by reducing triglycerides and increasing beneficial HDL cholesterol. And daily consumption of walnuts, a plant-based source of omega-3s, has also been associated with significant reductions in triglycerides and improvements in other blood lipids in several studies.

Omega-3s may lower triglycerides via several mechanisms, such as increased fatty acid oxidation, decreased liver production of fatty acids (and subsequent triglyceride synthesis), and reduced activity of triglyceride-synthesizing enzymes. Some preliminary research also suggests that when you get adequate omega-3s in your diet, saturated fats are less likely to raise triglyceride and cholesterol levels—though more research is needed. 

Aim for at least two 3-ounce servings of fatty fish per week, and add other sources of omega 3s (such as walnuts, ground flax seeds, chia seeds, and hemp seeds) to your meal and snack rotation. 

4. Exercise

Regular exercise has been shown to lower triglyceride levels and increase levels of HDL cholesterol. In fact, a 2014 research review suggests a dose-response relationship between physical activity and improvements in triglycerides—meaning the amount of improvement is proportional to the amount of exercise. This makes sense, considering the body burns the fatty acids that comprise triglycerides as a source of fuel during activity. The increased energy expenditure during and after exercise can also help offset periods of higher caloric intake that might otherwise contribute to increased triglyceride production by the liver. (Remember, the body makes triglycerides when we consume more calories than we burn.)

The majority of research highlights the benefits of aerobic exercise, but both aerobic and resistance exercise have been shown to help lower triglycerides and improve blood lipids in general. Consider the time and intensity, though. Greater improvements are associated with: 

• Longer-duration or higher-intensity aerobic exercise
• Lower-weight, higher-repetition resistance training

A 2023 review made similar findings and found that combining exercise and a healthy diet offered the greatest reduction in triglycerides.

5. Cut back on alcohol

Heavy drinking is associated with elevations in post-meal and fasting triglyceride levels, according to a 2011 research review. (For women, heavy drinking is described as more than seven drinks per week or four or more drinks per day. For men, it’s more than 14 drinks per week or five or more drinks per day, per the CDC.) Other studies have found a dose-response relationship between alcohol and triglycerides—the more you drink, the more they rise. 

Several mechanisms contribute to high triglycerides when you drink excessively. When it comes to triglycerides, alcohol does everything to the liver that fructose does. Alcohol consumption:

• Increases the liver’s synthesis of triglycerides and VLDL particles
• Decreases activity of the enzyme lipoprotein lipase, which usually allows your cells to take up triglycerides from the bloodstream
• Increases lipolysis in your fat tissue (i.e., the release of fatty acids from stored triglycerides), which leads to an influx of fatty acids to the liver, where they can be resynthesized into triglycerides

There’s likely no “better” type of alcohol when it comes to triglycerides, as these processes likely take place regardless of the type of alcohol consumed. 

You may not have to completely cut out alcohol, though. Per the review’s authors, having one to two drinks per day was not associated with a notable increase in triglyceride levels. That said, moderate drinking has been associated with other adverse health outcomes, such as digestive issues and increased cancer risk, so use your best judgment.

6. Lose weight, if you need to

It’s common for people with overweight or obesity to have high triglycerides, usually because obesity is associated with insulin resistance. These people have a higher baseline level of lipolysis in their body fat—meaning, more fatty acids are released from stored fat tissue and pumped out into the bloodstream, eventually making their way to the liver, where they contribute to the increased formation of triglycerides and VLDL. These processes also impair the ability of circulating VLDL to deposit their triglyceride load into cells, meaning there is a decreased ability to remove triglycerides from the blood.

Losing weight can help. In a 2016 study, women who lowered their body weight by 5–10 percent saw a 16 mg/dL reduction in triglyceride levels, while women who lost more than 10 percent experienced a 31 mg/dL reduction. The results were more dramatic for men: Weight loss of 5–10 percent lowered triglycerides by 59 mg/dL, while losing more than 10 percent reduced triglycerides by nearly 80 mg/dL. (Even participants who lowered triglycerides by less than 5% saw measurable weight loss.) To put this in perspective, for someone who weighs 200 pounds, a 5-percent weight loss is 10 pounds, and a 10-percent weight loss is 20 pounds. 

Don’t seek out a quick weight-loss fix, though. The goal is to find a combination of strategies that fit your lifestyle so you can gradually lose weight without yo-yo-ing back up to your starting weight. Regaining weight is associated with increased triglycerides and inflammation. In addition to the habits mentioned above, some studies suggest that time-restricted eating (confining all your daily eating to a set window, say 10 hours) may help you lose weight and lower triglycerides.

7. Manage stress

Psychological stress has been associated with elevated triglyceride levels in several studies. The authors of a 2021 study outline two potential mechanisms: 

• Stressful life events could potentially lead you to engage in behaviors known to raise triglycerides, such as eating more highly refined foods, drinking more alcohol, not exercising, and poor sleep.
• Psychological stress also stimulates activity of the hypothalamic-pituitary-adrenal (HPA) axis—a system that regulates the body’s stress response—which increases cortisol levels and, in turn, raises triglyceride levels.

To help lower cortisol levels, consider stress-reduction techniques such as:

• Regular physical activity
• Getting adequate sleep (seven to eight hours per night)
• Deep breathing
• Yoga
• Meditation
• Hugging a loved one
• Spending time in nature
• Engaging in any activity that brings you joy or makes you laugh may help lower cortisol levels. 

8. Prioritize sleep

Sleeping less than six hours per night has been linked to high triglycerides. Like psychological stress, insomnia can act as a stressor on the body, increasing cortisol levels, which can subsequently increase triglycerides. However, sleeping too much can also cause triglycerides to creep up. 

For optimal overall metabolic health, the sweet spot appears to be around seven to eight hours. 

9. Talk to your healthcare provider about medication

For some people, lifestyle changes aren’t enough to bring triglycerides below 150 mg/dL. If your levels are between 150 and 499 mg/dL, you should be checked for an underlying health condition that could be unknowingly driving up your triglyceride levels, such as hypothyroidism, Type 2 diabetes, and liver or kidney disease. Triglyceride levels above 500 mg/dL can predispose you to acute pancreatitis, which is dangerous and can even be life-threatening. Addressing these issues, in conjunction with making lifestyle changes, may get you into a safe range. If not, medication may help and can range from prescription omega-3 fatty acids to fibrate medications.

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