You’ve heard the advice—but is it right?
Reviewed by Dietitian Casey Wing, RD, CD
Key Points
- High triglycerides are a key heart health marker and may predict risk better than LDL cholesterol.
- Diet and lifestyle changes, like cutting refined carbs and exercising, can lower triglycerides effectively.
- A Mediterranean-style diet rich in whole foods and healthy fats supports lower triglyceride levels.
About 25% to 50% of people worldwide have high triglycerides, a type of fat that circulates in your blood. While this condition may be common, high triglycerides still shouldn’t go unchecked for too long. In addition to being an early warning sign and risk factor for heart disease, high triglycerides are also linked with insulin resistance, metabolic syndrome, type 2 diabetes, non-alcoholic fatty liver disease (NAFLD) and even pancreatitis.
However, there’s a lot of “fake news” spreading about high triglycerides that could negatively impact your physical health, mental health and even your social life. We interviewed a cardiologist and a heart-health dietitian who busted five common myths about high triglycerides to help you make more informed choices.
Myth #1: I Should Go Low-Fat or Fat-Free
For decades, researchers in the health industry blamed high-fat foods as the primary culprit and enemy of high cholesterol and triglycerides—but now we know (and experts agree) there’s more to the story. “While high-fat diets are shown to raise triglyceride levels, they also rise when you consume excess amounts of calories, refined carbohydrates and added sugar, or consume alcohol or smoke,” explains Kiran Campbell, RDNwho specializes in heart health.
“High triglycerides are driven primarily by excess carbohydrates and processed sugars,” notes cardiologist Philip Ovadia, M.D. “Low-fat diets typically replace fat with carbohydrates, which can actually raise triglycerides.”
Myth #2: A Vegetarian or Vegan Diet Will Automatically Lower My Triglycerides
“There is a big difference between healthy plant-based eating patterns and ones that contain mostly ultra-processed, plant-based products marketed as ‘healthy,'” says Campbell. (An example of an unhealthy plant-based diet might look like eating vegan pastry for breakfast, a bowl of sugary vegan cereal with soy milk for lunch and a bowl of vegan mac and “cheese” for dinner.) Campbell points out that many recent studies have concluded that plant-based diets that don’t align with a balanced, whole-food approach were not effective at reducing triglyceride levels long term.
She suggests that dietary education regarding healthy versus unhealthy plant-based eating from registered dietitians can be a great way to provide clarification around this misconception.
Myth #3: LDL Cholesterol Matters More than Triglycerides
“Cholesterol and [low-density lipoprotein (LDL)] get almost all the attention in heart health conversations,” Campbell points out. “Triglycerides are mentioned almost as an afterthought, so people assume they’re less important.”
Contrary to this popular narrative, Ovadia recommends paying closer attention to triglycerides and high-density lipoprotein (HDL) cholesterol (the “good” cholesterol), noting that these two biomarkers can be better predictors of metabolic health and cardiovascular risk than LDL cholesterol.
Myth #4: You Can Tell If You Have High Triglycerides by Your Symptoms
High triglycerides are asymptomatic, meaning you won’t feel any different symptom-wise. “There are no reliable symptoms until the damage is already done,” shares Ovadia.
Ovadia recommends getting a full lipid panel, a type of blood test that measures total cholesterol, HDL, LDL and triglycerides (and can be ordered by your doctor), at least once per year.
Myth #5: Having High Triglycerides is Genetic, So There’s Nothing I Can Do About It
Many people are under the false impression that if high triglycerides run in their family, diet doesn’t matter. However, this misconception couldn’t be further from the truth. Both Campbell and Ovadia agree that when it comes to high triglycerides, genetics is actually a small part of the equation.
“Many people with high triglycerides engage in unhealthy lifestyle behaviors, including poor dietary habits (like excess calories and sugary foods), an inactive or sedentary lifestyle or regular alcohol intake,” Campbell highlights, pointing out that the right lifestyle modifications are foundational and effective for managing and reducing high triglyceride levels.
“While genetics can influence baseline triglyceride levels, lifestyle—particularly diet—has a profound effect that can override genetic predisposition for most people,” Ovadia says, noting that in his practice, he often sees patients with extremely high triglycerides normalize their levels through dietary changes alone.
Strategies That Help Lower Triglycerides
- Cut back on refined carbs. Ovadia and Campbell recommend limiting and reducing food sources of refined carbohydrates such as soda, candy, cookies, ice cream, white bread and ultra-processed snack foods like chips.
- Lean into whole foods. When it comes to dietary modification, subtraction without addition is difficult to stick to. Instead, replace ultra-processed foods with whole, nourishing alternatives. “Focus on real whole foods — meat, eggs, fish, non-starchy vegetables,” says Ovadia. “Even today, people still need reminders that eggs should not be demonized for increasing cholesterol [and triglycerides] circulating in the blood,” Campbell adds. Try swapping refined carbs in your diet with more fresh fruit, veggies, whole grains, lean proteins and heart-healthy fats, with guidance from a registered dietitian as needed.
- Go Mediterranean. Research shows that a Mediterranean-style diet, which is high in whole foods like fresh fruits, veggies, lean proteins, whole grains and heart-healthy fats like olive oil, avocado, nuts and fatty fish, is effective for reducing high triglyceride levels naturally.
- Prioritize exercise. Kiran suggests incorporating regular moderate-intensity aerobic exercise into your routine, for a minimum of 150 minutes weekly—or about 30 minutes per day, 5 days a week.
- Test, don’t guess. “Request a full lipid panel from your doctor that includes triglycerides, HDL and ideally the triglyceride-to-HDL ratio — a far better predictor of metabolic and cardiovascular risk than LDL alone,” advises Ovadia, who notes that a ratio under 2.0 is ideal.
- Consider functional foods and omega-3 supplements. “Including certain foods and spices regularly, like cacao, cinnamon, nuts and marine-derived omega-3 fatty acids may also support lower triglyceride levels,” shares Campbell—although she emphasizes that more research is needed on this front.
Our Expert Take
High triglyceride levels are a red flag from a health standpoint and should not be left unchecked for too long. They are just as—if not more—important than your cholesterol levels when it comes to maintaining a healthy heart and overall well-being.
Getting an annual lipid panel is important for creating awareness, but the buck shouldn’t stop there. There’s a lot you can do to manage and reduce high triglyceride levels from a diet and lifestyle standpoint, even if you’re genetically at a disadvantage. The right dietary modifications, especially when paired with regular exercise and omega-3 fatty acid supplementation, can go a long way to help bring down high triglyceride levels over time.
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