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High total cholesterol can increase your risk of heart disease, the leading cause of death for men and women in the United States. To protect your heart health, knowing your cholesterol numbers is important. But so is knowing your triglycerides, one of three numbers that make up your total cholesterol level.

What Are Triglycerides?

Triglycerides are the most common type of fat found in your body. These fats are responsible for storing excess energy from unused calories. Your body needs a certain amount of triglycerides to function properly.

What Are Normal Triglycerides?

When it comes to triglycerides, a lower number is better.

You want to keep your triglycerides in the normal range. As they are for cholesterol, milligrams per deciliter (mg/dL) are the units of measurement for triglycerides.

For heart health, you should aim for these cholesterol numbers, according to the Centers for Disease Control and Prevention.

• A low-density-lipoprotein (LDL, bad) cholesterol of less than 100 mg/dL.
• A high-density-lipoprotein (HDL, good) cholesterol of greater than or equal to 60 mg/dL.
• Triglycerides of less than 150 mg/dL.
• A total cholesterol of less than 200 mg/dL. Total cholesterol includes your LDL, HDL, and triglycerides.

What Are High Triglycerides?

Your triglycerides can also fall into one of these categories.

• Borderline high are triglycerides between 150 mg/dL and 199 mg/dL.
• High triglycerides, also known as hypertriglyceridemia, are between 200 mg/dL and 499 mg/dL.
• Very high or severe triglycerides are anything equal to or above 500 mg/dL. Having very high triglycerides is rare but dangerous. They can lead to pancreatitis and fatty liver disease.

Some 26% of adults age 20 and older in the United States have triglyceride levels equal to or above 150 mg/dL. That’s according to the most recent U.S. National Health and Nutrition Examination Survey.

What Does It Mean If You Have High Triglycerides?

When combined with high-LDL and low-HDL cholesterol, high triglycerides can result from plaque in your blood vessels. “Plaque buildup can lead to atherosclerosis, a narrowing or hardening of your arteries, a risk factor for heart disease and stroke,” said Ankit Shah, MD, cardiologist, UPMC Heart and Vascular Institute.

Your total cholesterol level, which includes your triglycerides, is part of a complete heart health screening. A cholesterol screening involves a simple blood test known as a lipid panel profile or complete lipid profile. You will need to fast for 10 to 12 hours beforehand to get the most accurate measurements of cholesterol and triglycerides in your blood.

Evidence also suggests that high triglycerides on their own can also cause heart disease and early death. That’s according to a 2011 AHA scientific statement on triglycerides and cardiovascular disease.

High triglycerides are also associated with metabolic syndrome, a group of five conditions that increase your risk of heart disease, diabetes, and stroke. These other conditions include obesity or excess fat in the stomach area; low-HDL cholesterol; high blood pressure; and high blood fasting sugar.

What Causes High Triglycerides?

What increases your triglyceride levels is complex. Common health conditions and lifestyle risk factors for high triglycerides include:

• Obesity.
• Kidney disease.
• Poorly controlled diabetes.
• Having an underactive thyroid condition known as hypothyroidism.
• Cushing syndrome.
• Acute hepatitis.
• Rheumatoid arthritis.
• Psoriasis.
• Systemic lupus.
• Multiple myeloma.
• Sepsis.
• Regularly eating more calories than you burn, especially simple carbohydrates, added sugars, and saturated fats.
• Drinking too much alcohol or a history of alcohol abuse.
• Leading a sedentary lifestyle and not getting enough daily physical activity.
• Taking certain medications. These include diuretics, estrogen, retinoids, steroids, beta blockers, birth control pills, and certain HIV, cancer, and immunosuppressant drugs.
• Having a genetic or family history of high triglycerides.

How to Reduce Triglycerides

You should try to reduce triglycerides if your levels are higher than normal. You may also want to reduce triglycerides if you’re at risk for developing heart disease, diabetes, or fatty liver disease. Follow these tips from the AHA to reduce your triglycerides.

Follow a healthy diet

What you eat and drink can lower or raise your triglycerides.

What foods can reduce triglycerides?

Complex carbohydrates and fiber-rich foods can help reduce triglycerides. Evidence suggests that following a Mediterranean diet, which mostly focuses on plant-based foods, may help reduce triglycerides. In its 2021 expert consensus on controlling hypertriglyceridemia, the American College of Cardiology recommends:

• Fresh vegetables, limiting fruits.
• Whole grains.
• Unsaturated fats. Foods with these fats include nuts, nut butters, seeds, and avocados. Omega-3 fatty acids from fish are especially helpful at lowering triglycerides.
• Healthy cooking oils, including olive, safflower, canola, and sesame oils.
• Beans and legumes.
• Fat-free or low-fat dairy, including yogurt and cheeses.
• Lean fish and other seafood.
• Lean poultry.

What foods can increase triglycerides?

To reduce triglycerides in your diet, limit or avoid these foods:

• Refined grains.
• Highly processed foods and sweets.
• Added sugars, especially fructose. The AHA recommends limiting added sugars to fewer than 100 calories daily (or 6 teaspoons) for women and 150 calories daily (9 teaspoons) for men.
• Alcohol. The ACC recommends men limit alcohol intake to two drinks a day and women limit alcohol intake to one drink a day. If you have very high triglycerides, your doctor may recommend you don’t drink any alcohol and also reduce saturated fats. This can help you reduce your risk of pancreatitis.
• Saturated and trans fats. Foods containing these fats include fried foods, fatty cuts of meat, full-fat dairy products, coconut oil, and palm oil.

Lose weight

Your weight and body mass index contribute to your triglyceride levels.

If you’re overweight or obese, a 5% to 10% weight loss can decrease your triglycerides by 20%, according to the AHA. It also reduces your bad LDL cholesterol by 15% and increases your good HDL cholesterol by 8% to 10%.

Get regular exercise

Getting regular exercise and physical activity helps keep triglycerides in check. Exercise works best at lowering triglycerides when it is moderate to intense and combined with eating less.

Follow the Physical Activity Guidelines for Americans. For most adults, that means:

• Do at least 150 minutes to 300 minutes a week of moderate-intensity exercise.
• Or do 75 minutes to 150 minutes a week of vigorous-intensity aerobic physical activity.
• Or an equivalent combination of moderate- and vigorous-intensity aerobic activity.
• Also do two or more days a week of muscle-strengthening activities.

Quit smoking

Smoking is a risk factor for heart disease and diabetes. It can increase your triglycerides and blood glucose levels and also decrease your HDL, or good cholesterol.

Treatment for High Triglycerides

If lifestyle changes don’t lower your triglycerides, talk to your doctor. You may need to take medications to lower your triglycerides. These medications include statins, fibrates, and prescription-dose omega-3 supplements.

Certain over-the-counter (OTC) supplements may also reduce your triglycerides. These include omega-3 fish oil supplements and niacin.

Don’t take OTC supplements without talking to your doctor first. High doses of omega-3s may interfere with blood clotting. Niacin can also interact with other medications you take, causing severe side effects.

For many people with high triglycerides, medication alone can’t reduce triglycerides. Even with medication treatment, you still need to keep lifestyle changes in place.