Triglycerides are a type of fat found in the blood. When levels are elevated, they are often a sign of underlying metabolic problems — and at very high levels, they can increase the risk of acute pancreatitis. The good news is that triglycerides are among the most lifestyle-responsive markers in cardiovascular medicine.
In many people, improvements in diet, weight, exercise, alcohol intake, and diabetes control can make a major difference. Triglycerides can drop significantly within weeks of the right changes — something that often surprises patients when they see their repeat blood tests.
For people with very high triglycerides, including those with multifactorial chylomicronaemia, lifestyle measures are often the most important first step in treatment.
What Are Triglycerides?
Triglycerides are a form of fat that circulates in the bloodstream. After eating, excess calories — particularly from sugar and refined carbohydrates — can be converted into triglycerides and stored in fat tissue.
Raised triglycerides are commonly seen in people with overweight or obesity, insulin resistance, type 2 diabetes, fatty liver, and high alcohol intake. When levels are very high, the main immediate concern is the pancreatitis risk.
| Category | mmol/L | mg/dL |
|---|---|---|
| Normal | <1.7 | <150 |
| Borderline High | 1.7–2.2 | 150–199 |
| High | 2.3–5.6 | 200–499 |
| Very High | ≥5.6 | ≥500 |
Different Types of High Triglycerides
Not all hypertriglyceridaemia is the same. Understanding the cause helps guide treatment.
1. Common Lifestyle-Related
The most common form, usually related to excess weight, insulin resistance or type 2 diabetes, excess sugar and refined carbohydrate intake, alcohol, and physical inactivity. Levels are typically mildly to moderately elevated, and lifestyle changes can often produce substantial improvement.
2. Multifactorial Chylomicronaemia
Very high levels — often above 5.6 mmol/L (500 mg/dL), sometimes above 11.3 mmol/L (1000 mg/dL). This occurs when inherited susceptibility combines with triggers like obesity, uncontrolled diabetes, alcohol, high-carbohydrate diets, or certain medicines. In plain terms, the body is genetically more prone to handling fat poorly, and common metabolic triggers push triglycerides into a dangerous range. These patients may be at risk of recurrent pancreatitis.
3. Rare Genetic Forms (e.g. FCS)
Rare inherited disorders such as familial chylomicronaemia syndrome (FCS) can cause extremely high triglyceride levels from childhood. These patients usually need specialist management and very strict dietary fat restriction. (For more on genetic lipid conditions, see our article on familial hypercholesterolemia.)
Lifestyle Changes That Help Lower Triglycerides
Lifestyle modification is the cornerstone of treatment. Below are the changes I recommend most often in practice — with real examples of what to eat, what to cut back on, and how to get moving.
Reduce Sugar Intake
Excess sugar is one of the strongest dietary drivers of high triglycerides. The liver converts excess sugar directly into triglycerides, so cutting it back often produces a fast improvement. The American Heart Association recommends no more than 6 teaspoons of added sugar per day for women and 9 for men — most people far exceed this.
Reduce or avoid
- Soft drinks (Coke, Sprite, lemonade)
- Fruit juice and sweetened iced tea
- Energy drinks (V, Red Bull, Monster)
- Cakes, biscuits, pastries, chocolate bars
- Sweetened yoghurts and muesli bars
- Sugar in tea and coffee
Better choices
- Water, sparkling water with lemon
- Black coffee or tea (unsweetened)
- Whole fruit (berries, apple, pear) in moderation
- Plain Greek yoghurt with a few nuts
- Dark chocolate (small amount, 70%+ cocoa)
A practical starting point: if you currently drink one or more sugary drinks a day, replacing them with water alone can make a noticeable difference to your triglycerides within weeks.
Limit Refined Carbohydrates
Refined carbohydrates break down quickly into sugar and drive triglyceride production in the liver — even when they don't taste sweet.
Reduce or avoid
- White bread, white rice, pasta
- Most breakfast cereals (Weet-Bix is reasonable)
- Crackers, cruskits, rice cakes
- Hot chips, large portions of mashed potato
- Naan, pita bread, wraps in large amounts
Better choices
- Rolled oats or steel-cut oats for breakfast
- Wholegrain sourdough bread
- Brown rice or quinoa (smaller portions)
- Lentils, chickpeas, kidney beans
- Sweet potato (in moderation) instead of white potato
The goal isn't to eliminate carbohydrates entirely — it's to choose slower-digesting options and keep portions sensible. A palm-sized portion of wholegrain carbohydrate at each meal is a reasonable guide for most people.
Avoid or Minimise Alcohol
Alcohol can significantly raise triglyceride levels — even moderate amounts. Beer and sweet cocktails are particularly problematic because they combine alcohol with sugar or carbohydrates. A single night of heavy drinking can sometimes push triglycerides into the thousands.
For people with mildly elevated triglycerides, reducing to no more than 1–2 standard drinks, no more than a few times per week, is a reasonable starting point. For anyone with very high triglycerides or a history of pancreatitis, I generally recommend complete avoidance.
Aim for a Healthy Weight
Excess body weight — particularly around the waist — is a major contributor to raised triglycerides. The encouraging news is that you don't need to reach an ideal body weight to see results. Even a 5–10% weight loss can lead to a meaningful improvement.
For someone weighing 100 kg, that means losing 5–10 kg can make a real difference. Practical strategies include reducing portion sizes (try using a smaller plate), increasing vegetables at each meal so you fill up on lower-calorie foods, cutting back on takeaway and processed foods, and being more mindful of snacking between meals.
Exercise Regularly
Regular physical activity improves triglycerides and insulin sensitivity. You don't need to run marathons — consistent moderate activity is what matters most.
Practical examples that work:
A 30-minute brisk walk five days a week is a great starting point and achieves the recommended 150 minutes per week. Other options include cycling (outdoor or stationary bike), swimming laps, a group fitness class, or even vigorous gardening. If you can build up to 200–300 minutes per week, particularly if weight loss is also a goal, the benefit is even greater.
The key is choosing something you can actually stick with. A daily walk after dinner is far more effective long-term than a gym membership that goes unused.
Choose Healthier Fats
Not all fats are the same. Replacing saturated and trans fats with unsaturated fats supports overall metabolic health. Here are some specific swaps:
Reduce
- Butter and cream
- Fatty cuts of red meat, sausages
- Deep-fried foods (chips, fried chicken)
- Processed meats (salami, bacon)
- Full-fat cheese in large amounts
- Pastries, pies, croissants
Better choices
- Extra virgin olive oil for cooking and dressing
- Avocado (half an avocado on toast or in salad)
- A handful of raw almonds, walnuts, or macadamias
- Grilled or baked salmon, sardines, barramundi
- Seeds — chia, flaxseed, pumpkin seeds in yoghurt
For people with very high triglycerides, particularly multifactorial chylomicronaemia, reducing total dietary fat intake — not just the type of fat — may also be important. Your doctor or dietitian can advise on appropriate fat limits for your situation.
Increase Omega-3 Intake
Omega-3 fatty acids can help lower triglycerides naturally. The best dietary sources are oily fish — aim for two to three servings per week. One serve is about the size of your palm (roughly 150 g).
Best sources: salmon, sardines (tinned is fine and affordable), mackerel, anchovies, and herring. Australian barramundi also contains some omega-3. Tinned salmon and sardines on wholegrain toast make a quick, practical meal that's genuinely helpful for triglycerides.
In some cases — particularly when triglycerides remain very high despite dietary changes — prescription omega-3 therapy (high-dose EPA/DHA) may also be considered by your doctor. Omega-3s also play a role in broader lipid management.
Optimise Diabetes Control
Poorly controlled diabetes is one of the most common causes of severe hypertriglyceridaemia. When blood sugar is consistently high, the liver produces more triglycerides. Improving glucose control — through medication, diet, weight loss, or a combination — can dramatically reduce triglyceride levels, sometimes within a relatively short period.
If you have diabetes and your triglycerides are elevated, it's worth discussing your HbA1c target with your doctor, as better glucose control may do more for your triglycerides than any single dietary change.
Quick Tips to Lower Triglycerides
At a Glance
- Cut back on sugar and sugary drinks
- Reduce refined carbohydrates
- Avoid alcohol if triglycerides are high
- Lose excess weight
- Exercise regularly
- Eat more omega-3 rich fish
- Improve diabetes control
- Review possible secondary causes and medicines
Triglyceride Converter
Convert between mmol/L and mg/dL
Conversion factor: 1 mmol/L = 88.57 mg/dL
Frequently Asked Questions About High Triglycerides
When to Seek Medical Advice
If triglyceride levels are above 5.6 mmol/L (500 mg/dL), medical review is important because the pancreatitis risk rises at higher levels. Your doctor may recommend assessment for secondary causes, dietary counselling, tighter diabetes management, medicines such as fibrates or prescription omega-3 therapy, or specialist review if triglycerides are extremely high or recurrent pancreatitis has occurred. Understanding your broader cardiovascular risk — including your coronary calcium score and Lp(a) levels — can also help guide long-term management.
Concerned About Your Triglycerides?
If your levels are elevated or you have a family history of high triglycerides, a cardiology review can help clarify your risk and guide the right approach.
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