Triglycerides are a type of fat carried in the blood. When they are high, they usually point to something in the background — extra weight, too much sugar or alcohol, or blood sugar that is not well controlled — rather than being a problem on their own. The encouraging part is that triglycerides respond quickly to the right changes. Many people see a meaningful drop on their repeat blood test within a few weeks, which is something cholesterol rarely does as fast.
The biggest reductions usually come from a handful of changes: cutting out sugary drinks, reducing refined carbohydrate, cutting back on alcohol, losing 5–10% of body weight if you're overweight, improving diabetes control, and walking regularly. If your triglycerides are 5.6 mmol/L or higher, or you have severe abdominal pain, don't treat this as a routine lifestyle issue — arrange a medical review.
Triglycerides vs cholesterol — why they're not the same
Patients often assume triglycerides and cholesterol respond to the same advice. They don't, and that's the single most useful thing to understand here.
LDL cholesterol — the number most people focus on — is driven mainly by saturated fat in the diet, and we cover that in detail in our guide to what actually raises your LDL. Triglycerides are different. They rise mostly with sugar, refined carbohydrate, alcohol, excess calories and insulin resistance. When you eat more energy than you burn — especially from sugar and starch — the liver packages the surplus into triglycerides and ships them out in particles called VLDL. Alcohol and poorly controlled diabetes pour fuel on the same process.
This is why the same person can have near-perfect LDL but stubbornly high triglycerides, or the reverse. The dietary levers are not interchangeable.
For LDL, the main dietary lever is saturated fat. For triglycerides, it's sugar, refined carbohydrate and alcohol. If your triglycerides are high, cutting back on the sweet and starchy end of your diet — and on alcohol — usually does more than trimming fat.
What does my number mean?
Australian labs report triglycerides in mmol/L. Here's how the levels are graded, and what each one means for what to do next.
| Triglyceride level | Meaning | What to do next |
|---|---|---|
| < 1.7 mmol/L (< 150 mg/dL) | Normal | No triglyceride-specific action; overall cardiovascular risk still matters |
| 1.7–2.2 mmol/L (150–199 mg/dL) | Borderline-high | Review sugar, refined carbohydrate, alcohol, weight and activity |
| 2.3–5.6 mmol/L (200–499 mg/dL) | High | Lifestyle change; assess diabetes, thyroid, medicines and overall cardiovascular risk |
| ≥ 5.6 mmol/L (≥ 500 mg/dL) | Very high | Medical review; pancreatitis prevention becomes important |
| ≥ 11.3 mmol/L (≥ 1000 mg/dL) | Severe | Prompt review; often needs strict diet, alcohol avoidance and medication |
| Very high level + severe abdominal pain | Possible pancreatitis | Seek urgent medical care |
| mmol/L | mg/dL |
|---|---|
| 1.7 | 150 |
| 2.3 | 200 |
| 5.6 | 500 |
| 11.3 | 1000 |
To convert: mg/dL ÷ 88.5 = mmol/L. For other values, use our cholesterol & triglyceride unit converter.
A note on testing: most lipid tests can be done non-fasting, and a raised non-fasting triglyceride is still meaningful. If a non-fasting result is clearly elevated — particularly above about 4.5–5.0 mmol/L — a fasting repeat is often useful to confirm severity and guide treatment.
Above roughly 10 mmol/L (about 900 mg/dL) the risk of acute pancreatitis climbs, and it becomes a real concern from 11.3 mmol/L (1000 mg/dL) upward. At these levels lifestyle measures aren't optional extras — they are central treatment, alongside prompt medical review.
Why high triglycerides matter
There are two separate reasons to take a high triglyceride seriously, and they apply at different levels.
At the very high end, the concern is the pancreas — the pancreatitis risk above.
At the more common, moderate end, the concern is the heart. Triglyceride itself isn't thought to clog arteries directly, but it travels in particles whose leftover, cholesterol-rich "remnants" can lodge in the artery wall. This is why a high triglyceride often signals raised cardiovascular risk. If your triglycerides are high, it's worth understanding your overall risk picture — including, where relevant, your coronary calcium score, your Lp(a) level, and your estimated risk using our cardiovascular risk calculators.
When triglycerides are high, LDL cholesterol alone can understate risk. Non-HDL cholesterol (your total cholesterol minus HDL) and ApoB better reflect the total number of artery-damaging particles in your blood, including the triglyceride-rich remnants. You can read more in our ApoB guide.
What causes high triglycerides?
Not all high triglycerides are the same, and the cause shapes the treatment.
Lifestyle-related
Linked to excess weight, insulin resistance or type 2 diabetes, a diet high in sugar and refined carbohydrate, alcohol, and inactivity. Levels are usually mildly to moderately raised and respond well to the changes below.
Multifactorial chylomicronaemia
An inherited tendency to handle fat poorly combines with triggers — obesity, uncontrolled diabetes, alcohol, high-carbohydrate diets or certain medicines — to push triglycerides into a dangerous range. These patients can have recurrent pancreatitis and need closer management.
Familial chylomicronaemia (FCS)
Familial chylomicronaemia syndrome is different from familial hypercholesterolaemia. It is a rare inherited disorder that causes extreme triglyceride levels from childhood and needs specialist lipid care, often with strict dietary fat restriction.
High triglycerides are also frequently driven, or worsened, by a secondary cause — something other than diet. These are always worth reviewing, because treating the cause is often the fastest way to bring the number down.
| Cause | Examples | What to check |
|---|---|---|
| Glucose / insulin resistance | Type 2 diabetes, metabolic syndrome | HbA1c, fasting glucose |
| Thyroid | Underactive thyroid | Thyroid function (TSH) |
| Liver / kidney | Fatty liver, kidney disease | Liver and kidney function |
| Alcohol | Regular or binge intake | Standard drinks per week |
| Medicines | Steroids, oestrogens, retinoids, some beta-blockers and thiazides, some antipsychotics, some HIV medicines | Medication review with your doctor |
Never stop a prescribed medicine on your own — if one might be contributing, your doctor can weigh up alternatives.
How to lower triglycerides naturally
Lifestyle change is the foundation of treatment, and for mild-to-moderate elevations it is often all that's needed. These are the changes I recommend most often in clinic, roughly in order of impact.
Cut back on sugar and sugary drinks
This is usually the highest-yield change. The liver turns excess sugar straight into triglycerides, so reducing it tends to produce a fast result. Sugary drinks are the worst offenders because the sugar arrives quickly and in large amounts. Keeping added sugar to about 6 teaspoons a day for women and 9 for men is a reasonable target — one can of soft drink alone is close to that.
| Limit or avoid | Choose instead |
|---|---|
| Soft drink, lemonade, energy drinks | Water, soda water with lemon or lime |
| Fruit juice and sweetened iced tea | Whole fruit (berries, apple, pear) |
| Cakes, biscuits, pastries, lollies | A small piece of 70%+ dark chocolate |
| Sweetened yoghurt and muesli bars | Plain Greek yoghurt with a few nuts |
| Sugar in tea and coffee | Unsweetened tea or black coffee |
If you currently drink one or more sugary drinks a day, swapping them for water is often the single change that moves the number most.
Choose better carbohydrates
Refined carbohydrates break down quickly into sugar and feed the same pathway, even when they don't taste sweet. The goal isn't a no-carb diet — it's slower-digesting carbohydrates in sensible portions. A useful guide is a palm-sized serve of wholegrain carbohydrate per meal.
| Limit or avoid | Choose instead |
|---|---|
| White bread, white rice, white pasta | Wholegrain sourdough, brown rice, quinoa |
| Most sugary breakfast cereals | Rolled or steel-cut oats |
| Crackers, rice cakes, large naan or wraps | Smaller portions of wholegrain options |
| Hot chips, large serves of mashed potato | Sweet potato in moderation; legumes |
| — | Lentils, chickpeas, kidney beans |
Cut back on alcohol
Alcohol is one of the strongest and most reversible drivers of high triglycerides. Beer and sweet or mixed drinks are particularly bad because they pair alcohol with sugar or carbohydrate, and a single heavy session can push triglycerides up sharply. For more, see alcohol and heart health, and you can check your intake with our standard drinks calculator.
For mildly raised triglycerides, cutting back to no more than one to two standard drinks on a few days a week is a reasonable starting point. If your triglycerides are very high, or you've had pancreatitis, complete avoidance is usually the safest advice.
Aim for modest weight loss
You don't need to reach an ideal weight to benefit. Losing 5–10% of body weight typically lowers triglycerides by around a fifth — for someone who is 100 kg, that's 5–10 kg. Practical steps that help: smaller plates, more vegetables to fill up on, less takeaway and processed food, and being honest about between-meal snacking. If you'd like to gauge where you stand, our body composition calculator can help.
Move more
Regular activity lowers triglycerides and improves insulin sensitivity. You don't need to train hard — consistency matters more than intensity. A 30-minute brisk walk on five days a week meets the recommended 150 minutes, and cycling, swimming, a fitness class or solid gardening all count. If weight loss is also a goal, building toward 200–300 minutes a week helps more. The best exercise is the one you'll actually keep doing — a daily walk after dinner beats an unused gym membership.
Eat more oily fish (omega-3)
Omega-3 fats from oily fish lower triglycerides and fit every heart-healthy eating pattern. Aim for two to three serves a week — a serve is about a palm-sized piece (around 150 g). Good, affordable options include tinned salmon and sardines, plus mackerel, herring and anchovies; Australian barramundi contributes some too. Tinned salmon or sardines on wholegrain toast is a genuinely useful triglyceride-friendly meal. For everyday prevention the benefit comes from the fish itself rather than over-the-counter fish-oil capsules — prescription-strength omega-3 is a separate, specific treatment covered below.
Fix the fixable — diabetes, thyroid and medicines
Poorly controlled diabetes is one of the commonest causes of severely high triglycerides: when blood sugar runs high, the liver makes more of them. Tightening glucose control — through medication, diet or weight loss — can lower triglycerides substantially, sometimes faster than any single dietary change. If you have diabetes, it's worth discussing your HbA1c target with your doctor. The same applies to an underactive thyroid and to any contributing medicine: treating the underlying cause often does the heavy lifting.
How much, and how fast?
Every patient asks this, so here is a realistic guide. These figures are approximate, they vary from person to person, and they stack — combining several changes does more than any one alone.
| Change | Typical effect on triglycerides | Timeframe |
|---|---|---|
| Stop or cut alcohol (if it's a driver) | Large; sometimes 30% or more | Days to weeks |
| Cut out sugary drinks and added sugar | Moderate to large | 2–4 weeks |
| Lose 5–10% of body weight | Around 20% | Weeks to months |
| Regular aerobic exercise | Roughly 10–20% | Weeks |
| Better diabetes / glucose control | Often large | Weeks |
| More oily fish / omega-3 | Modest from diet | Weeks |
Because these changes add up, it's common to see triglycerides fall by a third or more within a month or two when several are tackled together — particularly when alcohol and sugary drinks are the main drivers. Ask your doctor when to repeat the blood test so you can see the result of your effort.
When triglycerides are very high
If your triglycerides are very high, the dietary advice changes. With mild-to-moderate levels the focus is on sugar, refined carbohydrate and alcohol. Once levels are very high, reducing total dietary fat also matters — to lower the pancreatitis risk.
| Situation | Main goal | Diet emphasis |
|---|---|---|
| Mild-to-moderate elevation | Reduce liver VLDL output | Less sugar, refined carbohydrate, alcohol and excess calories |
| TG ≥ 5.6 mmol/L (very high) | Reduce pancreatitis risk | No alcohol, urgent diabetes control, medical review, consider reducing total fat |
| TG ≥ 11.3 mmol/L or chylomicronaemia | Rapid risk reduction | Very-low-fat diet under medical or dietitian guidance; specialist review |
People with multifactorial chylomicronaemia or familial chylomicronaemia syndrome need specialist management. If you develop severe abdominal pain when your triglycerides are very high, seek medical care promptly — this can be pancreatitis.
When lifestyle isn't enough
When triglycerides stay high despite genuine lifestyle effort, or your overall cardiovascular risk is high, your doctor may consider medication. The choice is made case by case, and these are doctor's decisions — not something to start or stop on your own.
| Option | Main role | Important caveat |
|---|---|---|
| Statin | Lowers overall cardiovascular risk; modest triglyceride lowering | Chosen mainly by cardiovascular risk, not triglycerides alone |
| Fenofibrate | Triglyceride lowering, especially when pancreatitis risk is the concern | Your doctor checks kidney function and interactions |
| Icosapent ethyl (prescription EPA) | Cardiovascular risk reduction in selected statin-treated, high-risk patients with raised triglycerides | Prescription EPA; in Australia it's PBS-listed under Authority Required (Streamlined). Not the same as over-the-counter fish oil |
| Over-the-counter fish oil | May lower triglycerides modestly at higher doses | Variable EPA/DHA content; not interchangeable with prescription EPA, and little clear heart benefit |
For how these fit into modern lipid treatment thresholds, see our summary of the 2026 ACC/AHA dyslipidaemia guidelines, and our broader heart-attack prevention guide.
When to see a doctor
It's worth booking a review if:
- Your triglycerides are 5.6 mmol/L (500 mg/dL) or higher on a repeat test
- You have diabetes and persistently high triglycerides
- You've ever had pancreatitis, or there's a family history of very high triglycerides
- Your triglycerides stay high despite real lifestyle changes
Seek care promptly if you have very high triglycerides together with severe abdominal pain.
- Triglycerides rise mainly with sugar, refined carbohydrate, alcohol and excess weight — not mainly with saturated fat. That's what sets them apart from LDL.
- They are highly responsive: a meaningful drop within a few weeks is common.
- The biggest, fastest wins are usually cutting alcohol and sugary drinks.
- Modest weight loss (5–10%) and regular activity add steady further gains.
- Oily fish two to three times a week helps; everyday fish-oil capsules add little.
- Poorly controlled diabetes and certain medicines are common hidden drivers — fixing them often lowers triglycerides fast.
- Very high triglycerides (≥ 5.6 mmol/L) need medical review because of pancreatitis risk, and lifestyle becomes central treatment, not an optional extra.
Frequently asked questions
What level of triglycerides is considered high?
High is 2.3–5.6 mmol/L (200–499 mg/dL) and very high is 5.6 mmol/L (500 mg/dL) or above. Borderline is 1.7–2.2 mmol/L (150–199 mg/dL).
Can triglycerides be lowered without medication?
Often, yes — especially when they are mildly to moderately raised. Cutting alcohol and sugary drinks, losing a little weight, exercising and improving diabetes control can bring them down substantially, sometimes within weeks.
How quickly can triglycerides drop with diet?
Faster than cholesterol. Reducing alcohol and sugary drinks can lower triglycerides within days to a few weeks, and combining several changes often produces a fall of a third or more within a month or two.
Should I eat low-fat or low-carb if my triglycerides are high?
For mild-to-moderate elevation, reducing sugar, refined carbohydrate and alcohol usually matters most. If triglycerides are very high, especially above 5.6 mmol/L, your doctor may also recommend reducing total fat to lower pancreatitis risk.
What foods should I avoid if my triglycerides are high?
Mainly sugary drinks, sweets and desserts, white bread and white rice, other refined carbohydrates, and alcohol. Portion size matters as much as food choice.
What foods help lower triglycerides?
Oily fish (salmon, sardines, mackerel), wholegrains, legumes, vegetables and whole fruit in moderation, with water in place of sugary drinks.
Does alcohol raise triglycerides?
Yes — often significantly, and especially in people who already have high levels. If your triglycerides are very high, alcohol is usually best avoided completely.
Does fish oil lower triglycerides?
Eating oily fish helps. Over-the-counter fish-oil capsules vary in strength and haven't shown clear heart benefit in recent trials. Prescription-strength omega-3 (icosapent ethyl) is a separate treatment for selected high-risk patients.
Do I need to fast before a triglyceride test?
Usually not for general screening — non-fasting samples are acceptable. If a non-fasting result is clearly elevated, your doctor may ask for a fasting repeat to confirm the level.
When should I repeat my triglyceride blood test?
Many people repeat after several weeks of lifestyle change. A fasting repeat is often useful if the first sample was non-fasting and triglycerides were markedly elevated.
Can diabetes raise triglycerides?
Yes. Poorly controlled diabetes is one of the most common causes of severely high triglycerides, and better glucose control can lower them considerably.
At what level does pancreatitis become a concern?
The risk rises as triglycerides climb above 5.6 mmol/L (500 mg/dL) and becomes a real concern from about 11.3 mmol/L (1000 mg/dL) upward.
What is non-HDL cholesterol and why does it matter when triglycerides are high?
Non-HDL cholesterol is your total cholesterol minus HDL. It captures LDL plus other artery-damaging particles, including triglyceride-rich remnants, and can be more useful than LDL alone when triglycerides are elevated.
Do high triglycerides cause heart disease?
High triglycerides usually signal increased cardiovascular risk because of the cholesterol-rich remnant particles they travel in. Doctors often track non-HDL cholesterol or ApoB to capture this, alongside your overall risk.
References & further reading
Triglycerides & cardiovascular risk
- Miller M, Stone NJ, Ballantyne C, et al. Triglycerides and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation. 2011;123(20):2292–2333. doi:10.1161/CIR.0b013e3182160726
- Nordestgaard BG, Varbo A. Triglycerides and cardiovascular disease. Lancet. 2014;384(9943):626–635. doi:10.1016/S0140-6736(14)61177-6
Management & treatment
- Mach F, Baigent C, Catapano AL, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias. Eur Heart J. 2020;41(1):111–188. doi:10.1093/eurheartj/ehz455
- Bhatt DL, Steg PG, Miller M, et al. Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia (REDUCE-IT). N Engl J Med. 2019;380(1):11–22. doi:10.1056/NEJMoa1812792
Further reading for patients
- Heart Foundation (Australia). Physical activity and exercise.
- American Heart Association. Added sugars.
Concerned about your triglycerides?
If your levels are elevated, you've had pancreatitis, or there's a family history of very high triglycerides, a cardiology review can clarify your risk and guide the right approach. A GP referral is required.
Book a consultation