Triglyceride Reduction

Triglycerides are highly diet-responsive, driven principally by alcohol, refined carbohydrate, fructose and positive energy balance. Levels above 1.7 mmol/L (150 mg/dL) indicate elevated cardiometabolic risk, and above 5.6 mmol/L (500 mg/dL) the priority shifts to preventing pancreatitis. Uncontrolled diabetes, hypothyroidism, renal disease and certain medications are common secondary causes that should be excluded before treating the number in isolation. Prescription omega-3 at 4g/day lowers triglycerides by 20-30%, the largest supplement effect in the lipid field, though the cardiovascular outcome data behind it remains debated.

1) Cut or eliminate alcohol, often the single biggest contributor and capable of halving levels within weeks. 2) Reduce refined carbohydrate and fructose, particularly sugar-sweetened drinks, which drive hepatic triglyceride production. 3) Lose excess weight, with 5-10% loss producing meaningful reductions. 4) Exercise regularly, which improves lipoprotein lipase activity and clearance. 5) Replace saturated with unsaturated fats and eat oily fish twice weekly. 6) Optimise glycaemic control, since insulin resistance is a primary driver. 7) Screen for hypothyroidism and review medications that raise triglycerides. 8) Consider high-dose omega-3 under medical supervision when levels remain high after lifestyle change.

• •Cutting alcohol
• •Reducing refined carbohydrate and fructose
• •Weight loss of 5-10%
• •Regular aerobic exercise
• •Oily fish twice weekly
• •Glycaemic control
• •Reviewing contributing medications