5 Strategies on How to Lower Triglycerides
You’ve heard it all before from your doctor who says that your triglycerides and LDL cholesterol are too high and you need to lower them.
“But I’ve been on a low fat diet! What else do I need to do?” You ask the doctor. He just gives you a wry look and tells you, “I think I need to put you on statins!” Now before you throw your hands up in despair, I’m here to tell you that it’s actually quite easy to lower elevated triglycerides levels. And no, you don’t need to take statins to get the job done.
I’ve touched on why looking at LDL itself isn’t a good predictor of heart disease in one of my past articles here so I won’t touch on LDL today.
Instead I’m going to outline 5 simple strategies on how to lower triglycerides. But before we do that, let’s find out what triglycerides are and the role they play in heart disease risk.
What are Triglycerides?
According to the Mayo Clinic, triglycerides are a type of fat (lipid) found in your blood. When you eat, any unused calories are stored in your fat cells as triglycerides. Later, they are released to meet the energy requirements of the day.
If you consume more calories than you need especially those from sugar, refined carbohydrates and processed foods that contain artificial man made trans fats your triglyceride levels go up.
Mainstream medicine uses this guide on deciding how elevated triglyceride levels are within a lipid panel:
- Normal — Less than 150 milligrams per deciliter (mg/dl), or less than 1.7 milliliters per liter (mmol/l)
- Borderline high — 150 to 199 mg/dl (1.8 to 2.2 mmol/l)
- High — 200 to 499 mg/dl (2.3 to 5.6 mmol/l)
- Very high — 500 mg/dl or above (5.7 mmol/l or above)
However, increasingly there’s evidence like this study to show that when plasma triglycerides exceed a critical threshold of approximately 133 mg/dl (1.5 mmol/l), this favors the formation of small, dense LDL from larger, less dense species that promotes atherosclerosis and heart disease so you’re in danger zone if your triglyceride levels shoot past this reading.
Obviously the lower your triglyceride level, the lower your risk of getting heart disease. Here are 5 simple strategies on how to lower triglycerides:
Strategy Number 1: Lose Weight/Fat
I’ve mentioned earlier that if you consume more calories (energy) than you need, your triglycerides level goes up and you gain fat. Now if your weight gain is mostly lean muscle mass as in the case when you do resistance training, your triglycerides level won’t go up; it’s when you gain fat that’s when it’ll negatively impact your lipid levels.
So losing weight, or should I say, fat is one of the surest ways to lower your triglycerides level.
In this large 2011 mega study of 5,145 overweight or obese individuals, it was found that even a modest reduction of 5% to 10% of body weight can decrease triglyceride levels by as much as 40 mg/dl (0.45 mmol/l).
And even if you regain the weight/fat that you lost, your triglyceride levels will still be lower than when you first started out before going on your weight/fat loss program.
In a 1995 study by the University of Wisconsin Medical School, 97 individuals comprising both men and women who had earlier dropped out of a weight loss program after 16 to 18 weeks of treatment and losing 9 to 9.4kg wanted to rejoin the program after being out of it for 9 months. All of these folks had regained their weight but serum triglyceride levels were less than their initial readings before they embarked on the original program. For the men it was 24% lower than their initial readings and for the women it was 26% lower.
Strategy Number 2: Start Exercising Regularly
According to the Mayo Clinic being active boosts high-density lipoprotein (HDL), or “good,” cholesterol and decreases unhealthy triglycerides.
A 1977 study published in the American Journal of Clinical Nutrition showed that aerobic exercise like walking on a treadmill for 30 mins for 4 days reduced triglyceride levels. The reduction in TG, which averaged 120 mg/100 ml, occurred regardless of whether or not the increase in caloric expenditure was compensated for by an increase in food intake.
In another 1985 study of 21 obese men, it was found that aerobic work i.e. walking on a treadmill not only helped with weight/fat loss but it also decreased triglycerides while increasing HDL.
One 1990 4-month study by the Swiss Federal Institute of Technology in Zurich on 61 sedentary middle aged men found that there were significant reductions in serum triglycerides with just 2 hours of jogging a week.
So far all these studies point at the efficacy of aerobic exercise in lower triglyceride levels. Examples of aerobic work include brisk walking, jogging, cycling, swimming and stairs climbing,
However a 2013 study by the University of Texas at Austin found that moderate intensity exercise was more effective than low intensity aerobic work in reducing triglycerides.
At the end of the day, it doesn’t matter if you do moderate or low intensity exercise, the important thing is to just get moving and being regular about it: exercise every day if possible, if not at least 3 to 5 times a week.
Strategy Number 3: Avoid Sugar
Sugar has been linked not only to Type 2 diabetes, Alzheimer’s, non fatty liver disease, insulin resistance and metabolic syndrome but also to heart disease as it elevates triglyceride levels and this promotes atherosclerosis.
A 15 year study published in 2014 showed that folks who consumed 25% or more of daily calories from sugar had twice the risk of dying from heart disease as those who consumed only 10% or less of their calories from sugar.
Another 2014 joint study by the University of Alabama and the University of Colorado showed that increased consumption of added sugars may be associated with adverse cardiovascular health factors in children, specifically elevated diastolic BP and triglycerides.
In fact, a 2011 study published in the Journal of Clinical Endocrinology & Metabolism showed that in just 12 days, if 25% or more of the daily calories were from fructose or high fructose corn syrup, serum triglyceride levels would be raised considerably.
Even simple strategies like replacing sugar sweetened drinks with water can reduce triglycerides by almost 29 mg/dl (0.33 mmol/l) as seen in this 2014 Mexican study on overweight and obese women.
So as you can see, totally avoiding all forms of sugar will decrease triglyceride levels which will lower your risk of cardiovascular disease.
Strategy Number 4: Go Low Carb
It’s not only sugar that will elevate triglyceride levels but also carbohydrates especially highly refined ones found in cereals, pasta, white rice, pizza, noodles, bread etc.
In fact we know now for a fact that the recommended high carb low fat diet guidelines are contributing to a condition that’s known as carbohydrates induced high triglycerides or hypertriacylglycerolemia. The University of California at Berkeley did a mega analysis of this phenomenon looking at studies from the late 50s to when the results of the mega study was published in The American Journal of Clinical Nutrition in 2000.
Dr. Joseph Mercola, a renowned functional medicine specialist wrote in the Canadian Medical Journal in 2003 that low fat high carb diets actually contributes to high triglyceride levels because of the inherent high carbohydrate content of such diets.
In 2004, the Department of Veterans Affairs Medical Center and Duke University Medical Center in North Carolina conducted a joint randomized control study where 120 overweight and hyperlipidemic volunteers participated. They were divided into 2 groups: the 1st group was given a low carb ketogenic diet and the 2nd group was given a low fat diet. The results showed that serum triglyceride levels decreased more and high-density lipoprotein cholesterol level increased more with the low-carbohydrate diet than with the low-fat diet.
Another randomized controlled study involving 63 participants over a 12 month period and published in the New England Journal of Medicine in 2003 showed that the relative increase in HDL cholesterol concentrations and the relative decrease in triglyceride concentrations were greater in the group on the low-carbohydrate diet than in the group on the conventional diet throughout most of the study.
In yet another 6 month randomized controlled study published in the New England Journal of Medicine in 2003, involving 132 obese participants, there was a greater decrease in the mean triglyceride level in the low-carbohydrate group than in the low-fat group (43% vs. 31%).
If you want to start on a low carb diet, I’ve written a long article on how to start going low carb in one of my earlier posts. If you need personal coaching on how to go low carb without making the mistakes lots of beginners make, please complete the online form at the end of this article or just email me: firstname.lastname@example.org.
Strategy Number 5: Eat Fatty Fish and/or Take a Fish Oil Supplement
Omega 3 fatty acids have been well known for their beneficial effects on heart health especially the ability of decrease triglyceride levels.
Now it’s important to note that it’s the omega 3s from fish i.e. eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) that’s much more beneficial for heart health than alpha-linolenic acid (ALA) the plant based omega 3s.
A 2006 review by the Brigham and Women’s Hospital and Harvard Medical School showed that eating fatty fish twice a week can reduce the risk of death by as much as 36%.
Another 2016 study showed that eating salmon twice a week improved lipid profiles significantly including triglyceride levels: intake of salmon reduced plasma and serum triglyceride (TG) concentrations and increased plasma HDL-C concentrations. Total TG was reduced as was the TG content of VLDL-P and CM-P. Twice weekly intake of farmed Atlantic salmon portions influences lipoprotein particle size and concentration in a manner associated with cardiovascular disease risk reduction.
In fact one 2011 study on the effectiveness of omega 3 fatty acids found that at the pharmaceutical dose, 3.4 g/day, they reduce plasma TG by about 25-50% after one month of treatment, resulting primarily from the decline in hepatic very low density lipoprotein (VLDL-TG) production, and secondarily from the increase in VLDL clearance.
Even at lower doses of less than 2 grams of omega 3 per day saw triglyceride levels dropping significantly after 4 weeks of treatment as shown in this 2014 Dutch study on 332 patients with hypercholesterolemia.
So how much omega 3 do you need to take if you’ve got elevated triglyceride levels?
According to the Mayo Clinic, to treat high triglycerides, doses of up to two grams of omega-3 fatty acids from EPA and DHA have been taken by mouth daily. Doses of 2-4 grams of omega-3 fatty acids taken by mouth daily have been studied.
How many capsules of fish oil is that? Well, it depends on the concentration.
The normal concentration is 180 mg EPA and 120 mg DHA per capsule: this makes a total of 300 mg of omega 3. Let’s say you want to take 2 gm of omega 3 per day; you’ll have to take 7 capsules of normal concentration fish oil in 2 separate doses which will give you 2.1 gm of omega 3. So the higher the concentration, the lesser capsules you’ll need to take per day.
More isn’t necessarily better in this case so please DO NOT go over this dosage range unless you’re under medical supervision.
I personally take 3.5 gm of omega 3 per day, not because I have elevated triglyceride levels but because I personally find that this dosage helps keep my joints pain free as a senior at 60. This dosage also helps me prevent dementia and other age related chronic conditions. In addition it helps me recover much faster if, say, I have a sports injury like a wrist sprain since omega 3 is anti-inflammatory as well.
One last thing, there’s no such thing as pharmaceutical grade fish oil so don’t be deceived by the marketing tactics of supplement companies: the higher the concentration the more purified it is.
If you don’t know which brands of fish oil to trust, please refer to the ratings on Labdoor, a 3rd party supplement testing site. The higher a brand is ranked on Labdoor the better the quality of fish oil.
Please DON’T IGNORE triglyceride levels especially if it’s above 100 mg/dl or 1.129 mmol/l. Any reading above 133 mg/dl or 1.5 mmol/l is dangerous territory as I’ve mentioned earlier.
Fortunately lowering triglycerides isn’t rocket science and if you use all these 5 strategies, your triglycerides level will definitely drop unless you’ve got familial hypercholesterolemia.