What Causes High Triglycerides?

Triglycerides (a type of fat) circulate in the blood and are used for energy. When you consume more calories than your body needs, your body makes triglycerides and stores them for later use. Having high levels of triglycerides (a form of dyslipidemia) is associated with increased risk for chronic conditions like heart disease, stroke, metabolic syndrome and diabetes.

This article will discuss normal levels of triglycerides, their function, causes of high triglycerides and how to lower them.

What Are Triglycerides?

Triglycerides are a type of fat made of three fatty acids and one glycerol molecule. They are a main source of energy and stored energy. Triglycerides are found in certain foods we eat, such as butter and some oils, and can also be made by the liver. When a person eats more calories than their body needs, triglycerides are created within the body. When energy is needed, triglycerides are released into the bloodstream.

How Many Triglycerides Should You Have?

Triglyceride levels are considered normal if they are less than 150 millligrams per deciliter. Levels between 150 mg/dL and 199 mg/dL are categorized as "borderline high," while levels between 200 mg/dL and 499 mg/dL are "high." Very high levels are 500 mg/dL and higher.

What Are Symptoms of High Triglycerides?

There are typically no symptoms associated with high triglycerides unless they coincide with another condition, such as thyroid disease or diabetes. Very high triglyceride levels are associated with pancreatitis, which can lead to severe abdominal pain.

What Causes High Triglycerides?

Elevated triglycerides can be caused by a variety of lifestyle factors, such as an eating pattern that is high in added sugar and fat, high levels of visceral fat (adipose tissue around the abdominal area), smoking and sedentary behavior. Genetic predisposition and other diseases like heart disease, thyroid, kidney and liver diseases, diabetes, high LDL cholesterol and low HDL cholesterol are also linked to high triglycerides. Rarely, people can have genetic mutations that cause high triglycerides. Lastly, certain medications used to treat high blood pressure, HIV and breast cancer may increase the risk of developing high triglycerides.

What to Do to Help Lower Triglycerides

Treatment for high triglycerides (depending on your levels) usually starts with behavior modifications. Making changes to your eating habits, moving regularly, getting adequate sleep, managing stress and quitting smoking are all factors that can help improve your triglyceride levels. If your levels are extremely high, your health care provider may recommend treatment in the form of medication.

Foods That Help Lower Triglycerides

Weight loss can help lower triglycerides. In fact, research has shown that losing 5% to 10% of your body weight can result in significant reductions in triglycerides, total cholesterol and low density lipoprotein (LDL). Foods that are rich in healthy fat, fiber and lean protein can keep you fuller for longer, which can result in weight loss. Fiber-rich foods that can help lower triglyceride and cholesterol levels include fruits, vegetables, unsalted nuts, seeds, legumes and whole grains. Lean sources of protein, like chicken, turkey, legumes, tofu and lean beef are super filling (thanks to their protein content) and are lower in saturated fat. Pair them with fiber-rich foods for something extra nutritious and satisfying.

In addition, omega-3 fatty acids can also help to reduce triglycerides. The American Heart Association recommends eating two servings (about 6 ounces total) of fatty fish, such as anchovies, herring, mackerel, black cod, salmon, sardines, bluefin tuna, whitefish, striped bass and cobia, per week. Plant-based sources of omega-3 fatty acids include walnuts, flaxseed, chia seed, hemp seed, edamame, seaweed and algae.

Foods to Limit

When you consume more calories than you need for energy, your body converts the excess calories to fat in the form of triglycerides. In particular, added sugar and sugar-sweetened beverages can increase triglycerides if consumed in excess. Aim to limit added sugars, sweeteners and sweetened drinks to less than 10% of your daily calories.

Swapping refined carbohydrates for whole grains can help to reduce triglyceride levels as well. Whole grains contain more fiber, and high-fiber foods are digested more slowly, which improves feelings of fullness and satiety. Plus, fiber helps to pull "bad" (aka LDL) cholesterol out of the body. You don't need to avoid carbohydrates altogether, but focusing on choosing complex carbohydrates instead and enjoying them in moderate portions can help.

Excess amounts of alcohol, and foods with saturated and trans fat can also contribute to high triglycerides. Synthetic trans fat comes in the form of partially hydrogenated oil. The Food and Drug Administration banned the use of partially hydrogenated oil in 2018; however, some foods may still contain small amounts. Read labels and avoid foods made with partially hydrogenated oils when you can, or enjoy them sparingly.

Saturated fats are primarily found in highly processed meats, full-fat dairy products, butter and fried foods. Reducing your intake of these foods opens up room to enjoy more nutrient-dense foods, while lowering your intake of saturated fat and sodium. In addition, try to limit your intake of fried foods to help lower your trans fat intake.

Lifestyle Factors

Elevated triglycerides are often combined with other lifestyle factors that can increase the risk of developing a chronic disease. Elevated triglyceride levels—along with increased waist circumference, elevated fasting blood sugar, elevated blood pressure and low levels of "good" (aka HDL) cholesterol—can increase the risk of metabolic syndrome, heart disease and diabetes.

The first step to improving your heart health—including lowering your triglycerides—is to make healthy lifestyle changes that you can sustain for the long term. Dietary changes, increasing physical activity and reducing sedentary behavior, stress management, better sleep, smoking cessation and weight loss (when indicated) are all factors that can help improve triglycerides and heart health.

Creating goals that are realistic and fit into your lifestyle can help you make long-lasting and consistent changes, and ultimately will benefit your health the most. Aim to start with a just a couple of changes at a time, and add more as the changes become more like habits. For example, if you don't exercise at all, you may consider walking 10 minutes a day, 5 days a week. Build on that goal weekly, with the ultimate goal to achieve at least 150 minutes per week of moderate-intensity physical activity, plus muscle-strengthening activities on at least two days per week.

If you do not eat the recommended amount of fruits and vegetables daily (1.5 to 2 cup-equivalents of fruits and 2 to 3 cup-equivalents of vegetables), you can start by adding one serving to each of your meals. Snacking on fruit is another great, simple way to up your intake.

The 2020-2025 Dietary Guidelines for Americans recommends limiting added sugar to less than 10% of daily calories. For someone who consumes 2,000 calories per day, this would equate to 200 calories or 50 grams of added sugar per day. For reference, 1 teaspoon of granulated sugar contains 4 grams of sugar and one 12-ounce cola contains 39 grams of added sugar. If you drink several cups of coffee with sugar each day, this can add up. To reduce your intake, try using half of the sugar you typically would, and then one-third the following week and so on, until you get to a place where your added sugar intake is more in line with the recommendations.

Nutrition goals should be individualized and take into consideration factors like your health history, specific labs, lifestyle, culture, food preferences and nutrition goals. Reach out to your health care provider or registered dietitian for more specific guidance.

Frequently Asked Questions

What foods contribute to high triglycerides?

Foods high in saturated fat, trans fat, added sugar and alcohol can increase triglycerides. This includes highly processed meat, sugar-sweetened beverages, baked goods and fried foods, to name a few.

What are the warning signs of high triglycerides?

There may not be any physical warning signs of high triglycerides unless they are so high that they lead to acute pancreatitis. Symptoms of pancreatitis include severe abdominal pain. But, high triglyceride levels are often accompanied by other risk factors for heart disease, such as high cholesterol, high blood pressure and elevated blood sugar. A thorough assessment of risk factors is recommended.

Is hypertriglyceridemia the same as high cholesterol?

No, it is not the same, but understanding your levels of both can help to determine your risk for heart disease. A lipid panel will test triglycerides and cholesterol levels at the same time.

The Bottom Line

We need some triglycerides for energy, but high levels of triglycerides are one risk factor for heart disease. If your triglyceride levels are above the normal range (150 mg/dL and above), it's important for you to learn why your triglyceride levels are high and to create an individualized plan for lowering them.

Depending on your levels, treatment usually starts with making dietary and lifestyle changes. Meeting with a registered dietitian can assist you in creating a heart-healthy eating plan that meets your nutrition- and health-related goals. An individualized eating plan can help you understand how certain foods affect triglycerides—and can reduce stress when it comes to meal planning.