Can high triglycerides improve with lifestyle changes?

Question

Hello doctor,

I am 41 years old, and my recent blood tests showed that my triglyceride levels are much higher than they were last year. My family doctor advised me to change my diet, but I am already trying to avoid fried foods and sugary drinks, so I am feeling a bit lost.

I keep wondering, can very high triglyceride levels come down with lifestyle changes alone? My father had heart problems in his fifties, so I am becoming really worried that I am heading down the same path.

I do not always understand which foods actually make triglyceride levels worse because every website seems to say something different. I have even lost a little weight, but my triglyceride levels still look high. Am I missing something important, or should I already be thinking about medication?

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

It is understandable to be worried, especially with a family history of heart disease. The good news is that elevated triglyceride levels often improve with the right combination of lifestyle changes, although the best approach depends on how high the levels are.

The first step is to know your actual triglyceride level, as this helps determine whether lifestyle changes alone are likely to be sufficient. In many people, triglyceride levels can decrease significantly over several months by:

Reducing added sugars and refined carbohydrates, such as white bread, sweets, pastries, and sugary breakfast cereals.
Limiting or avoiding alcohol, as it can markedly increase triglyceride levels.
Reduce body weight by 5% to 10% if overweight or obese.
Engaging in regular physical activity, aiming for at least 150 minutes of moderate-intensity exercise per week.
Increasing dietary fiber and choosing healthy fats, such as those found in nuts, seeds, olive oil, and fatty fish.

Nevertheless, when the triglyceride levels are still high above 500 mg/dL after these interventions, medications may be prescribed not only to lower your risk of acute pancreatitis but also to minimise the cardiovascular risks you face. Based on your total lipid profile and the cardiovascular risks, your physician can prescribe medications like statins, fibrates, and omega-3 fatty acids.

Since your triglyceride levels have increased despite making positive lifestyle changes, it is also important to evaluate for other possible contributing factors, including:

Diabetes mellitus or prediabetes.
Hypothyroidism (underactive thyroid).
Certain medications.
Excessive alcohol intake.
Genetic lipid disorders.

Given your father's history of heart disease, I recommend following up with your doctor to review your complete lipid profile, assess your overall cardiovascular risk, and determine whether additional investigations or medication are appropriate.

If possible, please share the following information:

Your triglyceride level.
Low-density lipoprotein (LDL) cholesterol.
High-density lipoprotein (HDL) cholesterol.
Total cholesterol.
Height and weight.
Whether you consume alcohol.
Whether you have diabetes mellitus or prediabetes.

I hope this information is helpful. Please feel free to ask if you have any further questions.

Thank you.