The quick guide to triglycerides, and why they matter
High triglycerides are a major but underappreciated marker of metabolic dysfunction. Learn what causes elevated levels and what you can do to bring them down.
Triglycerides are a type of fat (lipid) in your blood, composed of three fatty acids attached to a glycerol backbone. They're your body's primary means of storing excess energy from food. When you eat more calories than your body needs---especially carbohydrates---the surplus is converted into triglycerides and stored in fat cells.
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Why Do Triglycerides Matter?
High triglyceride levels---called hypertriglyceridemia---are strongly linked to metabolic dysfunction. They're associated with increased risk for:
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- Stroke
- Type 2 diabetes
- Metabolic syndrome
- Insulin resistance
When triglyceride levels are elevated, they can promote atherosclerosis (plaque buildup in arteries) and reduce protective HDL cholesterol levels. High triglycerides also contribute to the formation of small, dense LDL particles, which are particularly harmful to cardiovascular health.
What Do Your Triglyceride Levels Mean?
Triglycerides are measured via a standard lipid panel, usually after fasting. The ranges are:
- Normal: <150 mg/dL
- Borderline high: 150-199 mg/dL
- High: 200-499 mg/dL
- Very high: ≥500 mg/dL
However, many metabolic health experts suggest aiming for <100 mg/dL (or even <70 mg/dL) for optimal cardiometabolic health.
A related metric, the triglyceride-to-HDL ratio (TG:HDL), is also highly predictive of risk. A TG:HDL ratio above 2-3 may indicate insulin resistance.
What Causes High Triglycerides?
The most common contributors include:
- Excess carbohydrate intake (especially sugar and refined grains)
- Overeating in general
- Sedentary lifestyle
- Obesity
- Insulin resistance
- Heavy alcohol use
- Genetic conditions (e.g., familial hypertriglyceridemia)
How to Lower Triglycerides
Evidence-based strategies include:
- Lower carbohydrate intake - Reducing total and especially high-glycemic carbs can significantly decrease triglycerides
- Lose excess weight - Even modest weight loss (5-10%) can lead to large reductions in triglyceride levels
- Exercise regularly - Aerobic activity helps lower triglycerides and improve insulin sensitivity
- Limit alcohol - Alcohol raises triglycerides, particularly in those already at risk
- Add omega-3s - Supplementing with EPA and DHA (4 g/day) may reduce triglycerides by 20-35%
- Avoid ultra-processed foods - Reducing sugar-sweetened beverages, baked goods, and fried foods helps lower metabolic load
Common Questions
Do I need to fast before a triglyceride test?
Yes, fasting for 8-12 hours is typically required for accurate triglyceride measurement, as levels can spike significantly after meals.
Can triglycerides be too low?
Very low triglycerides (<50 mg/dL) can sometimes indicate malnutrition or hyperthyroidism, but this is less common than elevated levels.
How quickly can I lower my triglycerides?
Triglycerides respond rapidly to dietary changes---you can often see improvements within 2-4 weeks of reducing carbohydrates and sugar.
What's the connection between triglycerides and diabetes?
High triglycerides and diabetes often go hand-in-hand through insulin resistance. Elevated triglycerides can predict diabetes development, while diabetes worsens triglyceride levels.
The Bottom Line
High triglycerides are a modifiable marker of poor metabolic health. With targeted changes to diet, lifestyle, and activity, most people can reduce triglycerides and dramatically improve long-term health outcomes.
More Articles on Triglycerides
The 2023 Levels Guide to triglycerides
A deeper dive into what triglycerides do in your body and how they relate to metabolic health
How to reduce triglycerides
A step-by-step guide to reducing triglyceride levels through diet and lifestyle changes
Test and improve your triglyceride levels
Levels members can test their triglyceride levels through Levels Labs, and then use the Levels app to help improve levels by logging meals and setting exercise goals. Click here to learn more about Levels.
