What are the non-pharmacological ways to lower triglycerides?

Non-Pharmacological Ways to Lower Triglycerides

Intensive therapeutic lifestyle changes can reduce triglyceride levels by up to 50% or more and should be the first-line approach for managing hypertriglyceridemia. 1

Weight Management

• A 5-10% reduction in body weight can decrease triglyceride levels by approximately 20% 1
• In some patients, weight loss can reduce triglyceride levels by up to 70%, making it the most effective non-pharmacological intervention 1
• Sustained weight loss of 3-5% provides clinically meaningful health benefits for triglyceride reduction 1

Dietary Modifications

Carbohydrate Management

• Reduce added sugars and fructose in the diet to achieve a 10-20% reduction in triglyceride levels 1
• Low-carbohydrate diets are more effective at lowering triglycerides than low-fat diets 1
• Very low-carbohydrate diets (<10% of calories from carbohydrates) can reduce triglycerides by approximately 24 mg/dL 1
• Eliminate refined carbohydrates and added sugars completely for severe hypertriglyceridemia 1

Fat Intake

• Replace saturated fats with unsaturated fats, particularly monounsaturated fats 1
• Eliminate trans fats from the diet 1
• For moderate hypertriglyceridemia (200-499 mg/dL), limit total fat to 30-35% of total daily calories 1
• For severe hypertriglyceridemia (500-999 mg/dL), restrict dietary fat to 20-25% of total calories 1
• For very severe hypertriglyceridemia (≥1000 mg/dL), implement a very low-fat diet (10-15% of total calories) 1
• In extreme cases, consider dietary fat restriction to <5% of total calories until triglyceride levels are ≤1000 mg/dL 1

Omega-3 Fatty Acids

• Increase consumption of marine-based omega-3 products (from dietary sources) 1
• Consuming fish rich in omega-3 fatty acids can help lower triglyceride levels 1

Physical Activity

• Regular aerobic activity can lower triglyceride levels by up to 30% 1
• Engage in at least 150 minutes/week of moderate-intensity or 75 minutes/week of vigorous aerobic activity 1
• The response may vary depending on the type, duration, and intensity of activity 1

Alcohol Management

• Complete abstinence from alcohol is recommended for those with very high triglyceride levels or a history of triglyceride-induced pancreatitis 1
• For those with mild to moderate hypertriglyceridemia, restrict or completely avoid alcohol consumption 1

Glycemic Control

• For patients with diabetes, optimizing glycemic control can significantly reduce triglyceride levels 1, 2
• Insulin therapy (alone or with insulin sensitizers) may be particularly effective in lowering triglyceride levels in diabetic patients 1, 2

Dietary Fiber

• Increase viscous (soluble) fiber intake (10-25 g/day) 1
• Adding plant stanols/sterols (2 g/day) can enhance lipid-lowering effects 1

Practical Implementation

• For mild to moderate hypertriglyceridemia, a combination of weight loss, reduced carbohydrate intake, increased physical activity, and alcohol restriction can achieve significant triglyceride reduction 1
• For severe hypertriglyceridemia, more aggressive dietary restrictions are necessary, particularly regarding fat and carbohydrate intake 1
• The response to lifestyle interventions may vary between individuals, with some experiencing dramatic improvements with minimal changes 1

Potential Pitfalls and Caveats

• Dietary fat restriction alone without addressing carbohydrate intake may not be effective and could potentially worsen triglyceride levels 1
• Focusing solely on weight loss without addressing dietary composition may limit triglyceride-lowering effects 1
• Patients with triglyceride levels ≥500 mg/dL are at risk for pancreatitis and may require more aggressive interventions, including pharmacological therapy in addition to lifestyle changes 1, 3
• Low-fat, high-carbohydrate diets may actually increase triglyceride levels in some individuals 1