To lower high triglycerides, the changes that matter most are cutting back on alcohol, added sugar and refined carbohydrates, losing weight if you're overweight, and being more active. A 5 to 10% weight loss alone can lower triglycerides by 20 to 30%. Under the 2026 ACC/AHA guideline, a fasting level of 150 mg/dL (1.7 mmol/L) or more that stays high after these changes counts as raised, and 500 mg/dL (5.6 mmol/L) or more increases the risk of pancreatitis.
The short version
Cut: alcohol, sugary drinks and added sugar, white bread and other refined carbs, and saturated fat. Eat: wholegrains, beans, vegetables, nuts, olive or rapeseed oil, and oily fish. Move: 150 minutes of moderate activity a week. Omega-3: oily fish is good food, but over-the-counter fish oil capsules aren't recommended to prevent heart disease. The prescription form, icosapent ethyl, is for specific higher-risk patients. See a doctor quickly if your level is 10 mmol/L (about 885 mg/dL) or higher.
What counts as high
Triglycerides are a type of blood fat that your body uses for energy. Labs report them in mg/dL in the US and mmol/L in the UK (1 mmol/L ≈ 88.6 mg/dL). Note that this is a different conversion from cholesterol, so use our unit converter rather than the cholesterol factor.
| Level | What the guidelines say |
|---|---|
| Below 1.7 mmol/L (150 mg/dL) fasting, or below 2.0 mmol/L (177 mg/dL) non-fasting | Healthy, according to HEART UK |
| 1.7 mmol/L (150 mg/dL) or more, persisting | "Persistent hypertriglyceridemia" under the 2026 US guideline, once other causes have been treated and you've made 4 to 12 weeks of lifestyle changes |
| 4.5 to 9.9 mmol/L (about 400 to 880 mg/dL) | NICE: heart-risk scores may underestimate your risk, so other risk factors should be managed as well as possible, with specialist advice if non-HDL is above 7.5 mmol/L |
| 5.6 mmol/L (500 mg/dL) or more | Severe (2026 US guideline): pancreatitis risk starts to rise |
| 10 to 20 mmol/L (about 885 to 1,770 mg/dL) | NICE: repeat a fasting test within 5 days to 2 weeks, check for other causes, and get specialist advice if it's still above 10 |
| 11.3 mmol/L (1,000 mg/dL) or more | 2026 US guideline: pancreatitis risk is particularly high, so lowering triglycerides becomes the first priority |
| Above 20 mmol/L (about 1,770 mg/dL) | NICE: urgent specialist review, unless it's due to heavy drinking or poorly controlled diabetes |
Below the pancreatitis range, the concern is your heart. The 2026 guideline says the remnants of triglyceride-rich particles are consistently linked to a higher risk of heart attack and stroke. High triglycerides often come with a low HDL and a higher non-HDL cholesterol, so look at the whole panel: our results guide explains each number. If your doctor mentions ApoB, the 2026 guideline suggests it's especially useful when triglycerides are 150 mg/dL or more (see what's new in the 2026 guideline).
Check for other causes first
The 2026 guideline lists many things that push triglycerides up besides diet. These include poorly controlled diabetes, kidney disease, an underactive thyroid, obesity, pregnancy, and some medicines, among them oral oestrogens, some beta-blockers and water tablets, steroids, and some antipsychotics. Don't stop a prescribed medicine because of this list. Ask your doctor whether anything you take could be playing a part.
What to cut
Alcohol
The 2026 guideline lists alcohol excess as a cause of high triglycerides, and its first-line advice is "alcohol reduction or elimination". The NHS low-risk limit for everyone is 14 units a week, spread over 3 or more days. If your triglycerides are very high, ask your doctor whether you should stop altogether.
Added sugar and sugary drinks
The guideline lists diets high in sugar as a cause of raised triglycerides, and advises a diet low in added sugars. The easiest wins are usually sugary drinks, sweets, cakes and biscuits, sweetened cereals and yoghurts, and syrups. If you're wondering whether sugar raises cholesterol, its clearest effect is on triglycerides; for LDL, saturated fat matters more.
Refined carbohydrates
The guideline also points to refined carbohydrates and high-glycaemic-index foods: white bread, white rice, many breakfast cereals, crackers and pastries. You don't need to cut carbs out. Swap to the wholegrain versions the NHS recommends, such as brown rice, wholegrain bread and wholewheat pasta, and keep portions sensible.
Saturated fat
A diet low in saturated fat is part of the same first-line advice, and it also lowers LDL. Cut down on fatty and processed meat, butter, cream, cheese, pastry, and foods made with coconut or palm oil. Our saturated fat calculator gives a daily limit for your calories.
What to eat
- Wholegrains and beans in place of refined carbs: oats, barley, brown rice, wholegrain bread, lentils, chickpeas.
- Plenty of vegetables and fruit.
- Unsaturated fats instead of saturated ones: olive and rapeseed oil, nuts and seeds.
- Oily fish such as mackerel and salmon, which the NHS suggests eating more of.
Our low-cholesterol recipes follow the same pattern: low in saturated fat, built on wholegrains, beans and vegetables.
Weight and activity
These move triglycerides more than they move LDL:
- Weight: the 2026 guideline says a 5 to 10% weight loss can lower triglycerides by 20 to 30%. In a meta-analysis of 73 trials, each kilogram lost lowered triglycerides by about 4 mg/dL (0.05 mmol/L).
- Exercise: moderate aerobic exercise lowered triglycerides by about 0.21 mmol/L (19 mg/dL) in a meta-analysis cited by the guideline. The target is at least 150 minutes of moderate activity, or 75 minutes of vigorous activity, a week.
The guideline suggests 4 to 12 weeks of lifestyle changes before deciding whether high triglycerides are "persistent". That's a sensible gap before a re-test (see how long changes take to show).
Omega-3: food, capsules and prescriptions
This is where most confusion comes in, because "omega-3" covers three quite different things:
- Oily fish: a healthy food, and a good swap for red and processed meat.
- Over-the-counter fish oil and omega-3 capsules: the 2026 ACC/AHA guideline recommends against using dietary supplements to lower LDL or triglycerides. NICE tells doctors not to offer omega-3 compounds to prevent heart disease, because there's no evidence they help, with one exception (below).
- Prescription icosapent ethyl (Vascepa in the US, Vazkepa in the UK): a purified form of the omega-3 EPA, taken at 4 g a day. In the REDUCE-IT trial of 8,179 people with heart disease, or with diabetes plus another risk factor, it cut major heart events by 25%. It also raised the rates of hospital admission for atrial fibrillation and of serious bleeding, and the trial's mineral-oil placebo may have made the benefit look bigger. The 2026 US guideline says it "may be reasonable" for adults 50 or over with persistently high triglycerides or diabetes plus at least one risk factor.
- In the UK, NICE recommends it only for adults already on a statin who have established heart or circulation disease, fasting triglycerides of 1.7 mmol/L or more, and LDL between 1.04 and 2.60 mmol/L.
Other prescription omega-3 products haven't shown the same heart benefit in trials, according to the guideline. At very high levels (500 mg/dL, 5.6 mmol/L, or more), doctors may use prescription omega-3 or a fibrate to lower triglycerides and the risk of pancreatitis. That's a decision for your doctor, not a reason to buy capsules.
Where statins fit
For triglycerides below 1,000 mg/dL (11.3 mmol/L), the 2026 guideline says statins remain the first-line medicine for heart risk. They lower triglycerides by about 20 to 40% as well as LDL. Fibrates lower triglycerides but don't add heart protection on top of a statin. If you're on a statin, alcohol is worth watching for another reason too: see what to eat on statins. If your total cholesterol is also raised, our plan for getting from 6 to 5 mmol/L overlaps a lot with this one.
Questions to ask your doctor
- Was my test fasting? Should it be repeated?
- Could a medicine I take, or a condition such as diabetes or thyroid problems, be raising my triglycerides?
- What are my LDL, non-HDL and HDL, and what's my overall heart risk?
- How much should I cut back on alcohol?
- Would I benefit from a statin, icosapent ethyl or another treatment?
- Should I have my Lp(a) measured too?
Sources
- Blumenthal RS, Morris PB, et al. 2026 ACC/AHA Guideline on the Management of Dyslipidemia. J Am Coll Cardiol. 2026;87(19). Also in Circulation, doi:10.1161/CIR.0000000000001423. Section 4.2.9, Figures 14–17, Table 23.
- NICE NG238: Cardiovascular disease: risk assessment and reduction, including lipid modification. Recommendations 1.4.6–1.4.8 and 1.12.5–1.12.7.
- NICE TA805: Icosapent ethyl with statin therapy for reducing the risk of cardiovascular events in people with raised triglycerides (July 2022).
- HEART UK: Familial hypertriglyceridaemia (updated March 2025).
- NHS: How to lower your cholesterol (reviewed March 2026).
Frequently asked questions
What is a normal triglyceride level?
HEART UK says healthy triglycerides are below 1.7 mmol/L (150 mg/dL) after fasting, or below 2.0 mmol/L (177 mg/dL) without fasting. The 2026 US guideline treats a fasting level of 150 mg/dL or more that persists after lifestyle changes as raised, and 500 mg/dL (5.6 mmol/L) or more as severe.
Does sugar raise cholesterol or triglycerides?
Its clearest effect is on triglycerides. The 2026 ACC/AHA guideline lists diets high in sugar and high-glycaemic-index foods among the causes of raised triglycerides, and advises cutting added sugar and refined carbohydrates to lower them. For LDL cholesterol, saturated fat has the bigger effect.
What should I cut first if my triglycerides are high?
Alcohol, added sugar and sugary drinks, and refined carbohydrates such as white bread and pastries. These are the first-line changes in the 2026 guideline, along with less saturated fat, weight loss if you're overweight, and regular exercise. It's also worth asking your doctor about medical causes and medicines that raise triglycerides.
Does alcohol raise triglycerides?
Yes. The 2026 ACC/AHA guideline lists alcohol excess as a cause of high triglycerides, and its first-line advice is alcohol reduction or elimination. The NHS low-risk limit is 14 units a week; if your triglycerides are very high, ask your doctor whether you should stop drinking.
Do fish oil supplements lower triglycerides?
The guidelines don't recommend over-the-counter fish oil for this. The 2026 ACC/AHA guideline advises against dietary supplements for lowering triglycerides, and NICE says omega-3 compounds shouldn't be offered to prevent heart disease. The exception is prescription icosapent ethyl, which is recommended only for specific higher-risk patients. Eating oily fish as part of your diet is still a good choice.
What triglyceride level is dangerous?
The risk of pancreatitis rises at 500 mg/dL (5.6 mmol/L) and is particularly high at 1,000 mg/dL (11.3 mmol/L) or more. In the UK, NICE says a level above 10 mmol/L should be re-tested and may need specialist advice, and above 20 mmol/L needs urgent specialist review unless it's due to alcohol or poorly controlled diabetes.
How much does weight loss lower triglycerides?
The 2026 guideline says losing 5 to 10% of your body weight can lower triglycerides by 20 to 30%. In a meta-analysis of 73 trials, each kilogram lost lowered triglycerides by about 4 mg/dL (0.05 mmol/L).
Watch your triglycerides respond
Heart Tracker charts your triglycerides alongside total cholesterol, LDL and HDL, so you can see what changes after you cut back on alcohol and sugar. Logging meals shows your sugars, total carbs, saturated fat and fibre each day. Free and ad-supported, with no account needed.
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