Losing 5% to 10% of your weight, if you carry extra, can lower triglycerides about 20% to 30%; cutting back on heavy drinking, carbs and added sugar each lower them about 10 to 23 mg/dL, and at 500 mg/dL or higher you should call your doctor within a few days because of the risk of pancreatitis.
Triglycerides are the fat in your blood that rises after meals and with alcohol and sugar. Of all the numbers on a lipid panel, they respond to food, drink and weight the most.
That's good news if yours are high, because the changes that move them most are ones you can start this week.
The book's grade: SUPPORTED (works) for triglycerides: losing weight if you carry extra, cutting back on heavy drinking, cutting added sugar and sugary drinks, and eating fewer carbs. Regular exercise helps too, with a smaller average drop.
What counts as high triglycerides
Most lab reports still use the older ATP III labels:
- Under 150 mg/dL: normal
- 150 to 199: borderline high
- 200 to 499: high
- 500 or higher: very high
Triglycerides count as persistently high at 150 or more on a fasting test, once other causes have been checked and you've given healthy habits at least 4 to 12 weeks (2026 guideline).
One test can mislead you. The same person's triglycerides typically vary about 23% from one test to the next, with nothing changed (30 studies). If your true level is about 150, a single test can come back anywhere from about 80 to 220.
What lowers triglycerides the most
This is the book's ranking, roughly largest first. The figures come from different studies, so treat the order as a rough guide.
- Lose 5% to 10% of your weight, if you carry extra. Triglycerides about 20% to 30% lower (2026 guideline). In a review of 73 trials, each kilogram (2.2 pounds) lost went with triglycerides about 4 mg/dL lower (review). If you weigh 200 pounds, losing 5% is 10 pounds, which works out to about 18 mg/dL lower on those averages.
- Cut back if you drink about 3 or more drinks a day. In one small trial in men, triglycerides fell about 19 to 23 mg/dL in 4 weeks (trial).
- Eat fewer carbs. Triglycerides about 15 to 22 mg/dL lower, more with stricter cutting (review, review).
- Cut added sugar, especially sugary drinks. Triglycerides about 10 mg/dL lower across 37 trials (review).
- Exercise regularly. About 8 mg/dL lower on average in 148 trials (review), and more when triglycerides start high. In 200 men who did 20 weeks of endurance training, those with high triglycerides saw them fall about 15% (study).
- Eat fatty fish in place of red or processed meat. Triglycerides about 7 to 23 mg/dL lower than with other foods, a PLAUSIBLE (might help) grade (review).
A registered dietitian can help. In trials, dietitian care lowered triglycerides about 33 mg/dL more than usual care (review).
Alcohol and triglycerides
Of all the lifestyle changes, cutting alcohol lowers triglycerides the most, according to the European guideline. Alcohol pushes the liver to make more triglyceride-carrying particles and slows the clearing of fat from your blood after a meal (review).
The 2026 U.S. guideline sets the limit by your number (2026 guideline):
- 150 to 499 mg/dL: keep alcohol to a minimum.
- 500 to 999: no alcohol.
- 1,000 or higher: no alcohol and no added sugars.
One standard drink is 12 ounces of regular beer, 5 ounces of wine or a 1.5-ounce shot (NIAAA). If you drink heavily every day, talk to your doctor before you cut back, because stopping all at once can bring dangerous withdrawal.
Sugar, carbs and triglycerides
Your liver turns extra sugar into fat and ships it out as triglycerides. In a New Zealand trial of 32 people with high triglycerides, the group that cut sugar by more than 70% for 6 months saw triglycerides fall more than 20% (trial).
- Start with drinks. Trade soda, sweet tea, energy drinks and sweetened coffee drinks for water, unsweetened tea or paper-filtered coffee. The 2025-2030 Dietary Guidelines suggest keeping any one meal to 10 grams of added sugar or less (Dietary Guidelines).
- Swapping one added sugar for another isn't the fix. Calorie for calorie, fructose didn't raise triglycerides more than other carbs, and honey had no effect on blood fats in 23 trials. The book grades these swaps UNLIKELY TO HELP (review, review).
- Keep whole fruit. Cutting it is UNLIKELY TO HELP. Juice is different, so keep portions small.
- Moderate low-carb works for triglycerides. Eating about 26% to 45% of calories from carbs lowered triglycerides about 15 mg/dL, with LDL about the same (review).
- Keto lowers triglycerides but can raise LDL. It's SUPPORTED for triglycerides, but POSSIBLY HARMFUL for LDL, which rose about 8 to 13 mg/dL on average (review, review). If you use it, recheck LDL too.
Does fish oil lower triglycerides?
Yes. Store-bought (nonprescription) fish oil lowers triglycerides about 15% on average in long trials, or about 6 mg/dL for every gram a day of EPA plus DHA (NIH fact sheet). That's like going from 250 to about 213.
My advice is still to skip store fish oil for cholesterol. It doesn't lower LDL, it hasn't prevented heart attacks in the big trials (review), and the 2026 guideline recommends against nonprescription fish oil. In large heart trials, fish oil pills also raised the risk of atrial fibrillation, an irregular heartbeat (review), mainly in people at high heart risk taking more than 1.5 grams a day (review).
If your triglycerides are high, ask your doctor about prescription options instead. At 500 mg/dL and up, prescription omega-3 or a fibrate is often used to lower the pancreatitis risk (2026 guideline).
Very high triglycerides: when to call your doctor
From 150 to 499, high triglycerides matter mainly as a heart risk. At 500 or higher, there's a second danger, acute pancreatitis, a sudden, painful swelling of the pancreas that can land you in the hospital. The risk is "particularly high" at 1,000 or more (2026 guideline).
- 500 to 999 mg/dL: call your doctor's office within a few days.
- 1,000 or higher: call the same day, even if you feel fine.
- Upper belly pain that spreads to your back or keeps getting worse: get care right away at urgent care, the ER or your doctor's on-call line the same day. Fever, nausea, vomiting and a fast heartbeat can come with it (NIDDK).
A high number on its own isn't a reason for the ER unless you have symptoms like chest pain or severe belly pain. Most people with very high triglycerides never get pancreatitis. In about 116,000 adults in Copenhagen, people with triglycerides of 443 mg/dL or more had about 9 times the pancreatitis risk of people under 89, yet only about 12 cases per 10,000 people a year (study).
At 500 or higher, your doctor should still set the plan. Expect a repeat fasting test, questions about alcohol, blood sugar and medicines, and a diet with no alcohol, no added sugars and very little fat (about 10% to 15% of calories) until the levels come down.
What causes high triglycerides?
Very high triglycerides usually come from an inherited tilt plus triggers that pile on, such as a diet high in fat and sugar, little activity, extra weight, alcohol and diabetes that isn't under control (review). Some common medicines can raise them too. Bring your full medicine list to your doctor, and never stop a prescribed medicine to see what happens.
What to do this week
- Start with drinks. Cut sugary drinks, and cut back on alcohol if you drink most days.
- Move most days, building toward about 150 minutes a week.
- Trim your carbs, starting with refined ones and sweets.
- Set a weight goal of 5% if you carry extra.
- Recheck in about 12 weeks under the same conditions as your last test.
Bottom line
Triglycerides respond to lifestyle more than any other lipid number, and weight loss, less alcohol, less added sugar and fewer carbs do the most. Store fish oil lowers them, but it doesn't lower LDL or prevent heart attacks. At 500 or higher, call your doctor's office within a few days, or the same day at 1,000 or higher, and get care right away for upper belly pain that spreads to your back.
Questions people ask
How can I lower my triglycerides fast?
Cut alcohol and sugary drinks first. In one trial, men who cut back on daily drinking lowered triglycerides about 19 mg/dL in 4 weeks. Because triglycerides swing about 23% between tests, judge the change at a recheck, not at day 7.
What foods lower triglycerides?
Fatty fish in place of red or processed meat helps, with triglycerides about 7 to 23 mg/dL lower than other foods. Most people get a bigger drop by cutting added sugar, sugary drinks, alcohol and refined carbs.
Do high triglycerides cause symptoms?
The one to know is pancreatitis, which becomes a risk at 500 mg/dL or higher. Pain in the upper belly that spreads to your back, sometimes with nausea or vomiting, needs care right away.
What is a normal triglyceride level?
Under 150 mg/dL. From 150 to 199 is borderline high, 200 to 499 high and 500 or higher very high.
Are high triglycerides dangerous?
From 150 to 499, they matter mainly as a heart risk. At 500 or higher, the risk of pancreatitis rises, and it's particularly high at 1,000 or more. Call your doctor's office within a few days at 500 to 999, and the same day at 1,000 or higher.
Does fish oil lower triglycerides?
Yes, about 15% on average. It doesn't lower LDL or prevent heart attacks, so ask your doctor about prescription options if your triglycerides are high.
What else the book ranks for your lipid panel
My book, Your Cholesterol by the Numbers, grades dozens of foods, habits and supplements with a real number for each. For high triglycerides, it also grades tai chi, PLAUSIBLE (weak evidence) at about 17 mg/dL lower; high-dose niacin, which moves the numbers but is a Skip because it didn't prevent heart attacks; and switching from unfiltered to paper-filtered coffee, SUPPORTED for LDL if you drink the unfiltered kind most days. The book is coming soon. Meanwhile, see how to lower cholesterol naturally for the LDL ranking.