How to lower
your triglycerides
Patient Information
2
Contents
Who is this leaflet for? 4
What are triglycerides? 4
Why is this important? 4
How can triglycerides be lowered? 5
Reduce fat intake 5
How do you know how much fat is in foods? 6
How to read a food label for fat content 6
Eat foods containing Omega-3 12
Cut down on sugar and sugary foods and drinks and
choose unrefined carbohydrate sources 15
If you drink alcohol, do so in moderation 21
Aim to take regular physical activity 23
Further information 26
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Who is this leaflet for?
This leaflet is for people with high triglycerides who have been
advised to make dietary changes to try and reduce these. It
provides information about what triglycerides are and explains
the dietary and lifestyle changes you can make to help reduce
these.
What are triglycerides?
Triglycerides are a type of fat. They are found in foods that
we eat, for example in meat, dairy products and cooking oils.
During digestion, triglycerides are absorbed in the intestines and
transported in the bloodstream to the tissues, where they are
either taken up by cells and used to provide energy or stored as
fat.
Any excess calories in our diet are converted to triglycerides by
the liver and stored in our fat (adipose) cells until required. As
well as absorbing triglycerides from the diet, many tissues also
have the ability to make triglycerides, including the liver, gut,
muscle, and adipose tissues.
Why is this important?
Triglyceride levels may be raised due to an unhealthy diet,
sedentary lifestyle and excessive alcohol intake. Being overweight
or having type 2 diabetes can also result in high triglyceride
levels. Managing these causes should lead to a reduction in
triglyceride levels.
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High levels of triglycerides have been shown to increase the risk
of coronary heart disease. Very high levels of triglycerides in the
blood can cause problems such as inflammation of the pancreas
(pancreatitis). This can be a very serious condition, causing a
lot of pain and admission to hospital. Having high levels of
triglycerides can be accompanied by changes in how the blood
clots, including abnormalities in clotting factors and in how
blood clots are broken down.
How can triglycerides be lowered?
Triglycerides can be very responsive to changes in diet and
lifestyle. There are several key changes you can make to help
reduce your triglyceride levels.
Diet and lifestyle recommendations
Triglycerides can be very responsive to changes in diet and
lifestyle. There are several key changes you can make to help
reduce your triglyceride levels.
1. Reduce fat intake
Follow a diet low in fat, with less than 30% of daily calories from
total fat intake. Choose unsaturated fats over saturated fat.
For example, if you were eating a 1500 calorie diet and aiming
for less than 30% fat you would need to aim for less than 450
calories from total fat intake. If your triglycerides do not reduce
with this, then you may need to aim for less.
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Fat should be spread out throughout the day, rather than all
eaten at one mealtime. Just one large, fatty meal can increase
your risk of developing pancreatitis (inflamed pancreas). A meal
should not contain more than 15g of fat at one time.
If your triglycerides are severely raised then it will be suggested
that you follow a very strict low fat diet (less than 25g of fat
per day) to bring the levels down as quickly as possible (further
information on this can be found at the bottom of this leaflet).
A dietitian will help you with this.
How do you know how much fat is in
foods?
Fat is found in many different foods and drinks for example
dairy products, meats, oils, nuts and cakes.
How to read a food label for fat content
Food packets will have a nutritional label, which should give
the amount of fat per 100g of the food. It may also give the
amount per recommended portion.
You don’t need to count the amount of fat in a food or drink
item if it has less than 0.5g fat per 100g. The below label has
1.4g fat per 100g so you would need to include this food within
your fat calculation. This label also shows the amount of fat in
one portion (0.5g fat).
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For example:
Typical values Per 100g Per one portion
Energy 240 kcals 96 kcals
Fat 1.4g 0.5g
Carbohydrate 47g 18.8g
Protein 8.4g 3.3g
Traffic light system
Some food labels have traffic light colour codes on the front. Try
to choose foods with a green colour for the fat content.
Each serving (150g) contains
Energy Fat Saturates Sugars Salt
1046kJ 3.0g 1.3g 34g 0.9g
250kcal LOW LOW HIGH MED
13% 4% 7% 38% 15%
of an adult’s reference intake
Typical values (as sold) per 100g: 697kJ/167kcal
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High fat - Avoid these foods
• Any drink with more than 8.75g fat per 100ml.
• Any food with more than 17.5g fat per 100g.
Medium fat - Avoid these or eat them only in
small amounts, and check that they are within
your daily fat allowance.
• Any food with more than 3g and less than
17.5g fat per 100g.
• Any drink with more than 1.5g and less than
8.75g fat per 100ml.
Low fat - Eat these alongside fat-free foods,
within your daily fat allowance.
• Any food with less than 3g fat per 100g.
• Any drink with less than 1.5g fat per 100ml.
Tips to reduce fat in the diet
• Try steaming, poaching, boiling or grilling instead of roasting
and frying. If you do fry, use a non-stick pan/air fryer and you
may not need to use any fat or oil at all. Spray oils are a good
way of reducing the amount of fat needed.
• Buy lean meats and avoid processed meats (such as sausages
and bacon). Take the skin off poultry and remove visible fat
from the meat before you start cooking.
• Use low-fat/fat-free products where available such as skimmed
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rather than semi-skimmed or whole milk; 0% fat yoghurts,
low-fat spreads rather than margarine or butter. Don’t be
tempted to put on more because it’s lower in fat.
• Avoid all cheese with the exception of extra low-fat cream
cheese and cottage cheese. There are also 3% fat hard cheeses
available in supermarkets which can be used.
The table below gives some examples of low and higher
fat food options:
Food group Higher fat (avoid) Lower fat options
Butter, margarine, olive Use small amounts of
Fats oil, vegetable oil, lard, low-fat spreads or use
suet. spray cooking oil.
Skimmed or semi
skimmed milk. Fat
Whole milk,
free/low fat yogurt or
evaporated or
fromage frais. Reduced
Milk/Dairy condensed milk, cream,
fat cheeses such as:
full fat yogurt, ice
cottage cheese, low fat
cream, full fat cheese.
soft cheese, edam, half
fat hard cheese.
Only have small
portions of oily fish
White fish e.g. haddock,
e.g. sardines, mackerel,
sole, plaice, cod,
Fish kippers (see section 2
whiting, prawns, tuna in
on omega 3 fatty acids
brine/spring water.
for more information).
Avoid fish tinned in oil.
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The table below gives some examples of low and higher
fat food options:
Fried or processed
meats. Fat on meat,
burgers, sausages,
Lean meats and poultry
Meat x salami, meat paste
without skin
or pâté, meat pies or
tinned meat, skin on
poultry
Pulses None to avoid Lentils, peas, beans
Pastry, chips, roast
Bread, rice, pasta,
Starchy foods potatoes, pasta in
cereals, potatoes
creamy/cheese sauces
Most varieties of fresh,
Fruit Avocado, olives frozen or tinned fruit
(juice drained off)
Roasted or fried
All raw/boiled/steamed
Vegetables vegetables, salads with
vegetables and salads
dressings
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The table below gives some examples of low and higher
fat food options:
Ketchup, pickle,
marmite, low fat or
Salad cream,
light salad dressings,
mayonnaise, salad
salsa, tomato-based
Sauces dressings, white sauce,
sauces, white sauces
cheese sauce, creamy
made with cornflour
sauces
and low fat milk, low fat
mayonnaise
Squash, juices, skimmed
Hot chocolate, Horlicks, milk, instant low calorie
Drinks milkshakes unless made hot chocolate or Horlicks
with skimmed milk made with water/
skimmed milk
Chocolate, toffee, Jelly sweets, ice lollies,
Snacks fudge, crisps, nuts, mints, marshmallows,
seeds, Bombay mix Turkish delight
Cakes, biscuits, milk
puddings (unless Sugar free jelly, tinned
Puddings Pudding skimmed milk), shop fruit (juice drained off),
bought desserts, low fat milk puddings.
custard
Sugar, honey, jam,
Lemon curd, peanut
Miscellaneous golden syrup,
butter
marmalade
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• Avoid or choose much smaller portion sizes of fatty foods such
as crisps, nuts, pastry, cakes, biscuits, cream, tinned meats,
Yorkshire puddings, dumplings and gravy made with meat
juices.
• When having potatoes choose boiled, mashed (without butter)
or jacket rather than roast or chips.
2. Eat foods containing Omega-3
Omega-3 fats ( a type of unsaturated fat) may help to reduce your
triglyceride level, lower your blood pressure and reduce the risk of
a blood clot.
Oily fish is the best source of omega-3. Aim to eat two portions
(140g) of oily fish per week from sustainable sources. This can
include fresh, canned or frozen varieties. White fish and shellfish
contain much lower levels of omega-3.
What counts as oily fish?
The following fish are classified as oily: salmon, mackerel, sardines,
pilchards, anchovies, herring, trout, kipper, eel, whitebait,
swordfish, bloater, carp and sprats. Tuna is not classified as an oily
fish.
It is suggested to include oily fish that are lower in fat than others,
for example trout and pilchards compared to herring or mackerel.
Please see the table below for more information on the fat
content of different oily fish. As previously mentioned, you need
to spread your daily fat content throughout the day with less than
15g at a time, so you may not be able to consume this all in one
go. It is best to have half portions and incorporate it into dishes
low in fat like pasta, salads or sandwiches.
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What if I don’t eat fish?
If you don’t eat fish there are plant-based sources of omega-3,
although your body can only convert a small amount of this into
the same type of beneficial omega-3 that you get from oily fish.
There are currently no recommendations on the amount of plant
sources of omega-3 needed.
Examples of omega-3 plant sources include:
• rapeseed, soya and flaxseed oils
• nuts eg. walnuts, pecans, peanuts, almonds
• flaxseeds or pumpkin seeds
• soya beans and soya products
• dark green leafy vegetables.
Some food products are also fortified with omega-3.
Type of fish Fat per 100g
Trout, steamed 4.5
Pilchards in tomato sauce 5.4
Kipper, baked 11.4
Sardines canned in tomato
11.6
sauce
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Type of fish Fat per 100g
Salmon, steamed 13
Herring, grilled 13
Anchovies canned in oil 19.9
Mackerel, smoked 30.9
Should I take a supplement?
It is recommended that you obtain your nutrients, including
omega-3, from food rather than supplements. However if you
choose to buy a supplement, choose a product containing fish oil
or omega-3 – a daily 500mg supplement is sufficient.
Do not choose a fish liver oil supplement as they contain less
omega-3 and too much vitamin A. If you are vegetarian or vegan,
there are supplements available that are made from algae.
Omega-3 supplements are not appropriate for everyone. Please
check with your doctor before taking them particularly if you
are taking blood thinning medications such as aspirin, warfarin,
or heparin. Pregnant women should avoid taking supplements
containing any vitamin A.
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3. Cut down on sugar and sugary foods and
drinks and choose unrefined carbohydrate
sources
Sugar is found naturally in many foods, including dairy and fruit.
As these foods also provide us with important vitamins, minerals
and fibre, you do not need to cut down on these. ‘Free sugars’
(refined carbohydrates) are those that are added to processed
foods such as cakes, sweets, cereals and some yoghurts as well
as those found naturally in syrups and fruit juices – this sugar is
harmful to your health. A high intake of free sugar will increase
triglyceride levels and can contribute to overweight. Choosing
unrefined carbohydrates (less processed foods, for example,
wholegrains) can help lower your triglycerides.
Tips to reduce free sugar
• Instead of sugary fizzy drinks and juice drinks, choose water or
no added sugar squash. If you like fizzy drinks, try no added
sugar squash with sparkling water or sugar free/diet options.
Avoid flavoured coffee or water.
• Don’t add sugar to drinks or cereal – gradually reduce the
amount until you can cut it out altogether. Alternatively, try
a sweetener for example Sweetex, Hermesetas, Splenda or
Canderel. They come in tablet or powder forms.
• Reduce the amount of snacks you eat that are high in sugar,
such as cakes, biscuits and chocolate. Try to cut them out as far
as possible or save them for occasional treats. If you do want
snacks, foods such as currant buns, plain scones, wholegrain
crackers, oatcakes, plain popcorn or a small handful of plain
nuts are better choices.
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• Aim to eat more whole fruits rather than flavoured products.
For example: swap fruit flavoured yoghurt for plain yoghurt
with added berries, swap flavoured porridge sachets for plain
porridge with added fruit, or swap a glass of orange juice for
a fruit salad.
• Choose wholegrain breakfast cereals, but not those coated
with sugar or honey.
• Be aware of hidden sugar in processed foods such as soups,
baked beans and jars of pasta sauce, and condiments such
as tomato ketchup and barbecue sauce. Choose low sugar
varieties where available, or try to swap for homemade
sauces, soups and dressings.
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The table below gives some ideas of suitable and
unsuitable carbohydrate choices:
Refined carbohydrates
Food group Try instead:
to avoid:
White breads e.g. High fibre breads:
sliced white, white Wholewheat, granary
Breads rolls, pitta, naan, and multigrain varieties
baguette, croissant, of breads. Oat enriched
chapattis, paninis. breads.
Cakes, biscuits, cream
crackers, water
biscuits, Ritz, Tuck Digestives, Hobnobs,
biscuits, Yorkshire Hovis biscuits (one to two)
pudding, dumplings, Oatcakes, wholewheat
pizza, pastry – pies, crackers and crispbread,
Flour-based pasties, quiche, for example Ryvita,
foods sausage rolls, spring cracker-wheats. Plain
rolls. Breaded and meat/fish without
battered foods, for breadcrumbs/batter
example fish fingers,
battered fish.
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The table below gives some ideas of suitable and
unsuitable carbohydrate choices:
Low fibre and sugar-
coated breakfast High fibre cereals e.g.
Breakfast cereals e.g. Cornflakes, Weetabix®, Shredded
cereals Rice Krispies, Special K, Wheat®, Shreddies®,
Sugar Puffs, Coco Pops, Branflakes®, porridge
sweetened Muesli
There may be benefit
from using basmati
No types need to be
Rice and pasta or brown rice, and
avoided.
wholewheat pasta instead
of white varieties.
Oven chips, French
Fries, Smiley faces,
waffles, Croquettes,
frozen roast potatoes,
instant potato, ready Home cooked potatoes
Potato
meals with instant e.g. new potatoes, sweet
products
potato topping for potatoes
example shepherd’s
pie/cottage pie.
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The table below gives some ideas of suitable and
unsuitable carbohydrate choices:
Hula Hoops®,
Quavers®, Pringles®, Sliced potato crisps, for
Savoury snacks Monster Munch®, example Walker’s® or
French Fries®, Skips®, Kettle® crisps.
baked crisps
Fruit juices and
smoothies, full sugar
Sugar free squash, sugar
squash and fizzy
Cold drinks free carbonated drinks,
drinks, Lucozade®.
water.
Artificial sweeteners
e.g. Splenda®,
Sugar, glucose,
Sugars Sweetex®, Hermesetas®,
maltose, dextrose
Nutrasweet®, Canderel®,
Stevia®
Jam, marmalade,
honey, lemon curd,
Very small amounts of
Preserves maple syrup, chocolate
reduced sugar preserves
spread, treacle and
syrup
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The table below gives some ideas of suitable and
unsuitable carbohydrate choices:
Fresh fruit, tinned fruit
in natural juice (juice
Sweets, chocolates,
drained off), sugar free
mints, sweet
jelly, sugar free Angel
puddings and ice
Delight, low fat Greek or
Desserts/ cream, sweetened
natural yoghurt/diet fruit
sweets yoghurt/ fromage
yoghurts/ fromage frais
frais, tinned fruit in
(no more than 10- 15g
syrup, condensed and
total carbohydrate per
evaporated milk
pot), sugar free mints/
chewing gum
Some ready meals
and sauces contain
significant amounts Tomato-based pasta
Ready meals/ of sugar, for example sauces. Tomato-based/
stir in sauces/ sweet and sour sauces, dry curries, reduced sugar
take-away jar or packet, Chinese baked beans (drain off
sauces. Chinese sauce).
takeaway, tomato
soup, baked beans
Malted drinks such
Cadbury’s Highlights®,
as Ovaltine® and
Hot drinks Ovaltine light Options®,
Horlicks®, drinking
Cocoa powder.
chocolate.
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4. If you drink alcohol, do so in moderation
When you drink alcohol it is broken down and re-built into
triglycerides in your liver, raising the triglyceride level in your
blood. Alcohol is also a source of additional calories that can
contribute to excess weight. The type of alcohol doesn’t seem to
matter: beers, wines and spirits all have the same effect on raising
triglyceride levels. Avoiding alcohol completely can result in a
significant reduction in triglyceride levels.
In susceptible people, even small amounts of alcohol can raise your
triglyceride levels. If your triglycerides are very high, your doctor
may ask you to stop drinking alcohol completely and see what
effect this has on your triglyceride levels.
The table below gives some ideas of suitable and
unsuitable carbohydrate choices:
Drink Units Average calories
One pint of ordinary strength
lager/beer/cider (3.5% to 3.8%
ABV) 2 227
Bottle of lager/beer/cider
1.7 142
(330ml, ABV 5%)
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The table below gives some ideas of suitable and
unsuitable carbohydrate choices:
One standard glass of wine
2.1 159
(175ml, ABV 12%)
One standard glass of
champagne/prosecco (125ml, 1.5 89
ABV 12%)
Single small shot of spirits
1 61
(25ml, ABV 40%)
Some types of drinks or brands can be stronger than others,
and additional calories will also come from sugary mixers. Take
particular care with drinks such as cocktails that may contain
multiple types of alcohols and mixers.
Tips for cutting down on alcohol
• Don’t drink alcohol every day.
• Alternate alcoholic drinks with non-alcoholic sugar-free drinks.
• Make your alcoholic drinks last longer by adding ice, water or
sugar-free mixers.
• Switch to low alcohol beer or wine (remember these will still
contain calories if you are trying to lose weight).
• Choose smaller amounts – for example, a small instead of
regular/large glass of wine, or a bottle instead of a pint of
beer/cider
• Drink slowly – getting into rounds with friends can lead you to
drink more and drink quicker.
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5. Aim to take regular physical activity
Being physically active will reduce the levels of triglycerides in your
blood as well as helping with weight loss. It is advisable to consult
your doctor before starting to exercise.
The government recommends one of these ways to exercise:
• 150 minutes per week of moderate intensity physical activity in
bursts of 10 minutes or more
• 75 minutes of vigorous intensity aerobic activity spread across a
week
• combinations of moderate and vigorous intensity activity
• muscle-strengthening activities on at least two days per week.
Moderate intensity activities will cause you to become warm,
breathe harder and increase your heart rate but still be able to
carry on a conversation. Examples include brisk walking, water
aerobics, riding a bike on level ground, pushing a lawn mower, and
hiking.
Vigorous intensity activities will cause you to become warm,
breathe much harder and make your heart beat rapidly making it
more difficult to carry on a conversation. Examples include jogging
or running, swimming, riding a bike fast or on hills, football,
rugby, hockey, skipping rope, and aerobics.
Muscle-strengthening activities involve using your body weight
or working against resistance and should involve all major muscle
groups. Examples include lifting weights, working with resistance
bands, push-ups and sit-ups, heavy gardening, carrying groceries,
yoga, and pilates.
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Aim to minimise sedentary behaviours by reducing the amount of
time spent watching TV or using the computer, going for a walk
at lunchtime, taking the stairs instead of the lift or swapping a
car/bus journey for walking part of the way. Look for ways to
incorporate small regular amounts of activity into your day.
If you are unable to exercise because of a medical condition or
personal circumstance, try to be as active as you can at a capacity
that is safe. Some activity, however light, is better for your health
than none at all.
Diabetes
In poorly controlled diabetes, high triglycerides are likely. If you
have diabetes, aiming for well controlled blood glucose levels
may improve your triglyceride levels. If you would like support
with managing your diabetes please speak with your dietitian,
diabetes specialist nurse or GP.
Severe hypertriglyceridaemia
If your triglycerides are very high it may be suggested that you
follow a triglyceride rescue diet for a short period of 2 weeks.
This involves reducing total fat in the diet to less than 25g per
day. You will be asked to get your triglycerides re-checked after
one week on this diet to see whether these are improving as
required. Your dietitian will advise you.
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Breakfast ideas
• Baked beans on wholemeal toast x 2 (no butter / fat spread)
• Egg whites on toast with tomato sauce
• Scrambled egg white and mushrooms on toast
• Porridge with skimmed milk and chopped fruit
• Wholemeal toast x 2 and jam / marmalade
• Cereal and skimmed milk and berries
Light meal idea
• Jacket potato (no butter) with baked beans (reduced sugar)/
tuna and salad
• Rice and grilled chicken and salad
• Sandwich – chicken/tuna and salad (with chutney/pickle instead
of butter)
• Egg white omelette with vegetables
• Prawn salad
• Crackers and a salsa dip
• Baked beans (reduced sugar) on toast
Main meal ideas
• Chapatti and vegetable/chickpea/dahl curry (home made with
minimal oil/ghee)
• Grilled chicken, rice and vegetables
• Stir fry with prawns/chicken/quorn/tofu with vegetables and
noodles
• Pasta with vegetable sauce and salad (add protein, for example,
chicken/tuna/beans)
• Low fat curry (tomato based sauce) and rice
• Quorn mince bolognaise and spaghetti
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Snack ideas
• Teacake
• Plain/fruit scone
• Low fat cottage cheese and crackers
• Zero fat yoghurt (and chopped fruit)
• Chopped vegetables and a tomato or a bean/chickpea dip
• Skimmed milk smoothie - skimmed milk and banana
• Yogurt dip (fat free natural yogurt with mint, herbs, garlic) and
crackers, vegetables sticks
Further information
Heart UK: Triglycerides
Website: heartuk.org.uk/cholesterol/triglycerides
NHS website
Website: nhs.uk
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royalcornwallhospitals.nhs.uk 27
To get this information in a different format
call 01872 252690
Royal Cornwall Hospitals NHS Trust For an online version of this
leaflet please scan this QR code
Treliske, Truro, Cornwall, TR1 3LJ.
Switchboard: 01872 250000
Reference RCHT 2093
Printed 05/2024
Version 1.0
Review due 05/2027
© Royal Cornwall Hospitals NHS Trust
Patient Information 2024
