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Heart Smart Living

Cardiologist, author, and heart health expert Dr. Sarah Samaan offers advice on how to live a heart smart life.

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High Triglycerides: The New American Heart Association Guidelines

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model of a triglyceride compound || model of a triglyceride compoundTriglycerides, simply put, are a form of fat that circulates in the blood. Triglycerides come from fat in the diet, but are also produced from the carbohydrates that we eat. Sugar and starchy carbs, including white bread, white rice, white pasta, and white potatoes are the usual suspects. About one in three Americans have high triglycerides, meaning levels over 150 mg/dL.

We have known for years that high triglycerides are associated with heart disease, but the role triglycerides play is not as clearly defined as cholesterol. Triglycerides appear to present more risk for women than for men, although no one is immune. This April, the American Heart Association published a new scientific statement to help clear up the confusion, clarify optimal levels, and provide guidance for lowering triglyceride levels.

According to the new statement, an optimal triglyceride level is 100 mg/dL or less. Levels over 500 mg/dL are considered very high, and can lead to pancreatitis; for this reason, numbers in this range usually warrant immediate medical treatment. High triglycerides can be hereditary. A slew of common medications, including estrogen pills (but not patches), steroids, certain diuretics, and some types of beta blockers can raise triglycerides. People with uncontrolled diabetes typically have high triglycerides as well. However, most people can lower their triglycerides with a heart smart diet, weight loss, and exercise, avoiding the costs and potential side effects of medical therapy.

The Heart Association recommendations for management of high triglycerides include:

  • Weight loss on the order of five to 10 percent of body weight.
  • Keeping carbs to about 50 percent or less of daily calories.
  • Restricting fructose (found commonly in sodas and sweetened juice drinks) and limiting other added sugars.
  • Making protein 15 to 20 percent of your daily caloric intake.
  • Having a minimal intake of saturated fats (including meat, dairy, and palm and coconut oils).
  • Including healthier monounsaturated and polyunsaturated fats at 10 to 20 percent of calories.
  • Incorporating fish oil at doses of 500 to 2000 mg, depending on triglyceride levels.
  • Exercising 150 minutes weekly.

Sounds simple? That’s because it really is. Follow a Mediterranean diet, keep your weight optimal, and exercise 30 minutes five days each week. For most of us, that’s all it takes. Be sure to check in with your doctor and have your lipid levels checked annually. If you need medication, don’t stop it without your doctor’s approval, but let your doctor know that you’re working hard to improve your numbers. In many cases, with a little work, you may be able to drop your triglycerides enough to avoid medication altogether. 

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Tags: Cholesterol and Lipids , Diet and Heart Health

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About the Author


MD, FACC

Dr. Samaan is an acclaimed cardiologist, writer, and heart health educator.

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