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If Your Doctor Orders a Diet to Lower Blood Triglycerides

Holly Alley, MS, RD, LD
Nutrition Specialist,
Department of Food and Nutrition

If you have high levels of triglycerides in your blood, your doctor may prescribe a special diet for you. Here is some information about a diet to lower high blood triglycerides.

What is a triglyceride?

A triglyceride is one type of fat. Most of the fats in food are triglycerides. You also have triglycerides in your blood and stored as fat in your body. When you have high levels of triglycerides in your blood, you have too much fat circulating in your blood. And you may be at a greater risk for heart disease than if your blood triglyceride levels were low.

The food you eat affects your blood level of triglycerides, so you need to stop eating 14 hours before getting your triglycerides measured. The normal range of triglycerides is between 10 and 250 milligrams per deciliter (mg/dl). Some people may have extreme levels (1000 or above), but your triglyceride level may be too high if it's above 150 mg/dl, depending on what other risk factors you have for heart disease.

Some people who have high blood triglycerides also have high blood cholesterol levels. Some people don't. If you have high blood cholesterol as well as high blood triglycerides, your risk for heart disease is probably greater than if you only had high triglycerides. This is because high blood cholesterol is one of the main risk factors for heart disease. In either case, there are some things you can change in your diet that may help decrease blood levels of both.

Reasons to Change Your Diet

Your weight can affect your blood triglyceride level. If you are obese (more than 20% above your ideal body weight) or just overweight, you may be able to lower your blood triglycerides by losing weight. To lose weight you'll need to eat fewer calories and exercise regularly. Since fat provides more calories than any other nutrient, one of the best ways to lose weight is to eat less fat.

Eating a diet low in fat, especially saturated fat, may also help you lower your blood triglyceride level. Only 30% of your total calories should come from fat. Less than 10% of your diet should come from saturated fat. Ask your dietitian to help you figure how much fat you can eat based on the number of calories your doctor has prescribed for you. A diet low in fat and saturated fat is the same as a diet to decrease blood cholesterol. By eating a diet lower in fat, you may lose weight, lower your blood cholesterol, and lower your blood triglyceride level.

Exercise, in addition to helping with weight loss may also help lower triglyceride levels.

Alcohol can increase blood triglycerides. So you may need to stop drinking alcoholic beverages.

Too much carbohydrate in your diet may also increase your blood triglycerides. You need carbohydrates in your diet, especially the "complex" carbohydrates like bread, rice, potatoes, other starchy vegetables and cereals. But you can reduce "simple" carbohydrates like sugar, candy, honey, and jelly without losing other nutrients. Ask your doctor if you have the kind of high blood triglycerides that is affected by the amount of carbohydrates in your diet. If you do, then you will need to eat less sugar and less high-sugar foods.

Following The Diet

1. Control calories to reach and maintain your ideal weight. Your doctor or dietitian should tell you how many calories to eat. Eating less food and getting more exercise will help you lose weight. Joining a weight control group may also help. Ask your doctor, dietitian, or county Extension agent to recommend a good weight control group in your area.

2. Eat low-fat foods instead of high-fat foods. This can help you lose weight, too.

These foods are lower in fat. Eat more of these:

• dried beans, peas, and lentils

• whole grain breads, cereals and pasta

• egg whites

• skim and nonfat dry milk

• cheese made with skim or part-skim milk, such as mozzarella, parmesan, farmers', ricotta, or pot cheese

• low-fat cottage cheese

• low-fat yogurt

• fish

• poultry without the skin

• lean cuts of meat, such as round, sirloin, rump, and flank

These are higher fat foods. Eat less of these:

• whole milk and foods made from whole milk, such as American, blue, cheddar, Monterey Jack, and Swiss cheese; high-fat meats, such as luncheon meats, sausages, knockwurst, bratwurst, hot dogs, ribs, corned beef, ground pork, and regular ground beef

• fried foods

3. Especially limit saturated fats in your diet. Substituting unsaturated fat for saturated fat may decrease your blood triglyceride level. You will need to read package labels to know which products contain saturated fats.

These foods are high in saturated fat. Eat less of these:

• coconut oil
  

• palm oil
  

• palm kernel oil
  

• margarines and baked goods made from these oils
  

• coffee whiteners and nondairy creamers made with these oils
  

• vegetable shortenings
  

• butter
  

• lard
  

• shortening
  

• cream
  

• cream cheese
  

• sour cream
  

• bacon
  

• fatback
  

• fried pork skins
  

• chitterlings
  

• whole milk
  

• cheeses made from whole milk
  

• fat from meats
  

• skin and fat from poultry
  

4. Use unsaturated fats (both polyunsaturated and monounsaturated) moderately. Remember, even though unsaturated fats are better than saturated fats, you still want a diet low in total fat.

These foods are high in unsaturated fat:

• canola oil
  

• safflower oil
  

• soybean oil
  

• sunflower oil
  

• olive oil
  

• peanut oil
  

• margarines made with these oils
  

• mayonnaise
  

• avocados
  

• olives
  

• almonds
  

• cashews
  

• pecans
  

• peanuts
  

• peanut butter
  

• walnuts
  

• pine nuts
  

• sunflower seeds
  

• pumpkin seeds
  

5. Avoid sugar and other high-sugar foods. This will decrease carbohydrates without decreasing other nutrients. Sugar in your food goes rapidly to your blood. When there is excess sugar in your blood, your liver may use it to make more triglycerides. Sugar also contains calories without other important nutrients.

Eat less of these:

• sugar, brown sugar, powdered sugar, jam, jelly, preserves, honey, syrup, molasses, pies, candy, cakes, cookies, frosting, pastries, colas, soft drinks, ades, punches, fruit drinks, and regular gelatin

6. Avoid alcohol. Alcohol, even more than sugar may increase blood triglycerides. In addition, alcohol is high in calories and low in nutrients. Ask for sparkling water, or a diet soft drink instead of an alcoholic beverage.

Suggestions for Planning and Preparing Meals

*Bake, broil, or roast meats instead of frying.

*Remove any visible fat from meats and the skin from poultry before cooking.

*Add spices, herbs, lemon juice or vinegar to vegetables instead of rich sauces or gravies.

*Use a non-stick skillet without fat or use no-stick sprays.

*Cool and refrigerate stews and broth. Then remove the hardened fat before serving.

*Refrigerate meat drippings and skim off fat to make low-fat gravies.

*Serve more fish.

*Use less butter, margarine and other high-fat spreads on bread or vegetables.

*Use skim or reconstituted non-fat dry milk for cooking.

*Cook with low-fat cheeses.

*Substitute low-fat yogurt or cottage cheese for all or part of the sour cream in recipes for sauces, dips or congealed salads.

*Use half yogurt/half mayonnaise in salad recipes.

*Substitute evaporated skim milk for cream. Evaporated skim milk or reconstituted non-fat dry milk can be whipped and substituted for whipped cream in certain recipes.

*Choose fresh fruits for dessert--they are naturally low in fat--instead of high-fat foods such as pies or cakes.

When Dining Out

*Order low-fat appetizers such as fruit or vegetable juice, pasta with vegetables or tomato sauce.

*Select clear rather than cream soups.

*Ask that dressings and gravies be served on the side. Then use less of them.

*Order foods that are baked, broiled, poached, steamed, stir-fried, or roasted.

*Ask for margarine instead of butter and use only a small amount.

*Drink sparkling water, unsweetened tea or coffee, or diet soft drinks instead of alcohol or other sweet beverages.

References:

American Dietetic Association, Handbook of Clinical Dietetics, 1981

FDA Consumer, March, 1984
Archives Internal Medicine 148:36-39, Jan., 1988

Reprinted with permission from the University of Georgia.
Alley, H. (1992). If Your Doctor Orders a Diet to Lower Blood Triglycerides. Athens, GA: University of Georgia, Cooperative Extension Service.

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