Ten steps to lower triglycerides

Ten steps to reduce your triglycerides:

Many of the same things you do to improve your overall health can dramatically lower your triglycerides. Lifestyle changes—such as modifying your diet and losing weight—can potentially cut your triglyceride levels in half.

1. Lose weight. If you’re overweight, losing 5 to 10 percent of your body weight—just 10 to 20 pounds for someone who weighs 200 pounds—will reduce your triglycerides by about 20 percent.

2. Cut the sugar. Individuals whose added sugar intake is less than 10 percent of daily calories have the lowest triglyceride levels. The AHA recommends that only 5 percent of your daily calories come from added sugars. That means no more than 150 grams (9 teaspoons) for men and 100 grams (6 teaspoons) for women per day. Because the biggest sources of sugar in the American diet are soda and other sugar-sweetened beverages, one way to restrict your sugar intake is to drink no more than three 12-ounce cans a week.

3. Stock up on fiber. Instead of consuming sugar and other refined carbohydrates, focus on more fiber-rich foods, such as vegetables, fruits and whole grains.

4. Limit fructose. Studies have found that consuming too much fructose—a type of sugar—leads to high triglycerides. High-fructose corn syrup is a major source of fructose. Because regular table sugar contains about the same amount of fructose as high-fructose corn syrup (50 percent versus 42 to 55 percent), you'll need to limit both in order to lower your triglycerides. You can determine whether a food contains sugar or high-fructose corn syrup by reading the ingredients list.

Even the fructose that's found naturally in fruit can increase triglycerides, so if you have high triglycerides you should watch the types of fruit you eat. Dried fruits, such as raisins and dates, have the most fructose, whereas peaches, cantaloupe, grapefruit, strawberries and bananas are relatively low in fructose.

To reduce your triglycerides, limit the total amount of fructose you consume to less than 100 grams per day—preferably less than 50. To learn about the fructose content of specific foods, visit the USDA nutrient database at www.nal.usda.gov/ fnic/foodcomp/search.

5. Eat a moderately low-fat diet. You may be surprised to learn that diets that are very low in fat are not as effective at lowering triglycerides as diets moderately low in fat. The AHA recommends that people with high triglycerides get about 25 to 35 percent of their daily calories from fat. That’s only slightly lower than the average American diet, which is about 37 percent. Replacing your regular dairy products with those marked "low-fat" may help lower your triglyceride levels.

How do you know whether you’re getting the right amount of fat? For someone who eats 2,000 calories a day, 30 percent is 600 calories. At 9 calories a gram, that's about 67 grams of fat a day. You can learn the number of grams in a single serving of packaged food by reading the "Nutrition Facts" label.

6. Watch the type of fat you eat. Cut back on saturated fats, which are found in red meat, poultry fat, butter, cheese, milk, and coconut and palm oils, and keep trans fats, found in shortening and stick margarine, to a minimum. Replace trans fats with healthier polyunsaturated and monounsaturated fats. Examples of polyunsaturated fats include safflower, corn and soybean oils. Examples of monounsaturated fats include canola and olive oils. Although unsaturated fats are better for you in terms of cholesterol and triglyceride counts, they're high in calories, so go gentle on the amount you cook with or you may gain weight.

7. Add omega-3 fatty acids. Fatty fish such as salmon, herring, sardines, lake trout and albacore tuna are abundant in omega-3 fatty acids—a type of fat that is actually good for you. To reap the benefits, the AHA recommends that you eat fatty fish at least twice a week. If you already have high triglycerides, you can take omega-3 capsules to supply the extra boost that food alone can't provide. The capsules must be taken under your doctor's supervision, as too much omega-3 can interfere with your blood clotting ability.

8. Exercise. If you have high triglycerides, getting at least 30 minutes of moderate-intensity physical activity most days of the week may lower your triglyceride levels. Exercise is also an important part of keeping your weight under control.

9. Limit alcohol. Some studies have linked even small amounts of alcohol to modest increases in triglycerides, although others have found no association at all. The AHA recommends that people with very high triglycerides avoid alcohol entirely.

10. Take triglyceride-lowering drugs. If your triglycerides are very high (500 mg/dL or above), your doctor might recommend a medication shown to lower triglycerides, such as fibrates, niacin, omega-3s (a prescription form called Lovaza is approved for lowering triglycerides) or statins. But lowering triglycerides with medication alone has never been shown to reduce the risk of heart attack or stroke, so be sure to watch your diet and continue exercising as well.

Getting tested

If you're healthy, your doctor will perform a simple blood test every five years to measure your levels of cholesterol and triglycerides. You may need more frequent testing if you're at high risk for heart attack or stroke.

Doctors have traditionally required that you fast the night before the test. According to the AHA statement, you may no longer have to do that. However, if your test results show triglyceride levels of 200 mg/dL or higher, you'll need to be tested again—and you'll need to fast first.

If your fasting triglycerides are 150 mg/dL or higher, the message is clear: It's time to start eating better and exercising more.