5 Ways to Naturally Lower Your Triglycerides with the Mediterranean Diet
It’s likely that you or someone you know has high triglycerides. This might sound like the start of a drug commercial, but it’s true.
Over 30% of the adult population in the United States has triglyceride levels equal to or above 150 mg/dL. In other words, about 1 in every 3 people has above-normal triglyceride levels. So, what does this really mean?
What should you do if your doctor tells you that you have “high triglycerides”?
Let’s take a closer look at these crucial questions and help you find the solution:
- Why lowering your triglycerides matters
- What triglycerides are exactly
- What causes high triglyceride levels
- Uncovering the optimal diet for high triglycerides
- How keto and Mediterranean diets help decrease triglyceride levels
- Mediterranean-style keto: The best diet to lower triglycerides?
- Ten more triglyceride-lowering tips
- Three things to avoid that cause high triglyceride levels
- Key takeaways
Why Lowering Your Triglycerides Matter
Lower triglyceride levels are one of the many indicators of better health, while high triglycerides are associated with several health conditions, including:
- An increased risk of heart disease. Studies suggest that high triglyceride levels impair cholesterol levels, increasing atherogenic (plaque-forming) cholesterol particles in the blood. Over time, this can cause plaque to accumulate in our blood vessels (atherosclerosis) and increase the likelihood of a heart attack.
- Obesity. One study found that approximately 80% of people who are obese or overweight had triglyceride levels ≥150 mg/dL. This suggests a close link between obesity and high triglyceride levels. Conversely, losing weight significantly decreases triglycerides.
- Metabolic syndrome. The prevalence of triglyceride levels ≥150 mg/dL is nearly twice as high in people with metabolic syndrome, which is diagnosed when someone has high blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels.
- Excess visceral fat (fat around the organs). Excess body fat is associated with elevated triglyceride levels, but visceral fat contributes more than subcutaneous fat.
- Poorly controlled type 2 diabetes. Around 35% of people with type 2 diabetes have high fasting triglyceride levels, indicating a close link between blood sugar and triglyceride levels.
- Low thyroid hormone levels. Cholesterol and triglycerides stay in the blood longer, increasing heart disease risk.
- Kidney disease. Triglyceride levels of 200 mg/dL are present in about half of those with chronic kidney disease, often caused by diabetes and high blood pressure.
- Rare genetic conditions. Very high triglyceride levels (1000 mg/dL) or chronically high levels not explained by diet and lifestyle are linked to rare genetic variants. However, these can usually be managed with dietary and lifestyle changes.
While it’s concerning to learn about the issues associated with high triglyceride levels, it’s not an emergency that requires hospitalization. Like other biomarkers, your blood triglyceride results should be interpreted alongside other validated measures for an accurate assessment of your overall health.
Our triglyceride levels do, however, provide us with important clues. The strong association between triglycerides, blood sugar, cholesterol, and the conditions listed above gives us a clearer picture of what causes high triglyceride levels and how to optimize them.
What Are Triglycerides?
Triglycerides are the most potent source of stored fuel in your body. They’re so energy-dense that stored triglycerides can sustain the body for about a month.
Where exactly are these stored triglycerides found in your body? You already know the answer—you just call them “fat” instead of “stored triglycerides.”
Yes, triglycerides are stored in your fat cells. When we fast, restrict carbohydrates, or limit calories, these triglycerides are released from our fat cells to provide energy. This process helps us lose fat and reduce triglyceride levels.
Why Do You Have High Triglycerides?
A major problem in Western societies is the abundance of food. If you’re reading this, you probably live in an area with constant access to a wide variety of foods. In this environment, our emotional and instinctual desires often override logical thinking, leading many of us to consume more calories and carbohydrates than we need.
In response to this excess calorie intake, cells become so full of energy that they reject the signal from insulin (an energy storage hormone stimulated mainly by carbohydrate consumption) to take in more energy. This is known as insulin resistance, which triggers a cascade of hormonal changes that increase blood sugar and triglyceride levels.
Additionally, carbohydrate consumption, especially processed sugars like fructose, stimulates hepatic lipogenesis (fat production in the liver) independently of insulin signaling.
This means that consuming excess calories increases the chances of having high triglyceride levels, and eating excess carbohydrates, particularly from fructose and other processed sugars, further elevates triglyceride levels.
Wait, what about fat?
We’re talking about triglycerides—a type of fat. Why talk about calories and carbohydrates without mentioning fat’s contribution to high triglyceride levels? There’s a good reason for that.
Sugar Can Become Your New Fat
It might seem logical that fats would raise triglycerides more than carbs, but science shows the opposite.
In one study, people with high triglycerides were switched from a high-fat diet (35%) to a low-fat, whole-food diet (15% fat). After just one meal on the low-fat diet, their triglyceride levels rose higher and lasted longer than on the high-fat diet.
Fasting triglyceride concentrations also increased by 60%, and production of atherogenic LDL cholesterol rose as well. This happened in both high and normal triglyceride groups in response to a whole-food based low-fat diet. (Imagine the effect if the diet had more simple sugars!)
Do these findings mean we should avoid carbs and eat more fat to reduce triglycerides?
What Is The Best Triglyceride Lowering Diet? Low-Fat or Low-Carb?
Let’s compare two dietary extremes—low-carb versus low-fat.
A recent meta-analysis of randomized controlled trials evaluated the effects of low-carb and low-fat diets on triglyceride levels. Researchers found greater reductions in triglyceride levels on the low-carb diet.
Another study by Bonow and Eckel concluded that low-carb diets produced a more robust triglyceride-lowering effect than low-fat diets, even with similar weight loss after one year.
These studies confirm that eating more carbs and less fat increases triglyceride levels, while the opposite occurs when eating fewer carbs and more fat. Researchers found that for every 5% decrease in total fat, triglyceride levels were predicted to increase by 6%, and HDL cholesterol to decrease by 2.2%.
However, other variables might be at play. Reducing fat consumption may lead to increased intake of processed carbohydrates, which limit fat burning and increase fat production. So, high triglyceride levels are only related to increased processed sugar consumption, right? Not quite.
After a meta-analysis of 60 controlled feeding studies, researchers found that replacing carbohydrates with fatty acids (saturated, monounsaturated, and polyunsaturated) decreases triglyceride levels. Specifically, replacing 1% of carbohydrates with each type of fatty acid reduced triglycerides by 1.9 mg/dL, 1.7 mg/dL, and 2.3 mg/dL, respectively.
Whether carbohydrates come from table sugar or whole foods, replacing them with the same energy equivalent of fat decreases triglyceride levels. Results may be better for people with type 2 diabetes, who also benefit from reduced carbohydrate intake.
In a subsequent meta-analysis of 30 controlled feeding studies in patients with and without type 2 diabetes, a moderate-fat diet resulted in significantly greater reductions in triglycerides for those with diabetes than for those without. On a higher-fat, lower-carb diet like the ketogenic diet, results are even better for people with type 2 diabetes.
However, another diet has been hailed for its health benefits. Could it be the perfect balance of carbs and fats? Or is the low-carb diet always better?
Which Is Better? The Low-Carb Diet vs. The Mediterranean Diet
In another randomized controlled trial, the effects of a Mediterranean-style weight-loss diet were compared with low-carbohydrate and low-fat energy-restricted diets. After six months, triglyceride levels were reduced the most in the low-carb diet group. However, after 12 months, the Mediterranean-style diet showed similar reductions in triglycerides as the low-carb diet.
How could two different diets yield similar triglyceride-lowering effects? Let’s explore the biochemistry.
How The Ketogenic Diet Lowers Triglycerides
When carbohydrates are restricted, insulin levels drop, increasing the activity of lipases like ATGL and HSL, which break down triglycerides for energy.
After lipases do their job, glycerol is taken to the liver for breakdown or glucose synthesis, while free fatty acids are transported to cells for energy via beta-oxidation. In the liver, free fatty acids are converted into ketones, an alternative fuel source.
With fewer carbohydrates, cells burn more fat and ketones, and the liver focuses on producing sugar and ketones rather than storing triglycerides. This process, which lowers triglyceride levels, is most effectively triggered by the ketogenic diet.
How The Mediterranean-Style Diet Reduces Triglyceride Levels
Replacing carbohydrates with fatty acids improves triglyceride levels. The Mediterranean diet, rich in polyunsaturated fats from nuts, seeds, fish, seafood, and olive oil, and low in red meat, processed meat, added sugars, and processed foods, leverages this effect.
This diet restricts carbohydrates more than a low-fat diet and contains more polyunsaturated fats than a typical low-carb diet like keto.
This explains why a meta-analysis found the Mediterranean diet provided similar triglyceride reductions after 12 months, despite higher carb intake, due to its polyunsaturated fat content.
The Best Diet For Lowering Triglycerides: A Mediterranean-Style Ketogenic Diet
Combining trends of carb restriction and polyunsaturated fat intake creates a Mediterranean-style ketogenic diet. This diet emphasizes omega-3 rich fish like sardines and salmon, polyunsaturated fat rich nuts and olive oil, while restricting carbohydrates more than other diets.
Examples of Mediterranean-style ketogenic meals include Smoked Salmon and Goat Cheese Bites, Spicy Cauliflower Rice Salmon Medley, Low Carb Walnut Crusted Salmon, and Ginger Sesame Glazed Salmon, or a can of sardines on an Oven Roasted Caprese Salad.
Ten Ways to Make The Best Triglyceride Diet Even Better
Following a Mediterranean-style ketogenic diet is likely the best way to reduce triglycerides. If you need more results, consider these additional tips:
- Focus on weight loss.
- Establish a sleep schedule.
- Eat more fiber.
- Increase marine-derived omega-3 intake.
- Supplement with niacin.
- Eat more medium-chain triglycerides (MCTs).
- Exercise.
- Include nuts in your diet.
- Eat more garlic.
- Supplement with curcumin.
Three Triglyceride Train Wrecks To Avoid
Even with the above suggestions, avoid these three triglyceride-elevating factors:
- Alcohol
- Trans fats
- Added sugars
Putting It All Together
Improving triglyceride levels is simple. Focus on two dietary changes: eat fewer carbs and more marine-derived omega-3s. The best way is a Mediterranean-style ketogenic diet, restricting carbs (under 35g daily) and emphasizing nuts, olives/olive oil, low-carb vegetables, and fatty fish like sardines and salmon.
To enhance results, consider calorie restriction for weight loss, improving sleep quality, daily exercise, supplementing with marine-derived omega-3s, curcumin, niacin, and/or garlic extract, increasing MCT intake, and avoiding alcohol, trans fats, and added sugars.
How To Know If Your Triglyceride Levels Are Optimal
Schedule a blood test with your doctor. Ask for a printout of the results and track your progress.
According to the American Heart Association, triglyceride levels are categorized as:
- Optimal: Less than 100 mg/dL
- Normal: Less than 150 mg/dL
- Borderline-high: 150-199 mg/dL
- High: 200-499 mg/dL
- Very high: 500 mg/dL or higher
Aim for optimal triglyceride levels, and don’t forget to monitor cholesterol and blood sugar levels as well.
P.S. Check out the Keto Academy, our foolproof 30-day keto meal planner, for all the tools, information, and recipes you need to succeed.
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