It is recommended that individuals consume less than 20% of calories as fat, with saturated fat reduced to less than 7% of calories, which may be achieved by avoiding trans fats, limiting dietary cholesterol to less than 200 mg/d. Restriction of refined carbohydrates, particularly sugar and liquid calories, is also important. In addition, lowering low-density lipoprotein (LDL) may be promoted by adding dietary options such as 2 g/d of plant stanols/sterols and at least 5-10 g/d of viscous soluble fiber to the diet.
Alcohol consumption should also be strictly limited or abstained; consuming more than 1 standard alcoholic drink per day may worsen hypertriglyceridemia.
Total fat intake should be limited if this will aid in weight loss. If triglyceride levels are >1000 mg/dL, no more than 10% of total calories from fat per day should be allowed, and this will usually lower triglycerides quickly and significantly.
But patients need to be careful if they have an isolated triglyceride elevation and do not lose weight on a very low fat diet, because the triglyceride levels may actually increase, and the good cholesterol, HDL, may drop. In such cases, addition of a healthy fat (monounsaturated or polyunsaturated fat) lowers levels of triglycerides, increases HDL, and sometimes decreases LDL.
If your diet is high in sugar and white flour products, you will have to restrict simple carbohydrates and increase dietary fibers. Large quantities or fruit juice or non-diet soda can increase triglycerides dramatically.
Again, alcohol should be eliminated or restricted to no more than 1 standard alcoholic beverage per day.
Omega-3 (N-3) fatty acids:
The class of polyunsaturated fats known as omega-3 fatty acids are derived mainly from fatty fish and some plant products (flax seed. In abundant amounts (10 or more g/d), N-3 fatty acids lower triglycerides 40% or more. This dose can be reached by the administration of purified capsules, though patients may prefer to eat large quantities of fatty fish. The fish highest in N-3 fatty acids are sardines, herring etc. But these may also be high in sodium (sardines) and mercury, so a high intake of these fish is not recommended.
Sustained aerobic activitycan have a dramatic impact on triglyceride levels and may increase HDL slightly. If patients have no known cardiovascular disease, they should be encouraged to begin an exercise program of graduated aerobics and toning.
Fibrates and Niacin . Caution must be taken with the use of niacin as it has multiple adverse effects, the worst of which is chemical hepatitis. However, at doses of 1.5-2 g/d, complications are unusual.