Dietary Interventions for Hypertriglyceridemia

This review summarizes the pathophysiology of hypertriglyceridemia (HTG) and describes the evidence for dietary interventions in the management of HTG.

HTG is most often caused by multiple triglyceride (TG)-raising gene variants. Rare monogenic disorders cause extreme HTG. Recommendations from dyslipidemia management guidelines emphasize that dietary interventions for HTG management should be tailored to the underlying causes and degree of TG elevation. Evidence-based cardioprotective dietary patterns can effectively reduce TG concentrations. The severity of TG elevation influences the level of restriction for intakes of foods/beverages with added sugars, alcoholic beverages, and total fat. Individual macronutrients impact TGs differently, with evidence supporting partial replacement of carbohydrates with unsaturated fatty acids, protein, or a combination for lowering the TG level. Physical activity is also a cornerstone of lifestyle intervention for HTG management. Weight loss for persons with overweight or obesity reduces TGs and can be achieved with dietary interventions, pharmacotherapy, and/or metabolic bariatric surgery, each of which may have a TG-lowering effect independent of weight loss.