High Triglycerides Versus Bad Cholesterol: What’s the Difference?
Updated on February 21, 2025
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Though you may know the difference between bad cholesterol and good cholesterol, you may not know that your triglycerides, a type of fat found in your blood, are equally important to your heart health. When levels are too high, fatty deposits are more likely to build up in the arteries, which raises the risk of heart problems.
“I now get asked about triglycerides a couple of times a week,” says Luke Laffin, MD, codirector of the Center for Blood Pressure Disorders at the Cleveland Clinic. People ask him how the fats are related to heart disease, and how they should reduce them.
What Is Cholesterol and What Are Triglycerides?
Both are types of fat (lipids) that circulate in your body. Cholesterol is a waxy substance that your body needs to build cells and make vitamins and other hormones. Cholesterol is made by the liver and also comes from animal products in your diet.
There are two types of cholesterol: LDL, which is “bad,” and HDL, which is “good.” HDL helps remove LDL cholesterol from your arteries and carries it back to your liver, where it gets broken down.
Triglycerides store unused calories; your body converts calories it doesn’t immediately use into triglycerides, which are stored in fat cells. When your body needs the energy, it releases the triglycerides.
What Causes High Triglycerides?
A common reason for high triglycerides is a high-fat diet. When you eat fatty calories, the fat levels in your blood go up. The body also makes triglycerides from the carbohydrates you eat and may send triglycerides to fat cells. The following factors can raise your triglyceride levels:
- Regularly consuming more calories than you burn
- Being overweight or having obesity
- Smoking cigarettes
- Excessive alcohol use
- Certain medications (diuretics, estrogen and progestin, retinoids, steroids, beta-blockers, some immunosuppressants, and some HIV medications)
- Some genetic disorders
- Poorly controlled type 2 diabetes
- Liver, kidney, or thyroid diseases
How Are Triglycerides Related to Heart Disease?
A high triglyceride level along with too much LDL and not enough HDL increases the likelihood that fatty deposits will slowly build up in your arteries, hardening and narrowing the arteries and increasing your risk of cardiovascular diseases like atherosclerosis, heart attack, and stroke.
According to the Mayo Clinic, high triglyceride levels are often a sign of metabolic syndrome — a condition where high blood pressure, obesity, and high blood sugar occur together, increasing your risk of heart disease. Extremely high triglyceride levels can lead to pancreatitis.
Triglyceride levels are categorized as follows:
Normal: Less than 150 milligrams per deciliter (mg/dL)
Borderline High: Up to 199 mg/dL
High: Over 200 mg/dL
Very High: 500 mg/dL is very high
As for cholesterol levels, you ideally want your total cholesterol to be 150 mg/dL (over 200 mg/dL is considered high cholesterol). But you also need to know your LDL and HDL levels.
- Your LDL cholesterol level should be below 100 mg/dL — the lower the better.
- Your HDL cholesterol level should be at least 40 mg/dL for men and at least 50 mg/dL for women — the higher the better.
How to Lower Your Triglycerides
Healthy lifestyle changes that counter bad habits can help control high triglycerides. These include the following.
Maintain a Healthy Body Weight
While genetics plays a part in each person’s ability to stay at the recommended body mass index (BMI) of 25 or lower, Dr. Laffin says that people should be concerned if they reach obesity levels of 30 or higher.
“Really high triglyceride levels typically can occur when you're obese,” he says. “That’s one of the risk factors, particularly if you have diabetes.” Research has found that elevated triglyceride levels are strongly associated with inadequate control of blood sugar, and that lowering triglyceride levels may help people with type 2 diabetes manage their blood sugar levels.
Follow a Healthy Diet
“The biggest thing that people can do is watch what they eat,” says Laffin, who puts patients on a triglyceride-lowering diet that includes nonstarchy vegetables, limited sugar, and lean proteins.
The Cleveland Clinic recommends sugar-free beverages, fresh fruit with no added sugar, whole grains, and swapping out butter and coconut oil for extra-virgin olive oil.
Get Regular Exercise
A regular exercise routine, like walking, jogging, or cycling, tends to reduce triglyceride levels.
One study found that eight weeks of aerobic exercises reduced triglycerides in patients with heart disease, along with bad cholesterol levels. A meta-analysis of 28 studies that compared aerobic exercise, resistance training, combined aerobic and resistance training, and high-intensity interval training (HIIT) found that HIIT was the most effective in reducing triglyceride levels, along with waist circumference, body fat percentage, and fasting blood glucose; aerobic exercise was most effective for weight loss and BMI.
The American College of Cardiology says that physical activity can reduce triglyceride levels up to 30 percent, but the regimen needs to be consistent.
Laffin recommends 150 minutes of physical activity a week, which is just over 20 minutes of moderate exercise a day.
Stop Drinking Alcohol
You may have heard that a glass of wine with dinner is okay, but Laffin recommends cutting out all alcohol if you have high triglycerides.
The ill effects of booze are partly due to how alcohol breaks down in your liver. Triglycerides and cholesterol are produced when the liver processes alcohol, and they’re released into the blood.
Quit Smoking
It’s perhaps not surprising that smokers often have higher levels of triglycerides in their system, as research shows. But Laffin says the two are not necessarily connected.
“Smoking is not good for cardiovascular health, so we don’t recommend it,” he says. “But it doesn’t really have a huge impact on triglycerides.”
Ask Your Doctor About Medications
There are medications that can lower high triglyceride levels. These include a prescription-only form of EPA (an omega-3 fatty acid found in fish) called icosapent ethyl. According to Harvard Health, it lowers triglycerides and, when taken with a statin (a class of drug that works in the liver to prevent cholesterol from forming), lowers the risk of heart attack, stroke, and death from cardiac causes by 26 percent in people with either diabetes or cardiovascular disease. Fibrate medications, such as fenofibrate and gemfibrozil, can lower your triglyceride levels, and niacin can lower your triglycerides and LDL cholesterol. Consult your doctor before taking over-the-counter niacin because it can cause significant side effects and interact with other medications.
How to Lower Your LDL Cholesterol
You can lower your LDL cholesterol with lifestyle modifications and, if necessary, medications.
Lifestyle changes that can lower your LDL are similar to those that can lower your triglycerides.
- Eat a heart-healthy diet. Limit saturated fats to less than 6 percent of your daily calories and avoid trans fats altogether. Follow a diet that emphasizes fruits, vegetables, whole grains, poultry, fish, nuts, and nontropical vegetable oils, while limiting red and processed meats as well as foods and drinks high in sugar. The DASH diet or the Mediterranean diet can be good options.
- Exercise regularly. To lower LDL, the American Heart Association (AHA) recommends at least 150 minutes of moderate-intensity aerobic exercise a week.
- Maintain a healthy weight. The AHA notes that a weight loss of 5 to 10 percent may help improve some cholesterol numbers and other heart disease risk factors.
- Stop smoking. When you quit smoking, you’ll raise your HDL cholesterol levels, which helps lower your LDL levels.
If you’ve tried these modifications and your LDL remains high, various medications can lower blood cholesterol levels. The AHA notes that statins continue to provide the most effective lipid-lowering treatment in most cases. When statins aren’t enough on their own, other medications may be prescribed by your doctor.
The Takeaway
- High triglycerides, like high LDL cholesterol, significantly increase the risk of developing cardiovascular diseases such as heart attack and stroke.
- Adopting a healthy lifestyle by maintaining a balanced diet, regularly exercising, and losing excess weight can effectively reduce triglyceride levels; medication can help, too, if needed.
- High triglyceride levels might signal underlying conditions like metabolic syndrome, and managing them could also aid in controlling type 2 diabetes for some individuals.
- If your triglyceride levels are high, talk with your healthcare provider to find the best approach to lowering them.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
- Triglycerides: Why Do They Matter? Mayo Clinic. September 3, 2022.
- What Is Cholesterol? American Heart Association. February 16, 2024.
- Triglycerides. MedlinePlus. October 7, 2020.
- HDL (Good), LDL (Bad) Cholesterol and Triglycerides. American Heart Association. February 19, 2024.
- Should You Worry About High Triglycerides? Harvard Health Publishing. May 22, 2023.
- About Cholesterol. Centers for Disease Control and Prevention. May 15, 2024.
- Zheng D et al. Association Between Triglyceride Level and Glycemic Control Among Insulin-Treated Patients With Type 2 Diabetes. The Journal of Clinical Endocrinology & Metabolism. April 2019.
- Triglycerides and Heart Health. Cleveland Clinic. August 2, 2022.
- Wang Y et al. Aerobic Exercise Reduces Triglycerides by Targeting Apolipoprotein C3 in Patients with Coronary Heart Disease. Clinical Cardiology. January 2019.
- Wang H et al. Comparative Efficacy of Exercise Training Modes on Systemic Metabolic Health in Adults with Overweight and Obesity: A Network Meta-Analysis of Randomized Controlled Trials. Frontiers in Endocrinology. January 16, 2024.
- Healthy Diet, Physical Activity Are First Line of Treatment for High Triglycerides. American College of Cardiology. July 28, 2021.
- Alcohol. Heart UK.
- Koda M et al. The Associations Between Smoking Habits and Serum Triglyceride or Hemoglobin A1c Levels Differ According to Visceral Fat Accumulation. Journal of Epidemiology. November 28, 2015.
- Medications to Lower Triglycerides. Harvard Health Publishing. September 1, 2022.
- Prevention and Treatment of High Cholesterol (Hyperlipidemia). American Heart Association. February 19, 2024.
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Chung Yoon, MD
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Chung Yoon, MD, is a noninvasive cardiologist with a passion for diagnosis, prevention, intervention, and treatment of a wide range of heart and cardiovascular disorders. He enjoys clinical decision-making and providing patient care in both hospital and outpatient settings. He excels at analytical and decision-making skills and building connection and trust with patients and their families.
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Zachary Smith is a data reporter specializing in health and climate for Cleveland.com and The Plain Dealer. He received his master's degree from the Craig Newmark Graduate School of Journalism at CUNY, where he studied health, climate, and data journalism. Smith has also reported for VICE UK, Food Bank News, Crain's New York, and local New York outlets. Before becoming a journalist, he worked in print production for magazine publishers. In his free time, he writes for A to Zagat, his New York City-centric restaurant blog about food culture, history, and trends.