13
Figure 1. Clinical Algorithm for Screening and Management
of Elevated TG
Screen with Fasting or Non-fasting TG
TG <200 mg/dL TG ≥200 mg/dL
Recommend Healthy Diet
Pattern Follow-up as Required
Fasting Lipoprotein Panel
1. Address non-dietary secondary causes of hypertriglyceridemia including
medications and conditions such as uncontrolled diabetes, renal disease
and hypothyroidism.
2. Refer to a Registered Dietitian/Nutritionist
General Dietary Pattern
Consume a dietary pattern that emphasizes intake of vegetables, fruits,
and whole grains; includes low-fat dairy products, poultry, fish, legumes,
non-tropical vegetable oils, nuts, seeds; and limits intakes of sweets, sugar-
sweetened beverages and high fat meats.
Borderline
150-199
mg/dL
High
200-499
mg/dL
Very High
500-999
mg/dL
Very High
≥1000 mg/dL with
chylomicronemia
b
Weight Loss 5-10%
Added
Sugars
c
<10% <10% <5% Near 0%
Total Fat 25-35% 30-35% 20-35% 10-15%
SFA <7% <7% <7% <3%
EPA+DHA 0.25-2 g/d 1-2 g/d 2-4 g/d 3-4 g/d
Alcohol
Moderate
or Less
Moderate
or Less
Eliminate Eliminate
Aerobic
Activity
≥5x per week
Pharmacologic therapy if
needed to attain LDL-C
and non-HDL-C goals
Pharmacologic therapy to lower
TG for pancreatitis prevention as
the primary objective
Monitor to determine response to intervention
Continue intervention or adjust as indicated
