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Triglyceride-to-HDL Ratio (TG:HDL Ratio)
Written by Forth
July 25, 2025
Reviewed by:
Dr Thom PhillipsWhat is TG:HDL Ratio?
The triglyceride-to-HDL ratio compares the amount of triglycerides (a type of fat found in your blood) to your high-density lipoprotein (HDL) cholesterol, often called “good” cholesterol.
It’s calculated by dividing your triglyceride level by your HDL level (both in mmol/L).
This ratio is a valuable marker for assessing your cardiometabolic health, with research linking it to insulin sensitivity, cardiovascular disease risk, and even early signs of metabolic dysfunction[1].
Why is it important to monitor?
The TG:HDL ratio is increasingly recognised as one of the most useful markers for assessing cardiometabolic risk. Unlike traditional measures such as total cholesterol or LDL alone, this ratio provides a clearer picture of how your body is processing and transporting fats, and can highlight early signs of metabolic dysfunction.
Monitoring your TG:HDL ratio can help:
- Detect early risk for insulin resistance, metabolic syndrome, and type 2 diabetes
- Reveal hidden cardiovascular risk, even when your total or LDL cholesterol appear within range
- Guide personalised lifestyle changes aimed at improving lipid balance and long-term heart health
- Support informed decision-making about diet, exercise, and other health behaviours
When tracked alongside other key markers such as ApoB, LDL, HDL, and Lp(a), the TG:HDL ratio offers deeper insight into your overall cardiovascular health. Understanding these values together enables a more complete and proactive approach to reducing future disease risk and maintaining heart health for the long term.
In short, it’s not just about knowing your cholesterol, it’s about understanding the balance.
What is a good TG:HDL ratio?
The recommended levels below are based on peer-reviewed clinical research linking this ratio to cardiometabolic risk, insulin resistance, and metabolic syndrome[2].
An ideal TG:HDL ratio is:
- Below 1.7 for women
- Below 2.6 for men
A lower ratio is considered more favourable and may suggest a reduced risk of insulin resistance and heart disease.
A higher ratio, especially above 3, may indicate poor lipid balance and a higher risk of metabolic dysfunction, even if other markers like LDL are within range.
"Triglyceride (TG) to high-density lipoprotein (HDL) ratio values >2.75 in men and >1.65 in women were found in the Metabolic Syndrome in Active Subjects (MESYAS) study to be highly predictive of the metabolic syndrome (MS) diagnosis. TG/HDL ratio was also found to have a high predictive value of a first coronary event regardless of body mass index (BMI)."
What impacts TG:HDL Ratio?
Your TG:HDL ratio is influenced by a range of lifestyle and health factors, including what you eat, how active you are, your weight, alcohol intake, smoking status, and your body’s ability to regulate blood sugar.
Diet – Diets high in added sugars, refined carbohydrates, and saturated fats can raise triglycerides and lower HDL. In contrast, diets rich in fibre, healthy fats, and lean protein can improve your ratio.
- Physical activity – Regular exercise helps lower triglyceride levels and increase HDL cholesterol.
- Weight – Excess body fat, particularly around the abdomen, is associated with a higher TG:HDL ratio.
- Alcohol – Drinking too much alcohol can raise triglycerides significantly.
- Smoking – Smoking is linked to lower HDL and poorer cardiovascular health.
- Insulin resistance – Poor blood sugar control and metabolic conditions like type 2 diabetes often cause an elevated TG:HDL ratio.
How to check your TG:HDL Ratio
You can calculate your TG:HDL ratio by dividing your triglyceride level by your HDL cholesterol level, using results from a standard lipid profile. Both markers are measured in mmol/L.
Our Advanced Cholesterol Blood Test includes all the key biomarkers needed to calculate this ratio, along with additional markers that give a more complete picture of your heart and metabolic health.
This test measures:
- Triglycerides – the main form of fat in the blood, which when elevated, can raise the risk of heart disease
- HDL (High-Density Lipoprotein) – often called “good cholesterol”, it helps remove excess cholesterol from the bloodstream
- LDL (Low-Density Lipoprotein) – traditionally known as “bad cholesterol”, linked with plaque build-up in the arteries
- Total Cholesterol – the sum of all cholesterol in the blood
- HDL Ratio (Total:HDL) – another important indicator of cardiovascular risk
- Apolipoprotein A (ApoA) – a major protein component of HDL, involved in cholesterol transport and clearance
- Apolipoprotein B (ApoB) – found in LDL and other atherogenic particles, providing a more accurate measure of harmful lipoproteins
- Lipoprotein(a) [Lp(a)] – a genetic marker associated with increased cardiovascular risk, regardless of other cholesterol levels
With these markers, you can not only calculate your TG:HDL ratio but also assess a wide range of lipid-related risk factors. Once you receive your results, simply divide your triglyceride (mmol/L) value by your HDL (mmol/L) to determine your ratio.
Tracking this ratio over time can help you stay proactive about your heart health, especially when paired with the advanced insights provided in your personalised report.
Triglycerides are one of our main energy sources and as they are so important we have two supplies – one supply from our diet and one supply made in the body by our liver. To better understand the factors influencing this level Dr Thom Philips recommends repeating this sample after a 16-hour fast. Inevitably, the fasting result will be lower but will be a much better reflection of your lipid physiology as it will be measuring only triglycerides made by your liver.
Improving your TG:HDL Ratio
To support a better ratio:
- Increase physical activity, aiming for 150 minutes of moderate aerobic exercise each week
- Choose unsaturated fats from sources like olive oil, oily fish, avocados, nuts and seeds
- Reduce intake of sugar, refined carbs and trans fats
- Limit alcohol to moderate levels or avoid it altogether
- Lose excess weight, particularly abdominal fat
- Quit smoking – which can help raise your HDL
- Improve insulin sensitivity with a balanced, low-glycaemic diet and stress management
These lifestyle shifts can help lower triglycerides, raise HDL, and support better long-term heart health.
What other markers are important to heart health?
To gain a fuller picture of your cardiovascular risk, it’s helpful to look at other markers alongside TG:HDL, such as:
- Total Cholesterol
- LDL (Low-Density Lipoprotein) – often referred to as “bad” cholesterol
- Non-HDL Cholesterol – includes all potentially harmful lipoproteins
- Apolipoprotein B (ApoB) – a marker of total atherogenic particle count
- Lipoprotein(a) [Lp(a)] – a genetically inherited risk factor
- hs-CRP – a measure of inflammation in the body
By monitoring these in combination, you can take more proactive steps to support long-term heart and metabolic health.
Article references
This information has been medically reviewed by Dr Thom Phillips
Thom works in NHS general practice and has a decade of experience working in both male and female elite sport. He has a background in exercise physiology and has published research into fatigue biomarkers.
Dr Thom Phillips
Chief Medical Officer