If you can, upgrade to a paid subscription today. It keeps this work going and unlocks full access to every workshop replay and archive—plus all fut…

Read more

Picture this:

You are 9 and you get your first ever blood draw at your pediatrician well visit.

You are scared because you hate needles, but you survive it. Then, a few days later, your parent tells you the doctor called to say you now need to, “watch what you eat” because you have something called high triglycerides.

You can barely pronounce it, but you try and ask…"what are high triglycerides?”

You are told that you eat too much “junk food” and now you have too much fat in your blood.

You are terrifed and ashamed.

You go numb.

Too much fat in my blood? I’m too fat? There’s something wrong with my body? What did I do to my body?

At dinner that night, you don’t know what to do. It’s spaghetti and garlic bread — one of your favorites — but you feel confused.

Should you not have the garlic bread? Or maybe just half a bowl of pasta? You realize you were looking forward to the brownies your parents typically serve with this meal…but now you wonder if you aren’t supposed to have one.

Now you can’t stop thinking about the brownies during the meal.

The table is cleared and your siblings grab brownies off of the platter. You look at your parent…and with your eyes you ask, is it safe to have a brownie?

They hesitate. Then they say, “Maybe just a small one.”

The vibe is awful.

And this vibe becomes the new normal for the rest of your childhood eating experience.

I’ve heard true stories like this. Over and over again.

I’ve sat with people in the thick of trauma work—peeling back years of shame and mistrust. Together, we’ve reprocessed the exact moments when a lab result, a sudden change in how food was talked about, or a well-meaning doctor’s comment became a defining rupture.

They were formative moments—ones that shaped how people fed and cared for themselves, moved their bodies, and judged their worth for years to come.

Emotional injuries like this occur because the adults raising kids with something as stigma-charged and murky as “high triglycerides” (much like elevated cholesterol or blood sugars) are often left without a clear, developmentally appropriate path forward.

But it doesn’t have to go this way.

I’m about to walk you through exactly how I’d guide you if you were in my office, asking:

My Kid’s Triglycerides Are High—Can I Support Their Health Without Wrecking Their Relationship with Food? (Spoiler: Yes. You absolutely can.)

But first, some quick context:

A few months ago a parent suggested that my food neutral approach may be to blame for her child's high triglycerides. She said she felt my content “pressured” her into being "too loose" and that wasn't ultimately good for her child's health.

I knew this parent had misunderstood the concept of food neutrality, confusing it with permissive feeding—a common mix-up. So I wrote this guide (free for all) to clarify what we really mean when we say “All Food is Good Food,” and why it matters.

But I also promised myself I’d circle back to the specific concern about triglycerides—because honestly, I wasn’t entirely sure. I wanted to check in with a medical professional and a couple of pediatric dietitians I trust before offering a response.

To be fair to that parent, most of us—myself included—have been taught that triglycerides — the fat stored in our blood — are directly shaped by what we eat, especially highly processed, lower-nutrient snacks. And we’re not necessarily wrong.

Elevated triglycerides may have something to do with food—or very little to not at all. Genetics, growth patterns, disease, pubertal timing, activity levels, stress levels, sleep quality, even how recently a child ate before the test can all play a role. Without the full picture, families are often left to fill in the blanks with fear or self-reproach.

I imagined this parent bringing their 9- to 11-year-old in for a standard well visit, not expecting anything unusual—then learning that the American Academy of Pediatrics recommends a fasting lipid panel at this age to screen for early cardiovascular risk. For many families, it’s the first time they contend with their child’s health status being reflected back to them in the form of lab results.

And all of this is happening at an age when kids are so developmentally tender—when their relationships with food, their bodies, and their sense of self are still taking shape.

This is why I created this guide to offer the kind of realistic, non-alarmist support path every child and family deserves.

Below you will learn:

• The order of operations that helps reduce shame and prevent trauma

• How to begin making sustainable, family-level shifts that align with body-positive, food neutral values

• Tips from highly specialized professionals — one adolescent medicine doctor and two dietitians I trust

• Scripts to draw inspiration from for when you need to speak directly to your child or teen about what is happening in their bodies and how food can be used to support their special needs

FYI: All content here is for educational and informational purposes only, aren’t a substitute for medical or mental-health advice, and don’t constitute a provider-patient relationship between any of the professionals represented below, myself included.

First Stop: An Adolescent Medicine Specialist Who Gets It

Medical Evaluation & Root Cause Clarity

I completely understand why seeing elevated triglycerides on your child’s lab report might send your mind racing toward nutrition overhauls. But, before we do anything with food, we need to know what we’re actually dealing with.

If I had my druthers, I’d take you to one of my favorite weight-inclusive adolescent medicine specialists —someone who brings eating disorder prevention savvy and a whole-child lens to the table: Dr. Olga Myszko (Dr. M) from Tribeca Adolescent and Young Adult Medicine.

Before assuming high triglycerides are a lifestyle issue, Dr. M will slow things down. No knee-jerk food policing. No assumptions based on weight. Instead, she’d take a thoughtful approach—asking about family history, stress levels, and sleep hygiene, reviewing medications, and ruling out medical conditions like thyroid dysfunction or insulin resistance.

She’d remind you that while many parents assume triglycerides are mostly driven by food, most are actually produced by the body itself. And she’d validate your concern—not just because of long-term heart health, but because significantly elevated triglycerides can sometimes point to something more urgent, like pancreatitis, a serious and potentially life-threatening inflammation of the pancreas.

Here’s what Dr. M will want to do:

• Confirm with fasting bloodwork. Eating beforehand can temporarily elevate triglycerides, so a follow-up fasting test is essential.

• Account for natural fluctuations. Puberty can skew results, which is why the American Academy of Pediatrics and Pediatric Endocrine Society recommend screening at ages 9–11 and again at 17–21.

• Stay weight neutral. Kids with higher BMIs have completely normal labs and kids with lower BMIs can have elevated ones. So if triglycerides are elevated, the real question is: Why this child? Is it lifestyle—or something else?

She’d explore a wide range of possible causes:

• Genetics. Some inherited conditions cause high triglycerides regardless of diet.

• Medical issues. Thyroid disease, insulin resistance, diabetes, kidney conditions, and hormone imbalances can all play a role.

• Medications and supplements. Certain prescriptions—and even some over-the-counter “natural” products—can affect triglyceride levels.

• Lifestyle factors. These matter too, but they’re just one part of a much bigger picture.

And then, gently and without judgment, she’d ask about feeding in your home—what foods are available, what your child enjoys, and what’s been tricky for them to accept. She’d approach these questions through a food-neutral lens, because even if a referral to a dietitian is part of the plan, shame and blame have no place in this process.

For the purposes of this piece, we’re going to assume that Dr. M finds no glaring underlying causes. She believes it’s reasonable to attribute the elevated triglycerides levels to family history, likely exacerbated by your child’s current lifestyle, which includes their diet—higher in quick-to-digest carbs, sugary drinks, and ultra-processed snack foods, and lower in fiber-rich, nutrient-dense foods that could be very supportive to this child’s condition.

Then she wouldn’t let you leave her office without explaining the most important thing: this is not your fault, and it’s not your child’s fault either. Triglycerides are shaped by a web of factors—genetics, sleep, stress, early development, pubertal timing, and even intergenerational trauma—not just by what a child eats. We see kids in the same family with totally different metabolic patterns, and often there’s no clear reason why one child is affected and another isn’t. This is not something you missed or failed to do. It’s just the reality of how complex bodies are.

Yes, she would then refer you to a dietitian—but that shouldn’t be mistaken for a referendum on your ability to feed your child. It’s simply a supportive next step. One that only works when it respects the full context: the things outside your control, the non-food factors that can be worked on—like sleep, stress, movement, and hydration—and then, yes, food too.

But Wait—You’re Having Feelings (Of Course You Are)

When parents hear something like, “Yes, the genetics you passed down—and some of the foods you offer—may be contributing to your child’s elevated triglycerides, which could increase their long-term heart health risks,” the most common reaction is to look for someone to blame.

This must be my failing as a parent.
Or, as a parent recently said to me, “I shouldn’t have listened to your food neutrality advice—it made me too loose.”

Whether the blame turns inward or outward—toward yourself, a professional, or a feeding style—it’s a natural response to fear and overwhelm. But it’s not the whole story.

I want to remind you of something every parent of a child with special nutritional needs must hear :

Two things are true:
You did nothing wrong and it is your responsibility to re-scaffold a feeding environment that is responsive to your child’s evolving needs.
You have given them a gift in allowing them to experience a relaxed relationship with food. You haven’t vilified sweets, demonized carbs, or normalized restriction. You’ve laid a foundation of food neutrality—a foundation absent of morality and full of trust.
That foundation will serve you now, even as you begin to make thoughtful, responsive adjustments.

Before we head off to the dietitian’s office, I’d want to make sure you could access a little self-compassion. And I’d assure you: the dietitian Dr. M and I are sending you to will not undo your work—she’s will help you build upon it.

The shift from feeding a child whose body knows exactly what to do with whatever food they eat…to feeding a child whose body needs a little more intentionality and support…is a loss of privilege. For both of you.

It is less stressful to feed kids whose labs are pristine and whose bodies regulate with ease.

That’s why this next step matters.

Take advantage of the Summer Special for 25% off paid subscription.

Read more