How to Lower High Cholesterol?

Understanding Cholesterol

Cholesterol is a waxy, fat-like substance found in all of the cells in your body. Your liver makes all of the cholesterol your body needs to form cell membranes and make vitamin D and hormones. But high levels of cholesterol in your blood, especially “bad” LDL cholesterol, can increase your risk for heart disease and stroke.

Cholesterol comes from two sources:

• Your liver makes all the cholesterol you need
• You get additional cholesterol from foods derived from animals, like meat, eggs, and dairy

When you have too much cholesterol circulating in your blood, it can slowly build up in your artery walls in the form of plaque. This plaque narrows your arteries and makes them less flexible, slowing down and even blocking blood flow.

There are a few different numbers to know when getting your cholesterol checked:

• Total cholesterol
  • The sum of all the cholesterol in your blood. A healthy level is under 200 mg/dL.
• HDL cholesterol
  • Often called “good” cholesterol, higher levels may lower disease risk. Target is 60 mg/dL or higher.
• LDL cholesterol
  • Often called “bad” cholesterol, higher levels raise disease risk. Goal is less than 100 mg/dL.
• Triglycerides
  • Another form of fat in your blood. Ideal is less than 150 mg/dL.

The good news is that even modest changes to your diet, activity levels, and other lifestyle factors can make a big difference in helping to lower high cholesterol!

Lifestyle Changes That Help Lower Cholesterol

Making some healthy lifestyle modifications is the first-line defense for reducing elevated cholesterol levels. Here are some of the most effective strategies:

Losing Weight

• Losing just 5-10% of your body weight can help boost HDL, lower LDL, and drop triglycerides
• Regular exercise helps drive weight loss and directly impacts cholesterol
• Focus on reducing waist size – belly fat increases risk

Exercising More

• Aim for 150 minutes per week of brisk walking, jogging, cycling, swimming etc
• Raises good HDL cholesterol while lowering triglycerides
• Improves cholesterol ratio for better heart health

Quit Smoking

• Stopping smoking can quickly lower LDL cholesterol
• Just 1 year after quitting, heart disease risk drops by 50%
• Smoking damages blood cells called endothelium needed for healthy arteries

Reduce Stress

• Managing stress levels is key for good heart health
• Chronic stress leads to elevated cortisol and inflammation
• Stress management lowers cortisol:
  • Regular exercise
  • Meditation
  • Yoga
  • Spending time outdoors

Dietary Changes That Help Lower Cholesterol

After getting increased physical activity and reaching a healthier weight, your diet is the next most powerful tool for improving cholesterol levels.

Increase Fiber Intake

• Aim for at least 25-30 grams of fiber per day
• Soluble fiber helps block absorption of cholesterol in gut
• Good sources: oatmeal, beans, apples, nuts, seeds, berries

Choose Healthier Fats

• Focus on heart-healthy unsaturated fats
  • Nuts, seeds, olive oil, avocado, fatty fish
• Limit saturated and trans fats
  • Red meat, full-fat dairy, fried foods, baked goods
    

    Limit Saturated Fats

• Less than 5-6% of total calories per day
• Watch out for red meat, processed meat, cheese, butter, ice cream etc.

Eat More Plant Stanols and Sterols

• Found in vegetables, fruits, nuts, seeds, grains
• Look for foods fortified with plant stanols & sterols
  • Margarines, orange juice, cereal, chocolate

Supplements That May Help

Along with a heart-healthy diet and active lifestyle, some key supplements may give an extra boost to lowering cholesterol:

Fish Oil

• Rich in omega-3 fatty acids EPA and DHA
• Helps lower triglycerides and raise HDL
• Aim for 2-4 grams daily of combined DHA/EPA

Soy Protein

• Shown to lower LDL cholesterol
• Recommend 25-50 grams per day
• Choose edamame, tofu, soy nuts, soy milk

Soluble Fiber Supplements

• Psyllium, glucomannan, oat bran help reduce LDL cholesterol
• Can take additional 5-10 grams daily on top of diet

Niacin

• A B-vitamin that raises HDL and lowers LDL/triglycerides
• Should only take under doctor’s advice due to side effects

Garlic

• Shown to mildly lower LDL and triglycerides
• Opt for garlic supplements providing 400-1,200 mg of allicin
• Can cause heartburn so take with meals

When to Consider Medications

In addition to lifestyle measures and supplements, your doctor may prescribe cholesterol medication if:

• You have existing heart disease
• Your 10-year risk of heart attack is over 7.5%
• Your LDL is over 190 mg/dL
• Your LDL remains over 70-100 mg/dL despite 3-6 months of dietary changes

Some of the most common cholesterol medications:

• Statins: Help lower LDL cholesterol levels in blood. Examples are atorvastatin (Lipitor), rosuvastatin (Crestor) or simvastatin (Zocor).
• PCSK9 inhibitors: Injectable drugs that lower LDL cholesterol by blocking PCSK9 protein. Examples are evolocumab (Repatha) and alirocumab (Praluent).
• Bile acid sequestrants: Bind to bile acids to remove cholesterol. Examples are cholestyramine (Prevalite), colesevelam (Welchol) or colestipol (Colestid).
• Fibrates: Break down blood triglycerides. Examples are fenofibrate (Tricor) and gemfibrozil (Lopid).
• Niacin: Increases HDL good cholesterol while lowering LDL and triglycerides.

Discuss all medication options thoroughly with your doctor to weigh the risks and benefits.

Tracking Your Progress

As you implement lifestyle, dietary and other changes to lower your cholesterol, follow up with your doctor regularly to track your numbers. Getting repeat lipid panels every 4 to 6 months will show how your HDL, LDL triglycerides and total cholesterol respond to your cholesterol lowering program.

Celebrate small milestones like losing 5 pounds, adding an extra walk per week, or switching from red meat to fish. Every step counts! Over time, your improved diet, increased exercise, supplements and possibly medication will all work together to help control cholesterol.

Sticking to healthy changes long-term is key – keeping cholesterol lowered means maintaining the habits you’ve built for life. But you may find that your energy improves, you feel better overall, and your heart disease risk plummets, making all the effort worthwhile.