How to Lower Cholesterol: 6 Things You Need to Do

Craig Primack, MD, FACP, FAAP, FOMA

Reviewed by Craig Primack, MD, FACP, FAAP, FOMA

Written by Vanessa Gibbs

Published 04/07/2024

Cholesterol is like the misunderstood movie villain. Is high cholesterol bad? Yes. But it shouldn’t be totally demonized because your body needs some cholesterol to stay healthy. When we talk about how to lower cholesterol, we mean the not-so-good kind.

High levels of low-density lipoprotein (LDL) cholesterol — aka “bad cholesterol” — can increase your risk of heart disease, stroke and heart attack. Luckily, we know what lowers cholesterol to protect your heart health. 

Here’s how to lower cholesterol levels: 

  • Eat foods like olive oil, fruits, veggies and whole grains  

  • Do more movement 

  • Lose weight 

  • Drink alcohol in moderation 

  • Quit smoking 

  • Take medication if needed 

Below, we’ll share advice on how to lower LDL cholesterol with each of these key steps.

Opting for nutritious, heart-healthy foods can be one of the best ways to lower cholesterol.

Add these cholesterol-lowering foods to your grocery list:

  • Fruits and veggies 

  • Whole grains like brown rice, quinoa, oatmeal and whole-grain cereals   

  • Olive oil and avocado oil 

  • Lean meats like chicken and turkey 

  • Fish like mackerel and salmon 

  • Nuts and seeds

  • Beans and lentils

Aim to up your intake of soluble fiber and plant sterols and stanols (plant compounds with a similar structure to cholesterol). These substances can block cholesterol from being absorbed into your bloodstream.

You’ll find soluble fiber in fruits, oats and beans. Plant sterols and stanols are in whole grains, nuts, olive oil, avocado oil and legumes like lentils and chickpeas.

Beyond this, try to replace saturated fats — found in foods like red meat and dairy products — with unsaturated fats, like omega-3 fatty acids found in fish and vegetable oils like olive and canola oil.

The American Heart Association recommends choosing skim milk and other low-fat or fat-free dairy products over whole milk options. It also says to avoid trans fats. Trans fats — aka partially hydrogenated oils — are found in fried foods and baked goods.

If you want to follow a low-cholesterol diet, consider the Therapeutic Lifestyle Changes program — created by the National Heart, Lung and Blood Institute — the DASH eating plan or the Mediterranean diet. The healthy eating choices in these diets have been shown to lower cholesterol.

Does exercise lower cholesterol? You betcha! Think of it as high-cholesterol self-care.

Exercise is beneficial for all types of cholesterol. It can lower LDL cholesterol levels and increase high-density lipoprotein (HDL) — this is known as “good cholesterol.” 

Aim for 30 minutes of physical activity a day. You don’t have to hit this number right away, but try gradually increasing the amount of movement you do each day.

This could come in the form of: 

  • Walking 

  • Jogging

  • Swimming

  • Cycling 

  • Yoga

  • Taking a group fitness class 

Set realistic goals to help you stay active without feeling overwhelmed, like getting an extra 2,000 steps in a day. Check out our guide to how many steps a day you need to lose weight for inspiration.

If you have overweight or obesity, losing weight can help reduce the risk of a whole host of health issues — including high cholesterol.

Research shows that people who lost five to ten percent of their body weight saw significant reductions in their total cholesterol, LDL cholesterol and triglycerides (a type of fat in your blood linked to cholesterol). Those who lost more weight saw even better results.

Sounds good, right?

If you’re looking to move toward a healthy weight, here’s what to focus on: 

You might also consider weight loss medication. That includes weight loss injections — such as Ozempic® and Wegovy® — and oral weight loss medications like metformin.

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Weight loss treatment that puts you first

Don’t worry — we’re not saying you can never enjoy a glass of red wine with dinner. It’s just that you might want to cut down on the amount of alcohol you drink to benefit your cholesterol levels.

According to the CDC (Centers for Disease Control and Prevention), women should stick to one drink or less a day. For guys, it’s two drinks a day or less, FYI.

If you drink more than this, consider moving to smaller serving sizes or swapping your favorite alcoholic drinks for non-alcoholic options, like alcohol-free beer or sparkling water.

You don’t need us to tell you that smoking comes with all kinds of health risks. 

If you’re looking for another motivator to quit, giving up smoking can increase your HDL cholesterol levels.

Here are some tips to help you kick the habit: 

  • Set a quitting date and let loved ones know about it. Consider if you’ll go cold turkey on this date or slowly cut down on how much you smoke.

  • Make a list of your triggers or where cigarettes fall into your daily routine and make a plan for how you’ll handle them (e.g., maybe you’ll go for a walk after a meal instead of reaching for a cigarette).

  • Remove all reminders, like ashtrays and lighters, from your home and throw out any cigarettes you’ve got left.

  • Consider over-the-counter medications or supplements, like nicotine gum or patches, or prescription medication.

Many people want to know how to lower cholesterol naturally. While natural methods exist — scroll up for those! — your healthcare provider may recommend medications to lower cholesterol.

These include:

  • Statins. These cholesterol-lowering meds work by disrupting cholesterol synthesis. They’re the most common high-cholesterol treatment but aren’t for everyone.

  • Bile acid sequestrants. These medications stop bile acids from being reabsorbed. They might be prescribed if you need something more powerful than statins or if you can’t take statins.

  • Familial hypercholesterolemia medication. Familial hypercholesterolemia is a hereditary condition that causes high cholesterol levels (thanks, Mom and Dad). Medications to treat this include mipomersen, lomitapide and ezetimibe.

  • PCSK9 inhibitors. These are injections you take every two to four weeks. Your provider might prescribe a PCSK9 inhibitor plus a statin in certain situations, like if you’re at high risk of heart attack, stroke or cardiovascular disease or if you have a history of familial hypercholesterolemia (high LDL blood cholesterol).

Your healthcare provider can let you know if you need medication to lower your cholesterol and walk you through the pros, cons and side effects. Existing health issues, like high blood pressure, may affect which treatment is best for you.

There are steps you can take in your daily life to lower cholesterol levels, but supplements or prescription medication might be necessary.

Here’s what to keep in mind:

  • Incorporate healthy lifestyle changes into your routine. Opt for nutritious foods, get in some movement each day and aim to lose weight if you have overweight or obesity.

  • Speak to your healthcare provider about cholesterol. If you have a buildup of high cholesterol, it’s normal to have a lot of questions. Don’t be afraid to ask your provider. Questions to ask include how to lower cholesterol fast and how to lower cholesterol without statins. They can let you know the best course of action for your situation. 

  • Reach out for support. Whether you’re quitting smoking, losing weight or building healthy habits, you don’t have to go it alone. Reach out to friends, family and medical professionals, or join structured programs for support in achieving your goals.

If weight loss is on your radar, weight loss medication, like diabetes drugs, may have a place in your plan.

Learn more about the many weight loss treatments that can help.

14 Sources

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