Got high cholesterol? Don’t assume you need drugs to get your numbers in line. Lifestyle changes—like getting active, losing even a little weight, and eating certain foods—can lower your cholesterol by as much as 30 percent. Even if you’re on cholesterol-lowering drugs, it’s best to take the lowest possible dose and combine it with lifestyle changes, says Dr. Stephen Kopechy, a Mayo Clinic cardiologist specializing in preventive medicine and president-elect of the American Society for Preventive Cardiology.
Most people take six months to a year to really get a handle on lifestyle changes, says Kopechy, so be patient. Here are the most important changes to make to get your cholesterol levels where they need to be.
Lose weight. Losing as little as about 7 percent of excess body fat can make a huge different when it comes to lowering cholesterol and reducing your risk for heart disease, Dr. Kopechy says. The same diet and exercise advice we give below to help reduce cholesterol will also help you to lose weight, as long as you are burning more calories than you eat. “Most people are just plain getting too many calories, and they need to cut back,” Dr. Kopechy says.
Exercise 30 to 60 minutes most days of the week. Whether you are overweight or not, exercise is the best way to naturally raise good HDL cholesterol and improve your ratio of total cholesterol to HDL (the good cholesterol), which many researchers now consider the most accurate predictor of heart disease. Interval training is especially helpful to burn calories and improve aerobic capacity, Dr. Kopechy says. During any type of cardio exercise, simply crank up your pace for 30 seconds to a minute or two every few minutes, then throttle back to a moderate, sustainable pace. “Exercise is especially important once you get to maintenance phase of weight loss,” he says. If painful joints are stopping you, try swimming or water aerobics.
Eat heart-healthy foods. Besides cutting back on cholesterol-boosting saturated and trans-fats, you’ll want to add monounsaturated fats (olive oil, avocadoes, nuts), omega-3 fats (salmon, herring, tuna, omega-3 eggs, flaxseed) beans and lentils, whole grains, and all sorts of vegetables and fruits, especially blueberries and pomegranate. “Substitute these healthy foods, and still, pay attention to calories,” Dr. Kopechy says. “A handful of almonds–10 or 12–may do you good, but a couple of hundred is not better.”
Take a psyllium fiber supplement. Certain types of soluble fiber are proven to help reduce cholesterol, but the amount needed—at least 7 grams a day–is more than many people get in their diet. So some people take a bulk laxative such as Konsyl or Metamucil, which contains the soluble fiber psyllium. In studies using psyllium-enriched cereal that provided about 10 to 12 g of psyllium a day, total cholesterol dropped five percent and LDL cholesterol dropped nine percent more than the reduction achieved with a low-fat diet alone. “This can be very effective for some people,” Dr. Kopechy says. Note that cellulose fiber, found in some breads, does not have a cholesterol-lowering effect.
Quit smoking. Smoking depresses HDL levels, but quitting allows HDL to come back to normal and quickly reduces your risk for heart attack and stroke. Within one year of quitting, your risk for heart disease is half that of a smoker.
If you drink, keep it moderate and stick with red wine. One glass a day for women, two for men, has been linked with higher levels of HDL cholesterol. Doctors won’t recommend you start drinking if you don’t already—the benefits aren’t strong enough to justify that–but if you do drink, this is one small pleasure that may help your cholesterol.