- The best way to lower cholesterol is with a heart-healthy diet and regular exercise.
- Foods that can lower cholesterol include nuts, avocados, whole grains, fruits, vegetables, and healthy oils.
- It generally takes at least three months to lower cholesterol and you will still need to maintain a healthy lifestyle afterward for any change to be effective.
- This article was reviewed by Jason R. McKnight, MD, MS, a family medicine physician and clinical assistant professor at Texas A&M College of Medicine.
- This article is part of Insider’s guide to High Cholesterol.
If you’re one of the 93 million adults in the US with high cholesterol, chances are you’re wondering what it’s going to take to lower it.
High cholesterol can be inherited, but by and large, it’s the consequence of unhealthy lifestyle choices. As a primer to the discussion you should be having with your doctor, there are several key changes you can make to your daily routine to keep your cholesterol levels at a healthy range.
According to Steven Reisman, MD, a cardiologist and director of the New York Cardiac Diagnostic Center, the best way to lower cholesterol is with lifestyle modifications through diet and exercise.
Understanding “good” and “bad’ cholesterol
Cholesterol has a bad reputation, but the truth is it is an essential part of the body that helps build hormones, make vitamin D, and produce bile acids in the liver, which is crucial for digestion.
In fact, according to the American Heart Association, the liver makes all the cholesterol your body needs to function. But cholesterol also enters the body through the animal-based foods you eat, like meat and full-dairy products.
To get your levels under control, it’s important to understand that cholesterol travels through the blood by substances called lipoproteins, and there are two main types:
- LDL (low-density lipoprotein) is known as “bad” cholesterol because when the body has too much LDL cholesterol, it can build up in your arteries and block the flow of blood, which increases your risk for heart disease or stroke.
- HDL (high-density lipoprotein) is called “good” cholesterol because it helps transport LDL cholesterol to the liver, where it can be removed before it builds up in the arteries. The higher the level of HDL cholesterol, the lower the risk of heart disease.
In general, what you’re aiming for is the right HDL-to-LDL ratio. But it takes more than just watching the cholesterol content of the foods you eat.
While one may think lowering cholesterol levels is all about prohibiting cholesterol-rich foods from your diet, that’s only a small factor.
What’s important to understand is foods that are high in cholesterol are also high in saturated and trans fats, and there is growing evidence that for most people, the types of fat you eat is just as important as cholesterol when considering HDL and LDL levels.
In addition to making healthier food choices, you can lower your cholesterol levels by staying active and avoiding tobacco products. Here’s a full breakdown of the diet and lifestyle changes worth considering.
1. Limit saturated fats
As mentioned, it’s understood that foods that are high in cholesterol are also high in saturated fats. Most saturated fats come from animal fats and dairy products, including:
- Red meats like beef, lamb, and pork
- Chicken skin
- Whole-milk dairy foods like cheese, butter, and cream
But you can also find them in other products like:
- Coconut oil and cocoa butter
- Palm oil and palm kernel oil
Saturated fats drive up “bad” LDL cholesterol levels, but they also boost “good” HDL cholesterol. Therefore, you don’t necessarily need to eliminate saturated fats completely. Instead, foods with saturated fats should be eaten in moderation.
2. Cut trans fats
In general, trans fats are more harmful than saturated fats — so much so that the FDA is working to phase out trans fats from the US food supply.
While trans fat naturally occurs in certain meat and dairy products, they become harmful when they’re artificially manufactured and found in partially hydrogenated oils. These oils are used in commercially fried foods and packaged goods.
Trans fats are worse than saturated fats because not only do they raise “bad” LDL cholesterol levels, they actively reduce “good” HDL cholesterol levels.
While the FDA has taken steps to eliminate trans fat from the production of processed foods, it’s a good idea for anyone with high cholesterol to eliminate these foods from their diet. At the very least, check the nutrition label on packaged goods for “partially hydrogenated oils”.
3. Replace saturated and trans fats with unsaturated fats
Not all fats are bad. Once you limit your intake of saturated and trans fat, the next step is to eat foods that are considered heart-healthy, which includes foods that contain unsaturated fats.
There are two kinds of unsaturated fats: monounsaturated fats and polyunsaturated fats. And when eaten in moderation, they both can help improve your cholesterol levels, especially when used in place of saturated and trans fats.
The benefit of monounsaturated fats
“Foods with monounsaturated fats are beneficial because they can decrease bad cholesterol (LDL) and increase good cholesterol (HDL),” says Reisman. Foods with monounsaturated fats include:
- Nuts like almonds, cashews, and pecans
- Cooking with canola, olive, or peanut oil
The benefit of polyunsaturated fats
Including polyunsaturated fats may also reduce the risk of heart disease and help lower your LDL cholesterol, says Reisman. Look for foods that contain an important type of polyunsaturated fat — omega-3 fatty acids. These include:
- Sunflower seeds
- Fish like salmon, herring, and tuna
4. Eat more foods high in soluble fiber
Fiber can bring many benefits, including promoting digestive health and regulating how the body absorbs fat and cholesterol.
There are two types of fiber:
- Soluble fiber: This type of fiber dissolves in water and slows down digestion, and is mainly found in whole grains and oats, legumes (like beans and lentils), and some fruits and vegetables (like apples, pears and peas)
- Insoluble fiber: This type of fiber does not dissolve in water and is also found in whole wheat flours, nuts, and vegetables like cauliflower and potatoes.
According to Reisman, soluble fiber can help reduce LDL cholesterol.
Soluble fibers soak up water and form a gel-like substance in the intestine, which help manage the absorption of dietary fat and cholesterol. Over time, eating more fiber helps the body remove cholesterol instead of absorb it, lowering LDL cholesterol along the way.
5. Exercise regularly
A daily exercise routine has many benefits, including improving cholesterol levels.
Research has found that regular exercise helps increase the amount of HDL cholesterol in your body, which prevents LDL cholesterol from building up in your bloodstream and blocking your arteries.
As for optimal levels of exercise, aim for at least 30 minutes of aerobic activity five times each week — walking, biking, jogging, or exercise classes should do the trick.
6. Stop smoking
If you’re a smoker, giving up the habit can also get your numbers under control. That’s because smoking lowers “good” HDL cholesterol.
It’s never too late to quit. A 2011 study published in the American Heart Journal found that the level of HDL “good” cholesterol can rise about 5%, or 2.4 mg/dL, within just six weeks after quitting smoking.
7. Drink alcohol in moderation
It’s true that drinking alcohol in moderation can bring heart-healthy benefits. For example, research has found that a glass of wine (5 ounces) can raise HDL cholesterol levels.
It should be noted, however, that the correlation is not strong enough to recommend drinking alcohol to those who do not drink.
Too much alcohol, however, can increase LDL cholesterol levels. If you’re worried about your cholesterol levels, you should follow the recommended limit, which is one drink per day for women and two drinks per day for men.
How long does it take to reduce cholesterol levels?
Reisman says it takes at least three months to lower your cholesterol.
Sasan Massachi, MD, a primary care physician specializing in internal medicine, says that patients are typically advised to adopt a lifestyle modification program for three months, focusing on a healthier diet and regular exercise. This is followed up with cholesterol tests after three months to gauge results.
“If patients reduce their cholesterol adequately and are not in any danger of cardiovascular diseases, and they commit to maintaining a healthy diet and exercise regimen, we have them follow up in three to six months for additional cholesterol tests,” he says.
Overall, how quickly you can reduce cholesterol will depend on your total cholesterol level, your family history, any pre-existing health conditions like diabetes, and the type of diet and exercise program.
If your levels are already closer to a healthy range, and you don’t have any pre-existing conditions, it may take less time.
When a doctor will recommend medication
“For some patients who don’t respond well to lifestyle changes, it is necessary to take medication,” says Massachi. This may include those with a family history of high cholesterol, and those who also have cardiovascular diseases or type 2 diabetes.
In these cases, Massachi says taking cholesterol medication can lower your cholesterol levels, and also help manage other pre-existing conditions. You should talk with your doctor if you think this might be the right option for you.