How to Lower Cholesterol Through Diet and Lifestyle

Elevated LDL cholesterol and unfavourable lipid profiles are major cardiovascular risk factors. Statins are effective at reducing LDL and are appropriate for many adults. They are not, however, the only intervention available, and dietary and lifestyle approaches produce meaningful improvements in lipid profiles that are frequently undertried before pharmaceutical intervention is considered.

The Dietary Interventions with the Strongest Evidence

• Soluble fibre: oats, barley, legumes, and psyllium reduce LDL cholesterol by binding bile acids in the intestine, forcing the liver to convert cholesterol into replacement bile acids. Each 5 to 10 grams of soluble fibre per day reduces LDL by 5 to 11 percent
• Plant sterols and stanols: 2 grams per day reduces LDL by 10 to 15 percent through competitive inhibition of cholesterol absorption in the intestine
• Replacing saturated fat with polyunsaturated fat: consistently reduces LDL cholesterol, particularly the atherogenic small dense LDL particles
• Olive oil polyphenols: reduce LDL oxidation, which is more relevant to cardiovascular risk than LDL quantity
• Oily fish and omega-3: primarily reduce triglycerides by 20 to 30 percent with regular consumption

Exercise and Lifestyle

• Aerobic exercise: raises HDL cholesterol by 3 to 6 percent with regular moderate-intensity training
• Weight loss: each 5kg of fat loss reduces LDL by approximately 5 percent and reduces triglycerides significantly
• Smoking cessation: raises HDL by 5 to 10 percent and reduces cardiovascular risk independent of cholesterol effects
• Alcohol reduction: reduces triglycerides significantly, as alcohol is the primary driver of hypertriglyceridaemia in most adults