If you’re one of the approximately 100 million Americans with high or borderline high cholesterol, you may think that medication is the only way to get it under control. But a better diet, exercise and other lifestyle changes can be nearly as effective as a cholesterol-lowering medication. Sure, it’s not as easy as swallowing a pill, but making the effort to live a healthier lifestyle is an essential part of any cholesterol treatment plan.
While you can’t control some risk factors, like family history and gender, you can seize these opportunities to make a positive impact on unhealthy cholesterol levels (200 to 239 mg/dL is considered borderline high; 240 mg/dL or more is high).
If you’ve already been prescribed a cholesterol medication, lifestyle changes may help get you to a point where your doctor feels it’s safe for you to reduce or even stop it; never stop taking a medication without your physician’s approval.
Get Your Heart Pumping
Research shows that exercise stimulates the enzymes that help move low-density lipoprotein (LDL, or “bad cholesterol”) from the blood to the liver, where it is converted to a substance that can be excreted. Aim for at least 30 minutes of moderate, aerobic exercise—such as walking, dancing or biking—most days. (You can break the time up into several shorter sessions, if that’s easier.) If you’ve been sedentary for a while, speak with your doctor first to create a safe exercise plan.
Swap in Healthier Fats
When it comes to diet’s influence on your cholesterol, doctors used to focus on the cholesterol you consume when you eat animal-based foods, like meat and eggs. Today, the bigger culprits of concern are unhealthy saturated and trans fats, found in red meat and dairy, palm and coconut oil, and processed or fried foods.
Aim to eat more omega-3 and monounsaturated fats, found mainly in fish and plant-based foods like nuts, flaxseeds and olive oil, instead. These fats are good for your heart because they help lower LDL levels.
Add Fiber to Your Diet
All fiber is good for you, but soluble fiber is a secret weapon when you’re working on your cholesterol: It binds to fatty substances in your intestines and helps your body get rid of them, which lowers your LDL levels.
Shoot for 20 to 30 grams of fiber per day, with at least half of your total intake consisting of soluble fiber. Good sources are steel cut oats, bran cereals, whole-grain bread, brown rice, kidney beans, hummus and other legumes, nuts, seeds, fruits and vegetables. Avoid peeling the skin from produce, as this is where much of the fiber is located.
Eat Eight to 10 Servings of Fruits and Vegetables a Day
Fruit and vegetables provide essential vitamins, minerals and fiber—and because they don’t contain cholesterol or trans fats, you can fill your plate with as much produce as you’d like. Just limit fat-laden toppings like cheese and butter, and opt for healthier choices like fresh herbs or a drizzle of olive oil or lemon juice.
Supplement with Sterols
Consider adding plant stanols and sterols, natural cholesterol-lowering compounds found in plants, to your diet. Stanols and sterols look like cholesterol on a molecular level, and that means they block real cholesterol from being absorbed in the bloodstream. You’ll find them in some fortified margarines, salad dressings, nuts and vegetable oils, and as dietary supplements.
Become Tobacco Free
Smoking increases the risk for cardiovascular disease and lowers levels of high-density lipoprotein—your “good cholesterol.” Researchers are still investigating this connection, but it seems toxins from smoking interfere with cholesterol balance and prevent HDL from working properly. If you’ve tried to quit in the past and found it difficult, speak with your doctor about how you can best support your efforts.
Have a Drink a Day
Although the scientific opinion on alcohol remains mixed, most research shows that one drink a day for women and two drinks a day for men can raise HDL levels and help keep your cardiovascular system healthy. However, any more than that can be detrimental. Don’t start drinking if you don’t already—but if you do enjoy an occasional drink, there are some cholesterol benefits.
Nurture Your Relationships
Research has shown that people in happy, affectionate marriages enjoy a reduced risk of heart disease. For example, a study done at the University of Utah Health Sciences Center found that thirty minutes of skin-to-skin contact (hugging, cuddling, holding hands) resulted in lower blood pressure and heart rate—two indicators of heart health. And a study in the American Journal of Cardiology found that men who don’t engage in sex often (once a month) were at a higher risk of cardiovascular disease compared to those who are frequently intimate with their partner (two or more times a week). Even if you’re not romantically involved, nurturing your friendships and relationships with family members delivers a heart-healthy payoff: Studies suggest people in loving relationships are less likely to develop heart disease during their lives.