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High cholesterol initially is a painless, and can be frustrating diagnosis. My patients usually respond one of two ways: 1) Just give me medication, as I am not going to change or 2) Let me try diet and exercise first. Trying diet and exercise may be an option if your cholesterol is slightly elevated. If you have been told you must start medications because you have a high risk for stroke or heart – then I recommend starting the medication. You can still initiate lifestyle changes with medication.

If your health care provider feels it is safe to allow you to try and lower your cholesterol naturally, here are some very important recommendations.

1) Know Your Numbers: According to the American Heart Association, people who have a total cholesterol of 240 mg/dL (milligrams per deciliter) are twice as likely to experience a heart attack as people who have a cholesterol level of 200 mg/dL. Knowing your level, and tracking it as you begin treatment, just makes sense.

Total Cholesterol: <200

Triglycerides:<150 (Your triglycerides will fluctuate most, based on your diet over the last few days)

HDL (Good cholesterol): >40

LDL: <130

2) Lose Weight:

A slow but steady loss of 1/2 to 1 pound a week is healthiest and easiest to maintain. Since 1 pound equals 3,500 calories, you could meet the pound-per-week rate by eating 500 fewer calories per day, burning 500 more calories per day through exercise, or–the best option–a combination of the two.

3) Exercise:

The recommendation is 30 mins of activity at least 5 times a week. I would encourage you to begin at 30 minutes and increase to 1 hour 5 times a week, if you are trying to control your cholesterol. Most importantly, GET MOVING! If you are not doing any physical activity, then something is better than nothing.

4) Eat Your Oats and Increase Your Fiber:

Oats. An easy first step to improving your cholesterol is having a bowl of oatmeal or cold oat-based cereal like Cheerios for breakfast. It gives you 1 to 2 grams of soluble fiber. Add a banana or some strawberries for another half-gram. Current nutrition guidelines recommend getting 20 to 35 grams of fiber a day, with at least 5 to 10 grams coming from soluble fiber. (The average American gets about half that amount.)

Barley and other whole grains. Like oats and oat bran, barley and other whole grains can help lower the risk of heart disease, mainly via the soluble fiber they deliver.

Beans. Beans are especially rich in soluble fiber. They also take a while for the body to digest, meaning you feel full for longer after a meal. That’s one reason beans are a useful food for folks trying to lose weight. With so many choices — from navy and kidney beans to lentils, garbanzos, black-eyed peas, and beyond — and so many ways to prepare them, beans are a very versatile food.

Eggplant and okra. These two low-calorie vegetables are good sources of soluble fiber.

Nuts. A bushel of studies shows that eating almonds, walnuts, peanuts, and other nuts is good for the heart. Eating 2 ounces of nuts a day can slightly lower LDL, on the order of 5%. Nuts have additional nutrients that protect the heart in other ways.

5) Out With Bad Fats and In With Good Fats:

I recommend baking, broiling and grilling meats. Stop frying your foods.

Peanut butter, avocados, olive and canola oils, and most nuts are mostly monounsaturated fat. Research has shown that monounsaturated fat can help lower LDL and triglycerides (another type of blood fat) while raising HDL. It’s a much healthier choice than saturated fat, found primarily in animal products–meats, butter, full-fat milk and cheese. Saturated fat can elevate your cholesterol level more than anything else you might eat.

Also included in the good fats category are the omega-3 fatty acids, found in abundance in fish such as mackerel, albacore tuna, and salmon. The omega-3s appear to lower levels of VLDL (very low density lipoprotein) and triglycerides. Studies have shown that when people cut back on saturated fat and consumed more fish oil, their LDL dropped. The American Heart Association recommends eating at least 2 servings of baked or grilled fish a week.

6) Take a Multivitamin

Even if you’re getting more good fats, avoiding bad fats, and filling up on fiber, your diet may have some nutritional gaps. A multivitamin/mineral supplement can help cover your nutritional bases and possibly lower your risk for heart disease and stroke.

Look for a multi that delivers 400 micrograms of folic acid, 2 mg of vitamin B6, and 6 micrograms of vitamin B12, advises Robert Rosenson, MD, director of the preventive cardiology center at Northwestern University Medical School in Chicago. In studies, all three of these B vitamins have played important roles in protecting heart health.

7) Cut out caffeine and alcohol – drink water.

Both caffeine and alcohol have been shown to elevate cholesterol. So it’s best to switch to pure water and, at the very least, follow the “no more than one a day” rule.


8) Don’t smoke or use tobacco in any form.

Smoking damages blood vessels, contributes to hardening of the arteries and is a major health risk for heart disease, stroke and other degenerative diseases.

9) Safe Supplements You Might Consider

Cholesterol-lowering supplement

What it does

Side effects and drug interactions

Artichoke extract May reduce total cholesterol and LDL, or “bad,” cholesterol May cause gas or an allergic reaction
Barley May reduce total cholesterol and LDL cholesterol None
Beta-sitosterol (found in oral supplements and some margarines, such as Promise Activ) May reduce total cholesterol and LDL cholesterol May cause nausea, indigestion, gas, diarrhea or constipation

May be ineffective if you take ezetimibe (Zetia), a prescription cholesterol medication

Blond psyllium (found in seed husk and products such as Metamucil) May reduce total cholesterol and LDL cholesterol May cause gas, stomach pain, diarrhea, constipation or nausea
Fish oil (found as a liquid oil and in oil-filled capsules) May reduce triglycerides May cause a fishy aftertaste, bad breath, gas, nausea, vomiting or diarrhea

May interact with some blood-thinning medications, such as warfarin (Coumadin)

Flaxseed, ground May reduce triglycerides May cause, gas, bloating or diarrhea

May interact with some blood-thinning medications, such as aspirin, clopidogrel (Plavix) and warfarin (Coumadin)

Garlic extract May reduce total cholesterol, LDL cholesterol and triglycerides May cause bad breath, body odor, heartburn, gas, nausea, vomiting or diarrhea

May interact with blood-thinning medications, such as warfarin (Coumadin)

Green tea extract May lower LDL cholesterol May cause nausea, vomiting, gas or diarrhea

May interact with blood-thinning medications, such as warfarin (Coumadin)

Oat bran (found in oatmeal and whole oats) May reduce total cholesterol and LDL cholesterol May cause gas or bloating
Sitostanol (found in oral supplements and some margarines, such as Benecol) May reduce total cholesterol and LDL cholesterol May cause diarrhea

Another popular cholesterol-lowering supplement is red yeast rice. There is some evidence that red yeast rice can help lower your LDL cholesterol. However, the Food and Drug Administration has warned that red yeast rice products could contain a naturally occurring form of the prescription medication known as lovastatin. Lovastatin in the red yeast rice products in question is potentially dangerous because there’s no way for you to know what level or quality of lovastatin might be in red yeast rice.

Finally, remember when you go have your cholesterol checked to fast 8 hours before you have your blood drawn. Do not eat anything 8 hours before, but you may have black coffee or water. I recommend drinking water before your labs are drawn, as dehydration can make it difficult to obtain the lab.

If you are placed on cholesterol lowering medication, with some simple lifestyle changes – you can lower your cholesterol and possibly be taken off the medication. Do not stop any medication without discussing it with your health care provider.

Have you been able to lower your cholesterol naturally? I want to hear from you!