Cholesterol

How Can Lower High Cholesterol?

Too much cholesterol in the blood can lead to heart disease and stroke — America’s No. 1 and No. 4 killers.

You can reduce your cholesterol by eating healthful foods, losing weight if you need to and being physically active. Some people also need to take medicine because changing their diet isn’t enough. Your doctor and nurses will help you set up a plan for reducing your cholesterol — and keeping yourself healthy!

Most heart and blood vessel disease is caused by a buildup of cholesterol, plaque and other fatty deposits in artery walls. The arteries that feed the heart can become so clogged that the blood flow is reduced, causing chest pain. If a blood clot forms and blocks the artery, a heart attack can occur. Similarly, if a blood clot blocks an artery leading to or in the brain, a stroke results.

For some people, diet tweaks are enough to lower cholesterol naturally without medication, while others will need drugs, or a combination of diet and medication

Diet can play an important role in lowering your cholesterol.

Here are some foods that can lower your cholesterol and protect your heart:

Can a bowl of oatmeal help lower your cholesterol? How about a handful of walnuts or even a baked potato topped with some heart-healthy margarine? A few simple tweaks to your diet — like these, along with exercise and other heart-healthy habits — may be helpful in lowering your cholesterol.

1. Oatmeal, oat bran and high-fiber foods

Oatmeal contains soluble fiber, which reduces your low-density lipoprotein (LDL), the "bad," cholesterol. Soluble fiber is also found in such foods as kidney beans, apples, pears, barley and prunes.

Soluble fiber can reduce the absorption of cholesterol into your bloodstream. Five to 10 grams or more of soluble fiber a day decreases your total and LDL cholesterol. Eating 1 1/2 cups of cooked oatmeal provides 6 grams of fiber. If you add fruit, such as bananas, you'll add about 4 more grams of fiber. To mix it up a little, try steel-cut oatmeal or cold cereal made with oatmeal or oat bran.

2. Fish and omega-3 fatty acids

Eating fatty fish can be heart healthy because of its high levels of omega-3 fatty acids, which can reduce your blood pressure and risk of developing blood clots. In people who have already had heart attacks, fish oil — or omega-3 fatty acids — reduces the risk of sudden death.

The American Heart Association recommends eating at least two servings of fish a week. The highest levels of omega-3 fatty acids are in:

  • Mackerel
  • Lake trout
  • Herring
  • Sardines
  • Albacore tuna
  • Salmon
  • Halibut

You should bake or grill the fish to avoid adding unhealthy fats. If you don't like fish, you can also get small amounts of omega-3 fatty acids from foods like ground flaxseed or canola oil.

You can take an omega-3 or fish oil supplement to get some of the benefits, but you won't get other nutrients in fish, such as selenium. If you decide to take a supplement, just remember to watch your diet and eat lean meat or vegetables in place of fish.

3. Walnuts, almonds and other nuts

Walnuts, almonds and other nuts can reduce blood cholesterol. Rich in polyunsaturated fatty acids, walnuts also help keep blood vessels healthy.

Eating about a handful (1.5 ounces, or 42.5 grams) a day of most nuts, such as almonds, hazelnuts, peanuts, pecans, some pine nuts, pistachio nuts and walnuts, may reduce your risk of heart disease. Just make sure the nuts you eat aren't salted or coated with sugar.

All nuts are high in calories, so a handful will do. To avoid eating too many nuts and gaining weight, replace foods high in saturated fat with nuts. For example, instead of using cheese, meat or croutons in your salad, add a handful of walnuts or almonds.

4. Olive oil

Olive oil contains a potent mix of antioxidants that can lower your "bad" (LDL) cholesterol but leave your "good" (HDL) cholesterol untouched.

Try using about 2 tablespoons (23 grams) of olive oil a day in place of other fats in your diet to get its heart-healthy benefits. To add olive oil to your diet, you can saute vegetables in it, add it to a marinade or mix it with vinegar as a salad dressing. You can also use olive oil as a substitute for butter when basting meat or as a dip for bread. Olive oil is high in calories, so don't eat more than the recommended amount.

The cholesterol-lowering effects of olive oil are even greater if you choose extra-virgin olive oil, meaning the oil is less processed and contains more heart-healthy antioxidants. But keep in mind that "light" olive oils are usually more processed than extra-virgin or virgin olive oils and are lighter in color, not fat or calories.

5. Foods with added plant sterols or stanols

Foods are now available that have been fortified with sterols or stanols — substances found in plants that help block the absorption of cholesterol.

Margarines, orange juice and yogurt drinks with added plant sterols can help reduce LDL cholesterol by more than 10 percent. The amount of daily plant sterols needed for results is at least 2 grams — which equals about two 8-ounce (237-milliliter) servings of plant sterol-fortified orange juice a day.

Plant sterols or stanols in fortified foods don't appear to affect levels of triglycerides or of high-density lipoprotein (HDL), the "good" cholesterol.

6. Red wine

Scientists are giving us yet another reason to drink to our health. It turns out that high-fiber Tempranillo red grapes, used to make red wine like Rioja, may actually have a significant effect on cholesterol levels. A study conducted by the department of metabolism and nutrition at Universidad Complutense de Madrid in Spain found that when individuals consumed the same grape supplement found in red wine, their LDL levels decreased by 9%. In addition, those who had high cholesterol going into the study saw a 12% drop in LDL.

7. Tea

While tea has become well known for its cancer-fighting antioxidants, it is also a great defense against LDL cholesterol levels. According to research conducted with the USDA, black tea has been shown to reduce blood lipids by up to 10% in only 3 weeks. These findings were concluded in a larger study of how tea may also help reduce the risk of coronary heart disease. (Here's how to make the perfect cup of tea every time.)

The Hot and Cool Superdrink Tea, whether it's iced or hot, delivers a blast of antioxidant compounds. Studies prove that tea helps to keep blood vessels relaxed and prevent blood clots. Flavonoids, the major antioxidants in tea, have been shown to prevent the oxidation of LDL cholesterol that leads to plaque formation on artery walls. These powerful antioxidants may even reduce cholesterol and even lower blood pressure.

How to get some Enjoy a cup of hot or iced tea. Although convenience iced teas still have high antioxidant levels, most homemade iced tea (both hot-brewed and fridge teas) have even more antioxidants. So, if you want the very max, make your own.

Drink this much A cup of hot tea actually contains more antioxidants than a serving of any fruit or vegetable. Both green and black teas have high antioxidant levels. Enjoy at least one cup of tea every day.

8. Beans

Beans, beans—they really are good for your heart. Researchers at Arizona State University Polytechnic found that adding ½ cup of beans to soup lowers total cholesterol, including LDL, by up to 8%. The key to this heart-healthy food is its abundance of fiber, which has been shown to slow the rate and amount of absorption of cholesterol in certain foods. Try black, kidney, or pinto beans; each supplies about one-third of your daily fiber needs.

9. Chocolate

Ah, the sweet side of a heart-healthy diet: This powerful antioxidant helps build HDL cholesterol levels. In a 2007 study published in AJCN, participants who were given cocoa powder had a 24% increase in HDL levels over 12 weeks, compared with a 5% increase in the control group. Remember to choose the dark or bittersweet kind. Compared to milk chocolate, it has more than 3 times as many antioxidants, which prevent blood platelets from sticking together and may even keep arteries unclogged.

10. Margarine

Switching to a margarine with plant sterols, such as Promise activ or Benecol, could help lower cholesterol. Plant sterols are compounds that reduce cholesterol absorption; a study published in AJCN found that women who had a higher plant sterol–based diet were able to lower total cholesterol by 3.5%.

11. Garlic

Aside from adding zing to almost any dish, garlic has been found to lower cholesterol, prevent blood clots, reduce blood pressure, and protect against infections. Now research finds that it helps stop artery-clogging plaque at its earliest stage by keeping cholesterol particles from sticking to artery walls. Try for two to four fresh cloves a day.

12. Olive oil

This common cooking ingredient can help your health. Olive oil is full of heart-healthy monounsaturated fatty acids (MUFAs), which lower LDL cholesterol—and have the welcome side effect of trimming belly fat. Use it to make your own salad dressings, marinate chicken and fish, or roast vegetables.

13. Spinach

This popular green contains lots of lutein, the sunshine-yellow pigment found in dark green leafy vegetables and egg yolks. Lutein already has a "golden" reputation for guarding against age-related macular degeneration, a leading cause of blindness. Now research suggests that just ½ cup of a lutein-rich food daily also guards against heart attacks by helping artery walls "shrug off" cholesterol invaders that cause clogging. Look for bags of baby spinach leaves that you can use for salads or pop in the microwave for a quick side dish.

14. Avocado

Avocados are a great source of heart-healthy monounsaturated fat, a type of fat that may actually help raise HDL cholesterol while lowering LDL. And, more than any other fruit, this delectable food packs cholesterol-smashing beta-sitosterol, a beneficial plant-based fat that reduces the amount of cholesterol absorbed from food. Since avocados are a bit high in calories and fat (300 calories and 30 g fat per avocado), use them in moderation.

High Cholesterol

What is cholesterol?

Cholesterol is a waxy substance that's found in the fats (lipids) in your blood. While your body needs cholesterol to continue building healthy cells, having high cholesterol can increase your risk of heart disease.

When you have high cholesterol, you may develop fatty deposits in your blood vessels. Eventually, these deposits make it difficult for enough blood to flow through your arteries. Your heart may not get as much oxygen-rich blood as it needs, which increases the risk of a heart attack. Decreased blood flow to your brain can cause a stroke.

High cholesterol (hypercholesterolemia) can be inherited, but it's often the result of unhealthy lifestyle choices, and thus preventable and treatable. A healthy diet, regular exercise and sometimes medication can go a long way toward reducing high cholesterol.

What Are the Symptoms of High Cholesterol?

High cholesterol has no symptoms. A blood test is the only way to detect high cholesterol.

In most cases, high cholesterol is a silent problem that typically doesn't cause any symptoms. For most people, if they have not had regular checkups and followed their cholesterol levels, their first symptoms are events like a heart attack or a stroke. In rare cases, there are familial syndromes where the cholesterol levels are extremely high (familial hypercholesterolemia). These people have cholesterol levels of 300 milligrams per deciliter (mg/dL) or higher. Such people may show symptoms from high cholesterol that are due to deposits of cholesterol (xanthomas) over their tendons or under their eyelids (xanthalasmas). While high cholesterol affects a large portion of the United States, familial hypercholesterolemia affects only about one in 500 people.

What Causes High Cholesterol?

Cholesterol is carried through your blood, attached to proteins. This combination of proteins and cholesterol is called a lipoprotein. You may have heard of different types of cholesterol, based on what type of cholesterol the lipoprotein carries. They are:

  • Low-density lipoprotein (LDL). LDL, or "bad," cholesterol transports cholesterol particles throughout your body. LDL cholesterol builds up in the walls of your arteries, making them hard and narrow.
  • Very-low-density lipoprotein (VLDL). This type of lipoprotein contains the most triglycerides, a type of fat, attached to the proteins in your blood. VLDL cholesterol makes LDL cholesterol larger in size, causing your blood vessels to narrow. If you're taking cholesterol-lowering medication but have a high VLDL level, you may need additional medication to lower your triglycerides.
  • High-density lipoprotein (HDL). HDL, or "good," cholesterol picks up excess cholesterol and takes it back to your liver.

Factors within your control — such as inactivity, obesity and an unhealthy diet — contribute to high LDL cholesterol and low HDL cholesterol. Factors beyond your control may play a role, too. For example, your genetic makeup may keep cells from removing LDL cholesterol from your blood efficiently or cause your liver to produce too much cholesterol.

High cholesterol is usually made worse by eating too many unhealthy foods that are high in cholesterol, saturated fats, and trans fats. Examples of foods that contribute to high cholesterol include:

  • red meat
  • liver and other organ meats
  • full fat dairy products like cheese, milk, ice cream, and butter
  • eggs (the yolk)
  • deep fried foods, like potato chips, french fries, fried chicken, and onion rings
  • peanut butter
  • some baked goods, like muffins
  • processed foods made with cocoa butter, palm oil, or coconut oil
  • chocolate

High cholesterol can also be genetic in many cases. This means that it’s not simply caused by food, but by the way in which your genes instruct your body to process cholesterol and fats. Genes are passed down from parents to children.

Other conditions like diabetes and hypothyroidism may also contribute to high cholesterol. Smoking can also increase cholesterol problems..

Who Is at Risk for High Cholesterol?

Over one-third of American adults have raised levels of LDL or "bad" cholesterol, according to the Centers for Disease Control and Prevention (CDC). People of all ages, ethnicities, and genders can have high cholesterol.

You may be at a higher risk of high cholesterol if you:

  • have a family history of high cholesterol
  • eat a diet containing an excessive amount of saturated fat
  • are overweight or obese
  • have diabetes, kidney disease, or hypothyroidism

You're more likely to have high cholesterol that can lead to heart disease if you have any of these risk factors:

  • Smoking. Cigarette smoking damages the walls of your blood vessels, making them likely to accumulate fatty deposits. Smoking may also lower your level of HDL, or "good," cholesterol.
  • Obesity. Having a body mass index (BMI) of 30 or greater puts you at risk of high cholesterol.
  • Large waist circumference. Your risk increases if you are a man with a waist circumference of at least 40 inches (102 centimeters) or a woman with a waist circumference of at least 35 inches (89 centimeters).
  • Poor diet. Foods that are high in cholesterol, such as red meat and full-fat dairy products, will increase your total cholesterol. Eating saturated fat, found in animal products, and trans fats, found in some commercially baked cookies and crackers, also can raise your cholesterol level.
  • Lack of exercise. Exercise helps boost your body's HDL "good" cholesterol while lowering your LDL "bad" cholesterol. Not getting enough exercise puts you at risk of high cholesterol.
  • Diabetes. High blood sugar contributes to higher LDL cholesterol and lower HDL cholesterol. High blood sugar also damages the lining of your arteries.

Complications

High cholesterol can cause atherosclerosis, a dangerous accumulation of cholesterol and other deposits on the walls of your arteries. These deposits (plaques) can reduce blood flow through your arteries, which can cause complications, such as:

  • Chest pain. If the arteries that supply your heart with blood (coronary arteries) are affected, you may have chest pain (angina) and other symptoms of coronary artery disease.
  • Heart attack. If plaques tear or rupture, a blood clot may form at the plaque-rupture site — blocking the flow of blood or breaking free and plugging an artery downstream. If blood flow to part of your heart stops, you'll have a heart attack.
  • Stroke. Similar to a heart attack, if blood flow to part of your brain is blocked by a blood clot, a stroke occurs.

High Cholesterol

Cholesterol is a waxy substance that's found in the fats (lipids) in your blood. While your body needs cholesterol to continue building healthy cells, having high cholesterol can increase your risk of heart disease.

When you have high cholesterol, you may develop fatty deposits in your blood vessels. Eventually, these deposits make it difficult for enough blood to flow through your arteries. Your heart may not get as much oxygen-rich blood as it needs, which increases the risk of a heart attack. Decreased blood flow to your brain can cause a stroke.

High cholesterol (hypercholesterolemia) can be inherited, but it's often the result of unhealthy lifestyle choices, and thus preventable and treatable. A healthy diet, regular exercise and sometimes medication can go a long way toward reducing high cholesterol.