Unless your cholesterol is dangerously high, lifestyle modifications—such as exercising regularly and eating a heart-healthy diet—are often recommended as the first line of treatment.
Dietary modifications combined with weight loss can lower LDL cholesterol by as much as 20 to 30 percent. Heart-healthy diets promote fruits, vegetables, whole grains, and legumes and limit foods high in sugar, sodium, and saturated fat. Vegetable shortening and any item made with hydrogenated oil contains trans fat and should be avoided. What sets heart-healthy diets apart from others is the emphasis on good fats, such as those found in fish, nuts, olive oil, avocados, and seeds. When used in place of saturated and trans fats, these oils—known as polyunsaturated and monounsaturated fats—can help reduce cholesterol. Some research also indicates that avoiding refined carbs may boost “good” HDL cholesterol and lower triglycerides. Refined carbohydrates include white rice, white bread, soft drinks, and baked goods.
People who are obese—having a body mass index more than 30—tend to have lower levels of “good” HDL and higher levels of “bad” LDL cholesterol and triglycerides than people of normal weight. Losing weight can help bring your good cholesterol up and your bad cholesterol down. Research shows that for every kilogram (2.2 pounds) of weight that an obese or overweight person loses, they may be able to raise their HDL by .35 mg/dL.
Some research suggests that what you eat to lose weight may also affect your cholesterol outcome. According to a study in the Archives of Internal Medicine, people who ate a low-calorie, low-carbohydrate diet high in plant-based protein (such as tofu, beans, and nuts) had the biggest LDL-lowering benefit compared to people who lost weight on other kinds of diets.
Avoid or Quit Smoking
Quitting smoking is good for your heart in more ways than one. Research shows that giving up cigarettes can increase a person’s “good” HDL by 4 mg/dL, on average. HDL helps clear the body of artery-clogging “bad” LDL cholesterol.
Research shows that being inactive elevates LDL. Exercise, on the other hand, can lower it. Moderate activity like brisk walking can also help lower triglycerides, while vigorous exercise like running can boost HDL. Cardiovascular exercise can also strengthen your heart and reduce blood pressure, which is a major risk factor for stroke.
In addition to lifestyle changes, your doctor may also recommend taking medication to manage your cholesterol. In general, drug therapy tends to affect cholesterol levels more quickly than your diet and exercise will. So if your doctor feels it’s important to get your cholesterol down immediately, he or she will likely opt for medication. There are several different types of cholesterol-lowering medications. Your doctor can determine which one or ones are right for you.