The Centers for Disease Control and Prevention (CDC) estimate that nearly 94 million adults ages 20 and over have high cholesterol. High cholesterol puts you at risk of cardiovascular diseases such as stroke or heart attack.

People often call high-density lipoprotein (HDL) the “good cholesterol” because it’s associated with a lower risk of heart disease. Low-density lipoprotein (LDL) is the “bad cholesterol” because it’s associated with a higher risk. Doctors measure both these types of cholesterol to measure your risk of developing heart disease.

Making lifestyle changes may be enough to get your cholesterol into a healthy range. If you’re at a high risk of developing cardiovascular complications, a doctor may recommend taking statins or other medications.

Here are 15 ways, backed by scientific studies, to help keep your cholesterol levels at optimal levels for your heart health.

What are healthy cholesterol levels?

Doctors commonly measure your total cholesterol as well as LDL and HDL cholesterol to estimate your risk of heart disease. They also commonly measure triglycerides, a type of fat found in your blood associated with heart disease.

According to the CDC, optimal cholesterol and triglyceride levels are:

TypeAmount in milligrams per deciliter (mg/dL)
Total cholesterolabout 150 mg/dL
LDL cholesterolabout 100 mg/dL
HDL cholesterolat least 40 mg/dL in men
at least 50 mg/dL in women
Triglyceridesless than 150 mg/dL

In many cases, lifestyle changes alone are enough to get your cholesterol levels into a healthy range. Here are some ways you can manage your cholesterol levels at home.

1. Exercise regularly

The American Heart Association (AHA) recommends getting at least 150 minutes of moderate physical activity per week for optimal heart health. Examples of moderate activity include:

  • brisk walking
  • gardening
  • water aerobics

Regular exercise can also help you maintain a moderate weight. A 2016 study found that people who have overweight or obesity who lost at least 5% to 10% of their body had significant improvements in their:

  • triglycerides
  • LDL
  • total cholesterol

If you’re currently inactive, you might find 150 minutes per week intimidating at first. In a 2018 study, researchers found evidence that even performing less than the recommended 150 minutes may increase heart-healthy HDL cholesterol more than not exercising at all.

2. Quit smoking

Quitting smoking can benefit many aspects of your health, including lowering your cholesterol. In a 2018 study, researchers found that people who smoked had a:

  • 60% higher chance of having low HDL
  • 20% higher chance of having high total cholesterol
  • 30% higher chance of having high triglycerides

Quitting smoking can greatly decrease your risk of cardiovascular disease, but heavy smokers may still be at an elevated risk 5 years after quitting.

3. Consume alcohol in moderation

Low to moderate levels of alcohol consumption are associated with better cardiovascular health, whereas heavy drinking is associated with poorer health. The CDC defines moderate drinking as one drink or less a day for women and two drinks or less a day for men.

In a 2020 study, researchers found that compared with non-heavy drinkers, people who drink heavily are more likely to smoke tobacco, have high blood pressure, and have elevated:

  • fasting glucose
  • triglycerides
  • LDL

The researchers also found that among people who drank alcohol, those who drank wine exclusively had better cardiovascular health than those who drank beer exclusively.

It’s important to note that the AHA doesn’t recommend drinking wine or any other form of alcohol to gain potential health benefits.

Here are some dietary changes you can make to help manage your cholesterol levels.

4. Limit saturated and trans fat

The AHA recommends minimizing saturated and trans fats. These fats are associated with increases in LDL cholesterol. To lower your intake of these fats, the AHA recommends emphasizing a diet high in:

  • fruit
  • vegetables
  • whole grains
  • low fat dairy
  • poultry
  • nuts
  • fish

Studies have shown that vegetarian diets, like the Portfolio Diet, can effectively lower cholesterol. The current Dietary Guidelines for Americans suggest that you can replace proteins from high fat meats with protein from plants. The AHA suggests that a plant-based diet could help reduce your cholesterol without using medications.

5. Cook more at home

Food cooked at restaurants often contains higher levels of saturated fat and sugar than meals you prepare at home.

There are still several unknowns about the role of sugar on cholesterol levels, but some research suggests diets high in processed sugar are linked to poorer cholesterol levels. For instance, a 2020 study found evidence that substituting the sugars fructose and sucrose for starchy carbs was associated with lower LDL.

The AHA recommends a diet emphasizing fish and poultry and limiting red meats to limit saturated fats. When you do eat meat, here are ways you can lower the saturated fat content:

  • Select cuts of meat and poultry with minimal fat.
  • Trim all visible fat when cooking.
  • Broil rather than pan fry your meats.
  • Choose chicken and turkey over fattier duck and goose.
  • Remove the skin of chicken and turkey before cooking.
  • Limit processed meats such as hot dogs, salami, and sausage.

The AHA has a database of heart-healthy recipes to make cooking healthy easy.

6. Add avocado to your diet

In a 2022 study, researchers found that people who had overweight and added one avocado per day to their diet had modest but significant reductions in total and LDL cholesterol.

7. Eat more soluble fiber

Studies suggest that soluble fibers can help lower LDL cholesterol levels. Foods high in soluble fiber include:

  • oats
  • beans
  • peas
  • fruits
  • vegetables

Weight loss and cholesterol management

Many of the above lifestyle and dietary changes directly contribute to losing weight. According to the AHA, losing about 5% to 10% of your weight can help reduce your cholesterol levels.

Here’s an overview of medications used to treat cholesterol levels.

8. Statins

Statins are the most prescribed cholesterol medications. They work by decreasing cholesterol production in your liver. Statins are generally very effective at reducing LDL cholesterol and lowering your risk of heart attack and stroke.

9. Non-statins

A doctor may also recommend non-statin medications such as:

  • Cholesterol absorption inhibitors: Cholesterol absorption inhibitors lower LDL by preventing your intestines from absorbing LDL. They’re the most common non-statin used to treat high cholesterol.
  • Bile acid sequestrants: Bile acid sequestrants help your body get rid of LDL cholesterol. They’re often used together with statins.
  • PCSK9 inhibitors: PCSK9 inhibitors inhibit certain proteins from breaking down LDL receptors in your liver. This allows your liver to take up more LDL and break it down so it doesn’t stay in your blood.
  • Adenosine triphosphate-citrate lyase inhibitors: These medications work by blocking the production of cholesterol in your liver. They’re used with statins and lifestyle changes to treat familial heterozygous hypercholesterolemia.
  • Fibrates: Fibrates are especially good at lowering triglyceride levels but can slightly lower LDL levels as well.

Some types of supplements may help lower cholesterol levels. It’s important to talk with a doctor before taking supplements since they may come with risks.

10. Psyllium fiber supplements

Psyllium is a type of fiber made from husks of Plantago ovata seeds. Some studies suggest that psyllium may lower LDL cholesterol by 6% to 24%.

11. Fish oil

Fish oil contains omega-3 fatty acids that are linked to increased cardiovascular health. Several studies have found fish oil can increase HDL (“good”) cholesterol. According to the AHA, fish also lowers your triglyceride levels and reduced your risk of heart attack and stroke.

12. Coenzyme Q10

Coenzyme Q10 (CoQ10) is an antioxidant produced in your body and is found in many foods. A 2018 review found that CoQ10 supplementation may decrease total cholesterol and increase HDL cholesterol.

13. Plant sterols

Plant sterols are waxes from plants that may help reduce the amount of cholesterol absorbed in your body. Reviews of studies show that 1.5 to 3 grams per day may lower LDL cholesterol by 7.5% to 12%.

14. Niacin

Niacin is also called vitamin B3. Some studies have found that niacin supplementation can raise HDL by up to 25%. But two large studies also found that niacin doesn’t decrease the risk of cardiovascular complications and may cause significant side effects.

15. Fenugreek

Fenugreek is an herb common in Indian dishes. In a 2020 review, researchers found that fenugreek may significantly improve cholesterol levels, but more high quality studies are needed to confirm its benefits.

Questions for a doctor

If you have high cholesterol, it’s important to visit a doctor regularly so you can monitor your cholesterol over time. Here are some questions that you may want to ask a doctor:

  • What should my target cholesterol levels be?
  • Will I need to take medication?
  • What are the potential side effects of medications?
  • How often should I have my cholesterol checked?
  • What are the risks of not lowering my cholesterol?
  • How long will it take to lower my cholesterol?

You can lower your cholesterol levels with a combination of lifestyle habits and, if needed, medications. Some habits that may lower your cholesterol include:

  • increasing your exercise levels
  • losing weight if you’re overweight
  • eating a diet low in saturated and trans fats

Some studies show that eating less processed sugar may also help to reduce your cholesterol levels.

If you’re at a high risk of developing cardiovascular complications, a doctor may prescribe statins or another medication. These medications can be effective but can also cause side effects. Some supplements may also have cholesterol lowering effects, but it’s important to talk with a doctor before taking them.