Heart disease is the number 1 killer of Americans and most other industrialized countries. Elevated lipids, like cholesterol, play a significant role in the risk of heart disease and heart attacks. These days, many people opposed to taking medications, ask if any natural ways exist to reduce elevated cholesterol levels? Fortunately, yes, are things you can do to help yourself. But which ones work? In this review, I'll present 9 science-proven ways to lower cholesterol and other lipids to help reduce your heart disease risk and improve your health. Leave a comment if you have any questions.
Normal Cholesterol Levels
For adults over the age of 20, here are what most experts consider healthy ranges:
| Cholesterol Type | Healthy Levels (mg/dl) |
|---|---|
| Total Cholesterol | 125-200 |
| Non-HDL | less than 130 |
| HDL (good) | 40 or higher |
| LDL (bad) | less than 100 |
| Triglycerides | less than 150 |
What is Non-HDL cholesterol? It's just your total cholesterol minus your HDL. For example, if your total cholesterol was 200 and your HDL was 40, your non-HDL cholesterol would be 200-40 = 160 mg/dl.
Triglycerides are not the same thing as cholesterol but because they are important -and usually measured by doctors – I included them in the table for your reference.
How To Reduce Your Cholesterol
1 Weight Loss
If you need to lose weight, then do so because it will help a lot. Even a little bit weight loss can help. The beneficial effects of weight loss on lipids has been observed since at least the 1980s. In one review study, researchers noted that every 20-pound loss was associated in a drop in cholesterol of about 9 points. Weight loss can also
- reduce bad levels (LDL)
- boost good levels (HDL)
Most people know LDL is bad for us, but the size of the LDL particles also affects our health. Larger LDL particles seem to be less “bad” than smaller, more dense LDL particles.
Some research suggests weight loss can increase the size of LDL cholesterol. In theory, losing weight may be another way to protect us from heart attacks. While more research on LDL particle size is needed, this is a very interesting finding.
Weight Loss Diets
If you are going to try a weight loss program, you have many options. Some programs are better than others. While it really comes down to eating a few less calories each day, two methods that have been deemed healthy are:
- Vegetarian-style eating programs
- Mediterranean style programs
Both of these eating programs place an emphasis on colorful foods like fruits and vegetables. To this list, I'd also add the Dean Ornish Program. Clinical studies have documented the Dr Ornish program can reverse plaque in the arteries. It's likely both vegetarian and Mediterranean-style programs have similar effects, especially when coupled with exercise.
2 Exercise
You can't go wrong with exercise. As a rule, when it comes to health problems, increasing physical activity will likely improve it. The same is true for cholesterol levels too. So how much exercise do you need? For adults, the Centers for Disease Control (CDC) recommends:
- Moderate exercise: 150-300 minutes per week
- Vigorous exercise: 75 – 150 minutes per week
Moderate exercise is defined as an intensity when you can hear yourself breathing and yet still carry on a conversation. There are other methods to determine how hard you are exercising, but this talk test is the simplest and requires no fancy equipment.
Even a little bit of physical activity helps a LOT. For example, Physical Activity Guidelines for Americans tell us exercising just 150 minutes per week can reduce the risk of dying – from all causes – by as much as 33%. That's huge!
Equally good news is you do NOT have to do all your exercise at the same time. For example, you could take three 10-minute walks per day and do this 5 days a week. This would give you 150 minutes of exercise.
Like weight loss, regular exercise can also:
- lower LDL
- lower triglycerides
- boost HDL levels
Generally, higher HDL levels are associated with less heart disease. Exercise is actually one of the few natural therapies which raise HDL levels. Triglycerides (fats in our blood) rise after a meal. Exercise studies have noted that both low and moderate-intensity physical activity can reduce the rise in triglycerides after eating. This can also improve our long-term health.
While moderate-intensity exercise is probably best for most people, see my guide to interval / HIIT training if that is something you want to try.
So how long does it take for exercise takes to work? It usually takes several weeks before a blood test detects favorable changes in lipid levels. As a rule, give yourself at least 2 months between blood tests.
How does exercise protect against heart disease? There are multiple ways exercise works. One way is by reducing an enzyme called PSCK9 which is involved in LDL metabolism. Exercise can reduce PCSK9 levels. Ironically, this is also how an expensive drug called Repatha works too. Exercise works without any of the negative drug side effects.
3 Don't Smoke
It goes without saying – but I'll say it anyway – smoking is bad for you. Smoking-related cancers caused the deaths of both of my parents, taking them far sooner than it should have happened. While smoking is well known to cause cancer, it also significantly reduces HDL (good cholesterol). This increases heart attack risk. Smoking also raises total cholesterol, LDL and triglyceride levels.
By reducing the good stuff and raising the bad stuff, smoking tobacco raises heart disease risk
Add to the long list of reasons to quit, another benefit of quitting includes having lower total cholesterol and elevated HDL levels. Several studies note HDL levels go back up again after only 3 weeks of smoking cessation.
Chewing tobacco is not a safer alternative because it raises both total cholesterol and LDL levels.
Effective Cholesterol Lowering Supplements
OK, so much for improving lifestyle factors. Do any supplements lower cholesterol levels? Research says yes. While there are several supplements, let's focus on the best, and by best, I mean those which have the most research.
4 Red Yeast Rice
This supplement (also called Monascus purpureus) is actually a fermented rice product. It's been available as as supplement for many years. Over a dozen human clinical trials have noted red yeast rice improves blood lipid levels. Specifically, studies find red yeast rice can significantly lower:
- total cholesterol (up to 20%)
- LDL (up to 30%)
In addition, researchers have noted that red yeast rice can lower triglycerides and even raise HDL.
So, how does red yeast rice work? It's simple: it contains a statin drug. Red yeast rice contains a naturally-occurring statin compound called monacolin K, similar to the active ingredient in the statin medication Lovastatin. It works the same way as statin medicines, by blocking an enzyme called HMG CoA Reductase, which we use to make cholesterol.
Block this enzyme, and cholesterol production goes down.
Studies finding improved lipid levels have used between 1200-2000 mg per day.
Because red yeast rice is basically a natural statin medicine, it may have the same side effects -like muscle pain – as prescription medicines. Some supplements try to reduce the muscle pain side effects by combining red yest rice with Coenzyme Q10 (CoQ10). In theory, this may work but individual side effects will probably vary.
Due to the potential for side effects, it's wise to start with the least effective dosage and do so under your doctor's supervision.
5 Citrus Bergamot
Bergamot comes from the bergmot orange. While it's a relative newcomer, it has some very interesting research. In one such investigation, researchers noted 1000 mg of bergamot reduced,
- total cholesterol
- triglycerides
- LDL
and boosted HDL levels better than a placebo when it was given to 237 people for 1 month.
These results were confirmed in another bergamot study which likewise noted 1000 mg was effective at improving blood lipid levels after only 30 days.
While citrus bergamot have less research than other lipid-lowering supplements, the research looks good and some people have commented in my bergamot review have said it worked for them.
Bergamot Video Review
Watch on my YouTube Channel if you prefer.
6 Fiber
Eating a high-fiber diet is often associated with a variety of health benefits -including a lower risk of heart disease. There is even some evidence suggesting the fiber product called Metamucil may reduce cholesterol levels. The fiber found in flax seeds has also been shown to reduce LDL and total cholesterol levels.
As pointed out in the blood pressure review, flax seeds may also play a role in hypertension management.
7 Garlic
Numerous investigations attest to the lipid-lowering power of garlic. At least one study hints garlic may even be more effective than fish oil, In people with abnormal lipid levels to start off with, garlic seems to improve both total cholesterol and LDL. It may also improve HDL too.
Additionally, some research finds garlic may help blood pressure too. Amounts shown to work in studies vary from about 500 mg to 1200 mg per day.
While garlic itself tends to get a lot of attention, an extract, called S-allylcysteine has also been shown to improve blood lipids. This supplement, called Kyolic Aged Garlic Extract, is something I personally take. Various studies have noted that Kyolic Aged Garlic Extract can reduce total cholesterol and LDL levels. The supplement has other effects as well.
See the Kyolic Aged Garlic Extract review for more insights.
If you take any medicine, speak to your doctor/pharmacist as garlic supplements may interact with various medications such as blood thinners.
8 Niacin
Since at least the 1950s, people have used niacin (vitamin B3) to improve blood lipid levels. Several studies have noted niacin can significantly reduce LDL, and triglycerides and boosts HDL levels. This B vitamin is so popular it's also available as a prescription drug (called Niaspan).
The problem however is it generally takes a lot of niacin to see results. Studies showing benefits may use 500 mg to over 1000 mg per day. This is much more than the RDA.
Niacin is not without side effects. In high doses, niacin might harm the liver and raise blood sugar levels among other things. As such, it's best to use niacin supplements under your doctors supervision.
A niacin-derived compound is also popular in anti-aging medicine. See this review for more information.
9 Fish Oil
When people talk about fish oils, they usually refer to the omega-3 fats called EPA and DHA. Various studies over the years have noted fish oils power to reduce lipid levels. Unlike other supplements mentioned above, the most consistent finding is fish oil reduces triglyceride levels. To achieve these effects, researchers often study more than most people typically use, such as 3-4 grams per day.
Most fish oil supplements contain a combination of EPA and DHA. Some evidence suggests EPA may be more powerful when it comes to reducing heart disease risk factors. The prescription drug, called Vascepa contains 4 grams of EPA. It has no DHA. At least one large trial has noted this EPA-only drug reduced the risk of strokes and heart attacks by 25%. Some researchers have criticized the evidence, however the placebo used in the study was a poor choice. this means it may work less well than first thought. Whether or not a fish oil supplement would produce similar benefits is not known.
At high doses, fish oils may have a blood-thinning effect. Fish oil supplements can also raise LDL bad cholesterol levels too. And then, there is research showing high dose fish oil may raise the risk of a serious condition called atrial fibrillation (A-fib). Because of this speak to your physician for the best advice.
What Do I Suggest?
I will always opt to try lifestyle factors first, so if you need to lose weight or eat better, these can definitely help. The same thing is true for exercise also. If you are considering a cholesterol-lowering supplement, then I suggest either
All of these have clinical studies showing they work, and in my opinion, the overall benefits are better than most other supplements.