11 Ways to Lower Cholesterol Naturally Without MedsNov 18, 2022
11 Ways to Lower Cholesterol Naturally
"Do I have to take statins?"
That's the number one question I get on social media, quickly followed by...
"How can I lower my cholesterol without medications?"
If you've been told that you have high cholesterol levels, you may be wondering how to lower your cholesterol without resorting to medications. While medications such as statins can be effective at lowering cholesterol levels, they may not be suitable or necessary for everyone. We will explore natural ways to lower cholesterol and improve your overall heart health.
Warning: Some people need to be on statins and this should not be a substitute for personalized information between you and your doctor. Join my Healthy Living VIP Community if you want more personalized advice.
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How to Lower Cholesterol
There are different strategies to lower cholesterol without medications. As cardiologist, we always recommend lifestyle changes first, before going to medications. Unfortunately, many times, by the tie a patient needs a cardiologist, it's too late, and you must be on cholesterol medicine to prevent further damage. Once you have had a heart attack or stroke, you will need to be on meds forever.
What Is Cholesterol? Why should we care?
Cholesterol is a waxy, fat-like substance that's produced by every cell in the body and cleared by the intestines and liver. It's found in the bloodstream inside of lipoproteins. Approximately 95% of circulating cholesterol is derived from synthesis in your cells, not from your diet. While it is essential for the body to function properly, you don't need to consume cholesterol. Your body can make it. Every cell in your body makes its own cholesterol.
Too much cholesterol can poison and kill cells When excess cholesterol accumulates in any cell, it crystalizes and kills the cell. This is especially true in arterial beds, like your heart.
Unfortunately, high levels of cholesterol in your bloodstream can increase the risk of heart disease and this is the main problem with cholesterol.
Do You Need Cholesterol?
Yes! Absolutely! cholesterol is essential for life. Without cholesterol, you will not be alive. Every cell in your body needs cholesterol. Every cell in your body is capable of making it's own cholesterol.
However, you do not need excess cholesterol. That's the difference. While it is necessary in small amounts, large amounts are deadly.
Does Your Brain Need Cholesterol?
Yes, absolutely. Your brain needs cholesterol and is composed of a lot of cholesterol. Your brain makes it's own cholesterol and the cholesterol in your brain has a very long half life, up to 6 years. Much of the cholesterol in your brain has likely been there since birth, depending on how old you are.
Do You Need Cholesterol to Make Hormones Like Testosterone, Estrogen, and Cortisol?
Yes, cholesterol is the precursor to almost all hormones. But all of the glands that make hormones (testicles, adrenals, ovaries, and many others) make their own cholesterol and do not need extra cholesterol from circulation. This is a constant source of misinformation online.
Types of Cholesterol
There are two main types of cholesterol. The good and the bad. LDL (low-density lipoprotein) is generally referred to as bad cholesterol. While HDL (high-density lipoprotein) is usually referred to as good cholesterol. The reason LDL is "bad" is because high levels of LDL can build up in the walls of the arteries, forming plaque that can narrow or block the arteries and increase the risk of heart attack and stroke. LDL has been shown in multiple studies to directly cause atherosclerotic heart disease. (https://pubmed.ncbi.nlm.nih.gov/28444290/)
On the other hand, HDL is often referred to as the "good" cholesterol because it helps remove cholesterol from plaques and helps reduce plaque in your arteries and lowers the risk of heart disease. HDL is no longer thought to be as protective as we previously thought. Very high levels of HDL actually are dysfunctional and do not offer protection.
Multiple medications that have raised HDL in the past have been discontinued because they didn't translate into improved human outcomes. In the case of niacin, it was actually fouind to be toxic to humans at therapeutic doses.
HDL also gives cholesterol back to LDL in plasma, in a process known as indirect reverse cholesterol transport, to return to the liver and be eliminated.
You do need both to live. But in excess, they can have deadly consequences.
What is LDL (Bad Cholesterol)?
LDL (low density lipoprotein) is usually called "bad cholesterol" because it correlates the highest, and even cause atherosclerotic cardiovascular disease. Lifelong exposure to high LDL will cause coronary artery disease without question.
Read this article by Brian Ference where they looked at every single study that has ever been done on LDL cholesterol. After 20 million person years of follow up, they concluded, without any question, that LDL cholesterol causes atherosclerosis. Without LDL-C, there is no ASCVD. You could not reach any other conclusion. (https://pubmed.ncbi.nlm.nih.gov/28444290/)
Unfortunately, we have too many "health gurus" online telling people that LDL doesn't matter and it's ok to be high. Which goes against thousands, if not millions of research articles. Can you find a few studies that may show that? Sure, but you need to evaluate the totality of evidence. You can't base your entire existence on the results of a one off study!
High LDL cholesterol has been shown to be causative of atherosclerotic heart disease, which is still the single leading cause of death worldwide.
While there are a multitude of medications available now that can effectively lower LDL cholesterol, some people want to try natural methods first.
If you're looking to lower your LDL levels without medications, here are some evidence-based strategies to consider:
Can Diet Lower Cholesterol?
While cholesterol is 90% genetic (https://pubmed.ncbi.nlm.nih.gov/30528924/), there are some dietary modifications you can make to lower cholesterol with diet.
One of the most effective dietary patterns for reducing LDL is the Mediterranean diet, which emphasizes plant-based foods, healthy fats, and lean proteins. A systematic review of 13 randomized controlled trials found that the Mediterranean diet reduced LDL levels by an average of 18.5 mg/dL. (https://www.sciencedirect.com/science/article/pii/S266614972200038X)
Another dietary pattern that has been shown to lower LDL is the DASH (Dietary Approaches to Stop Hypertension) diet, which is rich in fruits, vegetables, whole grains, and low-fat dairy. A systematic review of 27 randomized controlled trials found that the DASH diet reduced LDL levels by an average of 8.3 mg/dL. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8396128/)
Ways to Lower Your Cholesterol Without Medications
Now, let's look at some natural ways to lower LDL cholesterol and all the studies that prove it:
- Eat a heart-healthy diet. A healthy diet is an important foundation for good heart health, and there are certain foods that have been shown to be particularly effective at lowering LDL cholesterol. The most researched and proven diet is the Mediterranean diet. You must avoid saturated fat, eat more fruit, fiber, whole grains, lean meats, olive oil, legumes, beans, and tons of vegetables. Grab my Mediterranean Diet weight loos cookbook to lose weight while eating delicious, heart healthy foods. It's designed to prevent muscle loss, taste amazing, and be low salt and low saturated fat. It's the most unique cookbook ever designed.
- Reduce intake of saturated fat. This is the single most effective way to reduce cholesterol without medications! Saturated fats are solid at room temperature; butter, bacon, cheese, lard, margarine, fat on steak, chicken skin, red meat, coconut oil, ghee, tallow, and partially hydrogenated spreads and oils (trans fats). These raise your LDL which causes heart disease (blockages in your arteries). They increase cholesterol synthesis and reduce the amount of LDL receptors that remove LDL from circulation. (https://pubmed.ncbi.nlm.nih.gov/32428300/)
- Eating more beans and Legumes. Incorporating more beans and legumes in your diet can improve and enhance cardiovascular health by reducing LDL cholesterol by about 10.7% . Which can impart significant cardioprotective effect. Many beans have anti-oxidant properties as well. Fava beans, chick peas, lentils, kidney beans, soybeans, and peanuts are all a part of this important class. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7915747/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6414510/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8781140/)
Increase soluble fiber intake. This doesn't have a huge lipid lowering effect, but still can help a little. The more of these littles things you do, the more it can add up. Soluble fiber, which is found in foods such as fruits, vegetables, oats, barley, beans, apples, and pears, can help lower LDL cholesterol levels by binding to cholesterol and carrying it out of the body through your intestinal tract and colon. According to a review of 11 studies published in the Journal of the American Medical Association, increasing soluble fiber intake by 5 to 10 grams per day can lower LDL cholesterol levels by 3 to 5 percent as well as reduce blood sugar and insulin resistance. Soluble fiber can also help lower LDL by binding to cholesterol in the gut and preventing its absorption. If you can't get enough fiber from diet, psyllium fiber like Metamucil, which is very cheap, can help you increase your fiber intake. Fiber also helps reduce the incidence of colon cancer and other gastrointestinal cancers. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5413815/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6566984/)
Increase intake of monounsaturated and polyunsaturated fats (MUFAs and PUFAs). These are especially effective when replacing saturated fats with PUFAs. For example, instead of butter, you start to use olive oil. This can have a large impact on lipids when combined with a reduction in saturated fat. Unlike saturated fats, MUFAs and PUFAs are considered "healthy fats". They are found in olive oil, nuts, and avocados and have shown that they can lower LDL cholesterol levels and increase HDL cholesterol levels and thereby reduce cardiovascular risk and mortality as well as non-fatal cardiovascular event rates. This effect is especially profound if they are used as a replacement for saturated fat. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6517012/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6513455/)
Increase intake of plant sterols and stanols. This has a small effect, but could work. However, taking these in large amounts as a supplement can have adverse effects and can even be toxic. This is especially true if you have certain genetic mutations. If you have an ABCDG5/G8 mutation, ingesting these in large quantities, can be toxic. These plant compounds, which are found in foods such as vegetable oil spreads, orange juice, and granola bars, can help lower LDL cholesterol levels by blocking the absorption of cholesterol in the body. Similar to how soluble fiber would work. However, there is no long term data that suggests they lower mortality. More studies need to be done, but we know that lowering LDL will reduce cardiovascular events and mortality. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6130982/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9273387/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3620394/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3040800/, https://www.sciencedirect.com/topics/nursing-and-health-professions/sitosterolemia)
Eat more nuts. Nuts, particularly almonds, pistachios, and walnuts, have been shown to lower LDL cholesterol levels and improve cholesterol ratios in some studies as well as reduce all-cause mortality. Several studies have found that consuming nuts, particularly almonds and walnuts, can lower LDL levels, reduce cardiovascular risk, cardiovascular mortality, and even all-cause mortality.(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9776667/)
Exercise regularly. This one is obvious. The more "cardio" you do, the better your "cardio" outcomes! Physical activity of all types lowers LDL cholesterol levels and improves heart health and cardiovascular outcomes. The American Heart Association recommends at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise per week. A systematic review of 39 randomized controlled trials found that exercise, both aerobic and resistance training, reduced LDL levels by an average of 5.3 mg/dL. Further, an article in the Journal of the American College of Cardiology demonstrated a dose response to exercise. The more you exercised, the more you reduced cardiovascular and all-cause mortality. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3906547/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4262114/, https://www.jacc.org/doi/10.1016/j.jacc.2014.11.022)
Quit smoking and Vaping. Smoking damages the inside lining of your arteries and increases the risk of heart disease and every type of cancer. This includes all types of smoking, hookah, vaping, weed, cigars, etc. Quitting smoking can help lower LDL cholesterol levels and reduce cardiovascular mortality, as well as all-cause mortality. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6483019/, https://pubmed.ncbi.nlm.nih.gov/31462607/ https://pubmed.ncbi.nlm.nih.gov/35612935/, https://pubmed.ncbi.nlm.nih.gov/33574049/, https://pubmed.ncbi.nlm.nih.gov/32487933/ )
Reduce stress. Find ways to reduce stress in your life. Chronic stress increases LDL cholesterol levels and causes ASCVD. Stress raises cortisol levels, which can cause weight gain and salt retention. Try to find healthy ways to manage stress, such as through exercise, meditation, massage, acupuncture, lifting weight, yoga, swimming, running, reading, or spending time with loved ones. Engaging in stress-reducing activities, such as meditation, yoga, and exercise, can help lower LDL and improve overall health. (https://pubmed.ncbi.nlm.nih.gov/22473079/, https://pubmed.ncbi.nlm.nih.gov/29213140/, https://pubmed.ncbi.nlm.nih.gov/32791843/)
Avoid supplements. I'm not a big fan of supplements, because they are not regulated, usually contain contaminants, and are unproven. You have to be very careful because these are not regulated and not FDA controlled. Many times they are toxic. You may be buying a bottle of "red yeast rice" which does not contain any red yeast rice. Since red yeast rice is lovastatin, you might as well take prescription lovastatin so that you actually know how much you are getting and we can dose it properly. In fact, in the United States, Lovastatin is a controlled substance, and hence red yeast rice no longer contains the active ingredient. Please talk to your cardiologist. Many of these will react with medications and it's important to cross check. Make sure they are third party tested and actually contain what these say they contain.
- Improve sleep. Sleep is important for overall health and well-being, and it may also have an effect on LDL levels. A systematic review of 10 randomized controlled trials found that increasing sleep duration was associated with a reduction in LDL levels. Aim for 7-9 hours of sleep per night. (https://pubmed.ncbi.nlm.nih.gov/26972035/, https://pubmed.ncbi.nlm.nih.gov/28477772/)
There you have it! Those are the best ways to lower cholesterol without medications and improve heart health. This PubMed Study does a very good job summarizing the evidence:
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