Your doctor has told you to lower cholesterol. So what’s your next step in reducing your risk of heart disease before turning to medication? Diet and lifestyle changes, experts say. Learn which foods and supplements to stock up on and how exercise can boost good levels. Plus, are you on the road to a heart attack? Take our quiz to find out...
High cholesterol is one of the biggest risk factors for heart disease. Yet many adults – 50%, according to a 2007 Baylor College study – don’t take the proper steps to lower cholesterol.
Their inaction can be dangerous.
Prevention of heart disease is crucial because about two-thirds of women who have a heart attack don't fully recover, according to the National Institutes of Health.
If you’re at high risk for heart disease, prescription statins, like Lipitor or Crestor, are effective and commonly prescribed.
But for women with a low risk, diet and lifestyle changes are enough to lower cholesterol levels, especially if you have no other cardiovascular disease risk factors, like high blood pressure or diabetes, says Rita Redberg, M.D., a cardiologist at the University of California, San Francisco.
How to get started? For starters, if you smoke, quit, Redberg says.
Then try these 11 smart strategies to lower your cholesterol.
1. Supplement smartly
Many doctors and patients say natural supplements help lower cholesterol and improve overall heart health.
So why don’t more physicians prescribe them?
“Doctors tend to promote what they learned in medical school,” says Thom Lobe, M.D., who has authored more than 200 books and studied with former U.S. Surgeon General C. Everett Koop, M.D.
“Most doctors take few courses in alternative medicine, so they just aren’t aware of many of these supplements and their health benefits,” he says.
Here are three supplements that show promise in lowering high cholesterol to achieve a healthy heart.
(Always check with your doctor before taking any supplements, because some can interact with other medications or health conditions, including pregnancy.)
Artichoke leaf extract: In a 2008 study with 75 volunteers, University of Redding (England) researchers found that artichoke leaf extract reduced “bad” cholesterol, or low-density lipoproteins (LDL).
Participants were given 1,280 milligrams of the extract each day for 12 weeks and lowered their cholesterol an average of 18%.
Red yeast rice: While red yeast rice has been used for more than 1,000 years in China, it has received mixed reviews in the United States and isn’t approved by the Food and Drug Administration (FDA).
A 1999 UCLA study showed that 2.4 grams a day of red yeast rice helped lower harmful LDL cholesterol by 29% and triglycerides by 37% while increasing “good” cholesterol, or high-density lipoproteins (HDL), by 20%.
That finding was backed by a recent 2009 study by two Philadelphia cardiologists published in the Annals of Internal Medicine.
“So far, [red yeast rice’s] track record is good,” says Jay S. Cohen, M.D., author of Natural Alternatives to Lipitor, Zocor & Other Statin Drugs (SquareOne Publishers). “Reported side effects are few.”
The FDA, however, has warned that red yeast rice may be harmful, because it contains a natural form of levostatin (an ingredient found in prescription statins).
Patients may not know the amounts or quality of levostatin in supplements, the agency says, and they can also cause some of the same side effects as prescription Lovastatin, including muscle pain and weakness.
Green tea: Green tea effectively lowers LDL cholesterol and triglyceride levels, as well as increases HDL cholesterol, according to a 2008 study by the University of Florida, Harvard Medical School and Brigham and Women’s Hospital.
The researchers recommend drinking 2-3 cups of green tea each day or taking 100-750 mg each day of green tea extract.
2. Eat heart-healthy
If you have high cholesterol, change your diet and make sure it includes plenty of foods that lower cholesterol.
“I advise patients to cut out refined sugar, white breads and starches, and to consume fewer animal proteins,” Lobe says.
Meal plans like the low-fat DASH diet (Dietary Approaches to Stop Hypertension), a National Institutes of Health program that features lots of fruits, vegetables, whole grains, lean meats, fish, poultry and low-fat dairy, are low in calories, saturated fat and cholesterol.
Going meatless may help too, according a landmark 1999 Oxford Vegetarian Study that found vegetarians tended to have lower LDL cholesterol levels.
3. Fill up on fiber
Eat plenty of soluble fiber – found in oats, barley, prunes and beans, among other foods.
Or take supplements like Metamucil.
Fiber binds with cholesterol in the intestinal tract and moves it out of your body.
When your diet lacks fiber, up to 94% of the cholesterol is reabsorbed and recycled in your body, according to the American Heart Association (AHA).
“Try to get 25-30 grams of fiber each day,” says Joan Briller, M.D., director of the Heart Disease in Women program at the University of Chicago.
“Women can achieve this by eating 6-11 servings of fruits and vegetables each day.” (One-half cup generally equals one serving.)
4. Raise a glass to red
A daily glass of red wine or grape juice can boost levels of HDL and reduce LDL, thanks to saponins, beneficial compounds in red grapes, according to a 2003 University of California, Davis study.
Yale-New Haven Hospital in Connecticut recommends no more than 1 (4-ounce) glass of wine per day for women. If you’re a teetotaler, other high-saponin foods include soy beans and olive oil.
5. Keep out cholesterol
Also called phytosterols, these phytochemicals are found in corn and soybean oils, and other foods that lower cholesterol.
They can block cholesterol absorption and lower overall levels by up to 10% and LDL up to 14%, according to the Cleveland Clinic.
Consuming at least 1.3 grams a day, with a diet low in saturated fat and cholesterol, reduces heart-disease risk, says the FDA.
Plant sterols occur only in small amounts in fruits, vegetables, nuts and whole grains, so you may need to consume multivitamins or fortified foods, including orange juice, breads and margarines, to meet daily requirements.
6. Feast on fish
Fatty fish like salmon and trout contain omega-3 fatty acids, which decrease levels of triglycerides (fats in the blood) and harmful LDL, while raising beneficial HDL levels.
Eat at least two 3.5-ounce servings of fish each week, advises the AHA.
7. Go nutty
Eat a couple handfuls of nuts a day. About 2 ounces significantly lowers LDL and triglyceride levels, according to 2010 research from Loma Linda University’s School of Public Health.
Nuts are high in calories, though, so make room for them in your daily calorie totals.
8. Focus on fats
Minimize saturated fats (found in full-fat dairy, red meats and some oils like palm and coconut), and instead choose fats that help lead to a healthy heart, like olive and canola oil.
Avoid all trans-fats, which may increase harmful LDL levels and lower helpful HDL. (Look for amounts on the Nutrition Facts label.)
9. Whittle your middle
Just a little extra tummy weight raises cardiovascular-disease risk, especially if you have other warning signs like hypertension and high blood sugar levels.
Being overweight also tends to increase the amount of “bad” LDL in your blood.
An otherwise healthy woman with high cholesterol can often lower cholesterol readings by losing just 5-10 pounds, says Redberg, the San Francisco cardiologist.
10. Get a move on
A long-term North Carolina University study of more than 8,000 people (released in 2009) found that those who got 30 minutes of moderate exercise several days a week lowered triglycerides levels and boosted HDL.
“Find the best time of day to exercise and make a regular commitment to walking, going to the gym or even working out with DVDs at home,” Briller says.
“If you’re too busy to do 30 minutes of exercise at one time, try doing three 10-minute intervals.”
11. Stress less to lower cholesterol
High stress can raise your cholesterol levels. In 2007, researchers at Oregon State University found that study participants who had good coping skills – meditation, deep breathing, laughing, exercise, good nutrition and good conflict resolution – had higher HDL levels. Those with poor stress-coping skills had worse LDL and triglyceride levels.
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