If you’ve been told by your doctor that your cholesterol is too high, you have some decisions to make about how to go about getting your numbers down. Your doctor is likely to mention a few options: eating a low-fat diet, getting regular exercise, eating more “cholesterol lowering” foods or taking a statin drug—the most common prescription medication for lowering cholesterol. The method (or combination of methods) that works best for you depends on your will-power and genetics.
Researchers say that for some people diet and exercise can reduce cholesterol as effectively as a statin drug. It just takes a little more time and commitment to get results. And, the overall health benefits of eating the right foods and exercising more extend far beyond just managing your cholesterol.
As for what dietary changes are the most effective, those recommendations continue to evolve with research. Many years ago, doctors would have suggested that you go on a low-fat diet. More recently, cholesterol-lowering foods such as nuts, plant sterols and fiber have influenced new dietary guidelines for managing cholesterol. This begs the question: which is better, “low-fat” diets or "cholesterol-lowering" foods?
A group of Canadian researchers found that a low fat diet alone produced only a 3 percent reduction in LDL (bad) cholesterol. However, the addition of cholesterol lowering foods lowered LDL cholesterol by 13%. Similar studies found that adding soy proteins, fiber and almonds lowered cholesterol by as much as 20%. Overall, plant-based diets with very little meat products produced the best results.
When you add exercise to the mix, you can see even greater reductions in LDL cholesterol. Diet and exercise together can yield reductions in the 30-40% range for many. Just how much of an effect exercise has on cholesterol is a matter of debate, but researchers at Johns Hopkins found that those who had the worst diet and exercise habits to begin with benefited most. Their LDL cholesterol went down by 10-15% and their good HDL went up by as much as 20%.
If your cholesterol is not dangerously high and you want to try the “natural approach,” many doctors will provide nutritional counseling and give you a few months to work at it. If you’re not making progress on your own, it may be time to consider drug therapies.
If you have a genetic predisposition for high cholesterol a multipronged approach of cholesterol lowering drugs, diet and exercise is often needed.
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