Written by Dr. Burke

Having high cholesterol is one of the greatest risk factors for developing heart disease. When there is too much cholesterol in the blood it can build up and attach to arteries, causing dangerous arterial plaques. This leads to narrowing of the blood vessels, which can decrease blood flow and oxygen supply to the heart and the rest of the body. Eventually, this can cause episodes of chest pain or even a heart attack.

On its own, high cholesterol does not have any symptoms, so it is important to have regular blood tests to check your levels. The American Heart Association recommends that screening for cholesterol levels start at age 20. Newer tests like the Boston Heart Panel provide even more precise information about your cholesterol levels and heart disease risk.

The best way to lower cholesterol is to start with diet and exercise changes. Sometimes if your cholesterol is very high, you may also need medications to lower it. Although fats, especially animal fats, have long taken the blame for increasing cholesterol and heart disease risk, new evidence shows that the bigger issue is likely sugar and processed carbohydrates. This is because when we eat more carbs then what our body needs for energy, the excess is stored in the liver as cholesterol and triglycerides (another type of fat that is linked with heart disease). It also matters what kind of fats we eat, as some are healthier than others.

Here are some easy things that you can do to help support normal cholesterol levels and reduce your risk for heart disease:

1.) Increase Fiber:

There are two main forms of fiber: soluble and insoluble. Soluble fiber is the kind that attracts water and makes things slimy (like flax, chia, oats, and psyllium). Insoluble fiber is often called “roughage” and is found in green vegetables, lentils, beans, nuts, and seeds.  Fiber is like a scrub brush for the intestines and helps your body get rid of excess cholesterol.

2) Exercise

150 minutes per week of aerobic activity has been shown to significantly improve cholesterol, blood pressure, insulin sensitivity and blood sugar levels, and mood. You should exercise at a level of your safe target heart rate and talk to your doctor before starting a new exercise routine.  A good goal for most people is getting at least 30 minutes of exercise 3 to 5 times per week.

3) Avoid Fried Foods and Trans Fats:

Heavily processed oils such as safflower, canola, peanut, soy, and cottonseed oil, and all trans-fats (hydrogenated and partially-hydrogenated oils) should be avoided because they tend to increase unhealthy cholesterol levels. When cooking, it is best to heat oils at a low temperature. This is because when oils are exposed to high temperatures (such as with broiling, grilling, and frying) they become rancid and oxidize, unleashing free radicals that can be damaging to blood vessels and other tissues.

4) Eat Healthy Fats

Fats are important for helping us to feel full and to nourish the tissues of our nervous system. Eating healthy fats can also help increase HDL—our body’s naturally protective form of cholesterol, which is sometimes referred to as “good cholesterol”. Examples of healthy fats include cold pressed olive and sesame oils, coconut oil, ghee (also called clarified butter), nuts and seeds, avocadoes, cold-water fish, and grass-fed meats (which contain higher levels of anti-inflammatory Omega-3 fats).

Numerous research studies show eating raw nuts naturally lowers cholesterol. Raw nuts and seeds are high in fiber and plant sterols and contain healthy oils. Sterols are the plant version of cholesterol that tricks your body into making less of its own cholesterol. Good choices of nuts and seeds include almonds, walnuts, pecans, hazelnuts, pistachios, and brazil nuts, and flax, chia, sesame, sunflower, and pumpkin seeds. Aim to have 1 to 2 servings of these foods each day. A serving size is one ounce of nuts (about 20 whole, shelled nuts) or 2 tablespoons of ground chia or flax seeds.

Including 2 to 4 servings per week of oily, cold water fish (like true cod, herring, mackerel, sardines, halibut, and salmon) can also improve cholesterol. Eating fish is especially effective for reducing triglycerides because of their high levels of Omega-3 essential fatty acids (EFAs). The Environmental Working Group has a great online resource for finding sustainable seafood sources that are low in mercury and high in Omega-3 oils.

5) Reduce Sugar and Simple Carbohydrates

Simple carbohydrates are found in high amounts in sugar and most sweeteners (agave, corn syrup, honey, maple syrup, molasses, and coconut sugar), as well as fruits, white potatoes, and processed grains (wheat flour, white rice, bread, pasta, etc). These carbohydrates are processed by your liver and excess amounts are stored there as cholesterol and triglycerides. Simple carbohydrates should be eaten in moderation and combined with protein foods to help keep blood sugar stable.

6) Increase Antioxidants

Foods like green tea, pomegranates, berries, red grapes, and green leafy vegetables contain antioxidant pigments called flavonoids that help to repair damage to our cells and blood vessels. This is important for improving cardiovascular health and preventing the build-up of dangerous cholesterol plaques.

7) Quit Smoking

One of the many health benefits of quitting tobacco is improving your cholesterol levels. Studies show that quitting smoking increases your HDL cholesterol (also called “good cholesterol”) by as much as 10 percent. If you need help quitting, ask your doctor about what options are out there.