How to lower cholesterol

Reviewed by Dr Neel Patel

Cholesterol is a type of fat which is found in our blood and made in the liver. Cholesterol can also be found in some of the foods we eat. Cholesterol is important as it helps to keep the cells in our bodies healthy, but problems arise when we have too much, also known as high cholesterol.

This article will explore ways that you can lower your cholesterol levels, including medication if appropriate, losing weight, regularly exercising and following certain low cholesterol diets. If you’re worried about your cholesterol levels or have been told you have high cholesterol, read on for simple ways you can begin to lower it.

What is high cholesterol?

High cholesterol is when you have too much cholesterol in your blood. Too much cholesterol can increase your risk of heart problems or a stroke, as the cholesterol blocks blood vessels making it hard for blood to flow through your arteries.

High levels can be caused by lifestyle factors such as smoking, your diet and amount of exercise you do. These are things you can change and control. However other factors that cause high cholesterol, such as your age, weight, genetics and other health conditions like high blood pressure aren’t always in your control.

How do I know if I have high cholesterol?

If you have high cholesterol you may not know, as it usually doesn’t cause any symptoms. That’s why it’s important to follow a healthy lifestyle as much as possible.

You can also take a blood test at home to check your levels. Our general health blood test measures your lipid profile to reveal the different fats in your blood.

You can also speak to your doctor about a blood test. If your doctor thinks you might be at risk they may suggest a cholesterol test. If you’re under 40 you’re likely to be offered a blood test, if you’re over 40 you may be tested during your NHS Health Check. Cholesterol tests may also be available in your local participating pharmacy for a fee.

Ways to lower cholesterol

Medication may be needed to help keep your cholesterol levels in check. These can be combined with lifestyle changes to improve your cholesterol and support the effects of your medication.

Even if you haven’t been diagnosed with high cholesterol, you can take steps to live a healthier lifestyle, even small changes add up. 

Exercise more

With our busy lives it can be hard to make exercise a priority. But with all the benefits exercise brings including improved mood and lessening your risk of certain conditions, it’s important to find a physical activity you enjoy and that you can fit into your lifestyle.

It’s recommended that adults do 150 of moderate aerobic activity such as hiking or dancing or 75 minutes of vigorous aerobic exercise such as running or swimming. Find out how you can get started with exercise in our guide. 

Cholesterol lowering foods

Foods high in saturated fat and trans fat such as processed meat, pastry, cream, butter and cakes can increase cholesterol. Simple swaps may help you to lower your cholesterol levels, such as: 

• Using vegetable oil spreads instead of butter
• Using natural yoghurt instead of cream
• Swapping red meat for chicken or fish or plant based alternatives
• Cooking from scratch instead of ordering takeaways

If you steam, grill or boil foods instead of frying them you can decrease the amount of fat you eat as well.

Foods that reduce cholesterol are those low in saturated fat like:

• Vegetable oils and spreads
• Unsalted nuts and seeds
• Avocados
• High fibre foods
• Kidney beans
• Foods fortified with sterols or stanols 

Adding these into your diet, alongside other healthy eating can help. For more healthy swaps read our healthy alternatives guide. 

High fibre foods

Foods high in fibre reduce the amount of cholesterol that is absorbed by the body. Fruits, vegetables alongside lentils, beans, oats and pulses are high in fibre. Wholegrain foods such as brown rice, brown pasta and brown bread are higher in fibre than white varieties. 

Foods with plant sterols or stanols 

Plant sterols and stanols help block the absorption of cholesterol. They’re added to margarine, orange juice and yoghurts. Adding just 2 grams of sterol every day to your diet can lower your levels of “bad” cholesterol by 5-15%. 

Diets that lower cholesterol

As well as eating a healthy balanced diet, there are types of diets that can help to lower cholesterol.

The Mediterranean diet is one of these, the origins of this diet are Greece, Spain and Italy and the way people in these countries typically and traditionally eat.

It’s a way of eating that focuses on:

• Fruits and vegetables
• Beans and cereals
• Wholegrain bread and pasta
• Brown rice
• Fish and white meat 
• Low-fat diary 
• Olive oil
• Nuts

Red meat, sweets, desserts and alcohol are consumed occasionally and in smaller quantities. 

This diet also helps to lower cardiovascular risk by being low in salt as this seasoning is often swapped for garlic or herbs. It’s beneficial to be mindful of the amount of salt you consume for your cardiovascular health, check out healthy salt alternatives here. 

Stop smoking

We all know smoking is bad for our health including our heart health. Smoking can increase your risk of heart disease, heart attack and stroke. Smoking damages the walls of your arteries meaning that cholesterol can easily collect these. 

The good news is that quitting smoking can improve your cholesterol levels as well as offer other health benefits. We know that giving up smoking isn’t easy, which is why we’ve got advice to help you stop smoking and take control of your health.  

Drink less alcohol

The NHS recommends cutting down on alcohol to help lower your cholesterol. Drinking less alcohol can help your liver to better remove the bad cholesterol in your blood. 

The guidelines around alcohol consumption are drinking no more than 14 units a week which is roughly 6 pints of 4% beer or 6 (175ml) glasses of 13% wine. You should also spread your drinking over at least 3 days of the week. If you want to lower your cholesterol you should consider:

• Drinking less than 14 units a week
• Having alcohol-free days during the week
• Avoid binge-drinking

If you think you may be drinking too much, find out what support is available and how you can begin to cut down. 

Taking medication 

Lifestyle changes on their own might not be enough to lower your cholesterol. Your GP may decide that you need medication such as statins, alongside lifestyle changes, to help keep your cholesterol levels under control. Statins are the most common medication for cholesterol, and you usually need to take them for life, but don’t worry your doctor will tell you everything you need to know about this medication. 

Does losing weight lower cholesterol?

Losing weight can make a difference to your cholesterol levels. Losing just 10% of your body weight will help lower your cholesterol and blood pressure, helping to keep your heart healthy. One study found that participants who lost 5-10% of their starting weight had significant reductions in their total cholesterol levels including ‘bad’ cholesterol. 

Increasing your physical activity and eating less by following portion size guidelines can help you to lose weight. Some people may find weight loss treatments helpful too. Find out more in our how to lose weight guide.

Weight loss treatments

Following a healthy balanced diet and exercise plan can help most people lose weight, there are times however when you may want to try weight loss treatments. Medicated weight loss options include:

• Orlistat (sometimes known by the branded version Xenical) – a daily pill
• Saxenda® – a daily self-administered injection
• Wegovy® – a weekly self-administered injection - this is not available in the UK yet

To use a weight loss treatment a pharmacist or clinician will need to check they’re suitable for you. At Online Doctor you can complete a short online consultation to make sure your chosen treatment is right for you.

References
https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/reduce-cholesterol/art-20045935 
https://www.nhs.uk/conditions/high-cholesterol/how-to-lower-your-cholesterol/ 
https://www.heartuk.org.uk/cholesterol/what-is-cholesterol 
https://www.bhf.org.uk/informationsupport/risk-factors/high-cholesterol 
https://www.bhf.org.uk/informationsupport/risk-factors/high-cholesterol/five-top-questions-about-lowering-cholesterol 
https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/cholesterol/art-20045192 
https://patient.info/heart-health/cardiovascular-disease-atheroma/mediterranean-diet 
https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/symptoms-causes/syc-20350800 
https://www.heartuk.org.uk/healthy-living/quit-smoking 
https://www.heartuk.org.uk/low-cholesterol-foods/looking-after-your-weigh