The following measures tend to lower total cholesterol and LDL levels, and also tend to raise HDL levels—or may at least stabilize HDL while bringing down LDL. (Not everyone responds to these changes, and if your total cholesterol level remains high after several months of adopting these changes, you should consult your doctor about taking cholesterol-lowering drugs.
- Lose weight. Not only does excess body fat raise LDL levels and reduce HDL, but it also appears to be an independent risk factor for heart disease. Where the fat accumulates is also important: excess weight around the waist (the so-called apple-shape body) seems to reduce HDL more than weight in the hips and thighs (pear shape).
- Cut down on saturated fats. This is the most important dietary step you can take. First, keep your total fat intake at or below 30 percent of your daily calories. Secondly, substitute unsaturated fats for saturated fats. Studies have shown that polyunsaturated fats (such as safflower and corn oil) and monounsaturated fats (such as olive oil) help to lower blood cholesterol levels. Monounsaturated fats may help maintain or increase the level of HDL cholesterol as well.
- Cut down on dietary cholesterol. It’s estimated that reducing cholesterol intake from food from 500 to 250 milligrams a day will lower total blood cholesterol by an average of 10 milligrams. This response is variable, however; some people have little or no response, and others a far greater one.
- Watch out for “trans fats.” Manufacturers hydrogenate—that is, add hydrogen to—corn, soybean, and other liquid vegetable oils to make them more stable. This prolongs the shelf life of margarines, crackers, cookies, potato chips, and other foods that contain the semisolid oils. Hydrogenated oils are also often used for deep-frying in fast-food restaurants. But hydrogenation alters many of the oils’ unsaturated fatty acids, making them more saturated and changing their structure in other ways that transforms them into trans fatty acids, or simply trans fats. Studies have shown that trans fats act like saturated fats—raising total and LDL cholesterol levels—and there is some evidence that they lower HDL cholesterol as well. Nutrition labels have not specified how much trans fat is in the foods, and it’s not counted as saturated fat. Hence, trans fats have remained invisible on food labels. The Food and Drug Administration (FDA) has recommended that the amount of trans fatty acids in foods be included in nutrition labels (a final ruling on the proposal is expected in 2001). In the meantime, if you eat lots of margarine and also many processed foods, cut back, or switch to a tub or liquid “squeeze” margarine, which has fewer trans fatty acids. “Diet” margarines are even better—they contain more water and only half the fat of other margarines.
- Exercise more. Results of studies have been inconsistent concerning the effect of aerobic exercise or strength-training exercise on total cholesterol and LDL. But the evidence is stronger that an exercise program can help raise HDL, and its effect on lowering the risk of coronary artery disease (CAD) is overwhelming. The exercise doesn’t have to be strenuous—walking a mile or two or even gardening several times a week can help.
- Combine diet and exercise for better results. In a study at the Stanford School of Medicine, a group of subjects who followed both a low-fat diet and a moderate exercise program (equivalent to briskly walking for three hours a week) had an average drop of about 18 points in total cholesterol, while subjects who followed only a dietary or exercise regimen experienced just a small improvement not considered significant.
- Consume more soluble fiber. Eat more legumes, oats, fruits, and vegetables such as carrots, split peas, and corn. Sweet potatoes, zucchini, and broccoli have some soluble fiber, as do bananas, apples, pears, and oranges. If you regularly eat a high-fiber, low-fat diet that includes a variety of the these vegetables and fruits and some oatmeal or oat bran daily, you may see results the next time you have a cholesterol test—particularly if the level was previously elevated.
- Eat fish instead of meat. According to some studies, the oil in fish—polyunsaturated fatty acids called omega-3s—can lower elevated cholesterol. Evidence from other studies disputes this, but substituting some fish for meat (or other sources of saturated fat) should help lower blood cholesterol. Eating fish is preferable to taking fish oil supplements. Not only is fish one of the best nutrient-rich foods around, but it is unclear whether omega-3s, by themselves in supplements, provide the same health benefits as eating the fish itself.
- Consider a drink or two a day. A number of studies have shown that moderate alcohol consumption—defined as no more than two drinks a day for a man, one drink a day for a woman—may boost HDL. The health risks of heavier drinking, however, outweigh the potential benefit for the heart.
- Don’t smoke. Smoking increases total cholesterol and reduces HDL. In addition, it is an independent risk factor for heart disease.
- Drink green tea. It can help lower the level of LDL.
The Complete Home Wellness Handbook
John Edward Swartzberg, M.D., F.A.C.P., Sheldon Margen, M.D., and the editors of the UC Berkeley Wellness Letter
Updated by Remedy Health Media