If you Google “natural remedies for high cholesterol” you will get millions of hits. As you scroll through them, you’ll see that what “natural” means is in the eye of the beholder. For many people, natural means dietary supplements or “superfoods” thought to have special cholesterol-fighting properties. But in the end, based on good-quality science, the “natural” remedy for high cholesterol is sustained lifestyle change.
“Weight loss if you’re overweight and changing your diet can actually decrease your LDL significantly, but it does require dedication and motivation,” says Hanna Ahmed, MD, MPH, a cardiologist at Tufts Medical Center.
The bottom line is that it’s the total package of foods and nutrients that help to maintain a healthy cholesterol profile and prevent heart disease, as opposed to eating specific foods, vitamins, minerals or herbs to tweak your cholesterol. And of course a healthy lifestyle also has additional benefits, including lower blood pressure, maintaining a healthy weight and reduced stress.
Healthy Fats: Research by Tufts’ nutrition scientists and others has helped to establish that shifting to a healthier profile of fats in your diet can have a potent effect on LDL and total cholesterol and lower your overall risk for heart attack, stroke and other forms of cardiovascular disease.
“Eating more unsaturated fats from foods like nuts, plant oils and fish lowers blood levels of the ‘bad’ cholesterol and increases the ‘good’ HDL cholesterol,” says Dariush Mozaffarian, MD, DrPH, dean of Tufts’ Friedman School and editor-in-chief of Tufts Health & Nutrition Letter. “These foods also have other beneficial nutrients that likely lower cardiovascular disease, making it a win-win for health.”
But the solution is not to completely ban red meat, butter and other sources of saturated fat, or starches that raise VLDL cholesterol (another type of cholesterol that increases heart attacks). The idea is to shift the balance toward unsaturated fats from plant oils like soybean, corn and olive, as well as from nuts and fish. The weight of the evidence is more on the side of replacing with polyunsaturated fats as opposed to monounsaturated, although both are associated with lower cardiovascular risk.
And remember that when substituting carbohydrates for saturated fat, make sure they are not refined grains and added sugars. For carbohydrates, the best choices are whole grains, which should make up at least half of your total grains, as well as fruits and beans.
Fish Oil: Fish oil supplements are popular but have little effect on LDL, although in sufficient doses fish oil supplementation can lower triglycerides (a marker of VLDL) if your levels are elevated. There is a lack of evidence that fish oil supplements prevent heart disease in otherwise healthy people.
A 2017 American Heart Association (AHA) Science Advisory left the door open for people with existing heart disease to take fish oil to possibly lower their risk of death, second heart attacks or other problems. However, fish meals as part of an overall healthy diet are associated with lower risk of cardiovascular disease across the board.
The AHA recommends eating at least two 3.5-ounce (cooked) servings of seafood per week, preferably the varieties of fatty fish highest in omega-3s—salmon, mackerel, herring, lake trout, sardines and albacore tuna.
Some of the benefit may come from what you don’t eat when choosing fish. Fish may replace options such as fatty meats, starchy foods or fried foods that are high in saturated fat. Again, it’s all about the healthy eating pattern, not lionizing (or demonizing) individual nutrients.
Fiber: Whole grains contain fiber, which does have a moderate effect on blood (serum) cholesterol. The FDA allows several foods high in soluble fiber—that is, fiber that dissolves in water—such as oats, psyllium and barley, to carry a health claim for cholesterol benefits.
But have realistic expectations if you switch to whole oats for breakfast. The effect of soluble fiber on cholesterol is not dramatic. A meta-analysis of 67 clinical trials found that 2 to 10 grams per day of soluble fiber had a small but measurable effect on LDL cholesterol. Daily intake of 3 grams soluble fiber from either 3 apples or 3 bowls (28-gram servings) of oatmeal can decrease total cholesterol by 5 milligrams per deciliter.