The Best Ways To Lower High Cholesterol Without Medication
Nobody likes to take medication. Yet, we are seeing a rising number of people developing chronic illnesses that require them to take medication for the rest of their lives. Having high cholesterol (hyperlipidemia) is one of those conditions. But what is cholesterol, and how is it used in the body?
Cholesterol is a wax-like material that is surprisingly essential for life. According to StatPearls, the body uses cholesterol on a cellular level. It helps with the absorption of the fat-soluble vitamins A, D, E, and K via bile salts, and it acts as a precursor for vitamin D, steroid hormones (e.g., cortisol), and sex hormones (e.g., estrogen, testosterone). It also serves as an integral part of the cell membrane, which is the thin membrane that surrounds each individual cell. The amount of cholesterol determines how fluid or rigid the cell membrane is. It may not seem like much, but the cell membrane acts as a barrier to ensure that things that should be inside the cell stay inside, and unwanted external substances or structures stay outside. The cell membrane also has channels embedded within its walls, allowing ions, nutrients, and waste to pass through.
The American Heart Association (AHA) states that there are two sources from which cholesterol can come. One is the liver, which actually makes all the cholesterol our body needs. The other source is our diet. Dietary cholesterol can be found in oils and animal-derived food products, such as poultry, meat, eggs, and dairy.
Is cholesterol really that bad?
Cholesterol is not always harmful. In fact, it is often categorized as either "good" or "bad." High-density lipoprotein (HDL) is called good cholesterol because its main function is to bring cholesterol in the blood back to the liver. By doing this, HDL is able to help maintain normal cholesterol levels in the body. On the other hand, low-density lipoprotein (LDL) is referred to as bad cholesterol because it accumulates in the arteries and forms plaques. When plaques develop in the arteries, blood flow decreases and sometimes gets blocked completely. When there is not enough blood circulating in a certain area of the body, the cells in that area die, and several complications follow. For example, if the blood supply to the heart gets cut off, a person will develop a heart attack. If this happens to the brain, a person will develop a stroke. When it happens in the lower extremities, a person may end up losing their toes, feet, or leg (via Cleveland Clinic).
Healthline adds that high cholesterol can affect other organ systems as well, and vice versa. Studies on the menstrual cycle show that HDL rises and LDL declines whenever estrogen goes up. On the other hand, LDL and total cholesterol seem to increase in people who have insufficient thyroid hormone (hypothyroidism), while the opposite is seen in people with too much thyroid hormone (hyperthyroidism). Having high cholesterol is also associated with an increased risk of developing Alzheimer's disease and gallstones.
Eat the right type of fat
Fat is one of the body's three main energy sources, along with protein and carbohydrates. However, there are different types of fats, and not all of them are good for you.
Dietary fats include monounsaturated, polyunsaturated, saturated, and trans fats. Per Healthline, monounsaturated fats remain liquid at room temperature and are associated with multiple health benefits. Studies show that this type of fat can help lower blood sugar, blood pressure, weight, and triglyceride levels; they can also increase HDL levels. A popular example of monounsaturated fat is olive oil. Polyunsaturated fat (e.g., omega-3, omega-6) is also a healthier type of fat. Specifically, adding omega-3 to your diet can help protect against chronic illnesses and reduce inflammation. On the other hand, studies also show that consuming too much omega-6 (relative to omega-3) can paradoxically worsen chronic inflammation.
Moving on to the more unhealthy types of fat, Harvard Health explains that saturated fat is solid at room temperature. This type of fat can increase total cholesterol levels and raise the level of LDL relative to HDL. Foods rich in saturated fat include whole milk, cheese, and red meat. Even worse is trans fat, which is produced by chemically altering the structure of healthy oils to make them solid and less likely to spoil. The U.S. Food & Drug Administration (FDA) has recently banned the use of artificial trans fat in the country, but there are still natural sources of trans fat that can be found in milk and meat products that you should watch out for.
Incorporate more soluble fiber into your diet
It may be shocking to know that our bodies are not equipped to digest fiber. But this is exactly the reason why fiber is deemed a healthy addition to our diet. Fiber comes from plants, and can either be soluble or insoluble. Soluble fiber dissolves in water and turns into a gel-like substance (via Mayo Clinic). It can be found in barley, beans, carrots, citrus fruits, oats, and peas. On the other hand, insoluble fiber adds volume to digested food. Adding bulk to our stool enhances the rhythmic movement of our gut, propelling it more efficiently to promote healthy bowel movements. Insoluble fiber can be found in whole wheat, beans, and vegetables.
While insoluble fiber helps prevent constipation and exerts its benefits mostly in the gut, soluble fiber can help lower cholesterol levels, decrease fat absorption, slow down the digestion of carbohydrates, decrease the risk of heart disease, and promote microbial gut diversity. By adding more soluble fiber to your diet, you are allowing your gut to slowly digest the food that you eat, which in turn can make you feel full for a longer period of time and prevent you from eating more than usual (via Medical News Today).
WebMD warns that you may experience some bloating, gas, abdominal cramps, and worsening constipation with increased fiber intake. However, you can prevent this by increasing your water intake. Also be aware that fiber may interfere with certain medications, so speak with your doctor first if you plan on taking fiber supplements.
Abstain from drinking alcohol as much as possible
Although there are some health benefits that have been associated with drinking certain types of alcohol (e.g., red wine), they are incomparable to the harms it can cause, especially when consumed in large quantities.
If you do not drink alcohol to begin with, it is not recommended that you start drinking. If you do drink, the 2020-2025 Dietary Guidelines for Americans recommend limiting alcohol intake to 2 drinks (or less) a day for adult males and 1 drink (or less) a day for adult females. To add more context, a drink is equivalent to 12 fluid ounces of regular beer, 5 fluid ounces of wine, 1.5 fluid ounces of 40% distilled spirits, and 7 fluid ounces of 40% rum and cola.
As explained by Yale Medicine, as the alcohol you drink passes through the digestive system, it gets absorbed into your gut and into the bloodstream. It then gets shunted through your blood vessels and ultimately goes to the liver. It is the liver's job to remove toxic substances, and alcohol happens to be one of them. The more alcohol you drink, the more your liver has to work to remove it. The byproducts of breaking down alcohol are harmful to the cells of your liver, and with enough exposure, this will eventually lead to liver failure. The Cleveland Clinic also adds that these byproducts turn into cholesterol and triglycerides, effectively increasing your risk of heart disease, stroke, pancreatitis, and diabetes.
Calm your sweet tooth
Sugar that does not get used by the body gets converted into fat in a process called lipogenesis. The natural process in the body is to break down sugar (glucose) into energy molecules. When there are more than enough of these energy molecules in the body, a substance called acetyl-CoA is produced, which in turn gets converted into fat (e.g., cholesterol, fatty acids, triglycerides), per LibreTexts Biology. This not only applies to sugars that we naturally know are sweet but also to foods that are rich in carbohydrates. These include white rice, white bread, pasta, and pretzels.
Sugar can raise levels of bad cholesterol in the body and reduce the amount of good cholesterol. It also blocks the enzyme that helps break down triglycerides into fatty acids, making it a lot harder for us to get rid of them. Similar to having high cholesterol, having high triglyceride levels increases your risk of heart disease, heart attack, stroke, and pancreatitis (via Mayo Clinic).
Per WebMD, women should limit their sugar intake to 6 teaspoons per day, while men should limit theirs to 9 teaspoons per day. One of the ways you can achieve this is by being more cognizant of the nutrition labels printed on almost all food products available on the market. Cut down on sugary drinks and avoid commercially produced breakfast cereals. Instead, opt for more natural foods like yogurt, oatmeal, and fruit.
Do not smoke
It was not that long ago that smoking was advertised as healthy, even to pregnant women and the youth. History recounts that before the 1950s, solid evidence that smoking was bad for health was still very much lacking. It even reached a point where tobacco companies would use doctors to add credibility to their products in order to boost their sales. Unfortunately, it took many people getting sick and passing away for us to learn just how bad smoking really is, and it was a lot worse than what any of us could have imagined. To add to this, proving the saying that history repeats itself, the use of e-cigarettes (i.e., vaping) became an increasingly popular trend just a few years ago, with advertisements particularly targeting the youth. This time around, it did not take long for researchers to discover that vaping is not really all that different from cigarette smoking, and it also leads to detrimental health issues (via the AHA).
Aside from being a direct cause of lung disease and lung cancer, according to Medical News Today, smoking raises the level of bad cholesterol and lowers the level of good cholesterol, although it is still unclear how this happens. Smoking also damages the inner lining of blood vessels. When coupled with high LDL cholesterol levels, this tremendously increases the risk of plaque buildup within the arteries (i.e., atherosclerosis), which in turn can lead to various problems such as heart attack, stroke, and peripheral artery disease (PAD).
Exercise regularly
Physical activity has been linked to many health benefits. It can help you maintain a healthy weight, decrease your risk of developing several health conditions (e.g., heart disease, diabetes, osteoporosis, some cancers), aid in smoking cessation, prevent mental deterioration, improve your mood, reduce your risk of falls, help with getting good sleep, improve your sexual function, and prolong your life (via MedlinePlus).
For cholesterol levels specifically, exercise has been proven to increase the level of good cholesterol in the body, while also decreasing the levels of bad cholesterol, total cholesterol, and triglycerides. According to a 2014 review published in the Sports Medicine journal, different types of exercise have somewhat different effects. For aerobic exercises, the more intense they are, the greater the effect is on cholesterol levels. On the other hand, for resistance training, it has been found that the number of sets or repetitions you do has a greater effect on cholesterol levels compared to how intense your workout is (i.e., using heavier weights but doing fewer repetitions).
Per the Centers for Disease Control and Prevention (CDC), adults should do at least 150 minutes of moderate-intensity exercise and two days of muscle-strengthening exercises per week. Examples of moderate-intensity exercises include brisk walking, water aerobics, and riding a bike. If you are pressed for time, an alternative regimen is to do 75 minutes of vigorous-intensity exercise per week, such as jogging, running, and swimming.
Maintain a healthy weight
The body mass index (BMI) is a simple yet widely used tool to classify a person's health status based on their weight. Most of the time, it is assumed that the higher a person's BMI, the more fat they have in their body. However, this is not the case for everyone. As the Cleveland Clinic explains, some people may have a high BMI despite their body composition being more lean muscle mass than body fat (e.g., athletes, bodybuilders). Moreover, BMI should not be used to assess body fat content in children, teenagers, pregnant women, adults over 65 years old, or people with certain medical conditions that cause muscle wasting. Normal BMI is anywhere between 18.5 to 24.9. Anyone with a BMI below 18.5 is considered underweight. A BMI of 25 to 29.9 is classified as overweight, 30 to 39.9 is obese, and 40 and above is class III obese (formerly known as morbidly obese).
Similar to smoking, obesity is associated with low levels of good cholesterol and high levels of bad cholesterol and triglycerides (per Healthgrades). Fortunately, according to a 2016 study in Translational Behavioral Medicine, losing as little as 5% of your total body weight can significantly improve cholesterol levels. Obesity is also closely linked to several chronic health conditions, like heart disease, type 2 diabetes, stroke, obstructive sleep apnea, gastrointestinal problems (e.g., heartburn, gallbladder issues, fatty liver), osteoarthritis, and many types of cancer; it can also significantly lower a person's quality of life (via Mayo Clinic).
Get adequate sleep
With only 24 hours in a day, most people find themselves sacrificing sleep in order to fit more productive work into their daily schedules. However, it has long been proven that adequate sleep is important for maintaining overall health. According to the National Institutes of Health (NIH), the body uses sleep as a time to repair any damage and get rid of unwanted substances in the body. Without a good amount of sleep, you are depriving your body of the chance to heal itself, which in turn increases your risk of several health conditions like dementia, obesity, and heart disease.
A 2008 study published in Sleep found that both sleeping too much and sleeping too little are associated with higher levels of triglycerides and lower levels of good cholesterol. In a separate study published in 2016 in Scientific Reports, researchers also found that sleep deprivation may lower good cholesterol levels. These two independent studies, along with many others, provide a possible explanation as to why lack of sleep has been shown to be associated with an increased risk of heart disease.
Another factor that needs to be taken into account is obstructive sleep apnea (OSA). People who have OSA experience intermittent obstruction in their airways as they sleep, consequently diminishing oxygen levels in the body. According to a large 2018 study published in Respirology, study participants with OSA who had no prior history of hyperlipidemia experienced a significant increase in their total cholesterol, bad cholesterol, and triglyceride levels.
Find ways to manage your stress
Stress is a normal part of life, but excess stress can take a physical toll on the body. Studies show that people who are under a lot of stress are more likely to have high levels of bad cholesterol and low levels of good cholesterol. This is partly due to unhealthy habits (e.g., eating more unhealthy foods, smoking, drinking alcohol, not exercising), but it may also be related to high levels of cortisol and adrenaline.
According to Medical News Today, cortisol can indirectly increase cholesterol levels by forcing the body to release sugar and fatty acids for energy. High levels of cortisol can also increase a person's appetite and promote fat deposition around the stomach area. High-stress situations can also lead to temporary hemoconcentration, wherein blood and its components become more concentrated. This, in turn, can transiently increase cholesterol levels in the blood.
Ways to manage stress include being aware of unhealthy habits and fighting the urge to follow them, noticing what things make you feel relaxed and doing more of them (e.g., listening to music, meditation, yoga, mindfulness), spending time with people you enjoy being with (e.g., family, friends, significant others), and staying physically active through regular exercise (per WebMD). If your stress is mostly related to a health condition like anxiety or depression, it is important that you seek help from professionals such as your doctor, who can give you further insight into what you are going through and provide you with the right treatment.