When you have your cholesterol checked, your lab report may also have your total cholesterol number, which is made up of your LDL, HDL, and triglycerides. The goal for total cholesterol is a number less than 200 mg/dl.
Many people with high cholesterol are prescribed one or more medicines to lower their LDL cholesterol and/or triglycerides or to raise their HDL cholesterol. Statins are one of the more common types of medicines used, but there are others that work well, too, including bile acid resins and niacin. Fibrates are a type of medicine that can help lower triglycerides and raise HDL cholesterol. There’s also a medicine that blocks the absorption of cholesterol in the intestines.
However, as with all drugs, side effects can occur, although most are not usually serious. Statins, for example, may cause muscle pain and, of more concern, liver damage. Fibrates can cause gastrointestinal upset and may increase the risk of gallstones. If you experience side effects when taking a cholesterol drug, always call your health-care provider for advice, rather than stopping the medicine on your own.
Nature’s cholesterol reducers
There’s strong evidence that making dietary changes — including lowering saturated fat and dietary cholesterol intake — and staying physically active can help with cholesterol management and lower the risk of heart disease. For many people, though, these changes aren’t enough to bring lipid levels into their target range. That’s where medicines can help, but some people are reluctant to take medicines or wonder whether there is anything else they can do on their own before — or in addition to — starting medicines. And in fact, there may be.
Any number of magazine or online articles and advertisements tout supplements that can lower cholesterol without harmful or unpleasant side effects. Some of them may indeed work, while others remain unproven or appear to be ineffective.
Here are some of the more popular supplements and food items for which cholesterol-lowering claims have been made. Of those that may have a positive effect, some may help to lower LDL cholesterol more, while others may have more of an effect on triglycerides. Keep in mind that any decisions about taking cholesterol-lowering supplements or making significant dietary changes should be made with the knowledge of your health-care team, who can best guide you toward the therapies that are likely to help and caution you about any possible side effects.
When most people think of fiber, they think of a bowl of bran cereal or a slice of whole wheat bread. These foods are high in insoluble fiber, the type of fiber that helps to move food through the intestinal tract and prevent constipation. But insoluble fiber is not the only kind of fiber found in food.
Soluble fiber, or viscous fiber, is found in certain foods, including oatmeal, oat bran, and other oat products, dried beans and peas (black beans, chickpeas, lentils), barley, flaxseed, nuts, apples, oranges, prunes, carrots, Brussels sprouts, and psyllium (seed husks found in some fiber supplements and bran cereals). Soluble fiber works a little differently from insoluble fiber: It takes up water in the digestive tract, forming a gummy, gel-like substance. While it, too, may help prevent constipation, a unique feature of soluble fiber is that it can help lower LDL cholesterol by binding to cholesterol in the intestines. The evidence for soluble fiber’s cholesterol-lowering abilities is pretty strong and is supported by fairly extensive research.
How much soluble fiber does one need to lower LDL? Aiming for 7–13 grams of soluble fiber each day helps. And consuming adequate insoluble fiber can help, too: Eating a total of 20–35 grams of fiber (both insoluble and soluble) each day can lower total cholesterol by 2% to 3% and LDL cholesterol by up to 7%. One way to get that much fiber in your meals is to eat at least 5 servings of fruits and vegetables a day, as well as 6 servings of grains.