The battle against high LDL cholesterol levels should always start, and can often end, with lifestyle changes. Even people who take cholesterol-lowering drugs should make these changes, too, since they might allow them to take a lower and thus safer dose, and because the steps protect the heart in many other ways as well. Here's what has been found to work
Eat a heart-healthy diet. Focus especially on:
- Reducing your intake of saturated fats, found mainly in red meat and full-fat dairy products, to less than 7 percent of total calories.
- Eliminating trans fats or partially-hydrogenated oils, found in margarine, many fast foods, and store-bought pastries and other baked sweets.
- Limiting dietary cholesterol to less than 200 milligrams per day. That's about the amount in one egg yolk, 10 ounces of lean sirloin, or 8 ounces of skinless chicken breast.
- Getting plenty of fiber, mainly from whole grains, fruit, vegetables, and beans. Oat bran, psyllium, and barley might be particularly effective, cutting LDL by 5 to 10 percent.
- Drinking moderately—if at all. One drink a day for women and two for men can raise a low HDL, but too much can be harmful or addictive.
- Consider fish oil. A prescription fish-oil capsule boosted HDL by 8 percent over eight weeks in one study. Aim for a weekly intake of about 2 grams of the omega-3 fatty acids in fish oil, which you can generally accomplish by eating two to three servings per week of wild or canned salmon, sardines, pollock, tilapia, or other fish that tend to be low in mercury. If you're not a fish eater—or to get more omega-3s—consider a supplement, preferably one labeled "USP Verified," which means it meets standards for purity and potency set by the U.S. Pharmacopeia, a nongovernmental authority.
Control your weight by cutting calories and exercising. You can lower your risk of heart disease by losing as little as 5 percent of your weight. And for about every 10 pounds of sustained weight loss, HDL climbs by 2 mg/dL.
Stay active even if you don't have to lose weight, since exercise can raise your HDL level by almost 25 percent and might help lower LDL as well.
Quit smoking. HDL levels are about 7 mg/dL lower in smokers than in nonsmokers. And kicking the habit protects your heart in other ways, too, making it probably the single most important thing you can do to protect your hear.