Cholesterol-lowering methods


What are the best cholesterol-lowering methods? My doctor says I should try slow niacin, which is available over the counter. What does the research say?

— Saturated

Dear Saturated,

While cholesterol plays a key role in the body, too much of it can lead to serious health problems. While research indicates that niacin may be helpful at reducing cholesterol — or at least not harmful when taken in appropriate doses — there are more effective ways to lower cholesterol that have been clinically proven to work. Also, when niacin is consumed in high doses, it can cause side effects and other health concerns. So, if you’re interested in taking a niacin supplement, consider talking to your health care provider for specific dosage information and advice. The good news is that high cholesterol can be reduced through diet, exercise, and prescription medications.

One of the primary risk factors for high cholesterol is being overweight or obese. A well-balanced diet can make a significant impact on your cholesterol levels. Consider following these general guidelines to reduce cholesterol intake:

  • Make sure that no more than 35 percent of your daily calorie intake comes from fat sources, including saturated, monosaturated, polyunsaturated, and trans fats.
  • Consume less than 200 mg of cholesterol per day.
  • Eat less saturated fat, the primary culprit of excess LDL cholesterol.
  • Avoid transfats, which reduce your “good” HDL cholesterol levels.
  • Eat lots of soluble fiber, which helps to reduce cholesterol absorption. Whole grains, fruits (apples, bananas, oranges, pears, prunes), and legumes (kidney beans, chickpeas, lentils) are all good sources.
  • Reduce salt intake; avoid salty foods and try to stay under 2,300 mg per day (1,500 mg per day if you’re 51 or older and/or have high blood pressure).
  • Limit alcohol consumption to two drinks per day for men or one drink per day for women.

Stress is also a primary risk factor for high cholesterol. To complement a balanced diet and let off some steam, consider walking, yoga, tai chi, or other forms of physical activity to reduce stress. If improved diet and exercise aren’t enough to reduce your cholesterol, your health care professional may suggest prescription medication. The most common medications are statins, bile acid sequestrants, nicotinic acid, fibrates, and ezetimibe. All of these medicines have side effects, so it is a good idea to discuss them beforehand with your health care professional. 

Other risk factors for high cholesterol include:

  • Cigarette smoking
  • High blood pressure
  • Family history of heart disease
  • Age (men 45 years or older; women 55 years or older)
  • Gender (high cholesterol is more common among men than women)

I hope this helps you as you work to lower your cholesterol!

Last updated Nov 26, 2014
Originally published Sep 05, 1995

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