Can You Lower Cholesterol Without Medications Like Statins?

Someone holding a taco filled with black beans and avocado

Elevated cholesterol levels are associated with a greater risk of heart disease and stroke. But it is possible to manage your cholesterol. Some people may be able to lower cholesterol naturally without medication; others may require statins to help bring cholesterol levels back into the optimal range.

Here’s what you need to know about cholesterol-lowering medications like statins as well as lifestyle habits that can help naturally lower cholesterol.

First, what does it mean to lower cholesterol?

Cholesterol is a waxy, fat-like substance found in cells. It plays a vital role in digestive processes and helps produce hormones and vitamin D. The body makes all of the cholesterol you need. [1] While the body requires some cholesterol for normal processes, too much is unhealthy.

When people talk about high cholesterol, they’re usually referring to low-density lipoprotein (LDL) “bad” cholesterol, as this type increases your risk of heart attack, stroke, and other health issues. Below 100 mg/dL is considered optimal for LDL cholesterol. [2] High-density lipoprotein (HDL) “good” cholesterol is protective: it helps remove cholesterol from circulation to prevent damage to blood vessels. [3]

For most people, dietary cholesterol has minimal impact on blood cholesterol. Rather, serum cholesterol levels are influenced by saturated fat and the type and amount of carbohydrates you eat.

What are statins?

Statins are medications that manage and treat high cholesterol by lowering LDL, triglyceride, and total cholesterol levels and raising the concentration of HDL cholesterol. Statins inhibit the enzyme hydroxymethylglutaryl-CoA reductase (HMG-CoA), which decreases liver production of cholesterol, especially apoB-containing lipoproteins (ApoB) and encourages more LDL cholesterol to be removed from circulation and brought into the liver for excretion. [4]

When is statin use indicated?

As a prescription medication, statins are managed by a healthcare provider. And the decision to initiate statins should be made in consultation with a physician. When to start statins depends on many factors, such as the number of cardiovascular risk factors (diabetes, hypertension, dyslipidemia, or smoking) and the estimated 10-year risk of a cardiac event. [5,6]

For some people, it may be possible to reduce the dosage or discontinue statins through lifestyle modifications, such as diet and exercise. But statins are helpful and necessary for many people. For those at high risk or with a history of heart attacks or stroke, the American Heart Association discourages discontinuing statins, as these medications can reduce the risk of cardiac events by up to 50 percent. [7] Always consult your healthcare provider before making any changes to medications.

While statins are vital to ensure optimal heart health in people at high risk of cardiac events, lifestyle interventions may sufficiently lower cholesterol in some individuals with borderline high levels. And routine blood work allows you to monitor your cholesterol so you can enact changes before problems arise and track your progress toward heart health.

Natural ways to lower cholesterol

Certain dietary recommendations and participating in physical activity can help you naturally lower cholesterol levels or help maintain optimal cholesterol levels.

1. Avoid trans fats

Research shows that trans fats—found mainly in processed foods—raise LDL and total cholesterol levels while lowering HDL cholesterol. Guidelines recommend avoiding trans fats due to their association with an increased risk of developing cardiovascular disease. [8]

2. Limit saturated fat intake

A high saturated fat intake increases ApoB, LDL cholesterol, and total cholesterol concentrations. [9] And the Dietary Guidelines for Americans 2020-2025 recommends people reduce saturated fat— which is predominantly found in animal products and processed foods—to less than 10% of daily calories. [10]

3. Opt for monounsaturated and polyunsaturated fats

Monounsaturated fatty acids (MUFA) and polyunsaturated fatty acids (PUFA) are considered “healthy” fats because of their beneficial effects on cholesterol levels.

MUFAs are found in common food sources, such as olive oil, nuts, and avocados.

PUFAs encompass both omega-3 and omega-6 fatty acids. Sources of omega-3 include fatty fish (trout, herring, and salmon), walnuts, and flaxseed, while omega-6s abound in vegetable oils, such as soybean, corn, and safflower.

Swapping saturated fat for monounsaturated fat lowers LDL cholesterol. One study found MUFAs lowered LDL cholesterol in a dose-dependent manner: consuming 51% compared to 25% of fat intake in the form of monounsaturated fats more significantly reduced LDL cholesterol concentrations. [11] Another study found replacing saturated fat with MUFAs decreased total cholesterol by 12% and LDL cholesterol by 15%. [12]

Replacing saturated fat with polyunsaturated fat has an even more pronounced effect on cholesterol levels. In one study, swapping saturated fat for omega-6 PUFAs reduced total cholesterol by 19% and LDL cholesterol by 22%. [12] What’s more, choosing PUFAs instead of MUFAs can more significantly lower LDL cholesterol when replacing saturated fat. [13]

Despite the beneficial effects of unsaturated fats on cholesterol, it is still important to be mindful of portion size, as excessive intakes of calories—no matter the source—can contribute to changes in body composition and insulin resistance.

4. Increase soluble fiber intake

Soluble fiber is a non-digestible carbohydrate found in foods such as lentils, beans, oats, nuts, flaxseeds, and some fruits. You can lower your cholesterol naturally by increasing soluble fiber consumption. Soluble fiber binds to bile (a digestive juice made of cholesterol) and directs its removal from the body. So the liver takes more cholesterol out of circulation to form bile. This process results in reduced circulating levels of cholesterol. [14]

Pulses (beans, lentils, and peas) are a rich source of soluble fiber. Eating 1.5 cups of pulses per day lowered total cholesterol by 8.3% and LDL cholesterol levels by 7.9% compared to a regular diet. [15] And opting for pulses as a source of protein instead of animal meat not only lowers saturated fat intake but also increases soluble fiber—a double whammy for lowering cholesterol naturally.

Some forms of soluble fiber, like psyllium husk and beta-glucan, are even more effective at lowering cholesterol levels. These forms create a gel-like, viscous solution in the body that more aggressively traps cholesterol for removal.

Psyllium husk lowers apoB, LDL, and total cholesterol levels. Aim for two, five-gram servings of psyllium husk daily to help reduce cholesterol levels. [14,16,17]

In one randomized control trial of healthy people, consuming three grams per day of beta-glucans (abundant in oats) resulted in a 15.1% decrease in LDL cholesterol levels and an 8.9% reduction in total cholesterol concentration after 8 weeks of supplementation. [18] Another study found consuming 50-100 grams of oats (the equivalent of ½-1 cup of oatmeal) daily lowered total and LDL cholesterol in people with type 2 diabetes. [19]

5. Exercise can help lower cholesterol

Yoga: Practicing yoga can lower LDL and total cholesterol concentrations and triglyceride levels. [20,21]
High-intensity interval training (HIIT): Squeezing in a HIIT workout when you’re short on time can significantly benefit cholesterol health. Just 55 minutes of HIIT per week can lower triglycerides and total and LDL cholesterols, increase HDL cholesterol, and improve VO_2max (a marker of cardiovascular health). [22] And progressing from moderate-intensity workouts to a HIIT routine can result in continued or more significant reductions in LDL cholesterol and increases in HDL cholesterol. [23]
Moderate-intensity aerobic exercise: Participating in moderate-intensity aerobic exercise for an average of 40 to 60 minutes three times a week can increase HDL concentrations and decrease total and LDL cholesterol. [24,25]

6. Certain supplements may help lower cholesterol

Sometimes supplements may provide a boost to help you naturally lower cholesterol levels. Any time you add a supplement to your regimen and especially if you’re already on medication, it’s important to talk with a healthcare provider to ensure there are no potential interactions.

But before starting a new supplement, it’s always best to consult your healthcare provider to see whether it will be safe and effective for you.

Alpha-lipoic acid (ALA): ALA is a short-chain fatty acid produced in the body and found in some foods. It’s involved in lipid metabolism and acts as an antioxidant. Supplementing with ALA can decrease triglyceride, total cholesterol, and LDL cholesterol in people with elevated lipid profiles. [26]
Garlic powder: One meta-analysis found that garlic supplementation decreased total and LDL cholesterol by an average of 15 mg/dL and 8 mg/dL. [27] However, another study in people with elevated cholesterol levels found supplementing with garlic increased HDL cholesterol by 10 mg/dL. [28]
Plant sterols/phytosterols: Because of their similar molecular structures, plant sterols and cholesterol compete for absorption. So consuming sufficient amounts of plant sterols—naturally abundant in plants and added to many foods—can reduce cholesterol absorption. One meta-analysis found consuming one and a half to three grams a day of plant sterol decreased LDL cholesterol by an average of 12 mg/dL. But a dose of two grams daily may be most effective to lower cholesterol. [29]

Key takeaways:

Statins and cholesterol-lowering medications may be necessary for some people to lower cholesterol, and continued use is needed to maintain healthy levels and reduce the risk of cardiovascular complications.
Certain lifestyle factors can help to naturally lower elevated cholesterol levels and support heart health
Trans fat and saturated fat significantly affect blood cholesterol levels. Guidelines recommend avoiding trans fat and limiting saturated fat to less than 10% of total daily caloric intake.
Dietary modifications—such as opting for polyunsaturated and monounsaturated fats and increasing soluble fiber—can help lower cholesterol levels naturally and encourage greater overall health.
Exercise helps naturally raise HDL and lower LDL and total cholesterol concentrations.

References:

[1] https://medlineplus.gov/cholesterol.html

[2] https://www.ahajournals.org/doi/10.1161/CIR.0000000000000625

[3] https://www.nhlbi.nih.gov/health/blood-cholesterol

[4] https://www.ncbi.nlm.nih.gov/books/NBK430940/

[5]https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/statin-use-in-adults-preventive-medication

[6] https://www.ahajournals.org/doi/10.1161/CIR.0000000000000625#d1e757

[7] https://www.ahajournals.org/doi/10.1161/jaha.115.002497

[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7231579/

[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5293238/

[10]https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf

[11] https://academic.oup.com/ajcn/article/78/1/47/4689896?login=false