High cholesterol is a common issue linked to heart disease, high blood pressure, and diabetes. If your doctor says your cholesterol is "borderline," it means your levels are close to unhealthy and need improvement. Here’s how you can address this without medication.
What Is Cholesterol?
Cholesterol is essential for your body to:
- Maintain cell membranes.
- Produce hormones.
- Support metabolism.
- Generate vitamin D.
There are two main types of cholesterol:
- HDL (High-Density Lipoprotein): The "good" cholesterol that helps transport excess cholesterol to the liver for processing. If you don’t have enough HDL you will have too much cholesterol in your blood which can lead to heart disease.
- LDL (Low-Density Lipoprotein): The "bad" cholesterol that contributes to plaque buildup in arteries, leading to heart disease.
Healthy Cholesterol Levels
Here are the target ranges for healthy cholesterol:
- Total Cholesterol: Less than 150 mg/dL
- LDL Cholesterol: 100 mg/dL or less
- HDL Cholesterol: At least 40 mg/dL for men and 50 mg/dL for women
- Triglycerides: Less than 150 mg/dL
To improve cholesterol:
- Lower LDL first.
- Raise HDL.
- Reduce triglycerides.
Diet and Exercise: Your First Steps
1. Diet:
Focus on:
- Fruits and vegetables: Rich in fiber, plant sterols, and phytonutrients.
- Healthy fats: Eat more polyunsaturated and monounsaturated fats which are found in fatty fish, seeds, nuts, avocados, soybeans, and plant-based oils. These help to lower LDL.
2. Exercise:
While moderate exercise doesn’t dramatically lower LDL, it increases HDL and supports overall health. To actually decrease LDL you need to focus on more intense activity. Of course, any exercise will improve other health indicators such as general fitness, body composition and blood pressure.
Exercise Recommendations
- Starting with 30+ minutes of moderate exercise, 5 times a week.
- Combine moderate intensity aerobic and moderate to high intensity resistance training for best results.
To read more about exercise and cholesterol click on the link below:
Supplements and Cholesterol Management
Fiber:
- Each gram lowers LDL by ~2 mg/dL.
- Add fiber slowly to prevent gas and bloating.
- Increasing dietary fiber should be the first supplement considered.
Plant Sterols and Stanols:
- Found in cereals, nuts, fruits, vegetables, and fortified spreads like "Smart Balance."
Niacin:
- Lowers LDL by 15–20%.
- Start with 500 mg/day, gradually increasing to 2,000 mg/day.
- Can cause uncomfortable flushing in up to 50% of people; take with food and aspirin to minimize this. Avoid “No-Flush” niacin supplements, they do not have the same cholesterol lowering effects and may cause liver damage.
Red Yeast Rice:
- Contains natural statin-like compounds (monacolin K) that are the same as the prescription drug lovastatin and can lower LDL by 20–30%.
- Use products with verified monacolin content, remember that dietary supplements are not regulated by the FDA the same way as prescription medications.
Fish Oil:
- Helps with triglycerides and inflammation but not LDL.
- Dose: 4,000 mg/day (usually 2 capsules twice daily). Start with a low dose and build up slowly to avoid gastrointestinal side effects.
Other Supplements:
- CoQ10: Reduces muscle pain from statins (100 mg/day).
- Vitamin D: Supports cardiovascular health (blood levels >40 ng/mL recommended, have your levels checked before adding a supplement).
- Folate Foods high in folate (like leafy greens) are beneficial but supplements have not been proven useful in lowering the risk of heart attacks.
- Vitamin E: There is no evidence supporting the use of the supplement to decrease cholesterol.
Spices and Herbal Remedies:
Some spices may help lower cholesterol:
- Fenugreek, garlic, caraway seeds, cayenne pepper, turmeric, ginger, and rosemary.
- Results from supplements containing these spices show mixed results.
- Add to recipes for flavor and to support a heart healthy diet.
Two notable herbal products:
- Berberine: “Nature’s Ozempic” Somewhat effective in improving LDL clearance by the liver and lowering blood sugar levels, particularly in patients with Type 2 diabetes. The recommended dose is 500 mg, 3 times daily.
- Digestive bitters: Taken before meals to enhance digestion by stimulating the body to release the hormones that help you feel full and decrease indigestion and gas. Bitters stimulate bile production which helps the breakdown of fats and decreases the amount of cholesterol going into the bloodstream.
The Role of Prescription Medications
Statins can lower LDL by more than 50% and reduce the risk of heart disease by one-third. Common side effects like muscle pain (myalgia) can often be managed by adjusting the dose or switching medications.
Summary
If you have borderline high cholesterol:
- Start with diet and exercise.
- Consider supplements and natural remedies.
- Consult your doctor about medications if necessary.
Maintaining optimal cholesterol levels is vital for long-term health. Small lifestyle changes can make a big difference. I am able to help with exercise, diet and finding effective supplements to lower cholesterol. Give me a call today!
Linda Valazza RPh, CPT-NASM
732-241-2001