Ways to Lower LDL-Cholesterol
1) Weight Loss
2) Low Cholesterol Diet and Low Saturated Fat Diet
With low-cholesterol diets, the liver rapidly clears both LDL and VLDL, so LDL levels in the blood remain low .
In a study of 155 adults, replacing saturated fats with polyunsaturated fats for eight weeks reduced LDL by 10% .
Reducing saturated fat intake lowered LDL in children in a meta-analysis .
In a study of 8,433 people, a “healthy” diet was associated with lower LDL. This diet included high intake of whole grains, fruit, dairy, vegetables, and unsaturated oil, and low intake of fast food, sugary beverages, poultry, processed meat, and flavored rice .
3) Ketogenic Diet
4) High Monounsaturated Fat (MUFA) Diet
In a study (DB-RCT) of 22 healthy adults, consuming any of three high-MUFA diets (using either olive oil, peanut oil, or peanuts and peanut butter) lowered LDL by 14% on average. These diets also reduced LDL oxidation compared to a standard American diet [16, 17].
Consuming a moderate-MUFA diet (10% of calories from MUFAs) and high-MUFA diet (14% of calories from MUFAs) both lowered LDL in a study of 35 participants with high cholesterol. The high-MUFA diet produced the greatest benefits .
In a study of over 80,000 young adults, more days per week of either aerobic or strength exercise were associated with lower LDL .
A meta-analysis (of 51 studies and 4,700 adults) found that exercises such as jogging, running, and biking decreased LDL by 5% .
In a study of 20 overweight women, 12 weeks of combined aerobic and strength exercise reduced oxidized LDL .
6) Red Yeast Rice Extract
Red yeast rice is an Asian food and traditional medicine. Some red yeast rice products contain a chemical (monacolin K) identical to the active ingredient in a cholesterol-lowering drug (lovastatin) .
In a meta-analysis (6,663 patients), red yeast rice (3 – 24 mg/day) decreased LDL by an average of 39 mg/dL .
Red yeast rice is well-tolerated but is not approved by the FDA as a drug. More large-scale studies must confirm its safety and effectiveness .
Red yeast rice extract supplements contain a yeast toxin (citrinin) harmful to the liver and kidneys at high doses. Because companies rarely report the amount of citrinin in these products, users should be careful when purchasing red yeast rice supplements [24, 23].
7) Soluble Fiber
In a study of 30 adults, taking 3 grams of soluble fiber supplements daily for 12 weeks decreased LDL by 18% .
A meta-analysis showed that beta-glucan consumption of more than 3g/day reduces LDL by 8 mg/dL in people with high cholesterol .
In a meta-analysis of 21 studies and 1,717 people with high cholesterol, psyllium (3 – 20.4 g/day) reduced LDL by an average of 11 mg/dL .
In a study of 68 adults, adding 15 g of psyllium to cholesterol-lowering medication was as effective as taking more medication without psyllium .
10) Black and Green Tea
In a meta-analysis of 39 studies with 2,298 subjects with high cholesterol, consuming garlic for at least 2 months decreased LDL 9 mg/dL on average .
Most studies used garlic powder (600 – 5,600 mg/day), while some used garlic oil (9 – 18 mg/day), garlic extract (1000 – 7200 mg/day), and raw garlic (4 – 10g/day). Aged garlic extract had the strongest effects .
In a study of 40 older adults, daily consumption of a beverage made up of various berries lowered LDL .
In a study of 30 type 2 diabetes patients, cranberry extract lowered LDL .
Berries can also lower oxidized LDL. Frozen berries (bilberries, lingonberries, black currants) lowered oxidized LDL in a study of 60 healthy adults .
In a study of 21 healthy men, drinking cranberry juice daily for 2 weeks lowered oxidized LDL .
In a study of 58 diabetic patients, consuming 320 mg/day of anthocyanins for 24 weeks decreased LDL by 8% compared to placebo .
Anthocyanins did not lower LDL in studies of healthy participants .
14) Dark Chocolate
Consuming a diet high in cocoa powder and dark chocolate lowered oxidized LDL in a study of 23 healthy people .
15) Plant Sterols
The average effective dose is 1.6 g/day, with the largest effects at around 3 g/day .
Soy mildly reduced LDL (by 4.8 mg/dL) in a meta-analysis with 2,670 participants. Soy lowered LDL more effectively for those with high cholesterol than in healthy subjects. The average soy intake was 30 g/day .
In a study of 30 patients with high cholesterol, 500 mg of soy lecithin taken daily for 2 months lowered LDL by an impressive 56% .
19) Vitamin C
In a meta-analysis, eating 2 to 3 servings of nuts (including walnuts, almonds, macadamias, pistachios, hazelnuts, peanuts, and pecans) per day decreased LDL by an average of 10.2 mg/dL .
Eating half a cup of legumes per day reduced LDL cholesterol by an average of 6.6 mg/dL, according to a meta-analysis .
Glucomannan is another type of plant fiber extracted from the konjac root, also known as the elephant yam. It decreases LDL in adults and children, according to meta-analyses (of RCT studies) [64, 65, 66].
23) Coenzyme Q10
In a study of 100 healthy adults, taking 200 mg/day of coenzyme Q10 for 1 week removed cholesterol from immune cells (macrophages). This improves blood flow by shrinking the fatty plaques in the arteries .
As a supplement to standard therapy, 1 g/day of curcumin lowered LDL in a study (RCT) of 100 patients with high heart disease risk .
Because estrogen helps to lower LDL, the decline in estrogen levels after menopause makes older women prone to elevated LDL. In studies two studies conducted in postmenopausal women, estrogen replacement therapy lowered LDL 14-27% [72, 73].
In studies including 74 overweight adults, 27 participants with high cholesterol, and 57 patients with hardening of the arteries, grapefruit lowered LDL. In one of the studies, red grapefruit was more effective than white [74, 75, 76].
28) Black Cumin
Black cumin (Nigella sativa) lowered LDL by an average of 22 mg/dL according to a meta-analysis .
30) Artichoke Leaf Extract
Consuming artichoke leaf extract decreased LDL by 15 mg/dL, according to a meta-analysis (of 9 studies including 702 subjects, most of whom had high cholesterol). The only side effect was rare, mild stomach pain .
31) Rice Bran Oil
A meta-analysis showed that rice bran oil lowered LDL by 7 mg/dL on average in healthy participants and those with high cholesterol .
Spirulina consumption greatly reduced LDL — by 41 mg/dL on average — according to one meta-analysis. The Spirulina doses were between 1 – 10 g/day, taken for 2-12 months. Longer supplementation, but not dose, was linked with reduced LDL .
The bergamot orange is a citrus fruit from Italy. Bergamot extract (500 – 1500 mg/day) reduced LDL between 23% and 39% in a study of 237 patients with high cholesterol .
In a study of 80 people with high cholesterol, bergamot extract (150 mg/day) lowered LDL and harmful (small, dense) LDL particles .
34) Olive Oil
In a study of 25 healthy adults, adding 10 g of olive oil to a meal reduced LDL and oxidized LDL (compared to a meal with no olive oil or with corn oil) .
Consuming 50 g/day of olive oil for 4 weeks was associated with lower LDL compared to consuming the same amount of butter in a study of 91 older adults .
35) Fish and EPA
In another study of 36 patients with type 2 diabetes, taking EPA slightly reduced LDL .
36) Conjugated Linoleic Acid
37) Alpha-Lipoic Acid
In a study of 6 patients with polycystic ovary syndrome, taking 1.2 g/day of alpha-lipoic acid shifted LDL from smaller (more harmful) to larger (less harmful) particles .
40) African Mango
41) LDL Apheresis
A procedure called LDL apheresis removes LDL from the blood. It is an option for people who don’t respond to drugs and have very high cholesterol levels. LDL apheresis takes 2-4 hours and must be performed every few weeks .
LDL apheresis reduces LDL by more than 60% in patients with high cholesterol due to genetics (familial hypercholesterolemia) .
A study of 45 patients with high cholesterol resistant to drugs found that LDL apheresis lowered LDL by 56%. Quality of life improved in most patients .
In another study of 14 patients with high cholesterol, LDL apheresis was safe long-term (over 10 years), and lowered LDL by 82% on average .
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