Ways to Lower Cholesterol

Dietary fiber

Pros: Dietary fiber—found in beans, fruits, and other foods—binds to cholesterol, lowering LDL levels by about 5%, Dr. Pearson says. "It fills you up and often doesn't have a lot of empty calories in it," he adds. "It could be called a modest addition to the therapeutic regimen." It's also cheap and easy, available at grocery stores.

Cons: Despite its availability, Americans seem to have a hard time getting enough fiber. Experts recommend 25 to 35 grams a day, yet most adults get only about 12 grams.

Exercise

Pros: Exercise is a great way to raise HDL. People who have had a heart attack can reduce their death risk by 25% with exercise compared with usual care, Dr. Pearson says. "Physical activity is an amazingly important behavior," he says. "You could argue that it's an absolutely essential part of either community or therapeutic regimens."

Cons: Exercise requires more effort than popping a pill, and communities often aren't set up to make it easier. "There's no place to walk; it's unsafe; you may get run over; there are crime issues," Dr. Pearson says. "We need to engineer our environments better."

Red yeast rice

Pros: This dietary supplement is derived from a fungus that grows in rice and contains small amounts of lovastatin (Mevacor). It can be effective in people who can't take statins, says Jacob Warman, MD, chief of endocrinology at the Brooklyn Hospital Center, in New York City. Although different people see different benefits, he says, "it always works to some extent."

Cons: Dietary supplements aren't tightly regulated in the United States the way drugs are, so there can be confusion about concentrations and proper dosages. A 2008 study found a 100-fold difference between the highest and lowest levels of monacolin among various supplement brands tested.

Low-fat diet

Pros: Choosing healthy food such as fish and veggies over red meat and french fries is relatively straightforward, and Dr. Warman estimates it could lower cholesterol by up to 20% in some people. Societies with low-fat diets, such as Japan and parts of the Caribbean, have lower levels of heart attack and stroke.

Cons: Much like exercise, it can be hard to eat a healthy diet consistently. Some people have to go all out—adopting a vegan diet free of animal products, for example—before they see any difference, Dr. Warman says. Diet changes may not be enough to trump genetics, so don't hesitate to switch strategies if your cholesterol won't budge.

 

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