High LDL cholesterol levels (“bad cholesterol”), low HDL cholesterol levels (“good cholesterol”), and high triglyceride levels are now recognized as being major risk factors for cardiovascular disease. And for decades, cardiologists and public health experts have stressed the importance of controlling blood lipid levels in an attempt to prevent heart disease.
A number of prescription drugs are available to help reduce LDL cholesterol and triglyceride levels. However, many health-conscious people would prefer to improve their lipid levels without resorting to prescription medications. This article provides information about some of the more commonly used non-prescription methods of lowering cholesterol.
Before doing so, however, there are a few things you should know about cholesterol-lowering and its effect on cardiovascular risk.
Anyone who already has coronary artery disease, or has had a stroke or diabetes or other risk factors that place them at very high risk for cardiovascular disease, should strongly consider prescription therapy. If you are in this category, then taking supplements, even if they are effective in improving your lipid levels, may not be enough.3
If you are basically healthy, and a formal assessment of your cardiovascular risk places you in a low-risk group—or at least shows that your risk is not high enough to warrant statin therapy—then non-prescription cholesterol lowering makes good sense.
So let’s review some of the commonly used non-prescription means of lowering cholesterol.
Lifestyle, Lifestyle, Lifestyle
Whoever we are, and whatever our level of cardiovascular risk, the best way to avoid heart disease and stroke is to adopt a healthy lifestyle. A sedentary lifestyle, especially if accompanied by a poor diet, being overweight, and/or smoking, not only causes elevated blood lipid levels, but also produces an extremely toxic overall lipid and glucose metabolism that actively stimulates atherosclerosis.
Getting plenty of exercise, controlling your weight, eating a heart-healthy diet, not smoking, and treating hypertension and diabetes (if present) are essential steps not only in improving your cholesterol levels but more importantly, in reducing your cardiovascular risk. Anything else you may do—whether it involves prescription medication, supplements, or even invasive therapy—cannot be expected to have very much benefit unless you also get your lifestyle in order.
Supplements for Cholesterol and Triglycerides
Numerous dietary supplements have been claimed to improve cholesterol or triglyceride levels. Relatively few of these claims have actually been evaluated in legitimate scientific studies. The most commonly used supplements that have been studied include:
Fish oil and omega-3 fatty acids: Concentrates of fish oil containing high levels of omega-3 fatty acids can significantly reduce triglyceride levels, and are sometimes prescribed for people whose triglyceride levels are exceedingly high. However, neither fish oil nor omega-3 fatty acids have been shown to substantially improve cholesterol levels.
Plant sterols: Plant sterols are chemically similar to cholesterol, and when ingested appear to reduce cholesterol absorption from the intestines. However, the absorbed plant sterols themselves may increase the risk of atherosclerosis and other cardiac problems. The American Heart Association now recommends that plant sterol supplements not be used routinely by the general population.
Soy: In recent studies soy protein has shown to reduce LDL cholesterol.
Soluble fibers: Soluble fibers, found in foods such as whole grain oats, psyllium, and broccoli, can reduce blood cholesterol levels. Foods that contain soluble fibers tend to have other important health benefits, and ought to be included in the diet regardless of any effect on blood lipids.
Nuts: A variety of clinical studies have shown that eating nuts can reduce blood cholesterol and triglyceride levels, and can contribute to reduced cardiovascular risk.
Green tea: Studies have shown that drinking green tea may reduce LDL cholesterol levels. This cholesterol-lowering effect has been difficult to demonstrate with other kinds of tea.
Red yeast rice: a form of fermented rice that contains statin-like compounds called monacolins. Red yeast rice that has monacolins can, like statins, reduce LDL cholesterol levels. Natural Red Yeast rice powder and capsules are still available, but now on prescription only.
Policosanol: a product made from sugar cane was, was once popular as a cholesterol-lowering agent. But a large, well-designed randomized clinical trial has shown that policosanol actually has no effect on blood lipid levels. There seems to be no good reason to spend your money on it.
Artichoke Leaf extract: Artichokes are a delicious accompaniment to many dishes, and its leaves have been traditionally used to treat ailments like jaundice, acid reflux, and various liver disorders. There is research, however, to support the use of artichoke leaf extract to treat indigestion and high cholesterol with studies about cholesterol gaining interest. The manner by which artichokes lower cholesterol is not fully known. It is thought that artichokes may indirectly interact with the same protein that statins interact with to lower cholesterol. Called HMG-CoA reductase, this enzyme plays an important role in the making of cholesterol.
Artichokes also contain antioxidants, such as flavonoids. These chemicals are also in a variety of other, colorful vegetables and fruits and are thought to play a role in lowering the risk of atherosclerosis.
Berberine: The studies examining the use of berberine to lower cholesterol appear promising, however, more research is needed before it can be included as a recommended cholesterol-lowering agent.
Berberine by itself is difficult to find as a supplement to take to lower your lipids. However, many herbal supplements and plants are commercially available that contain higher amounts of berberine, including:
Goldenseal root (Hydrastis canadensis L) and Barberry (Berberis vulgaris) extracts.
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