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What's This Cholesterol Biz??

Cholesterol is a fat-like substance that has a lot of important roles in the body. In other words, we need it.

But when you have too much cholesterol, the lipoproteins carrying it can get caught in the artery walls, combining with calcium, fat, cellular waste, and fibrin (a material involved in blood clotting) to form the plaques that cause clogs.

It’s important to know that high cholesterol isn’t just one thing: You could have high total cholesterol, high LDL (“bad”) cholesterol, and/or high triglycerides (another measure of fat in the blood).

So, why’s it high? Well, sometimes high cholesterol is genetic. Other times it’s from eating too much saturated fat (from animal foods) and not enough plants.

What your diagnosis means

A basic cholesterol test usually includes a lipid profile, and has a few key components.

1. Lipoprotein cholesterol

Lipoproteins transport cholesterol around the body (basically, imagine passengers riding an inner tube in a water ride, and you get the idea).

A typical test includes:

  • Low-density lipoprotein (LDL) cholesterol, aka “bad cholesterol”. In general, you want the number of these to be lower.

  • High-density lipoprotein (HDL) cholesterol, aka “good cholesterol”. These bring cholesterol back to the liver for recycling and processing. Higher numbers here are usually good.

2. Triglycerides

Another type of fat in the bloodstream, triglycerides are also linked to heart disease. They are stored in fat cells throughout the body. Usually, you want these to be lower.

3. Total cholesterol

This is the total level of cholesterol in your blood.

Cholesterol tends to go up with age, but it doesn’t have to. Many populations, especially in regions that still eat traditional diets, have good blood chemistry throughout their lives.

The good news: Research shows that lowering your cholesterol sooner rather than later can curb your risk of cardiovascular disease.

(For more on understanding your lab tests, see

What you can do about it

Statin drugs and other blood lipid lowering chemicals are often seen as a quick fix.

Yet these drugs can come with side effects like memory loss, difficulty concentrating, lowered exercise tolerance, muscle pain, and depression — which, ironically, make it pretty tough to prioritize lifestyle changes that could turn your health around.

While these meds may be needed in many cases, revamping your diet can be a powerful supplementary — or even alternative — treatment.

If your LDL cholesterol level is between 160 and 190 and you don’t have heart disease, diabetes, or other risk factors, Dr. Nadolsky says, ask your doc about lifestyle changes you can make before going on meds.

If your LDL level is above 190, most doctors will insist on a prescription — unless they can trace your levels to an obvious diet choice (for example, more than one of Dr. Nadolsky’s patients have seen cholesterol go down when they rein in their Bulletproof Coffee habit).

Using these lifestyle strategies can help you avoid meds (or reduce the amount of time you’re on them).


When body fat goes down, cholesterol and especially triglycerides go down.

So if you’re overweight, consider changing your habits to get to a healthy weight. (Luckily, most people see benefits from even a little weight loss, perhaps just a few pounds. You don’t have to become an underwear model to be healthy.)

Dr. Nadolsky says a diet based heavily on plants is a good bet.

This will help you:

  • lower your saturated fat intake, which alone can help lower cholesterol (the biggest saturated fat culprits: processed foods and animal products); and

  • get more vitamins, minerals, phytonutrients and healthy fats, which have their own positive effect.

You don’t have to give up meat completely. Just add more plants.

Some ways to get there:

  • Add one serving of vegetables and/or fruits to each meal. Look for colorful plants (such as dark leafy greens, orange carrots, or purple berries), and add a handful or two to each meal.

  • Look for whole grain substitutes where possible. Think wild or brown rice instead of white; sprouted bread instead of white bread; or oats instead of your regular breakfast cereal. Adding these whole grains may lower your risk of clogged arteries by 30 percent.

  • Add a serving of legumes. Foods like beans, lentils, and chickpeas not only taste good; they’re high in fiber, which binds to cholesterol in the digestive tract.

  • Add nuts, seeds, fatty fish (such as salmon), avocado, and olive oil. They contain healthy fats, which lower LDL and raise HDL (“good” cholesterol).

If you have high triglycerides, try lowering your sugar intake. Since your liver uses sugar to make triglycerides, less sugar means less excess blood fat.


Working out — especially a combo of cardio and resistance work — helps lower cholesterol by:

  • helping you lose body fat (remember: less body fat equals less blood fat);

  • changing certain enzymes that can decrease your triglycerides; and

  • helping lower stress (which also contributes to poor cholesterol profiles and CVD).

If possible, do a little something every day. Even a 20-minute walk after a meal can tidy up triglycerides.

Work up to about 5 hours a week, and try to do a mix of low- and high-intensity activity, including weights, intervals, and low-intensity cardio. All activity — whether in the gym or not — counts!


Each of these supplements could independently play a role in helping manage cholesterol levels. (Which means you don’t have to take all of them to see benefits). Of course, always talk to your doctor before taking supplements for a medical condition.

  • Fish oil: Omega-3 fatty acids from fish may lower triglycerides by as much as 30 percent. Dosage: approximately 4 g per day.

  • Berberine: This plant alkaloid may help lower cholesterol by upregulating LDL receptors on the liver, thereby decreasing the LDL in your bloodstream. Dosage: 500 mg 2-3 times a day.

  • Spirulina: A type of blue algae, research shows that spirulina may help reduce LDL cholesterol and triglycerides by 10 percent and 24 percent respectively. Dosage: 4,500 mg per day.

  • Red rice yeast extract: It contains the same ingredient found in statin drugs — so should be taken only under your doctor’s supervision. Dosage: 600 to 1200 mg twice a day with food.

  • Plant sterols/stanols: These may be effective at blocking cholesterol absorption. Dosage: 2 g per day.

  • Soluble fiber: It can help lower cholesterol by trapping cholesterol in the gut and reducing absorption. Dosage: 5-10 grams daily.

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