Bad cholesterol not in range? Here’s how to lower it

Can a diet help?

Diet plays a crucial role in controlling bad cholesterol.

1. Focus on Heart-Healthy Fats: Unhealthy fats, such as saturated and trans fats, can raise LDL levels. Replace these with monounsaturated fats, which are found in olive oil, avocados and nuts like almonds and cashews. Go for polyunsaturated fats, found in fatty fish (like salmon and mackerel), flaxseeds, walnuts, and sunflower seeds.
2. Increase soluble fibre intake: Soluble fibre binds cholesterol in the digestive system and helps remove it before it enters the bloodstream. This is found in oats and barley, legumes, like lentils, chickpeas, and beans, fruits like apples, oranges, pears, or berries, and vegetables like Brussels sprouts, carrots and sweet potatoes.
3. Reduce refined carbohydrates: High sugar intake can decrease good cholesterol or high-density lipoprotein (HDL), which counters LDL. Opt for whole grains like quinoa, brown rice and whole wheat. No white bread, cakes and pastries. Practical steps for weight management include monitoring calorie intake meal to meal and focussing on nutrient-dense foods.
4. Incorporate plant sterols and stanols: These are compounds that prevent cholesterol absorption in the digestive tract and are found in orange, fruits, seeds and nuts.
5. Limit dietary cholesterol: While dietary cholesterol (from sources like eggs and shellfish) affects blood cholesterol minimally, those with sensitivity should moderate intake.

Which exercise routine works best?

Regular physical activity improves your cholesterol profile by lowering LDL and raising HDL.

Aerobic Exercises: Brisk walking, running, swimming, or cycling for at least 30 minutes, five times a week.
Strength Training: Twice a week to improve overall cardiovascular health and muscle mass.
Flexibility and Balance Exercises: Yoga or tai chi to enhance mobility, especially for older adults.
If you’re new to exercise, start with low-impact activities and gradually increase intensity. Excess weight can raise LDL while lowering HDL. Even losing 5-10 per cent of your body weight can result in noticeable cholesterol improvements.

Lifestyle modifications

Smoking damages blood vessels and lowers HDL cholesterol, allowing LDL to build up plaque. So quit it if you have high levels. Limit alcohol to very special occasions, two drinks per day for men, and one drink for women.

Chronic stress can negatively affect cholesterol by promoting unhealthy eating, physical inactivity, and higher cortisol levels. Include meditation, deep breathing exercises and hobbies in your daily routine.

Of course, lifestyle changes alone may not suffice, especially for individuals with genetic predisposition or severe cardiovascular risks. They will need medications like statins, which reduce cholesterol production in the liver, ezetimibe, which blocks cholesterol absorption in the intestine or PCSK9 inhibitors, which enhance the liver’s ability to remove LDL. But these need to be supported by a lifestyle discipline to meet your LDL control goals. Schedule lipid profile tests annually or more frequently if advised by your doctor.

(The author is Internal Medicine specialist at Indraprastha Apollo Hospitals, Delhi)

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