A medical professional has shared advice on how to reduce cholesterol levels without resorting to statins, in response to a patient who was struggling with the medication's side effects. The individual asked: "I have high cholesterol, but when I tried statins, I didn't like the side effects. What are non-pharmaceutical ways to lower my cholesterol?".

The NHS explains that high cholesterol is primarily caused by consuming fatty foods, lack of exercise, being overweight, smoking and drinking alcohol, and it can also be hereditary. It advises that cholesterol levels can be lowered through a healthy diet and regular physical activity, although some individuals may require medication such as statins.

The health service further warns: "Too much cholesterol can block your blood vessels. It makes you more likely to have heart problems or a stroke. High cholesterol does not usually cause symptoms. You can only find out if you have it from a blood test." In an article published in the New York Times, Dr Frank Hu, a professor of nutrition and epidemiology at the Harvard T. H. Chan School of Public Health, suggested lifestyle changes as an alternative to medication. He explained: " When we exercise, HDL cholesterol is released into the bloodstream, where it sweeps up fatty plaque deposits in the blood vessels and transports them to the liver for disposal."

Cardiac specialist Dr. Roberto Lobelo has emphasised the importance of regular exercise, telling Brits: "The AHA (American Heart Association) recommends that all adults get at least 150 minutes of moderate exercise, or 75 minutes of vigorous exercise, per week. That can include walking, swimming, lifting weights, dancing or whatever else you enjoy and can do without injury.

"The key is to ensure that your heart rate is elevated enough. If you're struggling to keep up your end of a conversation while you're exercising, that's how you know you're working hard enough."

Nutritional advice backed by experts pinpoints the role of the portfolio diet — incorporating soy products like tofu, plant proteins such as beans, lentils, chickpeas; viscous-fibre foods like oats, barley, psyllium husk, berries, apples, citrus fruits; together with nuts, seeds, avocado and certain plant oils, notably canola and olive oil — as an effective method for cholesterol management. Andrea Glenn, a nutrition researcher from New York University, outlined its benefits, revealing that clinical trials have demonstrated this diet can reduce LDL cholesterol levels by as much as 30 per cent, equating to the impact some older statins had in the '90s.

Dr Glenn and her team tracked approximately 210,000 American adults over a span of 30 years in a study published in 2023. The research revealed that those who adhered closely to this diet had a 14% lower risk of cardiovascular disease compared to those who consumed less of these foods, according to Dr Glenn.

The portfolio diet is effective because it amalgamates various types of food and nutrients that aid in reducing cholesterol in different ways, she explained. Plant proteins such as beans, chickpeas, and soy products can hinder the production of apolipoprotein B, which typically assists your body in absorbing cholesterol from food. Viscous fibre traps or binds cholesterol in the intestines, making it more difficult to absorb.

Moreover, nuts are rich in unsaturated fatty acids, plant sterols, and fibre, all of which can decrease LDL cholesterol levels. Even minor changes like adding nuts to your morning granola or replacing red meat with chickpeas or tofu can enhance your cholesterol levels, Dr Glenn suggested.

"There's certainly no magic bullet," stated Dr Hu. However, he emphasised that diet, exercise, and other healthy habits can significantly contribute to lowering cholesterol. We have to think about it from a holistic point of view."

NHS advice on lowering cholesterol:

Eat less fatty food

To reduce your cholesterol, try to cut down on fatty food, especially food that contains a type of fat called saturated fat.

You can still have foods that contain a healthier type of fat called unsaturated fat.

Check labels on food to see what type of fat it has in it.

Try to eat more:

  • oily fish, like mackerel and salmon
  • olive oil, rapeseed oil and spreads made from these oils
  • brown rice, wholegrain bread and wholewheat pasta
  • nuts and seeds
  • fruits and vegetables

Try to eat less:

  • meat pies, sausages and fatty meat
  • butter, lard and ghee
  • cream and hard cheese, like cheddar
  • cakes and biscuits
  • food that contains coconut oil or palm oil

Exercise more

Aim to do at least 150 minutes (2.5 hours) of exercise a week.

Some good things to try when starting out include:

  • walking – try to walk fast enough so your heart starts beating faster
  • swimming
  • cycling

Try a few different exercises to find something you like doing. You're more likely to keep doing it if you enjoy it.

More information here.