Learn practical ways to lower cholesterol without dieting.

A Few Words on the Non-Diet Approach

Whether you are working on lowering cholesterol or not, a non-diet approach can be helpful. As a Non-Diet Dietitian my take on helping people care for themselves and support health differs from the traditional role many think a dietitian serves. So much of the advice on nutrition centers around weight loss as the first line of defense for any and all conditions and restriction, avoidance, and deprivation as treatment – at all costs.

Whether it is for general health improvement purposes or to treat specific diagnoses and irregular lab values, weight loss and restriction are usually what is recommended. The emphasis on weight and dieting is an old-fashioned approach that does more harm than good. This approach isn’t sustainable for most. Ironically, it often prevents people from embracing and sustaining health-enhancing changes.

It is for that reason that I am starting a series of blogs that I plan to post periodically to address some chronic health conditions and irregular lab results such as diabetes/insulin resistance, heart disease, high blood pressure, and MASLD, aka fatty liver disease, from a non-diet approach. There are so many ways evidence-based ways that we can support our health through food, movement, and other lifestyle choices that do not center around weight. My approach focuses on positive nutrition and making sustainable lifestyle changes rather than weight loss and restriction as the answer.

First Up in the Non-Diet Series…Cholesterol

TL;DR Summary:

• Small, sustainable lifestyle changes that include more fiber, healthy fats, and movement without dieting or restriction can be a first line of defense in lowering cholesterol.
• Reducing stress, improving sleep, and minimizing alcohol intake can further support overall heart health and cholesterol management.
• A couple of supplements are evidence-based and can be helpful…plant stanol and sterol supplement, CholestOff Plus and HPF Cholestene a red yeast rice supplement. Take with meals.

I have had countless clients come to see me with recent labwork indicating high cholesterol. I also have friends in my age bracket who have recently been diagnosed with high cholesterol. Nearly all of them in response want to know what they should NOT eat in order to bring their cholesterol down. What if instead there are things we could add to help us manage our cholesterol? (Spoiler: there are!)

High cholesterol is fairly common. Especially as we age, it’s common for cholesterol levels to rise, which can be worrisome and lead us down the google rabbit hole which can be rife with misinformation. That’s why I decided to address this topic first.

In this blog I will provide clear, evidence-backed answers to common questions about cholesterol AND practical strategies to empower you in managing your cholesterol levels through lifestyle and nutrition changes.

What is Cholesterol?

Cholesterol is a waxy substance found in your blood and cells. Cholesterol isn’t all bad, in fact, your body needs it to build cells and make vitamins and other hormones. But too much cholesterol can potentially pose a problem.

Cholesterol comes from two sources. Your liver makes cholesterol and the remainder of the cholesterol comes from foods containing saturated and trans fats. These types of fat can increase the cholesterol in your body.

Why Cholesterol Matters?   

As cholesterol levels creep out of the ideal range our risk for heart disease and stroke goes up. Our cholesterol levels aren’t always completely under our control though. The reality is that increased cholesterol can be genetic or happen for other reasons outside of our control such as hormonal changes. In these cases, our behaviors and habits may have less of an impact on lowering it.

Even still, it is important to do what we can to support our health and cholesterol. Things like quitting smoking, incorporating joyful movement, boosting cholesterol lowering foods, as well as being mindful of stress, sleep, and alcohol intake are all factors worth focusing on.

How Cholesterol is Measured?

Cholesterol levels are assessed using a lipid panel, a blood test that measures the amount of fat molecules, called lipids, in your blood. Typical markers included in a lipid panel are :

• Total cholesterol – measures the overall amount of cholesterol in the blood.
• LDL cholesterol – often called “bad” cholesterol because increased amounts can contribute to plaque buildup in the arteries.
• HDL cholesterol – often called “good” cholesterol because high levels can remove cholesterol from arteries.
• Apolipoprotein B (ApoB) – not usually included in a standard lipid panel, but can also be measured – ApoB is a protein found in LDL particles and higher levels indicate increased risk of heart disease.

Cholesterol in Midlife

The menopause transition has become a special area of interest for me, so I wanted to share the connection with cholesterol.

It is not uncommon for women who have consistently maintained good cholesterol to experience a sudden increase during the menopause transition. This can be scary and lead to strict dieting and needlessly cutting out certain foods. It can help to understand why these changes may be happening.

The shifts in cholesterol levels are often related to hormonal changes, particularly the decline in estrogen. As menopause approaches, the levels of estrogen, an essential female hormone, start to drop. This drop is a normal and natural part of the menopausal transition.

Unfortunately, though, estrogen has a protective effect on cholesterol and heart health and is helpful in regulating and maintaining both HDL and LDL levels. As estrogen levels fall during menopause, LDL, often referred to as the “bad” kind of cholesterol can rise, and HDL (“good”) cholesterol may decrease. This shift in cholesterol levels can lead to an increased risk of heart disease, a known concern for postmenopausal women.

The good news is that all the recommendations listed below can help. Also having an open conversation with your doctor about menopausal hormone therapy can be an option. While it’s not officially recommended solely as a cholesterol treatment, many women who take it to help manage other symptoms of menopause like hot flushes, night sweats, anxiety and low mood also experience an improvement in cholesterol levels.  

(I am currently working through a Menopause Certification Training in order to help support women in managing and navigating this phase of life. I love being able to support women in better understanding their bodies and can’t wait to share more in the future.)

Now that you know the basics on cholesterol, let’s get to some evidence-based things you can do to help you manage your levels and improve your health!

3 Nutrition & Lifestyle Strategies for Managing Cholesterol

#1 Elevate Your Nutrition with Fiber Rich Foods

While protein seems to be the “it” nutrient, fiber is really the nutrition superstar. Eating more of it, especially soluble fiber, can help reduce LDL cholesterol by making it harder for your body to absorb dietary cholesterol. Soluble fiber is found in foods like oats, beans and peas and fruits and vegetables. Fruits and veggies particularly high in cholesterol lowering fiber include Brussels sprouts, sweet potatoes, carrots, broccoli, apples, bananas, and avocados. Incorporating more soluble fiber might look like…

• Start your day with a bowl of oatmeal or high fiber cereal. (You could even try mixing a high fiber cereal with your current favorite cereal)
• Incorporate beans, lentils, and peas into your meals. They make a great addition to a salad or bowl.
• Up your intake of fruits and vegetables high in soluble fiber. Add a banana to cereal or oatmeal in the morning or eat it as a snack. Add sliced avocado to a sandwich or keep cut up and washed veggies ready for when you are feeling snacky.

#2 Embrace Healthy Fats:

Certain types of fat are beneficial for heart health and including more of them can help improve cholesterol levels. Trading out foods high in saturated fats (like red meat, bacon and sausage, cheese, and full-fat dairy) for heart-healthy mono and polyunsaturated fats instead can help. Instead of focusing on what you can’t or shouldn’t eat, try thinking about what you can add in. These are some of the foods to include more of…

• Nuts and Seeds: Snack on a handful of almonds, walnuts, chia seeds, or flaxseeds or add some to oatmeal, cereal, and salads. They are packed with healthy fats and can help reduce LDL cholesterol.
• Olive Oil: Use extra-virgin olive oil for cooking or as a salad dressing. It’s a great source of monounsaturated fats.
• Fatty Fish: Fatty fish such as salmon, tuna, trout, and mackerel contain omega-3s, polyunsaturated fats that can help raise HDL cholesterol levels. Walnuts, flax seeds and canola oil are also good sources of omega-3s. Try to incorporate fatty fish a couple of times per week.

#3 Add More Movement to Your Day

Incorporating more movement into your daily routine can also help lower cholesterol and boost heart health. Being more active can not only help raise HDL cholesterol and lower LDL cholesterol, it can also lower blood pressure, reduce inflammation, lower stress levels, and help improve blood sugars. Here are some ways to add more movement…

• Include activities like walking, jogging, swimming, or riding a bike.
• Incorporate strength or weight bearing type exercises. This helps improve your overall fitness, strength, and ability and can positively affect cholesterol levels.
• Increase your NEAT or non-exercise activity thermogenesis. NEAT refers to everyday activities like playing with your kids or grandkids, doing yard work, taking the stairs, cooking, cleaning, and doing laundry. We know that looking for everyday ways to be less sedentary throughout the day can positively impact heart health. If you sit at a desk all day long, consider a walking pad or treadmill desk, which have been shown to improve blood sugars and raise heart protective HDL cholesterol levels.

The bottom line with movement is that all movement “counts” and any amount is beneficial for cholesterol and heart health. No matter where you are today, whether you are doing some or none, know that any amount you can add will benefit not only your physical health, but your mental health too.

What About Eggs and Shrimp?

A common misconception that I hear from people is thinking that it is the cholesterol in foods that contributes to high blood cholesterol. As a result, people avoid certain foods, like shrimp and eggs. The poor egg has gotten a lot of flak over the years!

What we know now is that it is actually the saturated fat in foods, more than the cholesterol, that contributes to increased blood cholesterol levels. So, while shrimp and eggs do contain cholesterol, they are relatively low in saturated fat and rich in other nutrients and therefore not of particular concern for most people and can absolutely be included in a heart healthy way of eating.

Other Lifestyle Changes That Can Help

Managing stress and getting good sleep are key to keeping your cholesterol in check since they help balance hormones like cortisol and ghrelin. These hormones can negatively impact your cholesterol if they’re out of balance. Try things like yoga, meditation, or even deep breathing to relax and de-stress. Reducing alcohol intake can also be beneficial to cholesterol.

What About Supplements for Lowering Cholesterol?

Despite many supplements being touted for lowering cholesterol, there are just a few that actually have evidence to back their efficacy. Here are two to consider and talk with your physician about.

Plant Stanols & Sterols

Plant sterols and stanols or phytosterols are naturally occurring compounds found in plants with a structure similar to cholesterol. Plant stanols and sterols can help lower LDL (“bad”) cholesterol levels by blocking cholesterol absorption in the gut. We can get them through foods like whole grains, nuts, seeds, legumes, and vegetable oils, but not in the amounts shown to clinically lower cholesterol. That’s where a supplement comes in. Recommended product by third party tester Consumer Lab: Nature Made CholestOff Plus. (Take 2 soft gels two times daily with meals.)

Red Yeast Rice

Red yeast rice is a substance made by fermenting rice with a species of yeast called Monascus purpureus. It contains a variety of natural compounds called monacolins known to inhibit cholesterol production. One of the monacolins, monacolin-K, is also known as lovastatin, the key ingredient in the cholesterol lowering “statin” drug Mevacor. Several well-designed human studies have shown that taking red yeast rice daily or two to three months can lower total cholesterol, LDLs, and triglycerides. Recommended product by third party tester Consumer Lab: HPF Cholestene (Take 2 capsules twice daily with food.)

Wrap Up

So, what is your takeaway from what you’ve read? What is one small step you can make in your own lifestyle and choices to incorporate these strategies?

Embracing these small steps can help you manage your cholesterol levels and make lifestyle changes that could significantly improve your overall health. The bonus is that by doing it in a non-diet way you are also cultivating a healthier more peaceful relationship with food in a sustainable way, no diets, no restriction necessary!

Know someone who could use some help with their cholesterol levels? Pass this along.

Stay tuned for more non-diet nutrition strategies for various chronic health conditions in the future! Need support? Get in touch.

**The information provided here is for general knowledge and educational purposes only, and should not be considered medical advice. I am a dietitian, but not your dietitian. Individual needs vary and readers should consult with a healthcare professional before making any significant dietary changes.**