They may seem helpful, but cardiologists say their benefits are misconstrued.
Reviewed by Dietitian Madeline Peck, RDN, CDN
Key Points
- Avoid low-fat diets and prioritize unsaturated fats to support healthy cholesterol levels.
- Diet is not the only thing that impacts cholesterol; genetics and lifestyle factors play a role too.
- Talk to your doctor to create a plan for cholesterol management.
If you’re part of the 10% of Americans with high cholesterol, you may have tried a number of things to get your numbers down, from exercise to supplements. While your habits may be well-intentioned, that doesn’t always mean they’re effective. Certain tactics, such as low-fat diets, may even be outdated. We spoke with cardiologists about the things they wish you’d stop doing for high cholesterol and what to do instead.
Following a Low-Fat Diet
There is a connection between the fat you eat and cholesterol levels, but cardiologists say that avoiding fat isn’t the best approach. “One common misconception about lowering LDL cholesterol through diet is the assumption that a low-fat diet is best,” says Alan Rozanski, M.D. In reality, dietary fat should make up about 20% to 35% of your daily calorie intake.
“It is now widely recognized that dietary fat is not the enemy; what matters is the type of fat consumed,” says Rozanski. Instead of eliminating fat, focus on eating more unsaturated fats and fewer saturated fats. Overconsuming saturated fat can increase cholesterol levels, but keeping your saturated fat intake to 7% or less of your daily calorie intake can support healthy cholesterol levels. Consuming more unsaturated fats can promote healthy cholesterol levels. Mono- and polyunsaturated fats can help lower LDL, often called “bad” cholesterol, by increasing the activity of LDL receptors in the liver.
Swaps to reduce saturated fat intake and increase unsaturated fat intake include cooking with olive oil instead of butter, choosing ground chicken instead of ground beef, and snacking on nuts instead of potato chips.
Relying Too Heavily on Supplements
You may have heard that supplements like fish oil, garlic or plant sterols help lower cholesterol, but cardiologists say supplements are not effective as a stand-alone treatment. “Many supplements are marketed as ‘heart healthy,’ but most don’t have the same level of evidence as a balanced diet, regular exercise or cholesterol-lowering medications when they’re indicated,” says Kevin Kheder, M.D. For example, the American Academy of Family Physicians advises against using omega-3 supplements to manage high cholesterol because they aren’t proven to lower the risk of cardiovascular events or mortality.
While certain supplements could be beneficial when paired with other evidence-based interventions for cholesterol management, always talk to your health care provider before starting a new supplement.
Assuming It’s Only About Diet
Kheder advises against assuming diet is the only thing that influences your cholesterol levels. In terms of individual behaviors, staying active and quitting smoking are also effective ways to lower cholesterol. But your cholesterol levels can also be influenced by elements out of your control, like genetics. “Some people do everything right and still have elevated LDL cholesterol because of inherited factors,” says Kheder. While diet and lifestyle habits are important, you may still need medical intervention. “That’s why it’s important to work with your physician to determine whether lifestyle changes alone are enough or whether medication is also appropriate,” says Kheder.
Habits to Adopt for Better Cholesterol Management
- Get in regular physical activity. Being active is one of the best habits you can adopt to promote heart health. “Exercise helps raise HDL (‘good’) cholesterol, lowers triglycerides and improves overall cardiovascular health,” says Kheder. For the most benefits, aim for at least 150 minutes of moderate-intensity aerobic activity per week, like bike riding, brisk walking or dancing.
- Follow a heart-healthy diet that prioritizes fiber. Eating a diet rich in heart-healthy fats, lean proteins, whole grains, fruits and veggies is another worthwhile lifestyle change for lowering your cholesterol. Consuming adequate soluble fiber and replacing saturated fats with heart-healthy fats are especially important. Opt for heart-healthy fats from nuts, seeds, fatty fish and avocado. For soluble fiber, eat foods like oats, beans and avocados.
- Get regular checkups. “High cholesterol usually doesn’t cause symptoms, so regular blood work is essential,” says Kheder. If you already have high cholesterol, regular checkups with your health care provider are crucial for tracking progress and making adjustments if necessary. “Monitoring your cholesterol allows you and your health care provider to see whether lifestyle changes are working and determine when additional treatment may be needed,” says Kheder.
Our Expert Take
High cholesterol is a prevalent health issue, but there are common misconceptions about how to manage it. Cardiologists wish people would stop assuming low-fat diets and supplements are the best way to lower cholesterol. In fact, assuming that high cholesterol boils down to diet discounts other key risk factors, like genetics. To manage your cholesterol, they recommend being active, following a heart-healthy diet and keeping up with regular checkups with your health care provider. To effectively manage your high cholesterol, talk to your health care provider. They can help assess which lifestyle changes would be most helpful for you, whether the changes you’re making are working and if support from medication would be beneficial.