10 ways to lower cholesterol

As a fat found in the blood, cholesterol has to be transported by a carrier; these carriers are protein complexes called lipoproteins. You’re probably familiar with them because they're often confusingly referred to as 'bad' cholesterol, or low-density lipoproteins (LDL), and 'good' cholesterol, or high-density lipoproteins (HDL).

As with most things, it’s not quite that simple. These lipoproteins are not actually cholesterol, and both LDL and HDL will be present in a variety of forms – the smaller, denser of which appear to pose the greater risk. Your unique mix of LDL and HDL depends on your genes, as well as your diet and lifestyle.

Why do we need cholesterol?

Although we’ve grown up to fear cholesterol, we do need it for our bodies to function properly. In fact, it’s fundamental to life. That’s because cholesterol is crucial for forming cell walls, producing hormones like oestrogen and testosterone, helping repair nerves, producing bile so we can digest and absorb the fats in our diet, and making the 'sunshine vitamin', vitamin D. What's more, cholesterol improves our memory and helps us feel good because it’s needed to make the mood-boosting hormone serotonin.

What are triglycerides?

Cholesterol is not the only type of fat found in your blood. If you’ve had a blood test to check your cholesterol levels, you’re likely to have also been told your triglyceride level. Triglycerides are the main form of fats in the body and we use them to store energy in our cells. Too much of this fat in your blood is an important risk factor for heart disease.

What are the symptoms of high cholesterol?

For many of us, high cholesterol is a symptomless condition – in other words, you won’t know you have it unless you have a blood test, or the condition leads to a heart attack or stroke. The exception to this is if you have familial hypercholesterolemia and the condition is advanced enough to show visible signs. These include:

• Small yellow lumps on the skin near the corner of your eye, or on your knuckles, feet, elbows or knees
• A pale white ring in your eye around the iris

How can I test my cholesterol?

Your blood fats, including cholesterol, can be measured by a simple blood test performed by your GP. You can read more about how to get your cholesterol checked on the NHS website. You should ask your GP for a cholesterol test if you have not had a test before or if you're over 40, overweight, if high cholesterol or heart problems run in your family, or if you have familial hypercholesterolemia.

Do dietary fats cause high cholesterol?

Alongside cholesterol, fat has long been treated as the enemy. Saturated fat is frequently vilified as it has been linked to cardiovascular disease and high cholesterol. Red meat, butter, cheese, burgers and sausages are all high in saturated fat, as are ghee, coconut and palm oils. A diet high in saturated fat can increase blood fats, including triglycerides, as well as increase your risk of obesity, heart disease, type 2 diabetes and stroke. However, recent studies are now suggesting that the saturated fats in some foods such as dairy products, including cheese, do not appear to be as harmful as we had once thought. This may be because other nutrients in dairy, like calcium or the process of fermentation, may modify the effects of these fats on our triglyceride levels.

What aspects of my diet should I focus on for heart health?

Increasing evidence points to overeating sugary, refined carbs as a cause of inflammation, raised insulin levels, high blood pressure and higher cholesterol and triglyceride levels. You’re likely to have also heard of trans fats – these are manmade unsaturated fats that behave more like saturated ones, only worse because the body can't recognise them. They are found in processed foods and are the worst type of fat for raising cholesterol levels. You can avoid them by cooking as much as possible from scratch and checking labels for hydrogenated, partially hydrogenated and semi-hydrogenated vegetable fats or shortening.

How do I know if a product is high or low in fat?

One way to keep a check on the amount of fat you are eating is to get into the habit of reading labels. Turn to the ‘nutritional panel’ found on the back of the pack and run your finger down the 'per 100g' column to the ‘total fat’ and ‘saturated fat’ figures. Look to see if the product is high or low by checking this handy guide:

Total fat:

• High: more than 17.5g of fat per 100g. (Packaging may be colour-coded red)
• Low: 3g of fat or less per 100g. (Packaging may be colour-coded green)

Saturated fat:

Look out for 'saturates' or 'sat fat' on the label: this tells you how much saturated fat is in the food.

• High: more than 5g saturates per 100g. (Packaging may be colour-coded red)
• Low: 1.5g saturates or less per 100g. (Packaging may be colour-coded green)

If the amount of fat or saturated fat per 100g is in between these figures, that's a medium level, and packaging may be colour-coded amber.

How to reduce cholesterol

A healthy, balanced diet is important for overall health and wellbeing, and there are several foods that are especially useful for maintaining heart health and lowering cholesterol. Aim to include a variety of these in your diet on a regular basis.

1. Focus on unsaturated fats and limit saturated ones

Replacing some of the saturated fats in your diet with unsaturated fats has been proven to benefit your heart. Aim for a diet with plenty of mono-unsaturated fat, such as that found in avocado and olives, and poly-unsaturated fats, especially the omega-3 fatty acids found in oily fish such as sardines, mackerel, salmon and trout.

It's important to remember to stick to reference intakes – these are the daily guidelines for key nutrients like fats. Aim to have no more than about ⅓ of the fat in your daily diet in saturated form, with the remainder being the monounsaturated and polyunsaturated varieties such as olive oil, rapeseed oil, unsalted nuts and seeds.

Get inspired with these delicious recipes...

Almond butter
Fish tagine with saffron & almonds
Sesame salmon, purple sprouting broccoli & sweet potato mash
Mediterranean sardine salad
Avocado salad
Chunky tomato & avocado salsa

2. Include dairy foods in moderation

Fats in fermented forms of dairy such as yogurt, kefir and cheese aren’t as harmful to blood cholesterol as we had first thought. However, you should still consume dairy in modest amounts. For plant-based alternatives, look for fortified soya products, as soy has natural cholesterol-lowering properties.

Try these delicious ways with dairy:

Raspberry kefir overnight oats
Peach & orange yogurt pots with ginger oats
Orange & dark chocolate yogurt bowls
Healthy salmon bowl
Cajun chicken traybake with sweet potato wedges & chive dip

3. Eat 2-4 portions of oats or barley a day

There’s plenty of evidence to show that oats and barley help manage cholesterol levels. Both these grains are rich in a soluble fibre called beta-glucan, which forms a gel that attaches to cholesterol and inhibits its absorption. A daily intake of about 3g of beta-glucan is considered an adequate amount to make a difference – that’s three servings of oats or barley per day. Many food products contain these grains. If you see a claim on the label saying that the food ‘lowers cholesterol’, the product will need to contain 1g or more of beta-glucan per portion.

Try these recipes:
Apple & linseed porridge
Vanilla-almond chia breakfast bowl
Pink barley porridge with vanilla yogurt
Squash & barley salad with balsamic vinaigrette
Bean & barley soup

4. Include foods with added plant sterols or stanols

Plant chemicals called sterols and stanols are a similar size and shape to cholesterol. When they are absorbed in the gut, they help to block some cholesterol from being absorbed, as well as inhibit its synthesis in the liver. This means they help lower LDL-cholesterol levels.

One of the richest natural sources of these compounds is avocado. Sadly though, you’d need to eat a lot to reach the recommended levels – for this reason manufacturers have developed foods with sterols or stanols added to them. These include yogurt, dairy drinks, spreads and milk. Ideally, include as part of a meal and aim for 1-3 servings each day in order to achieve the necessary 1.5g to 3g of sterols or stanols.

Please note – these foods are not suitable for pregnant or breastfeeding women or children.

5. Include oily fish up to twice a week

Eat two portions (140g each) of oily fish per week, or more regularly if you have a history of heart problems. This is because the omega-3 fatty acids found in oily fish may help lower harmful blood triglycerides. Varieties to choose include herring, mackerel, pilchards, sardines, trout and fresh tuna.

Try these oily fish recipes:

Tuna steaks with cucumber relish
Basil & lemon chickpeas with mackerel
Grilled mackerel with harissa & coriander couscous
Tandoori trout

6. Focus on fibre

Choose wholegrain carbs like wholemeal bread, brown rice and wholemeal pasta rather than white refined versions. These foods are more nutrient dense and contain more fibre.

Fibre, including soluble fibre, helps slow down digestion, trapping cholesterol and aiding its elimination from the body. Other foods that are rich in soluble fibre include sweet potatoes, beans, peas and lentils.

Give these tasty recipes a try:

Lentil salad with tahini dressing
Spinach, sweet potato & lentil dhal
Mexican bean soup with guacamole
Tomato penne with avocado

7. Cut down on sugary foods and refined carbs

Biscuits, cakes and fizzy drinks are high in sugar and calories, while providing little in the way of beneficial nutrients. Eating these and other white refined carbs regularly may lead to weight gain and can increase blood triglyceride levels.

Take a look at these healthier treats:

Matcha with vanilla
Raw raspberry shrub
Healthy flapjacks
Healthy cookies

8. Regularly include nuts

Often dismissed because of their high fat content, nuts make a great snack option. They boast a favourable fat composition, high in unsaturated and lower in saturated fats. They’re also a good source of fibre and valuable micronutrients that support our heart health including vitamin E, magnesium and potassium, as well as natural sterols and stanols.

Aim for a handful of unsalted nuts (30g) per day. Where possible, opt for those with the skin intact because they’re rich in protective plant chemicals called polyphenols.

Find out more about the health benefits of nuts.

9. Balance your intake of fat, protein and carbs evenly through the day

Eating at regular intervals throughout the day helps to balance blood sugar levels and prevents you getting so hungry that you’re likely to make less healthy choices. Spreading your intake of fat evenly through the day also gives your body chance to process and clear it from your blood and prevents it from accumulating and potentially triggering inflammation – this inflammation may damage the linings of your arteries and increase your risk of heart disease and stroke.

10. Learn how to make healthy choices

A little knowledge makes all the difference. When eating out, ask to see a menu with the nutritional information provided or check online before you visit the restaurant – if this isn’t available, look for dishes which are steamed, poached or grilled and avoid choices that are crispy, fried, sautéed, buttery or creamy.

What lifestyle factors affect cholesterol?

Don’t forget that your lifestyle plays a big part in maintaining a healthy heart as well as your diet. In particular, smoking, being overweight (especially carrying extra weight around the middle), stress, inactivity and too much alcohol all contribute to your risk of heart disease. Furthermore, having high blood pressure, diabetes or a family history of early heart disease puts you at a greater risk.

Top healthy lifestyle tips:
Stress relief: How diet and lifestyle can help
How to check your weight is healthy
How to drink responsibly
Cheap ways to get your 5-a-day

Enjoyed this? Now read…

Heart-healthy portions
Top 10 tips for a healthy heart
Is a low fat diet healthy?
Is saturated fat bad for you?
How much fat should I eat each day?
How much fibre should I eat every day?

This article was last reviewed on 15 November 2023 by Kerry Torrens.

Kerry Torrens BSc. (Hons) PgCert MBANT is a BANT Registered Nutritionist® with a postgraduate diploma in Personalised Nutrition & Nutritional Therapy. She is a member of the British Association for Nutrition and Lifestyle Medicine (BANT) and a member of the Guild of Food Writers. Over the last 15 years she has been a contributing author to a number of nutritional and cookery publications including BBC Good Food.

All health content on bbcgoodfood.com is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other healthcare professional. If you have any concerns about your general health, you should contact your local healthcare provider. See our website terms and conditions for more information.