If you have high cholesterol you aren't alone: nearly half of all American adults have high cholesterol. Typically, your lifestyle and your genetics combine to lead you to have—or not have—high cholesterol.
Pictured recipe: Steel Cut Oatmeal
Not all cholesterol is bad. In fact, your body makes its own and uses it for key functions, such as producing cells and certain hormones. Too much of this waxy substance in the blood, though, and it will build up as plaque in your arteries—and that raises your risk for heart attack, stroke and a condition called peripheral artery disease where the arteries in your limbs narrow.
Cholesterol is carried through the blood in molecules called lipoproteins. The two most commonly discussed in relation to heart health are low-density lipoproteins (LDL) and high-density lipoproteins (HDL). LDL (bad) deposit cholesterol inside your arteries. HDL (good) carry cholesterol to the liver to dispose of it or recycle it for future cell and hormone production, which makes it less likely that excess cholesterol in the blood will be dumped in the arteries where it can build up.
If you have high cholesterol, these nine heart-healthy tips could help you get your cholesterol back into a healthy range. But talk to your doctor too, because you might also benefit from a prescription, such as statins.
Related: Meal Plans to Lower Your Cholesterol
Pictured recipe: Really Green Smoothie
How much you eat does matter, but what you eat can make a big difference to help lower your cholesterol and improve your heart health. In fact, research shows that every step closer you get to eating in line with the Dietary Guidelines lowers your risk of heart disease. So aim to eat more healthy foods—fruits, veggies, lean protein, low-fat dairy, whole grains. At the same time, use those healthy foods to crowd out the less-healthy or empty-calorie foods from your diet (think: processed meats, salty snacks like potato chips, sweets and sweetened beverages). Eating high-quality, healthy foods also makes it easier to cut back on the nutrients that aren't good for your cholesterol: saturated fat, trans fat, and cholesterol.
Pictured recipe: Cajun Salmon with Greek Yogurt Remoulade
These healthy polyunsaturated fats are found in fatty, oily fish like salmon, tuna and mackerel, as well as oysters, walnuts, flaxseeds and canola oil. While they don't affect cholesterol levels directly, they are good for your overall heart health and, at high doses, may help lower your triglyceride levels. Most of the fat in your diet should come from these and other polyunsaturated fats, as well as monounsaturated fats. Other polyunsaturated fats are plentiful in certain plant oils—grapeseed, safflower, sesame, soy and corn oils. Olive, canola and peanut oils are good sources of monounsaturated fats, and so are avocados.
Learn more: The Best Oils for Cooking
Two other types of fat—saturated fat and trans fat—can negatively impact your cholesterol (raising your LDL and possibly even lowering your HDL).
Common food sources of saturated fat are red meat, butter and other full-fat dairy products, palm and coconut oils, and many baked and fried foods. The American Heart Association recommends you limit your daily saturated fat to no more than 5 to 6 percent of your daily calories. If you eat 2,000 calories per day, this translates to 11 to 13 grams of saturated fat.
Man-made trans fats are much less common in our diets now as food producers have worked to take them out of most processed foods, such as commercially prepared baked goods, margarine, snack foods and commercially prepared fried foods. But trans fats are technically more harmful to your cholesterol than saturated fats, so read Nutrition Facts panels (trans fat should be listed) and scan the ingredient list for partially hydrogenated oils to avoid trans fat as much as possible.
Pictured recipe: Spinach & Egg Scramble with Raspberries
Most of us don't get nearly enough fiber, so upping your daily fiber intake is always a good idea. Fiber keeps your digestive tract humming along; it's filling, so it can make it easier to still feel full when eating less to lose weight; and when it comes to cholesterol, it can have a big impact. Studies show that increasing soluble fiber by as little as 5 to 10 grams a day can lower your LDL cholesterol by 3 to 5 percent. How? Soluble fiber becomes gel-like when it dissolves in the intestines and binds some of the dietary cholesterol in your gut, preventing your body from absorbing it. Good food sources of soluble fiber include oatmeal, barley, kidney beans, Brussels sprouts, apples, pears, prunes and citrus fruits. Eating 1½ cups of cooked oatmeal provides 3 grams of soluble fiber; ½ cup of Brussels sprouts also has 3 grams; and an orange or grapefruit has about 2. Learn more about the top high-fiber foods to include in your diet.
Carrying around extra weight is another potential contributor to high cholesterol. Excess body fat can raise your LDL cholesterol and triglycerides (another fatty substance in your blood) and lower your HDL. But research shows that if you're overweight or even obese, you can improve your LDL and HDL cholesterol, as well as your triglycerides, by losing just 5 to 10 percent of your weight.
We know, thanks to research, that being physically active can help lower your LDL cholesterol and triglycerides—as well as boost your HDL cholesterol. It can also help you stay at a healthy weight (or lose weight), and it's helpful for stress management and for better sleep—all of which contribute to healthy cholesterol. So get moving and work your way up to 2½ hours of (moderately intense) exercise each week, but keep in mind than any activity is better than no activity.
By better, we mean both quantity and quality. Newer research is showing that logging about 7 hours of zzz's is what you need to protect your ticker—and other research suggests that poor sleep quality can adversely affect your cholesterol, lowering HDL cholesterol and raising LDL cholesterol. But what is considered quality sleep? There are three components: fall asleep in 30 minutes or less; wake up no more than once per night; and be awake for 20 minutes or less after initially falling asleep.
Read more: 7 Foods to Help You Sleep
Stress isn't just bad for your mental health: research shows that chronic stress can lower your HDL cholesterol and raise your LDL. Finding a way to manage your stress can help keep your cholesterol in a healthy range. And, a recent study showed that managing stress can help you lose weight (another boon for your cholesterol!). So find something that helps you de-stress—solid sleep, exercise, even laughter.
Learn more: 7 Foods for Stress Relief
Your lifestyle and diet can play a role in managing cholesterol, but genetics are also a factor. Eating more fiber and healthy fats and lots of fruits, vegetables and whole grains while limiting saturated fat and refined grains may help. Exercising, sleeping and trying not to stress too much are also important.