Too much LDL cholesterol can block blood flow and cause heart disease, but there are options available to anyone looking to lower theirs naturally. What factors can help decrease LDL? Read on to learn the best strategies.
Ways to Lower LDL-Cholesterol
The following substances, diets, and strategies have produced beneficial effects on LDL in multiple clinical trials, but they should never be used in place of something your doctor prescribes. If you are concerned about your LDL levels, work with your doctor to develop an appropriate management plan, which may or may not include some of the options discussed below.
Likely Effective
1) Weight Loss
Losing 5 to 10% body weight reduces LDL in overweight individuals [1, 2, 3, 4, 5].
In a study of 35 young women, weight loss lowered the creation of new cholesterol [6].
2) Low Cholesterol Diet and Low Saturated Fat Diet
With low-cholesterol diets, the liver rapidly clears both LDL and VLDL, so LDL levels in the blood remain low [7].
In a study of 155 adults, replacing saturated fats with polyunsaturated fats for eight weeks reduced LDL by 10% [8].
Reducing saturated fat intake lowered LDL in children in a meta-analysis [9].
The American Heart Association Step 2 diet reduces LDL by up to 20%. This diet is high in fish, vegetables, fruits, and low-fat dairy, and low in salt and alcohol [10, 11, 12].
In a study of 8,433 people, a “healthy” diet was associated with lower LDL. This diet included a high intake of whole grains, fruit, dairy, vegetables, and unsaturated oil, and a low intake of fast food, sugary beverages, poultry, processed meat, and flavored rice [13].
Two foods that have been individually found “likely effective” to reduce cholesterol are barley and oats. In many studies over multiple decades, barley, its oil, and its fiber have each reduced cholesterol in people eating it every day. Likewise, including oats into the diet of people with elevated LDL cholesterol tends to reduce LDL cholesterol. Researchers generally attribute these effects to the beta-glucans in both barley and oats [14, 15, 16, 17, 18, 19].
3) Ketogenic Diet
Consuming a ketogenic diet lowered LDL and reduced small, dense (unhealthy) LDL particles in studies (including 1 RCT) of 202 total people [20, 21].
4) High Monounsaturated Fat (MUFA) Diet
In a study (DB-RCT) of 22 healthy adults, consuming any of three high-MUFA diets (using either olive oil, peanut oil, or peanuts and peanut butter) lowered LDL by 14% on average. These diets also reduced LDL oxidation compared to a standard American diet [22, 23].
Consuming a moderate-MUFA diet (10% of calories from MUFAs) and a high-MUFA diet (14% of calories from MUFAs) both lowered LDL in a study of 35 participants with high cholesterol. The high-MUFA diet produced the greatest benefits [24].
5) Exercise
In a study of over 80,000 young adults, more days per week of either aerobic or strength exercise were associated with lower LDL [25].
A meta-analysis (of 51 studies and 4,700 adults) found that exercises such as jogging, running, and biking decreased LDL by 5% [26].
In a study of 20 overweight women, 12 weeks of combined aerobic and strength exercise reduced oxidized LDL [27].
6) Red Yeast Rice
Red yeast rice is an Asian food and traditional medicine. Some red yeast rice products contain a chemical (monacolin K) identical to the active ingredient in a cholesterol-lowering drug, lovastatin [28].
In a meta-analysis of 6,663 patients, red yeast rice 3 – 24 mg/day decreased LDL by an average of 39 mg/dL [28].
Red yeast rice is well-tolerated but is not approved by the FDA as a drug. More large-scale studies must confirm its safety and effectiveness [29].
Red yeast rice extract supplements contain a yeast toxin (citrinin) harmful to the liver and kidneys at high doses. Because companies rarely report the amount of citrinin in these products, users should be careful when purchasing red yeast rice supplements [30, 29].
7) Beta-Glucans
Beta-glucan is a type of soluble fiber found in mushrooms, oats, and algae [31, 32, 33].
A meta-analysis showed that beta-glucan consumption of more than 3g/day reduces LDL by 8 mg/dL in people with high cholesterol [34].
Consuming 5 – 15 g/day (European guidelines) or 10 – 25 g/day (US guidelines) of soluble fiber from oats with beta-glucan is recommended to reduce LDL [35, 36].
8) Soluble Fiber
In a study of 30 adults, taking 3 grams of soluble fiber supplements daily for 12 weeks decreased LDL by 18% [37].
In a study of 58 men consuming breakfast cereal with added fiber, soluble fiber from pectins reduced LDL by 4%. Fiber from psyllium reduced LDL by 6% [38].
9) Psyllium
In a meta-analysis of 21 studies and 1,717 people with high cholesterol, psyllium (3 – 20.4 g/day) reduced LDL by an average of 11 mg/dL [39].
In a study of 68 adults, adding 15 g of psyllium to cholesterol-lowering medication was as effective as taking more medication without psyllium [40].
10) Black and Green Tea
Meta-analyses show that black and green tea consumption reduces LDL in overweight or obese participants, or those at high risk of heart disease [41, 42, 43].
11) Plant Sterols
In numerous studies, plant sterol intake reduced LDL 12 mg/dL (8 – 10%) in healthy, diabetic, and high cholesterol participants [44, 45, 46].
The FDA has even approved the claim that plant sterols reduce the risk of coronary heart disease. The average beneficial dose in multiple trials was 1.6 g/day, with the largest effects at around 3 g/day [47, 48].
Two plant sterols which have individually produced benefits to LDL cholesterol levels in multiple clinical trials are beta-sitosterol and sitostanol [49, 50, 51, 52].
Possibly Effective
13) Garlic
In a meta-analysis of 39 studies with 2,298 subjects with high cholesterol, consuming garlic for at least 2 months decreased LDL 9 mg/dL on average [53].
Most studies used garlic powder (600 – 5,600 mg/day), while some used garlic oil (9 – 18 mg/day), garlic extract (1000 – 7200 mg/day), and raw garlic (4 – 10g/day). Aged garlic extract had the strongest effects [53].
14) Anthocyanins
Anthocyanins are flavonoids found in many berries. Anthocyanin extract lowered LDL in studies with 396 total patients with high cholesterol [54, 55, 56, 57, 58].
In a study of 58 diabetic patients, consuming 320 mg/day of anthocyanins for 24 weeks decreased LDL by 8% compared to placebo [59].
Anthocyanins did not lower LDL in studies of healthy participants [60].
15) Lactobacillus Probiotics
Meta-analyses have shown that Lactobacillus probiotic strains mildly reduce LDL in healthy participants, smokers, and those with high cholesterol, diabetes, and obesity [61, 62].
16) Berberine
In a meta-analysis of 27 studies, berberine lowered LDL 25 mg/dL on average. Berberine is found in barberries, goldenseal, and Oregon grape, among other plants [63, 64].
17) Soy
Soy mildly reduced LDL (by 4.8 mg/dL) in a meta-analysis with 2,670 participants. Soy lowered LDL more effectively for those with high cholesterol than in healthy subjects. The average soy intake was 30 g/day [65].
In a study of 30 patients with high cholesterol, 500 mg of soy lecithin taken daily for 2 months lowered LDL by an impressive 56% [66].
18) Vitamin C
According to a meta-analysis, taking at least 500 mg/day of vitamin C for at least 4 weeks lowered LDL by 7.9 mg/dL on average [67].
19) Nuts & Legumes
In a meta-analysis, eating 2 to 3 servings of nuts (including walnuts, almonds, macadamias, pistachios, hazelnuts, peanuts, and pecans) per day decreased LDL by an average of 10.2 mg/dL [68].
Eating half a cup of legumes per day reduced LDL cholesterol by an average of 6.6 mg/dL, according to a meta-analysis [69].
20) Glucomannan
Glucomannan is another type of plant fiber extracted from the konjac root, also known as the elephant yam. It decreases LDL in adults and children, according to meta-analyses (of RCT studies) [70, 71, 72].
21) Avocados
In one study of 87 adults with high cholesterol levels and 45 overweight adults, an avocado-rich diet reduced LDL [73, 74].
22) Black Cumin
Black cumin (Nigella sativa) lowered LDL by an average of 22 mg/dL according to a meta-analysis [75].
23) Pantethine
In studies of 120 healthy participants and 32 participants with high cholesterol, taking 600–900 mg/day of pantethine for 16 weeks lowered LDL up to 11% [76, 77].
24) Artichoke Leaf Extract
Consuming artichoke leaf extract decreased LDL by 15 mg/dL, according to a meta-analysis (of 9 studies including 702 subjects, most of whom had high cholesterol). The only side effect was rare, mild stomach pain [78].
25) Rice Bran Oil
A meta-analysis showed that rice bran oil lowered LDL by 7 mg/dL on average in healthy participants and those with high cholesterol [79].
26) Spirulina
Spirulina consumption greatly reduced LDL – by 41 mg/dL on average – according to one meta-analysis. The Spirulina doses were between 1 – 10 g/day, taken for 2-12 months. Longer supplementation, but not dose, was linked with reduced LDL [80].
27) Olive Oil
In a study of 25 healthy adults, adding 10 g of olive oil to a meal reduced LDL and oxidized LDL (compared to a meal with no olive oil or with corn oil) [81].
Consuming 50 g/day of olive oil for 4 weeks was associated with lower LDL compared to consuming the same amount of butter in a study of 91 older adults [82].
28) Cardamom
In studies of a total of 284 diabetic adults, green cardamom lowered LDL after 2 months [83, 84].
LDL Apheresis
A procedure called LDL apheresis removes LDL from the blood. It may be an option for people who don’t respond to drugs and have very high cholesterol levels. LDL apheresis takes 2-4 hours and must be performed every few weeks [85].
LDL apheresis reduces LDL by more than 60% in patients with high cholesterol due to genetics (familial hypercholesterolemia) [86].
A study of 45 patients with high cholesterol resistant to drugs found that LDL apheresis lowered LDL by 56%. Quality of life improved in most patients [85].
In another study of 14 patients with high cholesterol, LDL apheresis was safe long-term (over 10 years), and lowered LDL by 82% on average [87].
LDL apheresis is a medical procedure that can only be conducted by a medical professional. Your doctor will determine whether LDL apheresis is appropriate in your case.
