Let’s not arm wrestle about the cholesterol theory of heart disease. Most cardiologists believe LDL cholesterol is the culprit behind clogged coronary arteries. That’s why they are very quick to prescribe statins. Drugs such as atorvastatin, rosuvastatin or simvastatin are a fast way to lower total cholesterol as well as LDL cholesterol (LDL-C). But a meta-analysis published in JAMA Internal Medicine (Nov. 16, 2020) reveals that when statins are prescribed for primary prevention they only prevent 1 heart attack in 100 statin takers. That’s after 2.5 years. 0 lives were saved during that time. That’s why we think it makes sense to control cholesterol naturally if at all possible.
Would Berberine Supplements Lower Cholesterol?
Q. I’m not interested in taking a statin to lower my cholesterol. Someone said berberine could help, but I don’t know much about this supplement. What is it and is it worth taking? Does it have side effects?
A. A number of different plants make the natural compund berberine, including Oregon grape holly (Berberis aquifolium) and barberry (Berberis vulgaris). Such plants have long been used in Ayurvedic and traditional Chinese medicine.
A pilot study tested berberine supplements for three months. (Minerva Gastroenterology, Oct. 19, 2023). They lowered total cholesterol and increased HDL cholesterol significantly. Triglycerides dropped and CoQ10 levels were unchanged.
The volunteers did not report unpleasant side effects, but this study does not provide data on longer-term use of these tablets. A review of multiple trials concluded that berberine has no more adverse effects than statins (Frontiers in Pharmacology, Nov. 15, 2023).
The investigators used Sophy® tablets containing Berbevis™ berberine extract for this trial. that brand is available in Europe. American shoppers should be aware that many brands of berberine supplements tested by NOW Foods (and listed on the ConsumerLab.com website) do not contain the stated amount of berberine. Caveat emptor.
Using Diet to Control Cholesterol Naturally:
Most physicians did not learn much about non-drug approaches to cholesterol control in med school. They may tell patients to cut out saturated fat, but there is rarely much discussion about which foods people should eat.
What if you would like to control cholesterol naturally? Is it even possible? Many readers ask this basic question:
Q. What can I take to reduce my cholesterol besides pills? I would much prefer something natural rather than the statin my doctor suggested.
A surprising number of foods can help control cholesterol naturally:
Walnuts:
One of our favorites, walnuts, has received a lot of attention. When researchers replaced saturated fat in the diet with walnuts (2 to 3.5 ounces daily), the study volunteers had lower total cholesterol, LDL-C and non-HDL cholesterol after six weeks (Journal of Nutrition, April 1, 2020). A similar randomized controlled trial found lower blood pressure among volunteers eating walnuts (Journal of the American Heart Association, May 7, 2019).
Even better, over two years a walnut-rich diet resulted in lower levels of inflammation in the bloodstream (Journal of the American College of Cardiology, Nov. 10, 2020). Since cardiovascular disease is usually accompanied by inflammation, this suggests another way that eating walnuts might benefit heart health.
We have been writing about walnuts against heart disease for decades. An article in the New England Journal of Medicine (March 4, 1993) reported that walnuts can lower both total and LDL cholesterol. You can learn more about the benefits of walnuts at this link.
Almonds and Plant Sterols:
Walnuts are not the only nuts that can help control cholesterol naturally. Nearly twenty years ago, Canadian scientists demonstrated that a “dietary portfolio” low in saturated fat and rich in soluble fiber and plant sterols from soy can lower LDL-C and C-reactive protein as well as lovastatin (JAMA, July 23, 2003).
This diet contained almonds along with foods high in soluble fiber like oats, barley, okra, eggplant and psyllium. People who ate the recommended amounts of almonds lowered their blood pressure and kept it lower than baseline for a year (European Journal of Clinical Nutrition, June 2008).
Olive Oil to Control Cholesterol Naturally:
The research team found that adding monounsaturated fat to the basic dietary portfolio increased its effectiveness, raising good HDL cholesterol as well as lowering C-reactive protein and LDL-C (CMAJ, Dec. 14, 2010). Probably the most popular source of monounsaturated fat is olive oil.
Italian scientists report that people who routinely use extra virgin olive oil in their diets have lower cholesterol, blood pressure and arterial stiffness compared to those who use animal fats like butter (Nutrients, Oct. 7, 2020).
Although the monounsaturated fat in olive oil usually gets the credit for these benefits, extra virgin olive oil also contains polyphenols. These compounds bind to LDL-C to prevent oxidation and protect the heart (Archives of Biochemistry and Biophysics, Nov. 15, 2020).
Oatmeal to Control Cholesterol Naturally:
What do you eat for breakfast? If it is dry cereal with fruit and sugar it may not be as healthy as you think. Oatmeal, on the other hand, can be beneficial. Scientists have known for years that consuming oats can lower your cholesterol. In fact, the first study showing that oat bread instead of white bread reduced LDL cholesterol was published in 1963.
A meta-analysis of randomized controlled trials shows that the beta-glucan in oat fiber actually lowers three different markers of blood fats (British Journal of Nutrition, online Oct. 7, 2016). In addition to LDL cholesterol, beta-glucan consumption brought down levels of non-HDL cholesterol and apolipoprotein B. Elevated levels of these fats are particularly dangerous for people with type 2 diabetes or metabolic syndrome.
The meta-analysis included 58 clinical trials and nearly 4,000 individuals. Eating about 3.5 grams of beta-glucan daily lowered LDL by 4.2 percent, non-HDL cholesterol by 4.8 percent and apo B by 2.3 percent.
How Can You Get the Right Amount of Beta-Glucan?
Both oats and barley are rich in beta-glucan. Oat bran is a better source of beta-glucan than whole oats, so if you want to lower your cholesterol with this soluble fiber, you might consume oat bran rather than oatmeal.
A cup of cooked oat bran contains about 3 grams of beta-glucans, while a cup of cooked barley has roughly 2.5 grams. You’d need two cups of cooked oatmeal to get 3 grams of beta-glucans. To lower your cholesterol, you’d need to get beta-glucans into your diet every day.
If that is a bit daunting, psyllium is an alternative. This soluble fiber, found in Metamucil, Konsyl and certain other bulk-forming laxatives, can lower LDL cholesterol effectively (American Journal of Clinical Nutrition, online Sep. 15, 2018).
Eating Like a Vegetarian:
Following a vegetarian or mostly vegetarian dietary pattern can lower cholesterol, especially LDL cholesterol (Clinical Nutrition, June 13, 2018). Also consider adding some grape or pomegranate juice and possibly even red grapefruit (Journal of Agricultural and Food Chemistry, March 8, 2006).
Both grape juice and pomegranate juice have anti-inflammatory activity. A review of research found that pomegranate polyphenols may help slow the development of atherosclerosis (Evidence-Based Complementary and Alternative Medicine, Nov. 18, 2012).
Vinegar is another popular option to help control cholesterol naturally. Find that surprising? Here is a link to the science.
Are You a Pill Person?
Some people just love taking pills. We get that. We live in a pill-popping society. You can hardly watch television for more than 15 minutes without seeing commercials for prescription drugs.
If you like to swallow a pill, you may want to consider red yeast rice. This product contains naturally produced statins that have been shown to lower cholesterol (Nutrition, Metabolism, and Cardiovascular Diseases, Jan. 2017).
A combination supplement (Armolipid Plus) with red yeast rice, policosanol, berberine, folic acid, astaxanthin and Coenzyme Q10 has been tested in randomized controlled trials (Atherosclerosis. Supplements, Feb. 2017). It lowers both total and LDL cholesterol.
You can learn more about this approach in our comprehensive article:
How Does Red Yeast Rice Compare to Statins?
Other Ways to Control Cholesterol Naturally:
Other strategies include getting regular exercise, following an anti-inflammatory diet, including, cinnamon and chocolate in some meals and consuming soluble fiber as described above.
Laura Effel describer her strategy in our book Best Choices from The People’s Pharmacy (now out of print).
“How I Lowered My LDL (Bad) Cholesterol 44 Points in 5 Weeks Without Drugs”
Here are the highlights:
A listener of our radio show contacted us about her success with diet and cholesterol control. She wrote to tell us how she had lowered her cholesterol without drugs. We were so impressed with her story that we wanted to share it.
Not everyone can achieve such dramatic results with diet alone, but Laura’s story demonstrates that diet can make a difference. And lest you think this was a flash in the pan, we heard that three months later Laura had maintained her success and even managed to achieve greater improvement by lowering her LDL cholesterol to 70.
“With the help of a food scientist and the skeptical cooperation of my physician, I set about changing my diet to make a difference. Five weeks later, from changes in diet alone, my LDL cholesterol was down 44 points. I had a new way of eating, a permanent change, and I knew my cholesterol would continue to improve.
“My old way of eating had not been disastrous, especially not before the loss of estrogen. After all, at the age of 60, I weighed little more than I had the day I graduated from high school at 18. But I made changes that made a difference.
“Here is what I did:
- Avoided spikes in blood sugar
- Eliminated refined carbohydrates
- Ate a high-protein breakfast
- Substituted olive oil for other fats
- Added soluble fiber to meals other than breakfast
- Focused on fish
- Drank green tea
- Consumed other antioxidants
- Stopped eating before bed
“The experiment worked. My LDL cholesterol not only went down 44 points in 5 weeks, it also continued on its downward course.”
Learn More:
You can learn more about the details of these approaches in our Guide to Cholesterol Control and Heart Health.
If you have been able to control cholesterol naturally please share your success story in the comment section below. And if you think someone you know might benefit from this article, please scroll to the top of the page and use one of the icons to email it or make it available on Facebook or Twitter.
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