High Cholesterol: What Foods and Supplements REALLY Help?

I do a lot of health checks in my family clinic, and a large percentage have problems with their cholesterol tests. Since high cholesterol is one of the major risk factors for heart disease, I focus a lot of my time with patients on proper diet. But what is a proper diet, exactly? We hear so many crazy diet tips from so many sources, but what are the proven high-yield foods that people should focus on?

First, most sources agree on the most high-yield foods: nuts; fish; fiber; olive oils; and plant sterols/stanols. How much does each group benefit? Find out in the graph below from the Natural Medicines Comprehensive Database, my perennial favorite website for evidence-based supplement research:

I think this chart above is extremely useful, and it shows just how important are our food choices in controlling our cholesterol. It also helps to show side-by-side how the prescription medicines such as the statins (Lipitor/atorvastatin, etc.) compare with foods.

What about supplements to lower cholesterol? You can read another useful supplement article here from EBSCO CAM review board (for free, via iHerb). The Natural Medicines Comprehensive Database also has a terrific Recommendation Chart showing which are helpful – and which are not. You can see the chart below. For example, their green area of “Likely Safe + Effective/Likely Effective” has quite a few products, including EPA, fish oil; barley, beta-glucans, blond psyllium, niacin, oat bran, and plant stanols and sterols. They also mention what doesn’t work, including garlic and evening primrose oil.

My personal tips for anyone who has high cholesterol, even if they take medicines, are these:

  • Eat more nuts— a few servings a week can help more than you think. Look at the chart above: walnuts can lower total cholesterol by 8-16%
  • Eat fatty fish(salmon or sardines) at least twice a week, more if you can get it. Fish oil can lower triglycerides an amazing 20-50%, and most likely has overall benefit to your heart. I’m a big fan of fish oil for everyone in the family; BUT! The studies show the heart benefit is much more effective when you actually eat fatty fish, and much less so from supplements.
  • Fiber, fiber, fiber!Fiber can lower total cholesterol 5-26%. Fiber is especially important for breakfast: even the fiber from Cheerios can help, but oatmeal, muesli, or dark breads also are a better source. And don’t forget that fruits and vegetables also have a lot of fiber.
  • Improve your breakfast.The worst offenders usually have a very American breakfast of eggs and meat. A far healthier choice would be some fiber (dark bread, muesli, oatmeal) with a cup of yogurt and fruit. Want some sugar? Pour honey into non-sweetened yogurt. (And did you know a yogurt a day also helps keep your weight down?)
  • Think brown over white.If you must eat your pasta, rice and breads, at least try to switch from lily-white versions to the darker ones. Pick any, I don’t care — all brown grains have more fiber and nutrients than the ultra-processed white grains. This also has the added benefit of decreasing your risk of getting diabetes.
  • Switch to olive oil.We all need some fat in our diet, but there are good fats and bad fats, and it’s hard to beat olive oil for better health.
  • Avoid trans-fats.Trans-fat definitely tops the list of bad fats. This issue fortunately has received a lot of media exposure, but many cookies and snacks still contain a lot of this unnatural and artery-clogging fat. Take a look at your labels, which now require details about trans-fats.

My Bottom Line

If you have a diagnosis of high cholesterol and you only take your statin pill from your doctor but you don’t change any food choices, then you’re definitely not optimizing your health. Many people can avoid prescription meds for years if they follow proper food choices! And even if you do eventually need the prescription medicines, you still need to follow the nutrition tips.

On the flip side, nutrition changes can only go so far, and if you’ve tried nutrition advice and after a couple of lab retests (usually every 3-6 months) your cholesterol is still very high, then you really need to follow your doctor’s advice to start a prescription medicine; there’s an enormous amount of data proving that statins can save your life, by preventing heart attacks and strokes if taken for years as a daily medicine.

For more information about this topic, please check out my other articles about high cholesterol.

Good luck!


This article is updated from an earlier version in 2012. 

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