If you struggle with high cholesterol, you’re not alone. The Centers for Disease Control and Prevention reports that nearly 29 million adult Americans have high cholesterol, and a National Health and Nutrition Examination Survey found that 17 percent of people 40 to 59 years old and 43 percent of people age 60 to 74 take a prescription cholesterol-lowering medication. As common as it is, should you worry about taking a drug for your high cholesterol?
Fewer Medicines, Bigger Benefit
“When you are on several medications the risk of interactions and side effects increases,” said Alexander Ochman, DO, a resident physician at Albany Internal Medicine Resident Clinic. “The risk of human error when taking multiple pills increases. With higher dose often comes more risk and overall we want to keep everything as low as possible.”
Negative side effects, not to mention the expense, of taking many medications can affect your quality of life. So while you can’t always eliminate your need for medication, pursuing other options first can help you be free of excess medication as long as possible.
Lifestyle Changes to Make Now
Lifestyle changes can be some of the simplest — and hardest — changes to make. Ochman notes that daily exercise and a healthy diet are the two most important things you can do to lower your cholesterol. He recommends a Mediterranean-style diet that focuses on whole foods, healthy fats and plenty of fruits and veggies. A Mediterranean-style diet typically avoids red meat, which is considered anything with four legs. Replace beef, pork and deer with fatty fish, legumes and tofu for cholesterol-friendly protein choices.
“There’s been a lot of debate and research around low-fat and no fat diets,” said Ochman. “We’ve discovered that the best diet for cholesterol is one that includes healthy fats and moderate caloric intake. The famous food author Michael Pollan said, ‘Eat food. Not too much. Mostly plants,’ which holds a lot of truth.”
As you evaluate your eating habits, don’t obsess over specific foods that claim to lower cholesterol. Ochman prefers for patients to follow a balanced diet that incorporates a variety of whole foods.
Daily exercise that gets your heart rate up is also important. The American Heart Association recommends 150 minutes a week, about 20 to 30 minutes most days. A study published in the journal Metabolism found that aerobic exercise increased HDL “healthy” cholesterol and decreased LDL “lousy” and total cholesterol levels.
Ask About Supplements
After you’ve implemented diet and exercise changes, supplements can improve your cholesterol levels if you still need some help to get within target ranges.
“Omega-3s, red rice yeast and fiber such as psyllium husk — found in Metamucil — are all common supplements that may help people with high cholesterol,” said Ochman.
Available at health food or drug stores, these supplements can be taken as a pill or mixed into food, although it’s worth noting that helpful amounts of fiber and omega-3s can be obtained through a healthy diet.
Easily the most controversial supplement, red yeast rice has a natural statin-like effect that acts like cholesterol-lowering medication. A review in the journal Atherosclerosis found it was as effective as a prescription statin. It may also work for people who can’t take statin medication. However, because of its potency, red yeast rice may cause side effects or worsen existing health conditions.
Ochman notes that some supplements, like red yeast rice, contain chemicals that are biologically active, similar to prescribed medications. Therefore it is very important to discuss any supplements with your primary care provider because of the risk of harmful side effects.
Risks You Can’t Change
No matter how active and healthy you are, there is one risk factor for high cholesterol that you just can’t change — genetics.
“Genetics really drives a lot of the cholesterol abnormalities,” said Ochman. “It is the number one risk factor that exists for cardiovascular disease, and when we look at risk calculators for many different diseases genetics is factored into almost all of them.”
For those with inherited high cholesterol, taking medication may happen eventually but Ochman reports there is still value in making healthy choices.
“Exercise and diet can lower your overall medication burden, control your weight, strengthen your muscles, lower your cholesterol and blood pressure, and benefit your cardiovascular system,” said Ochman. “Even if you know you might one day wind up taking a medication, it’s important to make good lifestyle choices and prolong that day as long as possible.”
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