If you’ve been diagnosed with high cholesterol levels, your doctor may have given you a deadline for lowering it before opening up the conversation to medications to control your cholesterol

This sudden change in your health status—and the pressure to make potentially huge lifestyle changes in a short amount of time—may feel overwhelming, especially if you’re unfamiliar with the causes of high cholesterol, confused about what your cholesterol numbers mean, or at a loss about where and how to start making necessary changes to improve your cholesterol.

Welcome to the Forward guide to helping you get those numbers down naturally. Here, we take a look at the three overarching lifestyle factors that have the biggest impact on cholesterol—diet, exercise, and stress. Understanding how these affect your cholesterol is the first step to lowering it. After each section, you’ll find a link to a related guide offering practical and actionable tips for changing your eating and exercise habits and reducing stress.

How long does it take to bring cholesterol down?

In general, if your cholesterol levels don’t pose an immediate risk of heart attack or stroke, your primary care physician will give you three months to bring your cholesterol down to normal or near-normal levels naturally. How long it takes for you depends on a whole slew of factors, including your level of overall health, your genes and biology, how high your cholesterol is, and your sex—it typically takes women longer to see changes than men. 

Although these are things you can’t change, in many cases, high cholesterol—like many health conditions and chronic diseases—is largely the result of three overarching lifestyle factors: diet, exercise, and stress management. How quickly you can lower your cholesterol is highly dependent on the choices you make in these areas. 

How your diet affects cholesterol levels

Foods high in cholesterol are those that come from animals—full-fat dairy, organ meats, egg yolks, for example. If you have high cholesterol, strive to consume fewer than 200 mg of cholesterol each day. Although cholesterol in food can increase your cholesterol levels, it’s not the most important factor for high cholesterol. 

Here are the most important dietary considerations for lowering your cholesterol.

Eliminate or reduce bad fats in your diet

A diet high in trans fats or saturated fats, known as “bad” fats, can increase cholesterol levels. Lowering your intake of unhealthy dietary fats is central to lowering your cholesterol.

Saturated fats 

Mostly found in full-fat dairy products, fried foods, and red meats, saturated fats are solid at room temperature, and they’re a major contributor to high “bad” LDL cholesterol levels. Limit saturated fats to less than seven percent of your total daily calories—for a 2,000 calorie diet, that’s around 16 to 22 grams per day, roughly the equivalent of two slices of bacon.

Trans fat

Also known as partially hydrogenated vegetable oil, trans fat is so bad for heart health that it was banned by the FDA effective January 1, 2021. While trans fat occurs naturally in small amounts in dairy products and red meat, more concerning is that you may still be consuming it in your diet through certain baked goods and processed foods without knowing it. That’s because if a product contains less than 0.5 grams of trans fat per serving, manufacturers can list it as 0 grams on the label—but they still have to include it on the list of ingredients, where it’ll be listed as “partially hydrogenated vegetable oil.”  

If you frequently eat several servings per day of certain processed foods, those one-half-grams-or-less of trans fats can add up to serious problems for your heart health. These are some of the food products that may still have a surprising amount of trans fat:

  • Vegetable shortening and some margarines and vegetable oils
  • Some varieties of microwave popcorn
  • Fried fast food, including French fries, chicken nuggets, and fried chicken, fish, and noodles
  • Many bakery items made with vegetable shortening or margarine
  • Some non-dairy creamers
  • Some potato chip or corn chip varieties
  • Canned frosting
  • Some varieties of crackers

Eat plenty of good fat

Healthy fat, known as unsaturated fat, is liquid at room temperature. The two main types of unsaturated fat are monounsaturated and polyunsaturated fats. They’re very similar, and both types can help lower LDL, increase HDL, decrease inflammation, stabilize heart rhythms, and more.

Monounsaturated fat

Monounsaturated fats have just one carbon-to-carbon double bond in their molecular structure. They help lower LDL cholesterol and improve the health of your cells. Monounsaturated fat is found in nuts, avocados, sesame seeds, and olive, canola, corn, and safflower oils.

Polyunsaturated fat

Polyunsaturated fats have more than one double bond in their molecular structure. They’re essential for blood clotting and building cell membranes, and since your body doesn’t make polyunsaturated fats, you have to consume them in your food. 

Omega-3 fatty acids are a type of polyunsaturated fat found in fatty fish like salmon and sardines. Omega-3 fatty acids can lower triglyceride levels and increase HDL cholesterol, and they’re essential for brain function and cell growth. Non-fish sources of omega-3 fatty acids include walnuts, flaxseed, sunflower seeds, and seaweed.

Eat lots of fiber

Fiber helps lower your cholesterol and improves digestive and heart health. Two types of fiber are soluble and insoluble:

Soluble fiber

Soluble fiber grabs onto cholesterol particles in your gut before they can reach your bloodstream. Soluble fiber helps to lower “bad” LDL cholesterol levels. Foods high in soluble fiber include fruit, nuts, whole grains, beans, lentils, and chickpeas. 

Insoluble fiber

Insoluble fiber helps keep your stools soft and regular, and like soluble fiber, it makes you feel full, which can help you eat less. Foods high in insoluble fiber include whole grains, beans, lentils, and most vegetables. It’s best to get your fiber from food sources rather than supplements, because the fiber in food is better absorbed by the body and has additional nutritional value that supplements don’t have. But some fiber supplements, including those containing psyllium husk (Metamucil) or methylcellulose (Citrucel) may help lower your LDL cholesterol at a daily dose of 5 to 20 grams per day.

Eating to lower your cholesterol doesn’t have to leave you feeling deprived—and it doesn’t need to be complicated. Our guide to eating for disease management offers a lot of practical tips and tricks to help you modify your diet and reduce your cholesterol—and your risk for heart and other diseases—quickly, naturally, and pain-free.  

Can you lower cholesterol with exercise?

Exercising is a reliable way to lower your cholesterol fast. There’s no single-best exercise for lowering your cholesterol, but the two main categories of exercise that do the trick are cardio and strength training. Both are also key components in managing diabetes, lowering blood pressure, and reducing your risk for heart disease, cancer, and many other health problems. 

Cardio exercise 

Cardiovascular exercise, also known as cardio or aerobic exercise, is essential for lowering your cholesterol. A literature review of published studies found that moderate-intensity exercise increases “good” HDL cholesterol, which reduces the risk for atherosclerosis and ischemic heart diseases and improves total cholesterol levels. Higher-intensity cardio lowers LDL cholesterol and triglyceride levels.

Although it’s still unknown exactly how cardio affects cholesterol, researchers believe that it may enhance the ability of the skeletal muscles to utilize fats, rather than glycogen, for fuel. Exercise helps remove cholesterol from the bloodstream through a process known as “reverse cholesterol transport,” wherein exercise triggers changes in the activity of enzymes that increase the ability of the muscles to oxidize fatty acids.

The Centers for Disease Control recommends at least 150 minutes of moderate-intensity cardio each week—30 minutes each day five days a week—for optimal health and disease prevention. But if you already have high cholesterol, increasing the time or intensity—or both will produce better results.

Strength training 

Also known as weight training, weight lifting, or resistance training, strength training involves exercises that target and strengthen particular groups of muscles. Research shows that low- to moderate-intensity strength training helps reduce LDL and total cholesterol, but a higher intensity is necessary to increase HDL cholesterol. In the context of reducing cholesterol levels, higher intensity weight training should involve more sets with more repetitions, rather than heavier weights.

The CDC recommends strength training at least twice per week, but the more days you weight train, the better your results will be.

Learn more about exercising to reduce your cholesterol—including how to get started and how to stay motivated—in our guide to exercising for disease management.

Stress management

Psychological stress is an important risk factor for high cholesterol. When you’re stressed, your body releases stress hormones like cortisol and adrenaline. These hormones trigger the stress—“fight or flight”—response, increasing your heart rate, blood pressure, body temperature, and muscle tension. This stress response in turn triggers the release of triglycerides, or the stored energy in your fat cells. Very low-density lipoproteins, or VLDLs, provide the triglycerides with door-to-door transportation from your fat cells to where the fuel is needed. After the VLDL drops off the triglycerides, it metabolizes into “bad” LDL cholesterol. 

Stress also has less-direct—but potentially more important—effects on the mind and body that may contribute to high cholesterol. 

Stress, substance abuse, and cholesterol

Stress is a well-known factor for substance abuse that can lead to all sorts of unhealthy behaviors, including smoking, drinking, using drugs, or overeating in an attempt to self-medicate the physical and mental discomfort stress causes. 

While these vices may provide short-term relief, they can do serious damage to your physical and mental health over time—including increasing your blood pressure and cholesterol and contributing to anxiety, depression, or addiction.

Smoking 

Smoking cigarettes, cigars, and pipes is a major cause of high cholesterol, high blood pressure, and heart disease. Thousands of harmful chemicals in cigarettes change your blood chemistry, which increases the amount of plaque that builds up in your arteries. Smoking thickens the blood and hardens the plaque, making your heart work extra hard to get the oxygen-rich blood where it needs to go. Blood clots form more easily and can lead to a heart attack or stroke.

Excessive alcohol consumption

While alcohol doesn’t contain cholesterol, it adds extra calories and—in some cases—carbs to your diet. The excess calories and carbs turn into triglycerides and LDL cholesterol. While moderate alcohol use—defined as no more than one drink per day for women or two per day for men—is linked to higher “good” HDL cholesterol levels, heavy use is associated with numerous health problems, including high blood pressure, heart attack, and stroke. 

Stress, sleep, and cholesterol

Research shows that too much or too little sleep has a negative effect on your cholesterol levels. One study found that sleeping less than five hours or more than eight hours per night raised triglyceride levels and lowered “good” HDL levels in women. Another study, published in the Journal of Cardiovascular Nursing, found that people who sleep fewer than six hours each night have a greatly increased risk for cardiovascular disease. The researchers also found that snoring is linked to lower levels of beneficial HDL cholesterol.

Stress is a well known risk factor for insomnia and other sleep problems—and poor sleep contributes to stress by leaving you feeling fatigued, irritable, unmotivated, and unable to concentrate. Reducing your stress can improve your sleep, and improving your sleep can help reduce your stress.

For many people with high cholesterol, stress leads to unhealthy habits that can be very difficult to break—even when you’re facing health problems because of them. Our guide to managing stress and quitting vices has practical and actionable tips to help you lower both acute and chronic stress, quit smoking, cut down on alcohol, and sleep better.

Got high cholesterol? Forward can help

Forward takes a holistic approach to helping you improve your health. Members have full access to our doctor-led preventive and disease management programs, including our healthy heart program, weight management and stress reduction clinics, and cancer prevention program. Our app makes it easy for you to access your test and assessment results, stay on top of your health goals, monitor your progress, and communicate with your care team to help you take control over your health.

No long waits. One flat fee. No copays — ever.

Fed up with a soul-sucking healthcare system? Same. With unlimited visits, personalized insights and real, actionable results, find out what it’s like to actually enjoy seeing your doctor.