Millions of Brits are living with high cholesterol, a potentially dangerous condition that raises your risk of medical emergencies such as heart attacks and strokes. This occurs when there is too much cholesterol, a fatty substance, found in the blood.
Although a certain amount of cholesterol is needed by the body, having too much can lead to blockages and even the hardening of the arteries. It then becomes more difficult for blood to travel around the body, something which can result in cardiovascular disease.
It is thought around two in five people in the UK are living with high cholesterol, which is also known as hypercholesterolemia. Many people are prescribed a type of medication known as statins to help bring down their cholesterol levels as a result.
However, the first port of call should be making certain lifestyle changes to bring down your levels, before resorting to medication. The NHS says: “If you’re at risk of developing cardiovascular disease in the near future, your doctor will usually recommend lifestyle changes to reduce this risk before they suggest that you take statins.”
One such lifestyle change recommended by the health body is switching to a healthy diet. This includes eating plenty of fruits and vegetables, and cutting back on saturated fats and sugar.
But according to the British Heart Foundation (BHF) there are some specific foods you should consider adding to your diet that act as “natural alternatives to statins”. The charity listed four such foods and delved into some of the science behind them.
Plant sterols and stanols
You might be unsure what these are exactly but you will have seen certain products that contain added plant sterols and stanols and claim to lower cholesterol. These include items such as margarines, milks and yoghurts.
Experts at the BHF referenced one review of 124 studies published in the British Journal of Nutrition in 2014 that found that up to 3.3 grams of plant sterols and stanols daily gradually lowered “bad” low-density lipoprotein (LDL) cholesterol by six to 12 per cent after around four weeks.
“It’s thought that, because plant sterols and stanols have a similar structure to cholesterol, they reduce the amount of cholesterol absorbed by the gut, which lowers your cholesterol blood levels,” they said.
“You can also find small amounts in plant-based foods like fruit, vegetables, vegetable oils, nuts and grains. However, this usually adds up to less than 600mg of phytosterols [another name for plant sterols and stanols] a day, which is much lower than the effective dose of 2g you can get from fortified dairy products.”
However, plant sterols and stanols may lower your cholesterol but there have been no clinical trials that show they lower the risk of heart attack and stroke.
Oats
A bowl of porridge in the morning could be one of the healthiest types of breakfast to eat if you have elevated cholesterol. This is because oats and barley contain a type of soluble fibre known as beta-glucan.
“Soluble fibres form a gel in your gut, which can bind with cholesterol and stop it from being absorbed into the body,” the BHF says.
A review of 58 controlled trials also published in the British Journal of Nutrition found that middle-aged participants’ “bad” cholesterol decreased by 4.2 percent when they consumed 3.5g of beta-glucan from oat products a day over three to 12 weeks compared to those who did not.
According to the BHF, a 40g serving of porridge oats contains 2g of beta-glucan, while a 250ml glass of oat milk contains 1g of beta glucans. However, similarly to plant sterols and stanols there is no research linking oats to a lower risk of heart attack or stroke.
Garlic
Garlic may be more than just a way to add flavour to your meals. It is thought that a chemical in garlic called allicin could lower cholesterol and blood pressure, however, research is not conclusive.
The BHF explains: “One small study in Iran published in 2016 in the International Journal of Preventive Medicine found that people with high cholesterol who had 20g of raw garlic (around four cloves) and one tablespoon of lemon juice a day for eight weeks experienced a larger decrease in their ‘bad’ cholesterol levels than those who took just one or neither ingredient.
“But a Stanford University trial published in the Archives in Internal Medicine in 2007 found that taking raw garlic, or garlic supplements, almost daily for six months had no effect on ‘bad’ cholesterol levels in people with high cholesterol.”
Oily fish
Omega-3 fatty acids found in oily fish and fish oil supplements have been hailed as a way to boost your cardiovascular health. However, the BHF says they do not lower cholesterol, rather another type of fat in your blood known as triglyceride, which “can also increase your risk of heart and circulatory diseases if their levels are too high”.
An analysis of 90 studies with 72,598 participants published in 2023 in the Journal of the American Heart Association found that consuming supplements containing two types of omega-3s a day for around 13 weeks led blood triglyceride levels to fall. This reduction was seen in people with high cholesterol and those without.
“The research looked at the effects of supplements containing 2g of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) omega-3s,” the BHF says. “However, it also found that while taking over 2g of these omega-3 supplements a day decreased triglyceride levels further, it also increased levels of ‘bad’ cholesterol.”
Both DHA and EPA omega-3s can be found naturally in oily fish, like salmon, mackerel and anchovies, and another type of omega-3 called alpha-linolenic acid (ALA) is in some nuts and seeds and the oils made from them.
“But omega-3 supplements are not recommended to prevent heart disease, unless your GP prescribes them for high triglyceride levels, as the evidence behind taking them to improve your heart health is mixed,” the BHF adds.
“For example, research published in the journal BMJ Medicine in 2024 showed that fish oil supplements may increase the risk of someone developing a heart condition or having a stroke, but could reduce the risk for those who already have heart disease.”
If you are concerned about your cholesterol levels, you should speak to your GP.
