How can I control and improve my cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglyceride levels through a healthy lifestyle?

From the Guidelines

To improve your cholesterol profile, focus on a heart-healthy lifestyle that includes dietary changes, regular exercise, weight management, and avoiding tobacco, as recommended by the most recent guidelines 1.

Key Recommendations

• Eat a diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats like those found in olive oil, nuts, and fatty fish.
• Limit saturated fats, trans fats, and dietary cholesterol by reducing consumption of red meat, full-fat dairy, and processed foods.
• Aim for at least 150 minutes of moderate-intensity exercise weekly, such as brisk walking, swimming, or cycling, as suggested by the American College of Cardiology 1.
• Losing even 5-10% of your body weight if overweight can significantly improve cholesterol levels.
• Limit alcohol consumption to moderate levels and avoid smoking.
• Certain foods like oats, barley, beans, nuts, and foods containing plant sterols can actively help lower LDL cholesterol.
• Omega-3 fatty acids found in fish like salmon and mackerel can help reduce triglycerides and increase HDL.

Lifestyle Modifications

• The American Heart Association recommends lifestyle modification focusing on weight loss, reduction of saturated fat, trans fat, and cholesterol intake, and increased physical activity to improve the lipid profile in patients with diabetes 1.
• The American College of Cardiology suggests that instead of drinking sugar-sweetened beverages, try a no-calorie sparkling water with a lemon slice, and instead of eating a pastry, dessert, or candy, have fresh fruit or a small piece of dark chocolate 1.

Medications

• If lifestyle changes don't sufficiently improve your cholesterol levels after 3-6 months, your doctor may recommend medications like statins (such as atorvastatin or rosuvastatin), which can lower LDL by 20-60%, as recommended by the American Diabetes Association 1.
• The American Heart Association suggests that in patients with triglyceride levels of 200 to 499 mg/dL, a non–HDL-C goal of 130 mg/dL is a secondary target 1.

From the FDA Drug Label

Patients should be placed on an appropriate lipid-lowering diet before receiving fenofibrate tablets and should continue this diet during treatment with fenofibrate tablets. The initial treatment for dyslipidemia is dietary therapy specific for the type of lipoprotein abnormality. Excess body weight and excess alcoholic intake may be important factors in hypertriglyceridemia and should be addressed prior to any drug therapy. Physical exercise can be an important ancillary measure Diseases contributory to hyperlipidemia, such as hypothyroidism or diabetes mellitus should be looked for and adequately treated.

To control and improve cholesterol, LDL, HDL, and triglyceride levels through a healthy lifestyle, dietary therapy is the initial treatment. This includes:

• A lipid-lowering diet
• Addressing excess body weight and alcoholic intake
• Incorporating physical exercise as an ancillary measure
• Managing diseases that contribute to hyperlipidemia, such as hypothyroidism or diabetes mellitus 2

From the Research

Healthy Lifestyle Changes to Improve Cholesterol Levels

To control and improve cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglyceride levels, several healthy lifestyle changes can be implemented, including:

• Dietary modifications: A healthy dietary pattern is essential for treating elevated LDL-C and triglycerides 3. This can include minimizing saturated fats and refined carbohydrates, eliminating trans-fat, and increasing fruits, vegetables, whole grains, low-fat dairy, and fish or other omega-3 fatty acids 4.
• Physical activity: Increasing physical activity has extensive benefits, including improving both blood pressure and blood cholesterol, and is a critical component of first-line treatment for elevated blood pressure or cholesterol 5.
• Weight management: Maintaining a healthy weight can also help improve cholesterol levels and reduce the risk of cardiovascular disease.

Dietary Recommendations

Specific dietary recommendations for improving cholesterol levels include:

• Following a Mediterranean diet, which has been shown to lower cardiovascular disease and total mortality 4.
• Increasing intake of omega-3 fatty acids, which can help lower triglyceride levels and reduce cardiovascular risk 4.
• Limiting intake of saturated fats and refined carbohydrates, which can help lower LDL-C and triglyceride levels 3, 4.

Lifestyle Interventions

Lifestyle interventions, including dietary intervention and physical activity, should be individualized and customized to patient preferences to achieve clinically relevant lipid/lipoprotein improvements 3, 5. Clinicians can play a crucial role in assessing, prescribing, counseling, and referring patients to support increased physical activity and healthy lifestyle changes 5.

Additional Considerations

Additional considerations for improving cholesterol levels include:

• Getting enough sleep and managing stress, which can help improve overall cardiovascular health.
• Quitting smoking, which can help reduce the risk of cardiovascular disease.
• Limiting alcohol consumption, which can help improve cholesterol levels and reduce the risk of cardiovascular disease.
• Monitoring cholesterol levels regularly and working with a healthcare provider to develop a personalized treatment plan 6.