Cholesterol is a fatty substance in the blood. There are two types of cholesterol. A correct balance between the two is needed for good health.

High-density lipoprotein (HDL) or “good” cholesterol helps remove excess cholesterol from the body. Low-density lipoprotein (LDL) or “bad” cholesterol can cause cholesterol to build up in the arteries.

Low HDL or high LDL cholesterol increases the risk of coronary heart disease. LDL cholesterol forms a substance called plaque in the arteries of the heart. Over time, this plaque can build up, form a clot, and block the arteries of the heart. This may result in chest pain or a heart attack.

High cholesterol usually means too much LDL. There are no symptoms, so many people are unaware they have it. Having high cholesterol can double the risk of heart disease, compared with normal levels.

This article looks at some natural remedies that may help to improve the balance of the two types of cholesterols.

Lifestyle changes and natural supplements may help reduce or control cholesterol levels in many people. The following lifestyle changes have been found to reduce the overall risk of heart disease through lowering blood cholesterol and blood pressure.

Exercise

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30 minutes of exercise a day can reduce the risk of heart disease.

Physical activity is a good way to reduce LDL cholesterol and a person’s overall risk of heart disease. The Physical Activity Guidelines for Americans say that people should aim for 30 minutes a day, 5 days a week (2.5 total hours per week).

Although 2.5 or more hours per week is best, any amount of exercise can help improve health. If a person has heart disease or other health conditions, safe exercise should be discussed with a doctor before beginning.

Eat a heart-healthy diet

Fruits, vegetables, whole grains, and dairy are staples of a healthful diet. However, eating good fats is also important for heart health and cholesterol levels.

A person’s diet should include mostly unsaturated fats, such as those found in fish, nuts, seeds, avocados, and vegetable oils. These unsaturated fats can improve heart health and lower cholesterol levels.

Saturated fats, found in many fatty animal products and processed foods, should be limited to less than 10 percent of daily calories.

Trans fats found in some packaged and fried foods should be avoided as there is no safe amount. These fats can increase the risk of high cholesterol and heart disease.

Achieve a healthy weight

Being overweight can put someone at greater risk of heart disease and high cholesterol. Losing even 5 to 10 percent of body weight has health benefits.

Regular exercise and a healthful diet can help lose body fat and, as a result, lower a person’s cholesterol levels. People should choose to eat foods rich in nutrients and avoid high-calorie, empty-nutrient junk food.

Though some natural supplements are marketed to combat high cholesterol, only a few have been studied adequately.

Aged garlic extract

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Garlic extract may help lower blood cholesterol and is generally well tolerated by the body.

Garlic has been used medicinally since ancient times, and it may help with lowering blood cholesterol. A paper in the Avicenna Journal of Phytomedicine points to a review of 39 trials that showed aged garlic extract could reduce total cholesterol and LDL.

A study in the Journal of Nutrition affirms this, stating that aged garlic extract reduced total cholesterol and LDL by 7 and 10 percent, respectively. Garlic is well tolerated, but people should discuss taking garlic supplements with their doctors.

Flaxseed

Flaxseeds are tiny seeds that contain soluble fiber, lignans, and plant-based omega-3 fats. All of these components may have an effect on the health of arteries or the level of blood cholesterol.

These nutty-flavored seeds can be used in cooking, baking, and smoothies, and their fiber content may help lower cholesterol. A study in Nutrition and Metabolism found that a flaxseed drink lowered total cholesterol and LDL cholesterol by 12 and 15 percent, respectively.

Another study in the Journal of Nutrition found that taking milled flaxseed reduced LDL cholesterol by 15 percent in 1 month.

Because flaxseeds are so small and have a hard outer shell, milled flaxseed is recommended over whole seeds. When the seeds are milled or ground, the body is better able to absorb the nutrients inside.

Soluble fiber

Most Americans do not consume enough fiber, which is necessary for healthy digestion. Fiber has also been shown to lower LDL cholesterol better than a low-fat diet alone.

The American Heart Association say that soluble fiber reduces LDL cholesterol, while insoluble fiber helps reduce the overall risk of heart disease. Soluble fiber is found in high amounts in oats. Other good sources of soluble fiber include fruits, vegetables, and legumes, such as beans and peas.

People should eat whole-grain breads and pastas and limit “white” or refined grains. Fiber supplements can also help increase intake of soluble and insoluble fiber.

Hawthorn fruit

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Hawthorn fruit has been used for centuries to improve heart health but it may interact with some medications.

Some studies have found that hawthorn can lower cholesterol levels in the blood. The leaves, fruit, and flowers of hawthorn have all been used medicinally for hundreds of years to treat heart problems, including high cholesterol.

Although hawthorn can be effective, people with high cholesterol or heart disease should ask a doctor before taking this supplement.

It may interact with some medicines, including many drugs prescribed for heart disease.

Red yeast rice extract: Safety questions remain

A study published in Complementary and Alternative Medicine found that a red yeast rice extract lowered LDL cholesterol by 22 percent and total cholesterol by 15 percent in 8 weeks.

However, the National Center for Complementary and Integrative Health warn that it can be difficult to know whether red yeast rice supplements are safe or effective.

Some of these products were found to contain an active ingredient that is the same as one found in a cholesterol-lowering drug called lovastatin. Therefore, these supplements can cause the same side effects and drug interactions as lovastatin and are not safe for everyone.

Other red yeast supplements that were studied had little or none of the ingredient, but whether these supplements can lower cholesterol was unknown. Some red yeast rice supplements were also found to contain contaminants that can cause kidney failure.

The United States Food and Drug Administration (FDA) do not monitor purity or quality of supplements such as red yeast rice extract. So, if a doctor recommends its use, a person should ensure they buy it from a reputable source.

Other natural products, such as turmeric and guggul, may lower cholesterol, but studies and research on them are limited.

To ensure safety and effectiveness, people should ask their doctor about which natural remedies would be best for their individual lifestyle and health conditions.

The lifestyle changes listed above are often recommended as part of a cholesterol-lowering treatment plan.

Herbs or other supplements, however, should only be used with a doctor’s approval. Natural supplements can interfere with other medicines or cause unwanted and dangerous side effects in some people.