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Cholesterol: How to reduce it and which food & supplements can help?

by Katia Annousi, Dietitian & Nutritionist, QMU

16 May 2024 • 0 min read

Cholesterol is a lipid produced by the liver and is required by the body for vitamin D production, the formation of the layers of cell membranes and the production of certain hormones, such as estrogen.

Main types of cholesterol:

Total cholesterol: This is the total amount of cholesterol circulating in the blood and is calculated by the following equation: HDL + LDL + 20% triglycerides = total cholesterol.

HDL. This is the "good" cholesterol that carries extra cholesterol from the bloodstream to the liver. The liver then flushes it out of the body. HDL helps the blood vessels exert cholesterol that the body doesn't need.

LDL. This is the "bad" cholesterol that contributes to plaque buildup in the arteries. This cholesterol buildup, along with plaque (inflammatory deposits), can lead to atherosclerosis, also known as hardening or narrowing of the arteries. Atherosclerosis increases the risk of stroke, heart attack and peripheral arterial disease (PAD).

Triglycerides: HHigh levels (hypertriglyceridemia) increase the risk of atherosclerosis and other diseases.

Non-HDL cholesterol: This is all the cholesterol in the blood that is not HDL. The formula for calculating this number is simple:
Total cholesterol - HDL = Non-HDL cholesterol.

The American Heart Association recommends that everyone over the age of 20 get a cholesterol test every 4 years. You may need to test more often if you have risk factors for high cholesterol, such as a family history.

Cholesterol values

Total Cholesterol Level


Less than 200 mg/dL


200-239 mg/dL

Bordeline High

240 mg/dL and above

Very high


HDL Cholesterol Level


Less than 40 mg/dL

Significant risk factor for heart disease

40-59 mg/dL

The higher, the better

60 mg/dL and above

Protective against heart disease

LDL Cholesterol level


Less than 100 mg/dL


100-129 mg/dL

Almost ideal

130-159 mg/dL

Borderline High

160-189 mg/dL


190 mg/dL and above

Very High


How can you lower your cholesterol levels?

  • Physical activity. The American Heart Association (AHA) recommends at least 40 minutes of moderate-intensity aerobic exercise 3 to 4 times a week.
  • Saturated fat. Try to avoid trans fats (certain baked goods, fried foods, some margarines) and limit saturated fats (full-fat dairy, meats).
  • Dietary fibre. Try to add more fiber to your diet, such as replacing white bread and pasta with whole grains.
  • Avoid processed meats and sausages.
  • Weight management. If you are overweight, losing weight can help lower LDL (bad) cholesterol.
  • Smoking. Try to quit smoking (tobacco products are known to lower HDL levels and raise LDL levels and triglycerides).
  • Alcohol: Avoid or limit alcoholic beverages (up to one drink a day for women of all ages and men over 65 and up to two drinks a day for men age 65 and younger).
  • Management of underlying health conditions, such as thyroid conditions
  • Management of stress. Research has shown that chronic stress can sometimes raise LDL cholesterol and lower HDL cholesterol.

Why are my cholesterol values important?

Cholesterol values are important because they help to know your risk for heart disease and may lead to serious problems such as:

  • Coronary arterial disease: a reduction in blood flow to the heart.
  • Peripheral arterial disease: blocking blood flow to the legs and arms.
  • Carotid artery disease: Blocks blood flow to the brain.

Which foods help lower cholesterol levels?

  • Oats
  • Fruits and vegetables
  • Whole wheat products
  • Almonds and other nuts
  • Pulses
  • Olive oil
  • Avocados
  • Fish
  • Flaxseeds
  • Cinnamon
  • Turmeric

Which supplements could help lower cholesterol levels?

  • Red rice yeast, because of its active ingredient, monacolin.
  • Berberine: a bioactive compound, which belongs to an alkaloid group and is present in various plants, mainly in the Berberis shrub family
  • Phytosterols/Plant Sterols
  • Turmeric
  • Milk Thistle, due to its active ingredient, silymarin
  • Fish oil
  • Cod Liver oil
  • Garlic
In conclusion

A dietary plan that will help you lower cholesterol is basically a nutrition plan, which is focused on the main features of the Mediterranean diet, which is rich in fruits, vegetables, legumes and whole grain products. Lifestyle changes such as avoiding smoking, regular exercise, managing stress and reducing alcohol consumption are considered critical for the management of total and LDL cholesterol.

Remember that food is your medicine and your medicine can be your food!

Scientific references

Tsao CW, Aday AW, Almarzooq ZI, Beaton AZ, Bittencourt MS, Boehme AK, et al.(2023) Heart Disease and Stroke Statistics — Update: A Report From the American Heart Association.
Morbidity and Mortality Weekly Report. (2018). 67(35):983–991.

Washington, DC: U.S. (2018).Department of Health and Human Services.

Hellenic Cardiology Society,