Cholesterol is treated like a 4-letter word sometimes, but the truth is that the soft waxy substance is essential for your health. Your body produces it to build cell walls everywhere--including inside your brain, nerves, muscles, skin, liver, intestines, and heart. Cholesterol is also used to produce hormones, and to make the bile acids that help digest food.
But problems arise when there's too much "bad" LDL cholesterol and not enough "good" HDL cholesterol. The LDL kind pumps your artery walls full of dangerous plaque, which raises the risk of heart attack and stroke. HDL, on the other hand, helps sweep out the artery-clogging LDL, but only if you have lots of it. According to current American Heart Association guidelines, women should aim for total cholesterol of less than 200 mg/dL, HDL of 60 mg/dL or greater, and LDL of less than 100 mg/dL, but other risk factors like your weight, blood pressure, and family history also play a role in determining healthy levels for you.
If you're among the 16% of adults with high total cholesterol, your risk of heart disease is double that of someone with healthy levels. And, according to cardiologist and Prevention advisor Arthur Agatston, MD, virtually every heart attack starts with cholesterol. Each occurs because the waxy substance burrows into the heart vessel wall and eventually bursts, much like a pimple, leaving an ulceration of the artery lining that the body tries to heal by forming a blood clot. This clot blocks the artery, causing a heart attack.
Things like your age, gender, and family history can all affect your cholesterol in ways you can't control, but your eating and exercise habits can make a big difference in maintaining a healthy cholesterol profile. Losing just 5 or 10 pounds may be enough to lower levels, as can regular exercise, choosing healthy unsaturated fats over saturated and trans fats, eating more fiber, and managing stress.
After these lifestyle changes, there are some supplements that can help you maintain healthy cholesterol levels. Keep in mind that what we didn't include on this list is just as important as what we did. Red yeast rice, a popular remedy, acts similarly to statin drugs; many doctors don't see a good benefit of taking it in place of the more effective and government-monitored drugs. And we didn't list niacin, a B vitamin, as a supplement here because the levels needed to raise HDL cholesterol and lower triglycerides, another type of blood fat, are only available in prescription-level doses and must be supervised by a doctor. Also, niacin is only effective if you pair it with statin drugs; as a standalone treatment, it doesn't help. Soy foods may help lower cholesterol if you eat them in place of ones packed with saturated fat, but the most recent research on standalone soy supplements as a cholesterol cutter doesn't hold up.
These heart-protective plant compounds occur naturally in fruits, vegetables, nuts, and oils, but you'll need a higher concentration than those amounts to nudge cholesterol. Now, concentrated doses are added to margarine-like spreads and other foods; research shows they can lower LDL levels by as much as 20%! Experts believe that sterols and stanols, with chemical structures similar to cholesterol, help prevent cholesterol from being absorbed into the bloodstream. More about sterols/stanols.