Cholesterol balance

How is cholesterol assessed?

A blood test measures cholesterol fractions. LDL and non-HDL help assess vascular risk; blood pressure and other risk factors also matter. 1

Why can cholesterol be high?

Diet rich in saturated and trans fats and little physical activity can contribute. Some people have inherited high cholesterol. 1

When should high cholesterol be discussed?

High cholesterol usually causes no symptoms. Treatment decisions depend on overall cardiovascular risk, particularly after cardiovascular disease or with inherited hypercholesterolemia. 1

What can supplements change?

The following findings concern cholesterol levels; they do not by themselves demonstrate prevention of heart attacks. 1

SoyMixed

NCCIH reports small cholesterol reductions, with soy foods outperforming protein supplements in an analysis of 35 studies. Isoflavones did not lower cholesterol. 2

FlaxseedMixed

Benefits appear more likely with whole seeds or lignans than flaxseed oil, especially in women and people starting with higher cholesterol. 2

GarlicMixed

Research summarized by NCCIH found a modest reduction after more than two months, smaller than that of cholesterol-lowering medicines. 2

Green teaToo little evidence

The evidence for a cholesterol-lowering effect is limited. 2

Is red yeast rice a safer alternative?

Products containing substantial monacolin K can lower cholesterol, but this compound is chemically identical to lovastatin. Amounts vary across products, and muscle, liver and kidney harm and drug interactions are possible. Citrinin contamination is another kidney risk. 3

What matters more than a supplement?

Risk reduction includes avoiding smoking, being active and improving dietary fat quality. Statins have evidence for reducing cardiovascular events; supplement-related changes in blood results alone are not equivalent evidence. 1

Questions people ask