“The sooner we start building [healthy] habits in our adult life, the better it will be,” says Rajaram. “The age-old saying ‘Prevention is better than cure’ is really true.”
Exercise often
Aim for 150 minutes of moderate-intensity exercise per week, recommends the US Surgeon General. What that blood-curdling activity looks like is up to you. It can be yard work, walking, swimming, high intensity interval training (HIIT) – the key is to do things you enjoy.
“The best exercise is the one that people will do,” says Petersen. However, she adds that aerobic activity is associated with improving cholesterol levels in a way that weight training is not.
Eat a balanced diet
When it comes to controlling cholesterol, specific foods can help or hinder your efforts. The Centers for Disease Control and Prevention (CDC) recommends limiting saturated fats and choosing foods that are low in added trans fat, sugar and sodium. Lean meats and foods naturally high in fiber and unsaturated fats can help keep LDL and triglycerides low while supporting healthy HDL levels.
If that guidance feels overwhelming, Rajaram suggests looking at food on a continuum. On the one hand, there is a diet of mainly refined and/or animal foods. On the other end of the spectrum is a whole plant-based diet. Everyone is somewhere in this range. She suggests moving more toward the whole-food, plant-based end of the spectrum to improve your cholesterol levels.
“The idea here is to understand where you are on the continuum and then take steps forward,” she says. “You’re going to see a difference in your overall health.”
Small changes like choosing whole-wheat toast with avocado over hash browns, bacon, and white toast can add up. You may see your LDL and body weight drop. In addition, these kinds of changes are sustainable in a way that restrictive diets are not.
“Will a fad diet or restrictive eating bring results? Absolutely,” says Rajaram. “But can you live like this for the rest of your life? No.”
Both Rajaram and Petersen recommend progressive changes. Swap whole milk for 2% milk. Replace an animal-based meal with whole grains, lentils, and beans. Try nuts as a snack – they help lower cholesterol and keep you feeling full. And increase your intake of fruits and veggies — they’re high in soluble fiber and usually have cholesterol-lowering properties, too.
“Including more servings of whole, plant-based foods is a good start, even if you can’t be exclusively plant-based,” says Rajaram.
Avoid smoking
Smoking damages blood vessels and can worsen hardening of the arteries. The habit also significantly increases the risk of heart disease. So if you don’t smoke, don’t start and if you smoke, talk to your doctor about ways to quit.
Limit alcohol
To control triglyceride levels, men should have no more than two drinks a day and women no more than one drink a day.
“Keep in mind that you can’t keep all your drinks for one day,” says Petersen.
Manage your weight
Excess body fat changes the way your body uses cholesterol. It also slows down the body’s ability to remove LDL cholesterol from the blood. However, even small changes in body weight can have a clinical impact on cholesterol levels.
For people with elevated cholesterol, losing 5% to 10% of their body weight can also help lower their LDL levels.
“Even five pounds can put you on track,” says Rajaram.
Work with your doctor to determine a healthy weight for you and how to achieve or maintain it.
Make incremental changes
People are attracted to dramatic changes, but small shifts are often more sustainable.
“If you’re making changes to your diet, sleep, or activity, don’t go for the all-or-nothing approach,” says Petersen. “Start small. Make a few changes and if you feel comfortable with it, add another change until you finally meet the recommendation.
And it’s always the right time to build heart-healthy habits.
“Don’t wait for your cholesterol to go up,” says Rajaram. “Now is the time – anything you do now can make a difference as you move forward.”