6 steps to lowering cholesterol naturally

Even though statin therapy safely lowers cholesterol and prevents cardiovascular disease, many patients resist taking them. A study in May 2025 set out to determine why patients were resistant to taking a proven medication. Slightly more than 50 percent of the patients interviewed said they preferred lifestyle modifications to taking a statin.

Miguel Prieto, MD, an internist with Cape Cod Healthcare’s Bourne Primary Care, said he advises his patients that there are lifestyle modifications that can lower cholesterol naturally, with the stipulation that if their (LDL or ‘bad’) cholesterol level is high enough that it points to significant plaque formation, medication will be required. While the treatment for those patients is to start with the lowest dose of a statin and raise it as necessary, patients who have already had a stroke or heart attack will need to take the highest dose to prevent another attack – regardless of what their cholesterol numbers are, he said.

But for those patients who don’t already have high cholesterol, Dr. Prieto offers six pillars of lifestyle modifications that can maintain healthy cholesterol levels naturally.

“You cannot medicate your way out of a poor lifestyle,” Dr. Prieto said. “While medications are tools, the six pillars of lifestyle medicine are the foundation of everything.” Below, he explains the six pillars and how to apply them to your life.

Nutrition is Number One

“If you get rid of animal fat, your cholesterol will drop,” he said. “If not, do what you can, but that certainly is a major thing.”

Dr. Prieto has long advocated the benefits of a whole-food, plant-based diet. Studies show that that is indeed a successful way to prevent cardiovascular disease, diabetes, stroke and cancer. Even just cutting down on animal fat and adding more fruits and vegetables can be extremely beneficial, he said.

“Soluble fiber is a great prescription for using food as medicine to get rid of cholesterol in your body,” he said.

Foods rich in soluble fiber like beans, oats, fruits and vegetables, digest more slowly, which makes people feel full longer. The slower nutrient absorption lowers cholesterol and stabilizes blood sugar, which helps manage diabetes and heart disease risk.

The remarkable thing about switching to a whole-food, plant-based diet is how quickly it helps drop cholesterol numbers, Dr. Prieto said. In just seven to 10 days, significant changes can occur, he said.

He also cautioned that animal fats aren’t the only dangerous fats. Plant-based fats like coconut oil and palm oil have twice as much saturated fat as lard does, so make sure to avoid eating those as well.

Physical Activity is a Close Second

“When it comes to physical activity, the recommendation is 30 minutes a day of aerobic exercise five days a week,” Dr. Prieto said. “When you exercise 30 minutes a day five days a week, you decrease your risk of dementia by 30 percent. And the second-best benefit is you prevent a condition we call sarcopenia, meaning loss of muscle mass.”

As we get older, recovering from sarcopenia is still possible but it takes longer and requires more effort, he said.

Exercising doesn’t really lower cholesterol that much, he said, but what it does do is increase your ‘good’ cholesterol level and it changes the size of the ‘bad’ LDL cholesterol particles. By changing the size of the particles, it makes them less likely to create plaque.

Stress Reduction

“Long-term stress is a direct contributor to increasing your LDL levels,” Dr. Prieto said. “The medical studies have shown that when you are really stressed and it is continuous stress, your body releases stress hormones like cortisol and adrenaline, which trigger the release of triglycerides.”

Triglycerides are very sticky so they create a lot of plaque. He compared it to mixing butter and sugar together when baking because triglycerides are one carbon molecule combined with three fatty acid molecules.

One easy way to lower stress is to exercise, because exercise significantly lowers the release of adrenaline, which then lowers the cortisol level too, he said.

Exposure to natural light in the morning is another easy way to lower stress, he said.

Avoiding Risky Substances

That means quitting smoking or vaping, and limiting alcohol.

“Smoking doesn’t just damage your lungs,” Dr. Prieto said. “It also makes the bad cholesterol, the LDL, stickier, so it accelerates plaque formation, and it lowers good cholesterol. And when you drink alcohol it increases your triglycerides, which is, again, sticky.”

Recent studies have shown that there is really no cardiovascular benefit to drinking alcohol, so it should be used sparingly for most people, and cancer survivors shouldn’t drink any alcohol at all, he said.

Get Adequate Sleep

The recommendation is to get at least seven hours of sleep every night, Dr. Prieto said. Sleep is when your body repairs itself, because when we are awake our bodies are unable to get rid of toxic waste. Poor sleep is also associated with weight gain, insulin resistance and worse cholesterol profiles.

“If it happens one night, it is not an issue, but if this happens continuously, the damage begins to accumulate,” he said. “The best thing you can do when it comes to sleep is go-to bed at the same time every day and get up at the same time.”

Positive Social Connections are Important

“When people are socially isolated, they have a three to 10 times higher rate of death than someone who is not socially isolated, even if they are taking medication for cholesterol,” he said. “Social integration is like the glue that holds all the other pillars of lifestyle medicine together.”

Dr. Prieto recommends that people have at least three pleasant social interactions every week. You can combine social interactions with other pillars of healthy living for even more benefit. For example, studies have shown that having a workout or diet buddy improves the success rates for those activities, making them a win/win.