Why is one form of cholesterol considered good and another bad? There are actually as many as 18 kinds of cholesterol, but to save confusion, doctors divide them into two categories: LDL (bad) and HDL (good). Your liver manufactures most of your cholesterol, and small amounts of it go toward a variety of healthy purposes, including creating hormones that help turn food and exercise into muscle. Serving as cholesterol chauffeurs are fat/protein bunches called lipoproteins, and that’s where the fun begins: Low-density lipoproteins tend to deposit cholesterol on artery walls, where it builds up and eventually interferes with blood flow. But the high-density variety seems to take cholesterol back to the liver, where it can be eliminated from the body.

Foods naturally rich in soluble fiber have proven particularly good at lowering cholesterol. Excellent sources include oats, oat bran, barley, peas, yams, sweet potatoes and other potatoes, as well as legumes or beans, such as pinto beans, black beans, garbanzo beans, and peas. Vegetables rich in soluble fiber include carrots, Brussels sprouts, beets, okra, and eggplant. Good fruit sources are berries, passion fruit, oranges, pears, apricots, nectarines, and apples.
All cherries are delicious, but there's something extra special about this sour variety. "I love snacking on dried Montmorency tart cherries not only because they have a sour-sweet flavor, but because they also have fiber," Gorin says. "Plus, you get other heart-helping benefits, too. Anthocyanins, a type of antioxidant found in purple and dark red fruits and vegetables, may help decrease the risk of heart attack in women."

DAVID MONTGOMERY: The ways to reduce your bad cholesterol have a lot to do with your lifestyle. So your diet is really important. And although this kind of sounds trite, really one of the best and most effective ways to reduce cholesterol is by having a low fat diet, particularly saturated fat. We find saturated fat in eggs, dairy, and red meat. If you're able to reduce those, you reduce your bad fat, which reduces your bad cholesterol. Another really effective way that I use with my patients all the time to reduce your cholesterol is regular exercise. If you're doing aerobic type exercises, most days a week, four days a week, 30 minutes at a time, then you're doing your body the best amount of good, not just from lowering your cholesterol standpoint, but from so many different ways. There are other ways that we can reduce the fat. It may have to do with supplementations or medications. In some people, they are born with genetic conditions that predispose them to have very, very high cholesterol. And as a result of that, they have different problems like heart attacks or strokes. In those people, they really do benefit from cholesterol lowering drugs. But there are other things that you can get from over-the-counter, like omega fatty acids, omega-3 fatty acids in particular. They come in krill oil or fish oil. We've all heard of these before. And those help reduce parts of your cholesterol.


Perhaps most disappointing of all, a new class of drugs (the so-called CETP-inhibitors), which several pharmaceutical companies have been enthusiastically developing for several years to raise HDL levels, has become a great disappointment. While these drugs do indeed increase HDL levels, they have not demonstrated an ability to improve cardiac risk — and on the contrary, studies appear to show a worsening in cardiac risk with some of these drugs. It is unclear today whether any CETP-inhibitors will ever reach the market.
HDL serves as a chemical shuttle that transports excess cholesterol from peripheral tissues to the liver. This pathway is called the RCT system. In this system, plasma HDL takes up cholesterol from the peripheral tissues, such as fibroblasts and macrophages. (A study by El Khoury et al indicated that in persons with HALP, macrophages have an increased plasma cholesterol efflux capacity. [18] ) This may occur by passive diffusion or may be mediated by the adenosine triphosphate (ATP)–binding cassette transporter 1. The latter interacts directly with free apo A-I, generating nascent, or so-called discoidal, HDL. Cholesterol undergoes esterification by lecithin-cholesterol acyltransferase (LCAT) to produce cholesteryl ester, which results in the production of the mature spherical HDL. Cholesterol is also taken up from triglyceride-rich lipoproteins in a process mediated by a phospholipid transfer protein (ie, CETP). [19, 20, 21, 22]
Flavor foods with herbs and spices whenever you can. It’ll help you cut back on condiments high in saturated fat while maximizing flavor. Spices and herbs also pack antioxidants, which can help improve cholesterol levels when combined with veggies. Ones we love: Basil, cilantro, rosemary, sage, ginger, garlic, tarragon, black and red chili pepper, mint, and oregano. 
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