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What Are Effective Methods for Reducing Cholesterol? Are Supplements, Including Psyllium and Probiotics, Beneficial?


Your doctor has informed you that your cholesterol levels are high, and you have a six-month window to make dietary changes to see if this can reduce your cholesterol. During this period, you may wonder if taking supplements could assist in this process.

While supplements alone cannot be relied upon to control cholesterol, there is substantial evidence suggesting that specific supplements, when combined with a healthy diet, can be beneficial.

The concern about cholesterol mainly revolves around two types of cholesterol, both having an impact on the risk of heart disease and stroke. These cholesterol types are transported in the bloodstream within structures called lipoproteins.

  • Low-density lipoprotein (LDL) cholesterol, often referred to as "bad" cholesterol, carries cholesterol from the liver to cells throughout the body. Elevated LDL cholesterol levels can lead to the accumulation of plaque in arteries, increasing the risk of heart disease and stroke.
  • High-density lipoprotein (HDL) cholesterol, often termed "good" cholesterol, aids in removing excess cholesterol from the bloodstream and transporting it back to the liver for processing and elimination. Higher levels of HDL cholesterol are associated with a reduced risk of heart disease and stroke.

Diet plays a pivotal role in reducing blood cholesterol levels, particularly LDL cholesterol. Health-conscious dietary choices involve focusing on consuming more unsaturated fats (e.g., from olive oil or avocado) while reducing saturated fats (found in animal products) and trans fats (present in certain store-bought baked goods).

Additionally, increasing soluble fiber intake can significantly lower total cholesterol and LDL cholesterol levels. Soluble fiber, which dissolves in water to form a gel-like substance in the gut, can bind to cholesterol molecules, preventing their absorption into the bloodstream and facilitating their elimination through feces. You can find soluble fiber in whole foods like fruits, vegetables, oats, barley, beans, and lentils.

Fiber supplements, such as psyllium, are available and have strong evidence supporting their effectiveness in improving cholesterol levels. Numerous high-quality trials have demonstrated that consuming about 10g of psyllium daily as part of a healthy diet can reduce total cholesterol levels by 4% and LDL cholesterol levels by 7%.

Apart from fiber supplements, probiotics have emerged as another cholesterol-lowering option. Probiotics may influence cholesterol levels through various mechanisms, including cholesterol incorporation into cells and gut microbiome adjustments that enhance cholesterol elimination via feces. Research on probiotics indicates promise, with studies showing a 13% reduction in total cholesterol levels in individuals who took probiotics.

Red yeast rice, a non-fiber supplement, has gained attention for its potential cholesterol-lowering properties. However, a systematic review of 15 randomized controlled trials found that while it was effective at lowering triglycerides, it was less effective at lowering total cholesterol compared to statins. The long-term safety and efficacy of red yeast rice remain uncertain due to limited research.

It's essential to consult with your GP and dietitian before incorporating supplements into your cholesterol-lowering plan. Keep in mind that dietary changes, with or without supplements, may not be sufficient to achieve the desired cholesterol levels. Other lifestyle factors like quitting smoking, stress reduction, regular exercise, adequate sleep, and genetic factors should also be considered. Depending on your cholesterol levels and overall risk factors, your GP may recommend cholesterol-lowering medications like statins during your six-month review.

Lauren Ball is a Professor of Community Health and Wellbeing at The University of Queensland, while Emily Burch is a researcher and lecturer at Southern Cross University. This article was originally published on The Conversation.