Walking into a grocery store these days, people are likely to see many products touting their “cholesterollowering” abilities. Everything from oatmeal to margarine can have labels promising lower cholesterol.

But how many of these foods actually do lower cholesterol? What drugs and supplements are effective when cholesterol levels need to be lowered?

“Cholesterol is a substance our bodies make naturally, and it can be both good and bad,” said Jose Mejia, M.D., a cardiologist with The Austin Diagnostic Clinic.

“Knowing about cholesterol and getting a yearly cholesterol test is important for everyone starting in their early 20s. High levels of cholesterol can affect your heart health and your risk for heart disease, heart attack, and stroke.”

Controlling levels with diet

The good news about cholesterol is that it can often be managed by lifestyle and dietary changes. Staying active, losing weight, and eating a low-fat, high-fiber diet can all help lower cholesterol.

Eating fewer foods high in saturated fats, trans fats and cholesterol can also lower cholesterol levels. “There are some foods you can eat that can actually improve your cholesterol levels,” said Mejia, including:

• Oatmeal. Oatmeal, and other foods with soluble fiber, can bind to cholesterol in the digestive track. Soluble fiber is believed to reduce the amount of cholesterol absorbed from food.

• Fish. Fish contains high levels of omega-3 fatty acids, which are good for the heart and also reduce blood pressure. In clinical studies, omega-3 fatty acids have been shown to lower triglyceride levels. Omega-3 fatty acids can also be found in canola oil and flaxseed.

• Walnuts and almonds. Along with a few other types of nuts, almonds and walnuts contain polyunsaturated fatty acids, which keep blood vessels healthy and lower cholesterol.

• Olive oil. Olive oil can help lower bad cholesterol without affecting good cholesterol. It contains monounsaturated fat and antioxidants, which are both good for the heart.

• Plant sterols or stanols. Many foods such as juices, margarine and yogurt are fortified with sterols or stanols. These plant substances are thought to block the absorption of cholesterol.

“Some people have more success with dietary changes to manage cholesterol levels,” said Mejia. “Others may need to take medication to help them make a significant change in their cholesterol levels.”

• Vitamins and supplements. There are many supplements and vitamins that claim to lower cholesterol, including garlic, ginseng and guggul. Most of these supplements don’t have enough conclusive evidence to support their use as significant cholesterollowering tactics.

Niacin, a naturally occurring B vitamin, does seem to raise good cholesterol levels, but niacin has potentially serious side effects and a doctor should be consulted before using it.

• Soy protein also has a modest effect on lowering bad cholesterol. But research suggests that even consuming large amounts of soy protein daily doesn’t lower bad cholesterol enough to reduce heart disease risk.

Lifestyle and weight

In addition to diet, there are other factors that influence cholesterol levels. Being overweight can contribute to high levels of cholesterol. Even losing five or 10 pounds can help lower bad cholesterol and raise good cholesterol levels.

Exercise is another good way to help control cholesterol. More physical activity can lower triglycerides and bad cholesterol, and may also raise good cholesterol. Try taking short walks at lunch every day.

“If you’re a smoker and you need to lower your cholesterol, one of the best things you can do is quit smoking,” adds Mejia. “Smoking can lower your good cholesterol levels.

Seasonal rise and fall

A study in the Archives of Internal Medicine found that people’s cholesterol levels change according to the season, and seem to be slightly higher in winter.

“It’s a good idea to get your cholesterol checked at different times of year, since activity levels or changes in diet may have an effect on your cholesterol levels,” said Mejia. “That way, doctors can get a better overall picture of your cholesterol throughout the year.”

“There’s no magic way to reduce your cholesterol levels,” Mejia said. “But a comprehensive management plan, including diet and exercise, can help lower risk for heart disease and stroke.”

Cholesterol basics There are two types of cholesterol: HDL or “good” cholesterol, and LDL or “bad” cholesterol. Having not enough “good” cholesterol and too much “bad” cholesterol can lead to health problems. High levels of cholesterol can lead to the build up of plaque, or fatty deposits in the arteries, which can lead to heart attack or stroke.

The American Heart Association recommends everyone after age 20 get a cholesterol test every five years to help manage cholesterol levels.