What to Do About High Cholesterol? An Honest Guide to Better Levels

An elevated cholesterol level is often only discovered during a blood test, because it does not hurt. Nevertheless it is worth taking seriously, because cholesterol plays a role in vascular health. The good news: lifestyle and diet have a noticeable influence, and even small, permanently implemented changes can achieve a lot over weeks and months.

What lies behind high cholesterol

Cholesterol is a vital fat building block that the body needs for cell walls, bile acids, vitamin D formation and hormones such as testosterone and oestrogen. No human could exist entirely without cholesterol. Because fat and water do not mix, cholesterol is not transported freely in the blood but packaged in small transport spheres, the lipoproteins. A rough distinction is made between LDL cholesterol, colloquially considered “unfavourable” because it brings cholesterol to the tissues and can deposit in vessel walls when in excess, and HDL cholesterol, referred to as “favourable” because it leads surplus cholesterol back to the liver. If the values are out of balance, one speaks of a lipid metabolism disorder. Alongside LDL and HDL, specialists frequently also look at the triglycerides, a further fat fraction in the blood that reacts strongly to sugar, alcohol and excess weight.

The causes are varied: a hereditary predisposition, a very fat- and sugar-rich diet, excess weight, lack of movement, smoking and certain underlying conditions such as an underactive thyroid or poorly managed diabetes. Medications and hormonal changes, for example during menopause, can also influence the values. Frequently several factors come together. In some people there is additionally familial hypercholesterolaemia, a hereditary form in which the values are markedly elevated already at a young age, independent of lifestyle. Such cases need medical attention particularly early.

Important to understand: part of the cholesterol comes from food, but the far greater part is formed by the body itself in the liver, usually around three quarters. That is why it often achieves less to avoid individual cholesterol-rich foods such as eggs alone than was previously assumed. More decisive are the overall picture of the diet, body weight, movement and predisposition, which together determine how much the body produces and breaks down. The body even regulates its own production downward when more cholesterol comes in through food, which is why the interplay is so much more important than a single “forbidden” ingredient.

When you should have it medically checked

Elevated cholesterol values fundamentally belong in medical hands, because only a professional can assess your personal risk and decide on measures. In doing so they consider not just a single value but the overall picture of LDL, HDL, triglycerides, blood pressure, blood sugar, age, weight and family history. Medical assessment is particularly important if cardiovascular disease occurred early in your family, if further factors such as high blood pressure, diabetes or smoking are added, or if values remain high despite lifestyle changes. Do not make unauthorised adjustments to prescribed medications and do not stop them without consultation. This section does not replace a diagnosis but shows why medical guidance is central here.

What you can do in everyday life

Movement is a strong lever: regular endurance activity such as brisk walking, cycling, swimming or hiking has a favourable effect on the lipid metabolism balance and can particularly support HDL. As a rough guide, around 150 minutes of moderate movement per week, spread over several days, applies. Anyone who has so far been little active is better off starting small, for example with a daily walk, and increasing slowly. A healthy body weight additionally relieves the metabolism, and even moderate weight loss can noticeably improve blood lipids. Anyone who smokes does their vessels one of the greatest favours of all by quitting, because smoking lowers HDL and additionally burdens the vessel walls.

Stress management and sufficient sleep also belong to this, because chronic stress and lack of sleep influence the metabolism unfavourably and encourage unhealthy eating habits. Phases of relaxation, walks in nature, breathing or mindfulness exercises and fixed rest periods are therefore more than just a feel-good programme. You should enjoy alcohol at most in moderation, because it burdens the liver, which is central to cholesterol balance, and drives up the triglycerides above all.

What matters is staying with it: the values do not react overnight but over weeks and months of consistent habits. Small, lasting changes bring more than short-term, strict regimens that one cannot keep up. A food diary, fixed movement appointments in the calendar or a step counter on the wrist can help to stay on the ball until the new routines have become a matter of course. Making the change together with a partner or family also noticeably eases seeing it through.

Nutrition that supports

Fibre is a key building block. Soluble fibre from oat flakes, barley, pulses, apples, carrots and vegetables binds in the gut and supports a healthy lipid metabolism. A breakfast of oat flakes with fruit is therefore a simple, effective everyday building block. Also rely on plant oils such as olive, rapeseed and linseed oil instead of plenty of saturated fats from fatty meat, sausage, butter and cream. Even swapping butter for a high-quality plant oil, or sausage for plant-based spreads, changes the fat profile of a meal.

Oily sea fish such as salmon, mackerel, herring or sardine provides omega-3 fatty acids; nuts and seeds bring unsaturated fats and fibre at the same time. A small handful of unsalted nuts such as walnuts or almonds a day is a simple building block, as is a spoonful of flaxseed or chia seeds in muesli. At the same time, reduce heavily processed foods, fried food, fatty sausage products, ready-made baked goods and sugar, because these burden the metabolism in several ways at once. Sugary drinks too have an unfavourable effect via the triglycerides and can easily be replaced with water or unsweetened tea.

Particularly unfavourable are so-called trans fats, which are found in some fried and industrially processed products. A glance at the ingredient list, which may name “hydrogenated” or “partially hydrogenated” fats, helps with avoiding them. A Mediterranean-style diet with plenty of vegetables, fruit, wholegrains, pulses, fish and olive oil is regarded overall as particularly heart-friendly and can be built into everyday life well without it feeling like deprivation. A rule of thumb that has proven practical is to fill the plate half with vegetables, reserve a quarter for wholegrain sides and a quarter for a high-quality protein source.

Nutrients & plants with relevance

Some substances contribute, according to EU health claims, to a normal cholesterol level in the blood. Beta-glucans from oats and barley contribute to the maintenance of normal blood cholesterol levels; the beneficial effect is obtained with a daily intake of 3 grams. Plant sterols and plant stanols contribute to the maintenance of normal blood cholesterol levels. The unsaturated fatty acids also play a role: replacing saturated fats with unsaturated fats in the diet contributes to the maintenance of normal blood cholesterol levels, which additionally underpins the switch from butter and cream to plant oils and nuts. For monacolin K from fermented red rice, the authorised claim is that it contributes to the maintenance of normal blood cholesterol levels; it applies at a daily intake of 10 mg. Important to know: in 2022 the EU significantly tightened the requirements for monacolin K from red rice (Regulation (EU) 2022/860) – with lower permitted amounts and warning notices. Therefore use red-rice-based preparations exclusively after medical consultation. This substance should not be taken without medical consultation and not together with certain medications.

Traditionally, garlic and artichoke are also valued for the metabolism and have long been part of many kitchens. Soluble fibre from psyllium husks is likewise regarded as a proven swelling agent that binds a lot of water. Such plants do not replace medically supervised treatment but can sensibly accompany a healthy, balanced diet. It is important that, particularly with cholesterol-related preparations containing monacolin K, medical consultation comes first, because interactions and contraindications must be observed here, for example with already prescribed cholesterol-lowering medications.

Keeping an eye on the values

Anyone who actively works on their cholesterol values benefits from regular checks, because they show whether the new habits are taking effect. It makes sense to know a baseline value before a change and to have it measured again after a few months. This way progress becomes visible and motivates staying with it. It is best to note down the most important values and discuss changes with your doctor rather than interpreting them yourself. Other risk factors such as blood pressure, blood sugar and waist circumference also belong in the overall picture, because together with cholesterol they determine vascular health.

Honestly put into perspective

Elevated cholesterol is not something you get under control with a single food or preparation alone. The greatest effect comes from the interplay of diet, movement, weight and giving up smoking, consistently over time. Food supplements with recognised claims can be a supplement but replace neither medical monitoring nor prescribed medications. Anyone who is unsure is best off discussing every step with their doctor.

Matching products from Scheunengut

Anyone who wants to get to know the traditionally valued fermented red rice will find with us the Red Rice Vital Complex with monacolin K and black garlic. Monacolin K from fermented red rice contributes at a daily intake of 10 mg to the maintenance of normal blood cholesterol levels. Please take this product only after medical consultation and not together with cholesterol-lowering medications.

Frequently asked questions (FAQ)

How do I know whether my cholesterol is too high?

Only a blood test at the doctor shows this, because elevated values cause no noticeable symptoms. That is why regular checks make sense.

Do I have to give up fat completely?

No. It is about the quality of the fats. Unsaturated fats from oils, nuts and fish are favourable, while many saturated fats from fatty meat and cream should be reduced.

How quickly do the values change?

Lipid metabolism reacts slowly. After several weeks to months of consistent dietary and lifestyle change, an effect often shows that a renewed blood check makes visible.

Are eggs really that bad when it comes to cholesterol?

For most people, eggs in usual amounts are less decisive than previously thought, because the body forms the largest part of cholesterol itself. More important is the overall picture of the diet. Anyone who is unsure should discuss this individually with a doctor.

What is red rice with monacolin K?

Fermented red rice is a traditional food that contains the substance monacolin K. For this there is an EU claim regarding a normal cholesterol level. Intake should be medically supervised.

Can I take food supplements instead of medications?

No, this is not a decision one should make alone. Prescribed medications may never be replaced or discontinued on one's own authority. Discuss everything with your doctor.

Does movement really help with cholesterol?

Yes, regular endurance activity has a favourable effect on the balance of blood lipids and at the same time supports weight and the cardiovascular system.