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What really works to lower cholesterol?
From lifestyle changes to plant sterols and statins - we look at the ways you can lower your cholesterol and why it matters
Public health nutritionist with 20+ years at Which? and the NHS delivering evidence-based food and nutrition insights.
High cholesterol is often called a 'silent killer' because it has no symptoms, yet it is a major risk factor for heart disease and stroke.
If your GP has told you your levels are high, you may be weighing up lifestyle changes and medication options.
But, beyond aiming for a generally healthier diet and lifestyle, are foods or supplements containing added plant stanols or sterols worthwhile? And what's the latest on statins?
We explain what you need to know, from how to access free health checks to what really works, with insight from heart health experts and our recent lab tests.
What is high cholesterol and why does it matter?
There are two main types of cholesterol:
- LDL (low-density lipoprotein) - often referred to as 'bad' cholesterol. Too much LDL cholesterol in your blood narrows and hardens your arteries making it tougher for blood to flow through.
- HDL (high-density lipoprotein) - often called 'good' cholesterol, this carries cholesterol away from your cells and artery walls to the liver where it's broken down and excreted.
When people talk about having 'high cholesterol' they mean high non-HDL levels which includes LDL.
In the past a total cholesterol level of under 5mmol/L was the magic number everyone aimed for.
However, recent NICE guidelines have moved toward more personalized targets, especially for those who have already had a heart-related issue. These are:
For healthy adults
Total cholesterol: Below 5.0 mmol/L
Non-HDL cholesterol: Below 4.0 mmol/L
HDL cholesterol: Above 1.0 mmol/L (men) or 1.2 mmol/L (women)
For those at high risk
If you have existing heart disease, the targets are now much tighter to prevent further issues. Your GP will likely ask you to aim for:
LDL cholesterol: 2.0 mmol/L or less
Non-HDL: 2.6 mmol/L or less
What about triglycerides?
Triglycerides are another type of blood fats that can cause issues if at higher levels, especially if your HDL cholesterol is low.
As a general rule, a healthy level of triglycerides is considered to be below 2mmol/L (non-fasting)
You can find more information in the NHS guide to cholesterol levels, as well as at Heart UK.
Who's most at risk of high cholesterol?
Up to age 44 typically men are more likely than women to have high cholesterol, but after 45 it affects more women than men due to hormonal changes related to the menopause.
People of South Asian origin are more susceptible to high cholesterol and heart disease than people from other ethnic backgrounds, so should keep a closer eye on their levels.
Lifestyle changes that can help manage cholesterol levels
- Keep active - this helps raise HDL and lower LDL cholesterol. Aim for 150 minutes of moderately intense or 75 minutes of vigorous activity a week. But even exercising once or twice a week can be beneficial.
- Eat more fibre - fruit, vegetables, lentils, pulses, wholegrains, nuts and seeds are good sources.
- Eat oats and barley - eating 3g of beta-glucan fibre a day is proven to lower cholesterol. A bowl of porridge has around 1g. Other sources include oatbran, oatcakes and pearl barley.
Avoid or limit:
- Saturated fat - limit your intake of red and processed meat, cheese, processed food and takeaways.
- Being overweight - if you are overweight, losing 10% of your bodyweight can lower cholesterol, triglycerides, blood pressure and risk of type 2 diabetes.
- Smoking - smoking makes LDL cholesterol 'stickier' so that it clings to your artery walls and lowers HDL cholesterol.
- Alcohol - don't drink more than 14 units of alcohol a week (roughly six pints of beer or medium-sizes glasses of wine).
Can plant stanols, sterols or beta-glucan help?
Plant stanols and sterols reduce the absorption of bad cholesterol from the food we eat. While they are naturally found in foods, it's hard to get the amount needed to impact cholesterol levels through diet alone.
Enriched foods and supplement versions of these phytosterols are available, and consuming 1.5-3g (max) daily can lower total and non-HDL cholesterol blood levels by around 7-10%.
Foods that contain added phytosterols include spreads such as Flora ProActiv, Benecol yoghurt and yoghurt drinks.
The cost of these can vary. We found the cheapest way to reach your daily dose was with Flora ProActiv spread (32p) however this involves consuming 3 x 10g portions each day so you need to think about how realistic this is for you.
A Benecol daily yoghurt drink costs around 75p and a Benecol yoghurt, £1. Both of these contain the daily amount of phytosterols needed. Supermarket own-brand 'cholesterol-lowering' drinks (like Tesco's version) are often identical in active sterol content but cost significantly less (approx £3 for 6 x 100g drinks).
A daily dose of Vitabiotics Ultra plant sterols (three capsules) costs approx £1.10 and Nature's Best plant sterols (two tablets) costs 32p, but again, swallowing multiple supplement tablets per day won't be for everyone.
Lynne Garton, dietetic adviser at HEART UK, told us: 'You need to take these consistently to see a benefit and as part of a healthy, balanced diet'.
She adds: ' Most of the studies that have shown a positive effect have used foods and drinks such as yoghurts and spreads. There's less evidence available for the effectiveness of supplements'.
These products can be taken in addition to beta-glucan (found in oats and barley) as they work in different ways to reduce cholesterol, and can have a cumulative effect.
Where to buy:
- Flora ProActivspread is available at most major supermarkets including Tesco, Sainsbury's, Asda, Morrisons, Waitrose and Ocado.
- Benecol spread, yoghurts and yoghurt are also available in Tesco, Sainsbury's, Asda, Morrisons, Waitrose and Ocado.
- Vitabiotics Ultra plant sterols are available to buy directly from Vitabiotics and often have three for two offers on. They are also available at Holland & Barrett.
- Nature's Best plant sterols can be bought directly from the Nature's Best website.
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What about statins?
Statins are the main group of prescription medicines used to lower cholesterol and they are effective at doing so.
If your risk of heart disease or stroke is high - or you've previously suffered one of these events - dietary changes alone are unlikely to be enough and you will probably be advised to take statins too.
Professor Sir Rory Collins, Professor of Medicine and Epidemiology, British Heart Foundation Centre of Research Excellence, says: 'It's important to think about someone's overall risk of cardiovascular disease and not their cholesterol in isolation. Two people can have the same cholesterol levels but their treatment plan could be different depending on other risk factors.'
He adds: 'We know that each mmol/L reduction in LDL cholesterol reduces someone's relative risk of heart attack and stroke in the next five years by 20%. And the more you reduce LDL cholesterol, the more you lower the risk'.
Some people are hesitant to take statins or are worried about the side effects. However, a major new study published in The Lancet in March 2026 found that statins did not cause 62 out of the 66 common side effects listed on patient leaflets.
Researchers analysed data from 124,000 patients and found that symptoms like headaches, fatigue, memory loss, and depression occurred just as often in people taking a placebo pill as those taking the real drug. You can read more on this in the British Heart Foundation guide.
The only genuine side effects confirmed were:
- Muscle symptoms: Affecting about 1% of users, mostly in the first year.
- Fluid retention: A slight increase in ankle/foot swelling (oedema).
- Blood Sugar: A small increase in blood sugar, which may lead to an earlier diagnosis of diabetes in those already at high risk.
Side effects such as muscular issues can resolve over time, or can be prevented by using a different dose or different statin. If you experience unwanted side effects it's important to go back to your GP.
Overall, for most people the 25–50% reduction in heart attack risk offered by statins far outweighs these rare and often manageable risks.
However, do be aware of potential interactions between statins and other medication, supplements or foods. For example, people on certain statins should avoid grapefruits and grapefruit juice (which can interact with many medicines). Find out more in our guide to the everyday food and drink that affect medications.
How do you know if your cholesterol is high?
You won't necessarily know if you have high cholesterol as there aren't usually symptoms. The only way to tell is by having a blood test.
If you have concerns you can raise these with your NHS GP and they can arrange a blood test if needed.
If you're over 40 years old, you should be invited for a free NHS health check by your GP surgery (and reassessed every five years after that).
During this check you will have your height, weight and blood pressure measured and a blood sample taken, and your risk of heart disease, a stroke, type 2 diabetes or kidney disease is calculated.
Cholesterol self-test kits
You can also buy cholesterol self-testing kits in high street pharmacies or online. These range from cheap instant fingerprick tests costing less than £20 up to £50-70 for send-away lab tests and several hundred for a cholesterol monitor.
However, it's worth bearing in mind that these tests can vary greatly in terms of the level of detail, accuracy and helpfulness of the results. Some have poor instructions, and may give you a false sense of security - or cause undue concern.
We recently tested a range of cholesterol test kits and home monitors and our findings left us alarmed. Multiple products failed critical accuracy tests, and only one product impressed us enough to recommend it.
Ultimately, while you may wish to check your levels independently, self-tests should never replace professional medical advice. If you're concerned about your cholesterol or heart health, it's important to see a doctor who can interpret your results, suggest lifestyle changes, and recommend treatment if needed.
See our full review of the best cholesterol monitors and the ones to avoid - plus more advice on choosing
