Lower cholesterol with 'natural alternatives to statins' including garlic and oats

Millions of Brits are grappling with high cholesterol, an insidious condition that heightens the risk of life-threatening medical crises like heart attacks and strokes. It occurs as a result of excess cholesterol - a type of fat found in the blood - and can cause blockages and hardening in the arteries

Over time this impedes blood circulation which poses a risk of cardiovascular disease. Around two in five of the UK population may suffer from high cholesterol or hypercholesterolemia. While many patients are prescribed statins to mitigate their high cholesterol levels, it's generally advised to try improving your lifestyle first.

The NHS recommends: "If you're at risk of developing cardiovascular disease in the near future, your doctor will usually recommend lifestyle changes to reduce this risk before they suggest that you take statins." Top among these lifestyle adjustments is adopting a balanced diet, rich in fruits and veggies while reducing saturated fats and sugar intake.

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The British Heart Foundation (BHF) has suggested some specific foods that could serve as "natural alternatives to statins". The charity highlighted four such foods and explored the science behind them.

Plant sterols and stanols

Plant sterols and stanols, which are added to some products like margarines, milks and yoghurts, can help lower cholesterol. The BHF cited a review of 124 studies published in the British Journal of Nutrition in 2014, which found that consuming up to 3.3 grams of plant sterols and stanols daily gradually reduced "bad" low-density lipoprotein (LDL) cholesterol by six to 12 per cent after about four weeks.

"It’s thought that, because plant sterols and stanols have a similar structure to cholesterol, they reduce the amount of cholesterol absorbed by the gut, which lowers your cholesterol blood levels," they explained. Small amounts can also be found in plant-based foods like fruit, vegetables, vegetable oils, nuts and grains.

However, this usually totals less than 600mg of phytosterols [another name for plant sterols and stanols] a day, much lower than the effective dose of 2g you can get from fortified dairy products. Despite their ability to lower cholesterol, there have been no clinical trials showing that plant sterols and stanols reduce the risk of heart attack and stroke.

Oats

Starting your day with a bowl of porridge could be the ticket to managing high cholesterol levels, health experts suggest. The secret lies in the soluble fibre known as beta-glucan found in oats and barley.

"Soluble fibres form a gel in your gut, which can bind with cholesterol and stop it from being absorbed into the body," the BHF says. A comprehensive review of 58 controlled trials, published in the British Journal of Nutrition, highlighted that consuming 3.5g of beta-glucan from oat products daily over three to twelve weeks led to a 4.2 percent reduction in "bad" cholesterol among middle-aged participants compared to those who didn't partake.

The BHF notes that a 40g serving of porridge oats contains around 2g of beta-glucan, while a 250ml glass of oat milk has about 1g. However, there's no direct evidence linking oat consumption to a reduced risk of heart attack or stroke, similar to plant sterols and stanols.

Garlic

Beyond its role in enhancing meal flavours, garlic might also contribute to cardiovascular health. Allicin, a compound found in garlic, is believed to potentially lower cholesterol and blood pressure, although the research remains inconclusive.

The BHF cites a small study from Iran, published in 2016 in the International Journal of Preventive Medicine, which discovered that individuals with high cholesterol experienced a more significant drop in their 'bad' cholesterol levels after consuming 20g of raw garlic (approximately four cloves) and one tablespoon of lemon juice daily for eight weeks, compared to those who consumed just one or neither ingredient.

"But a Stanford University trial published in the Archives in Internal Medicine in 2007 found that taking raw garlic, or garlic supplements, almost daily for six months had no effect on ‘bad’ cholesterol levels in people with high cholesterol," it says.

Oily fish

Oily fish and fish oil supplements, rich in omega-3 fatty acids, are often touted as a means to improve cardiovascular health. However, the British Heart Foundation (BHF) states they do not lower cholesterol but rather another type of fat in your blood known as triglyceride, which "can also increase your risk of heart and circulatory diseases if their levels are too high".

A comprehensive analysis of 90 studies involving 72,598 participants, published in 2023 in the Journal of the American Heart Association, found that consuming supplements containing two types of omega-3s daily for approximately 13 weeks resulted in a decrease in blood triglyceride levels. This reduction was observed in individuals with high cholesterol as well as those without.

"The research examined the effects of supplements containing 2g of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) omega-3s," the BHF explains. "However, it also discovered that while taking over 2g of these omega-3 supplements daily further reduced triglyceride levels, it also increased levels of ‘bad’ cholesterol."

Both DHA and EPA omega-3s can be naturally sourced from oily fish such as salmon, mackerel, and anchovies, while another type of omega-3 called alpha-linolenic acid (ALA) is found in certain nuts and seeds and the oils derived from them.

The BHF notes: "But omega-3 supplements are not recommended to prevent heart disease, unless your GP prescribes them for high triglyceride levels, as the evidence behind taking them to improve your heart health is mixed. For example, research published in the journal BMJ Medicine in 2024 showed that fish oil supplements may increase the risk of someone developing a heart condition or having a stroke, but could reduce the risk for those who already have heart disease."

If you are concerned about your cholesterol levels, you should speak to your GP.