Hearing that our cholesterol is high can feel discouraging, especially if it has never been an issue before. I know it was for my husband. Many people worry that it is “too late” or “nothing I can do” to make a difference. The truth is exactly the opposite. Research consistently shows that cholesterol levels can be improved at any age, and even modest reductions can significantly lower the risk of heart attack, stroke, and cognitive decline.
The best approach is often to focus on making step-by-step changes rather than drastic changes or perfection.
Focus on Heart-Healthy Eating
What we eat matters. Our goal should be proper nourishment and not deprivation. Emphasizing fruits, vegetables, whole grains, legumes, nuts, seeds, lean proteins, and healthy oils and fats, such as olive oil, can help support our heart. These foods help to lower LDL cholesterol and support HDL cholesterol. Reducing saturated fats, found in fatty meats, full-fat dairy, butter, and many processed foods, can lower LDL cholesterol. Replacing these with unsaturated fats is more effective than simply cutting fat altogether. Soluble fiber, found in foods like oats, beans, lentils, apples, and citrus fruits, helps bind cholesterol in the digestive system so it can be removed from the body. Even small increases in fiber intake can lead to measurable reductions in cholesterol. It is especially important that dietary changes remain enjoyable, affordable, and culturally familiar. A heart-healthy pattern should feel sustainable, not punishing.
Gentle, Consistent Physical Activity Makes a Real Difference
Physical activity is one of the most effective ways to improve cholesterol at any age. Regular movement helps to lower LDL cholesterol, raise HDL cholesterol, improve blood pressure, and enhance insulin sensitivity. It also benefits our balance, strength, and mood. Improving our cholesterol doesn’t require us to commit to intense exercise. In fact, we recommend that you start with lower-intensity activities to avoid potential injury and build. Walking, swimming, chair exercises, gardening, light resistance training, and stretching all count. The American Heart Association recommends aiming for at least 150 minutes of moderate activity per week, but benefits are seen even at lower levels. Consistency matters more than intensity. Try taking five to ten minutes of exercise breaks throughout the day, and the time will start to add up.
Address Weight and Body Composition Gently
When it comes to cholesterol, the number on the scale tells only part of the story. What matters just as much, and maybe more, is your body composition. Body composition is the ratio of fat to muscle in your body. Body fat isn’t just stored energy. It’s a metabolically active tissue that affects how your body handles cholesterol and triglycerides (a type of fat in your blood). Excess fat builds up, especially around your belly, and can raise triglycerides, lower “good” HDL cholesterol, and increase LDL cholesterol. Small reductions in our body composition can help lower LDL cholesterol and triglycerides. We should focus on preserving muscle mass and reducing our fat content rather than aggressive weight loss. Losing even 5 to 10 percent of body weight (fat) has been shown to improve our cholesterol levels. Try adding strength-based activities to a weight loss plan and adequate protein intake to help protect muscle while improving metabolic health.
Improve Sleep and Manage Stress
Sleep and stress directly affect cholesterol metabolism, as poor sleep is associated with increased LDL cholesterol and decreased HDL cholesterol. Stress hormones can increase cholesterol production in the liver. We can improve our sleep quality and manage stress through relaxation techniques, social connection, faith practices, or counseling, which can support healthier cholesterol levels. These factors are often overlooked but are especially important in caregiving roles and during major life transitions.
Review Medications and Health Conditions
Certain medications and chronic conditions can raise cholesterol levels. Conditions such as hypothyroidism, diabetes, kidney disease, and inflammatory disorders are common later in life and may contribute to elevated cholesterol. Regular medication reviews with a healthcare provider can identify whether adjustments are possible. Treating underlying conditions often leads to cholesterol improvement without additional interventions.
Medication Therapy When Appropriate
For some older adults, lifestyle changes alone may not be enough. Cholesterol-lowering medications, particularly statins, have been shown to reduce the risk of heart attack and stroke. The decision to use medication is your choice. When faced with the decision consider your overall health, life expectancy, existing cardiovascular disease, potential side effects, and personal goals. When used thoughtfully, medications can help protect our quality of life and independence. Don’t think of medication as a failure, but as one of the many tools available to us.
Focus on the Whole Heart Health Picture
Remember, cholesterol does not exist in isolation. Our blood pressure, blood sugar, physical activity, sleep, and smoking status all interact to influence cardiovascular risk. The American Heart Association’s Life’s Essential 8 encourages focusing on improving your overall cardiovascular health more than a single number. Improving even one area often leads to other improvements.
Small changes matter. Gentle movement counts. Nourishing food helps. Medications, when needed, are tools, not judgments. Most importantly, cholesterol improvement is about supporting the ability to live well, stay independent, and enjoy life.