My cholesterol is borderline — how should I eat and change my lifestyle?

If you experience chest pain, shortness of breath, fainting, sudden arm/face weakness or speech problems, seek emergency care immediately. This guide is not for acute emergencies.

Overall goal: lower intake of saturated and processed fats and favor a diet based on vegetables, whole grains, legumes and healthy oils.

• Healthy fats: Prefer monounsaturated oils such as olive oil; cook by baking/grilling/steaming rather than deep-frying.
• Vegetables and fruit: Increase daily portions; aim for vegetables to make up a large part of your meals.
• Whole grains: Choose whole-grain bread, brown rice, bulgur, oats instead of refined grains.
• Legumes and nuts: Include legumes several times a week; a small handful of unsalted nuts daily can be beneficial.
• Fish and protein sources: Increase fish intake during the week; limit red and processed meats; lean poultry, legumes and fish are good alternatives.

Diet change plus regular activity and weight management can improve cholesterol levels.

• Aim for at least 150 minutes per week of moderate-intensity activity (e.g., brisk walking) or 75 minutes of vigorous activity.
• Add muscle-strengthening exercises on two or more days per week (bodyweight exercises are fine).
• Gradually increase daily step count and reduce prolonged sitting periods.
• Supportive habits: aim for 7–9 hours’ sleep and use stress-management techniques (deep breathing, short walks, scheduled breaks).

Primary care (Family Medicine) is usually the starting point. Your clinician may order a fasting lipid panel, blood pressure check and, if indicated, fasting glucose/HbA1c and thyroid function tests. If values remain higher than expected despite lifestyle changes, or if there is a family history of early cardiovascular disease, referral to Internal Medicine, Cardiology or Endocrinology and Metabolic Diseases may be considered.

It is common to repeat lipid testing about 8–12 weeks after lifestyle changes to assess effect.

Small, sustainable changes work better long-term than drastic short-term measures.

• Breakfast: oats or whole-grain cereal with milk or yogurt, fresh fruit and a small handful of walnuts/almonds.
• Lunch/dinner: vegetable-rich dishes with whole grains (brown rice, bulgur, whole-grain bread) and grilled fish or legume-based main dishes.
• Snacks: fresh fruit, yogurt, unsalted nuts or raw vegetables.
• Other tips: watch portions, avoid packaged snacks, and prepare meals at home when possible.