When cholesterol levels are high, statins—common medications used to lower cholesterol—are not always necessary, especially if a person does not have familial hypercholesterolemia or other risk factors like diabetes. "In our department, we systematically offer a nutritional assessment and lifestyle modifications before considering whether treatment is necessary," says cardiologist Jean Ferrières. For this specialist, dietary changes can reduce LDL-cholesterol, often called "bad" cholesterol, by 10% to 15% after 3 to 6 months. It all starts at the supermarket. Why are fibers, in all their forms, good for cholesterol? Dietary fibers are our best weapon against cholesterol. Another advantage: they are satiating and limit snacking. Although no study has been able to determine the exact amount of fiber needed to reduce cholesterol, there is still a reference. "A balanced diet should provide us with 30 g of fiber per day," says dietician Alexandra Retion, "but very few people achieve this." To increase fiber intake, one can start by replacing refined flour, bread, pasta, and rice with whole grain varieties, which contain twice as much fiber. If these are difficult to digest, semi-whole grain options can be a good alternative. Oatmeal flakes, popular on social media, are also rich in fibers called beta-glucans. Several studies have shown that a bowl of oatmeal per day can reduce LDL-cholesterol by 5% to 8%. We also stop at the legume section (lentils, dried beans, chickpeas), which are twice as rich in fiber as vegetables. Two to three times a week, they are just as good in salads as in soups or curries. "Finally, one can easily increase consumption by sprinkling a tablespoon of wheat bran or oat bran on a salad, soup, compote, or yogurt," specifies dietician-nutritionist Alexandra Retion. Why prefer vegetable oils and margarine over butter? Two slices of lightly buttered bread are enough to reach the 10 to 15 g of butter allowed when one has cholesterol. One can then consume cholesterol-lowering margarines. Studies on these products have shown a decrease in LDL-cholesterol starting from 30 g per day. It is better to prefer those containing omega-3 and free from hydrogenated fats, especially palm oil. Phytosterols, despite their cholesterol-lowering properties, have in fact been accused of increasing cardiovascular risks. Five to seven portions of antioxidant fruits and vegetables per day are important for several reasons. They provide about 15 g of fiber, half of our daily dose, and numerous antioxidant compounds. Polyphenols or carotenoids do not directly lower cholesterol, but they partially neutralize its effects. We also know that they promote HDL-cholesterol, often called "good" cholesterol, and its protective action on arteries. Strawberries, lychees, grapes, artichokes, parsley, or broccoli are among the fruits and vegetables that contain the most of these compounds. Raw or cooked, in salads, stews, purées, compotes... we vary the families and forms to avoid getting tired of them. "If we buy organic ones, we eat the skin to further increase our antioxidant intake," says dietician-nutritionist Alexandra Retion. Which proteins to choose? Prefer fatty fish and lean meats. Polyunsaturated fatty acids, and in particular omega-3, protect the walls of arteries. "They also fluidify cell membranes," says Professor Bruckert, "which facilitates the uptake and destruction of cholesterol." Once a week, small fatty fish, such as sardines or mackerel, are a good source of omega-3. They are also less contaminated than large ones, such as salmon. Regarding meat, we prefer chicken, rabbit, or rumsteck to entrecôte and pork ribs. Fatty meats release compounds that disrupt cholesterol elimination and promote atherosclerosis. Not to forget plant-based proteins, such as tofu. As for eggs, they remain a non-negligible source of cholesterol that one must be cautious about, as recalled by Professor Ferrières. "One should not exceed five eggs per week, counting those that go into culinary preparations," he points out. This is even more true since the absorption of lipids varies greatly from one person to another. Another cholesterol-lowering measure: physical exercise. 30 minutes of walking per day, combined with 45 minutes of sport, 2 to 3 times per week, are part of the cholesterol-lowering measures to implement alongside new dietary habits. The weekly amount of activity—more than its intensity—has a beneficial effect on the lipid profile.