I don’t really like the idea of taking prescription medicine for life, plus many friends have experienced side effects. Because my QRisk score (which calculates a person’s risk of developing a heart attack/stroke over the next 10 years) is under 10 and my blood pressure is optimal, my GP was happy to let me try to take my cholesterol down naturally.

So “Project Liz” began. I tackled my diet, gave up dessert, upped fibre, cut down booze. It was all going well until I had a relationship break-up. Kind friends brought wine, ordered pizzas. It took a month to get back on track.

This week I had my cholesterol tested again, convinced I’d sabotaged everything. To my delight, it’s down to 5.7. The GP called it a “good result”. All my readings are “normal” apart from the high LDL of 3.2 (optimal is 2.6). So I’m motivated to keep going. I do really need to get the LDL down so my total reading is 5. But seeing it reduce twice now has been incredibly encouraging. Pass the sardines.

Here’s what I’m doing to get my cholesterol down.

1. Porridge for breakfast to increase fibre

Before Project Liz, I’d start the day with a cheese and mushroom omelette. But I need more fibre to reduce the amount of cholesterol absorbed into the blood stream from my digestive system, says Emily McGrath, a senior cardiac nurse at the British Heart Foundation.

She explains that the cholesterol-lowering effect of oats is due to a soluble fibre called beta-glucan, which reduces the amount of bile absorbed into the intestines.

“Your cholesterol is not as good as you get older, because you have less secretion of bile acid, which is something your body uses to metabolise cholesterol.” Eating 3g of glucans a day can help lower cholesterol and there is around 8g in half a cup of porridge oats. I commit to porridge three times a week with nuts, chia seeds, apple and berries (all high in fibre) and turmeric. At first I find it a little sweet, but my palate adapts.

2. Swap battered food for stir fry

The challenge is to reduce my intake of saturated fat and so-called trans fats, which can make it harder for the liver to reabsorb (“bad”) LDL cholesterol, and stop the production of bigger LDL molecules.

Dr Nathan Curran, a GP and functional medicine practitioner at London’s Galen Clinic, explains that small, dense cholesterol particles are problematic because “they tend to become trapped in blood vessel walls and will contribute to plaque formation”, whereas the big cholesterol particles bounce off.

“If you have these large cholesterol particles, the likelihood of suffering a heart attack or stroke driven by cholesterol is much lower.” By lowering my intake of saturated fat, I can hopefully reduce the size of my cholesterol particles. So instead of having chips with hake or salmon, I opt for stir-fried veg.

3. Cut portion size

I plate up meals on my trusty “portion control” plate because carrying extra weight will raise my chances of having too much LDL cholesterol. And sadly exercise alone won’t offset it. For every 10 pounds [4.5kg] of excess weight, the body produces an additional 10 milligrams of cholesterol per day.

“With weight loss, you lower your triglyceride, push up your good cholesterol level [which helps remove excess cholesterol from the blood stream] and your blood pressure comes down a bit more. So you’re offsetting some of the causal factors that accelerate that furring up of the blood vessels,” says Prof Kausik Ray, a leading consultant cardiologist and the president of the European Atherosclerosis Society.

4. Treat cheese like caviar

“Cheese is quite high in saturated fats, and in small amounts it’s not going to cause a problem. But if it’s on top of a burger or a pepperoni pizza, which is how a lot of people get their cheese, it’s less healthy,” says Alice Smith, a senior health and wellbeing physiologist at Nuffield Health.

Dutifully, I grate my daily allowance – a matchbox-sized piece of cheese. Dr Zia Stratos, a nutritionist, advises me to buy tahini as a filling alternative (anti-inflammatory, full of calcium) or cheese from my local farmers’ market. “It’s cheaper, you get the vitamins and gut-healthy bacteria from the soil.”

5. Swap filter coffee for drip coffee

I had no idea that by draining the dregs of my coffee cup, I was giving my cholesterol level an unwelcome jolt. “There are some studies that link unfiltered coffee to increased LDL cholesterol levels compared to drip filtered, instant and percolator coffee,” says Emily McGrath. My beloved cafetière lets through cafestol, which raises levels of LDL cholesterol. So I experiment with Pact’s V60 New Kit (a blue plastic dripper with paper filters). Simple and efficient, I take it everywhere.

6. Drink less

Most people don’t realise alcohol increases cholesterol. “When you drink alcohol, it is broken down and rebuilt into triglycerides and cholesterol in the liver,” explains McGrath. “If your triglyceride levels become too high, they can build up in the liver, causing fatty liver disease.”

This is my hardest challenge. But I replace my large gin and tonic with non-alcoholic margarita.

7. Swap butter for extra virgin olive oil

I swap butter for virgin olive oil and the low-cholesterol ProActiv spread. Out of all the cooking oils at the supermarket, olive oil has the highest level of heart-healthy monounsaturated fat. A friend even keeps a small dish of oil in the fridge so it solidifies.

“I spread avocado on toast,” says Smith. “They’re high in monounsaturated fats, so they’ll bring LDL cholesterol down and boost HDL cholesterol.”

8. Avoid sugar

Excess sugar in the diet can increase our triglycerides (a type of fat in the blood) and LDL cholesterol. “One of the things that increases the liver’s production of the more dangerous cholesterol particles is poor blood sugar and insulin control,” Dr Curran explains, “which is why diabetes is a higher risk factor for developing cardiovascular disease.”

At my midlife health check the blood test measuring my blood sugar levels was 41 (mmol/mol), a point from being pre-diabetic.

My dad had Type 2 diabetes before he died, and my slim mum is pre-diabetic. Looking at my diet, Dr Stratos determines that the real issue is sugar, and a diet high in carbohydrates. With my history, I should look at improving my glycemic control. I crave a small treat at the end of a meal so I invest in figs, dates (considered lower glycemic than other refined sugars) and, when I really need a hit, TrüFrü‘s dark chocolate-covered raspberries from the freezer.

9. Eat sardines

“We should all try to eat at least two portions of fish a week,” says McGrath. “We recommend naturally oily fish such as sardines, mackerel and salmon that contain omega-3. Studies have shown omega-3 can keep blood pressure and heart rate in check, reduce our risk of heart attacks, lower LDL and increase HDL cholesterol.”

I eat sardines on wholemeal toast and learn to make Jamie Oliver’s sardine spaghetti with wholemeal pasta.

10. Lifting weights is as important as cardio

Guests curse as they trip over 3kg weights in my kitchen. But in 2023 the American Heart Association published a statement saying resistance training interventions result in improvements in HDL cholesterol, total cholesterol and triglycerides. They recommend moderate- to high-intensity weight training at least twice a week.

“You could start with small dumbbell weights, doing bicep curls. Or use your own body weight for resistance in activities like push-ups, lunges, crunches, then eventually work up to a plank,” says McGrath.

11. Walk after eating

Regular brisk walks can lower LDL cholesterol, reduce blood pressure and the risk of developing Type 2 diabetes. One way to tell if you’re working at a moderate intensity level is if you can still talk, but not sing.

“Exercise does make a big difference to your cholesterol levels,” says McGrath. “The guidelines are 150 minutes of moderate activity or 75 of vigorous activity a week.” I get into the habit of posting letters after supper.

12. Eat more protein

Increasing protein and reducing refined carbs is really important for managing our blood sugar, decreasing LDL cholesterol and maintaining our muscle mass. “Start the day with a savoury breakfast of eggs or salmon and you can add fibre with vegetables,” advises Smith. For a mid-afternoon snack I have two boiled eggs with posh salt.

13. Eat more beans

A 2012 study found a daily serving of pulses can cut LDL cholesterol by up to 8%. They also keep you fuller for longer, so you’re less likely to reach for unhealthy snacks. “Eat unprocessed plant foods, beans, lentils, seeds, nuts,” says Smith.

“If it’s been minimally processed, and it’s come from a plant, it’s got a good amount of fibre in there.” Thankfully it’s a mostly invisible remedy – I throw chickpeas into curries, stir-fries and soups and bulk up my beloved Cajun Bake with red kidney beans (cutting the amount of potato in half).

14. Swap salted peanuts for pistachios

Nuts are high in unsaturated fat and fibre, which are great for bringing cholesterol down. But salted peanuts (my go-to supper at the theatre) tend to have higher sodium content, which could impact blood pressure. So for a West End theatre marathon, I take walnuts (which contain omega-3), almonds and pistachios in my bag.

15. Opt for wholemeal

I chuck out the white rice and pasta in my cupboard. “Always go for wholegrains – brown rice, pasta, bread. They take longer for your body to metabolise and keep you full for longer,” says McGrath.

“They’re a great source of soluble fibre, which can bind to cholesterol in the small intestine, preventing it from entering the bloodstream and removing it from the body.”

16. Take apple cider vinegar

In 2016, the BBC ran a study for their science show Trust Me, I’m a Doctor and found that drinking two tablespoons of diluted apple cider vinegar twice a day reduced overall cholesterol levels by 13%. Trust me, it’s vile but my hair looked shinier.

17. Opt for low-fat milk

Milk, cheese and yoghurts are good sources of calcium and proteins, but can be high in saturated fat, which can raise cholesterol levels. The British Heart Foundation recommends choosing low-fat options without added sugars.

18. Eat more at the beginning of the day

I start adding seeds and nuts to cereals, soups and salads. It’s really important to make sure you’re fuelling yourself throughout the day to avoid snacking, says Smith. “When people want to lose weight or improve a health metric, they think about cutting things out. But I say: ‘Can we actually put more of the good stuff in so there’s less space for the unhealthy stuff?’”

19. But stop after 8pm

Keeping meals within a 10-hour period can improve blood sugar and cholesterol levels. “Our circadian rhythm, our body’s natural 24-hour clock, has evolved for us to eat earlier in the day,” says Smith. “Our insulin is more sensitive in the morning, so we know our body processes carbohydrates and sugars better then, compared to late at night.

“When they give people a meal late at night, they see an increase in LDL cholesterol and triglycerides.” I get into the habit of brushing my teeth at 7pm, so I’m not tempted to refuel.