Milly Gaines
High cholesterol can put you at risk of coronary artery disease and other heart diseases. While medicines like statins can help manage cholesterol, a heart-healthy diet is the most effective way to lower cholesterol levels naturally. A largely vegetarian diet, with plenty of fruits, vegetables, whole grains, and plant-based proteins, can substantially lower bad LDL cholesterol. Soluble fibre, polyunsaturated fats, and plant sterols and stanols are particularly effective at lowering LDL cholesterol.
Which diet lowers cholesterol most effectively?
| Characteristics | Values |
|---|---|
| Foods to eat | Fruits and vegetables, whole grains, legumes, nuts, seeds, fatty fish, and foods high in soluble fiber |
| Foods to avoid | Saturated fats, trans fats, fatty meats, deli-style meats, butter, cream, ice cream, coconut oil, palm oil, deep-fried takeaway foods, commercially baked products |
| Foods to limit | Red meat, processed meat |
| Foods to eat sparingly | Meat, added as flavour to casseroles, stews, soups, and spaghetti |
| Foods to eat in moderation | Polyunsaturated and monounsaturated fats |
| Other recommendations | Exercise regularly, manage weight, limit alcohol consumption |
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What You'll Learn
The Mediterranean diet
This style of eating is known to provide numerous health benefits. It can help manage weight, protect the heart, and prevent diabetes, stroke, and heart disease. Research suggests that people from the Mediterranean region tend to be healthier and have a lower risk of chronic conditions compared to those on a standard American diet. The Mediterranean diet has also been linked to improved brain health, with one study finding that the healthiest eaters at age 50 had a 90% lower risk of dementia.
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Vegetarian or vegan diets
Vegetarian and vegan diets have been found to lower cholesterol levels effectively. A study that pooled results from 30 trials (including a total of nearly 2,400 people) found that those following a vegetarian or vegan diet experienced average drops in total cholesterol levels of 7% and 10% respectively, compared to those eating an omnivorous diet.
What to Eat
The key components of a vegetarian or vegan diet that lowers cholesterol are:
- Plenty of fruits and vegetables: These are high in fiber, which helps to lower LDL cholesterol.
- Whole grains: These are a good source of fiber and plant stanols and sterols, which prevent the digestive tract from absorbing cholesterol.
- Plant-based proteins: Replacing animal protein with plant protein has been linked to lower LDL cholesterol. Good sources of plant-based protein include soy products such as tofu, tempeh, and edamame.
- Nuts: These are high in plant stanols and sterols, as well as omega-3 fatty acids, which can lower LDL cholesterol.
- Oats: These are high in soluble fiber, which helps to lower cholesterol.
What to Avoid
When following a vegetarian or vegan diet to lower cholesterol, it is important to avoid or limit:
- Animal products: These often contain cholesterol and saturated fat, which can raise cholesterol levels. This includes meat, chicken, fish, eggs, and dairy products.
- Ultra-processed foods and trans fats: These can be high in saturated fat and negatively impact cholesterol levels.
- Keep added fats and oils low: Even plant-based oils like olive oil and avocado oil should be consumed in moderation, as they are high in calories and can contribute to weight gain.
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The TLC diet
The TLC (Therapeutic Lifestyle Changes) diet is an eating plan that was originally designed to promote heart health and lower "bad" LDL cholesterol. It was created by the National Heart, Lung and Blood Institute and is part of a three-part program that includes physical activity and weight management strategies. The TLC diet provides specific guidelines for consuming cholesterol, fat, sodium, soluble fibre, and phytosterols. It recommends limiting total fat and saturated fat intake, with no more than 25-35% of daily calories from total fat and less than 7% from saturated fat. It also suggests consuming 10-25 grams of soluble fibre per day and 2 grams of phytosterols, which are plant compounds that safely lower cholesterol.
One of the benefits of the TLC diet is that it does not completely eliminate any foods or food groups, providing flexibility and making it easier to follow. It focuses on making healthier choices and promoting a balanced approach to nutrition and weight management. This diet is particularly effective in lowering LDL cholesterol, which is the harmful cholesterol-carrying particle that contributes to artery-clogging.
To follow the TLC diet, it is important to learn how to read nutrition labels to ensure that you are staying within the recommended guidelines for cholesterol, fat, sodium, and soluble fibre intake. Keeping a TLC diary can also be helpful to track your food, physical activity, weight, and other vital signs such as blood pressure and blood test results.
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Omega-3 fatty acids
There is evidence that omega-3 fatty acid supplementation can effectively lower triglyceride levels in the blood. This is supported by a meta-analysis of 90 randomised controlled trials, which found a near-linear relationship between omega-3 intake and reduced triglyceride levels, particularly in individuals with hyperlipidemia and those who are overweight or obese. Additionally, a Cochrane review of 23 RCTs involving participants with type 2 diabetes found that fish oil supplementation reduced triglyceride levels and very low-density lipoprotein cholesterol levels.
However, the effect of omega-3 fatty acids on cholesterol levels is more complex and remains controversial. While some studies suggest that omega-3 fatty acids may increase LDL ("bad") cholesterol levels, others indicate that they can reduce LDL levels, especially when combined with cholesterol-lowering medications. For instance, a study from 2021 found that higher blood DHA levels were associated with reduced LDL levels. Additionally, combining cod liver oil supplements with the cholesterol-reducing medication rosuvastatin resulted in greater cholesterol reduction than rosuvastatin alone.
The American Heart Association recommends daily supplementation with 2 to 4 grams of EPA/DHA for patients with elevated triglyceride levels. However, it is important to consult a doctor before taking any supplements or making significant dietary changes, especially for individuals already taking prescription medications for high cholesterol.
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Soluble fibre
The recommended daily intake of soluble fibre is approximately 30 grams, which can lower LDL cholesterol by up to 18%. Sources of soluble fibre include oatmeal, beans, lentils, and various fruits such as bananas and strawberries. Whole grains, while rich in insoluble fibre, also contain soluble fibre and are recommended as part of a cholesterol-lowering diet.
It is important to note that insoluble fibre, found in abundance in whole grains, beans, lentils, and most vegetables, also provides significant health benefits. Insoluble fibre aids in normal bowel function, adding bulk to foods and promoting satiety. However, it does not dissolve in water and passes through the digestive tract relatively unchanged, so it is less effective at lowering cholesterol levels.
A well-rounded diet that includes both soluble and insoluble fibre is ideal for improving overall health and lowering cholesterol. In addition to soluble fibre, a cholesterol-lowering diet may include plant sterols and stanols, which actively block cholesterol absorption in the body. These can be found in whole grains, nuts, legumes, and oils like olive oil and avocado oil.
It is worth noting that while dietary fibre is crucial, it should be obtained primarily from whole foods rather than supplements. This is because whole foods, such as fruits and vegetables, also provide essential nutrients like vitamins, contributing to overall health and wellness beyond just lowering cholesterol.
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Frequently asked questions
Cholesterol is a waxy, fat-like substance found in all the cells in your body. While your body needs some cholesterol to function properly, too much of it in your blood can stick to the walls of your arteries and narrow or even block them, putting you at risk for coronary artery disease and other heart diseases.
Foods that are high in fibre, such as fruits, vegetables, whole grains, legumes, nuts and seeds, can help lower "bad" LDL cholesterol. Oats, in particular, are an easy way to start lowering your cholesterol, as they provide 1 to 2 grams of soluble fibre per serving. Other foods that lower cholesterol include fatty fish, which are high in omega-3 fatty acids, and plant sterols and stanols, which are found in nuts, legumes, and oils such as olive oil and avocado oil.
Foods that are high in saturated and trans fats, such as fatty meats, deli meats, butter, cream, ice cream, coconut oil, palm oil, deep-fried takeaway foods, and commercially baked goods, can raise "bad" LDL cholesterol levels. It is best to limit or avoid these foods when trying to lower your cholesterol.
The Mediterranean Diet is often recommended as a heart-healthy eating plan that can help manage cholesterol levels and support overall health. This diet is centred around plant-based foods, including fruits, vegetables, whole grains, and beans. The DASH diet and the Therapeutic Lifestyle Changes (TLC) diet are also popular options for lowering cholesterol.
In addition to diet, other lifestyle changes such as regular physical activity and weight management can help lower cholesterol. If diet and lifestyle changes are not enough, cholesterol-lowering medications such as statins may be prescribed by a doctor to help manage cholesterol levels.
