Cholesterol-lowering Diet

( Low-Density Lipoprotein [LDL] Lowering Diet)

by Cynthia M. Johnson, MA

This way of eating lowers your levels of bad and raises your levels of good cholesterol. Having too much bad and not enough good can lead to atherosclerosis. This is when plaque builds up in your arteries. This thins and hardens them. It also raises your risk of having a heart attack or stroke.

The Risk

Cholesterol is one cause that plays into your risk of having a heart attack, heart disease, or stroke. Others are:

Age
Whether you are male or female
Race
Other health problems, such as diabetes or obesity

Eating this way may help if you are at high risk. The goal is to lower bad and raise good cholesterol.

Diet

Making changes to how you eat may help to lower your cholesterol.

Fat

Fat has many jobs. It carries fat soluble vitamins , protects organs, and makes you feel full. Fat can be broken down into four types:

Fats that should be not eaten or eaten in small amounts:
Saturated fat	Found in margarine and shortening, snack foods, and fried foods, it raises total blood cholesterol, chiefly bad the bad type. Animal fats are butter, lard, whole-milk dairy products, meat fat, and poultry skin Vegetable fats are shortening, palm oil, coconut oil, and cocoa butter
Hydrogenated or trans fat	Found in margarine and shortening, it raises total blood cholesterol, chiefly the bad type. It also lowers the good type.
Fats that help and should be eaten in moderation:
Monounsaturated fat	Found in oils such as olive and canola, it can lower total cholesterol level while keeping levels of the good type high.
Polyunsaturated fat	Found in oils such as safflower, sunflower, soybean, corn, and sesame, it can lower total cholesterol.

Less than 5-6% of calories should come from saturated fat. Trans fat intake should be kept very low with a goal to remove them.

If you eat 2,000 calories a day, this is less than 13 grams of saturated fat per day. Most of the fats you eat should be mono- and polyunsaturated.

Cholesterol

This is found only in animal products. It can raise bad levels, but saturated or trans fats are worse. You should eat as little as you can.

Fiber

Eating foods that are high in soluble fiber can help lower your bad levels. There are two types of fiber: soluble and insoluble. Both are vital, but only soluble changes cholesterol levels. It breaks down into a gel that helps block fat and cholesterol in the blood.

It is found in foods such as oatmeal, oat bran, barley, soy products, apples, and strawberries. You should eat at least 5-10 grams per day. It's even better if you can eat 10-25 grams.

Stanols and Sterols

Stanols and sterols are found in certain plants. Plant stanols and sterols can lower bad levels by blocking them. They are now being added to foods like margarines and orange juice.

Eating Chart

Food	Foods to Eat	Foods to Not Eat
Grains	Whole grain breads and cereals, pasta, rice, potatoes, low-fat crackers	High-fat baked goods like muffins, donuts, and pastries Crackers made with trans fat
Fruits	All; choose whole fruit over juice for added fiber	None
Veggies	All	Veggies with added fat or sauce
Milk	Nonfat or low-fat (1%) milk Nonfat or low-fat yogurt, sour cream, buttermilk Cottage cheese, low-fat cheeses	Whole milk Reduced-fat (2%) milk Malted and chocolate milk Most cheeses
Meat and beans	Lean cuts of beef, pork, veal, or lamb; trim fat before cooking Poultry without the skin Fish and most shellfish; limit your intake of shrimp Egg whites and egg substitutes; limit whole eggs to two per week Tofu Seeds, nuts; peanut butter should be eaten in moderation due to high calories Dried peas, beans, and lentils	Fatty cuts of meat Organ meats like brain, liver, and kidneys Poultry skin Breaded fish or meats More than two egg yolks per week, such as those found in baked goods, cooked foods, or processed foods
Fats and oil	Vegetable oils like olive, canola, corn, safflower, or soybean Trans fat-free soft or liquid margarines; the first item should be unsaturated liquid vegetable oil Margarine with stanol/sterol Low-fat salad dressings and mayonnaise	Butter, stick margarine, coconut and palm oils, bacon fat Salad dressings made with egg yolk
Snacks, sweets, and condiments	In moderation: fat-free or low-fat cookies, ice cream, frozen yogurt; sherbet; angel food cake; baked goods made with unsaturated oil or trans-free margarine, egg whites or egg substitutes, and nonfat milk; jello; candy made with little or no fat like hard candy or jelly beans	High-fat desserts; baked goods made with butter, lard, shortening, egg yolks, or whole milk

Tips

Choosing Foods

Make whole grains, fruits, and veggies the base of the foods you eat.
Look for products that are labeled as fat free, low-fat, cholesterol free, saturated fat-free and trans fat-free. A product can say it doesn't have trans fat, even on the label, but still have a small amount. Be sure to look for partially hydrogenated oil. If it has this, do not eat it.
Learn how to read a food label. It lists things like the amount of calories, fat, and cholesterol per serving.
Eat foods rich in omega-3 fatty acids. These are fatty fish such as salmon, mackerel, and tuna; flaxseed, walnuts, and canola oil. Eating fish at least two times a week is more helpful than taking pills.

Try all kinds foods and make changes based on what you like to eat. It may take some time to get used to new changes.

Making Meals

Make foods using low-fat methods, such as steaming, boiling, grilling, poaching, baking, broiling, or roasting. If you are sautéing or stir frying, use a cooking spray or small amount of vegetable oil.
Trim any fat off meat or poultry before cooking. Drain the fat after browning.
Limit high-fat sauces. Add flavor to foods with fresh herbs, salsas, or chutneys.
Raise your fiber by adding fruit to your cereal or yogurt, beans to your salad, and choosing whole-grain breads.
Cook at home more often. When you eat out, the food tends to be high in fat and calories.

Other

Workout at least 30 minutes most days of the week.
If you need to, talk with your doctor about the best ways to lose weight.
Talk to a dietitian for help with meal plans.

RESOURCES:

Eat Right—Academy of Nutrition and Dietetics
http://www.eatright.org

National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov

CANADIAN RESOURCES:

Dietitians of Canada
http://www.dietitians.ca

Heart and Stroke Foundation of Canada
http://www.heartandstroke.ca

References:

Dietary Guidelines for Americans 2020-2025. US Department of Agriculture and US Department of Health and Human Services. Available at: https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf. Accessed February 3, 2021.

Dietary interventions for cardiovascular disease prevention. EBSCO DynaMed website. Available at: https://www.dynamed.com/prevention/dietary-considerations-for-cardiovascular-disease-risk-reduction. Accessed February 4, 2021.

Hypercholesterolemia. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hypercholesterolemia. Accessed February 4, 2021.

Lowering your cholesterol with TLC. National Heart, Lung, and Blood Institute website. Available at:
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Accessed February 4, 2021.

The skinny on fats. American Heart Association website. Available at:
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Accessed February 4, 2021.

What is cholesterol? American Heart Association website. Available at:
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Accessed February 4, 2021.

What your cholesterol levels mean. American Heart Association website. Available at:
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Accessed February 4, 2021.

Last reviewed December 2020 by EBSCO Medical Review Board Dianne Scheinberg Rishikof MS, RD, LDN
Last Updated: 2/4/2021

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