From the Guidelines
For high cholesterol management, it is crucial to avoid trans fats completely and choose non-trans fat options instead, as trans fats significantly raise LDL ("bad") cholesterol while lowering HDL ("good") cholesterol, creating a harmful effect on cardiovascular health. Trans fats, found in partially hydrogenated oils, fried foods, and some processed products, have a particularly detrimental impact on cardiovascular health compared to other types of fats. Instead, focus on healthier fats like monounsaturated fats (olive oil, avocados, nuts) and polyunsaturated fats (fatty fish, flaxseeds, walnuts) as recommended by the American Heart Association 1. Even saturated fats (found in animal products and coconut oil) are less harmful than trans fats. When shopping, check nutrition labels and avoid products listing "partially hydrogenated oils" in the ingredients. The American Heart Association recommends limiting trans fat intake to less than 1% of daily calories, but ideally, you should aim for zero trans fat consumption, based on the evidence from the 2006 diet and lifestyle recommendations revision 1. Additionally, some studies suggest that for individuals with diabetes and elevated LDL cholesterol, saturated fatty acids and transunsaturated fatty acids should be limited to <10% and perhaps to <7% of energy, and if replaced, can be substituted by carbohydrates or monounsaturated fats 1. However, the most recent and highest quality study from the American Heart Association 1 takes precedence in guiding recommendations for high cholesterol management.
Some key points to consider when making dietary choices for high cholesterol management include:
- Limiting saturated and trans fatty acid intakes, which are directly related to LDL cholesterol levels 1
- Replacing animal fats with unsaturated fats (polyunsaturated and monounsaturated fats) and selecting lower-fat versions of foods 1
- Choosing healthier fats like monounsaturated fats (olive oil, avocados, nuts) and polyunsaturated fats (fatty fish, flaxseeds, walnuts) 1
- Avoiding products with partially hydrogenated oils in the ingredients
- Aiming for a diet with less than 1% trans fatty acids, and ideally, zero trans fat consumption 1.
From the Research
Trans Fat vs Non-Trans Fat for High Cholesterol
- Trans fats have been associated with an increased risk of cardiovascular disease, with a 2% absolute increase in energy intake from trans fat linked to a 23% increase in cardiovascular risk 2, 3
- The American Heart Association recommends limiting trans fats to <1% energy, while other organizations recommend limiting dietary trans-fat intake from industrial sources as much as possible 2
- Trans fatty acids increase plasma low-density lipoprotein (LDL)-cholesterol concentrations, but do not increase high-density lipoprotein (HDL)-cholesterol concentrations, unlike saturated fatty acids 4
- Foods high in unsaturated and low in saturated and trans fatty acids, such as rapeseed/canola oil, can cause moderate reductions in LDL cholesterol 5
- Soluble dietary fibers, such as those found in whole oats, whole barley, legumes, and fruits, can reduce total and LDL cholesterol levels by about 5-10% 6
Key Findings
- Limiting trans fat intake is crucial for reducing the risk of cardiovascular disease 2, 4, 3
- Choosing foods high in unsaturated and low in saturated and trans fatty acids can help lower LDL cholesterol levels 5
- Consuming soluble dietary fibers can also help reduce lipid levels and improve cardiovascular health 6