Can someone with elevated Low-Density Lipoprotein (LDL) levels eat milkfish or other fatty fish?

Fatty Fish Consumption for Individuals with Elevated LDL Cholesterol

Yes, individuals with LDL of 138 mg/dL can and should eat fatty fish like milkfish at least twice per week as part of a heart-healthy diet. 1

Benefits of Fatty Fish for Elevated LDL

Fatty fish consumption offers several benefits for individuals with elevated LDL cholesterol:

• Fatty fish provides beneficial omega-3 fatty acids (EPA and DHA) that have positive effects on lipoproteins and heart health 1
• The American Diabetes Association and American Heart Association recommend consuming two or more servings of fish per week 1
• Fatty fish intake has been shown to increase HDL particle size, which may have beneficial effects for cardiovascular health 2
• Fish consumption can shift lipoprotein subfractions to a less atherogenic pattern 3

Dietary Recommendations for Managing LDL Cholesterol

While including fatty fish, individuals with elevated LDL should follow these additional dietary guidelines:

1. Limit saturated fat intake:

   • Restrict saturated fat to 7% of total calories 1, 4
   • Minimize trans fat consumption 1, 4

2. Limit dietary cholesterol:

   • Keep dietary cholesterol below 200 mg/day 1, 4

3. Increase fiber intake:

   • Consume 10-25 g/day of viscous (soluble) fiber 4
   • Add plant stanols/sterols (2 g/day) to enhance LDL cholesterol lowering 4

4. Choose healthy fats:

   • Replace saturated fats with monounsaturated fats or carbohydrates 1
   • Include omega-3 fatty acids from fatty fish 1

Specific Fish Consumption Guidelines

• Eat fatty fish at least twice per week 1
• Avoid commercially fried fish filets, as these don't provide the same benefits 1
• Choose preparation methods that don't add unhealthy fats (baking, grilling, steaming)
• Milkfish and other fatty fish are good sources of omega-3 fatty acids

Important Considerations and Caveats

• While fish consumption is beneficial, it should be part of an overall heart-healthy diet
• Some studies suggest that very high fish consumption (>5 servings/week) may have diminishing returns 5
• The quality of fish preparation matters - avoid deep-fried fish or adding unhealthy fats during cooking
• Fish oil supplements may increase LDL cholesterol in some individuals, so whole fish consumption is preferable 1

By incorporating fatty fish like milkfish into a diet that's low in saturated fat and high in fiber, individuals with elevated LDL can help manage their cholesterol levels while enjoying the cardiovascular benefits of omega-3 fatty acids.