From the Guidelines
To lower hypercholesterolemia, it is essential to focus on a diet rich in fruits, vegetables, whole grains, and lean proteins while limiting saturated fats, trans fats, and dietary cholesterol. This approach is supported by the American Heart Association's diet and lifestyle recommendations revision 2006, which emphasizes the importance of consuming an overall healthy diet to reduce the risk of cardiovascular disease 1. The recommendations include balancing caloric intake and physical activity to achieve and maintain a healthy body weight, consuming a diet rich in vegetables and fruits, choosing whole-grain, high-fiber foods, and limiting intake of saturated fat, trans fat, and cholesterol.
Some key dietary changes that can help lower cholesterol include:
- Replacing saturated fats with healthier unsaturated fats from sources like olive oil, avocados, nuts, and fatty fish like salmon
- Incorporating soluble fiber from oats, barley, beans, and fruits, which can help remove cholesterol from the body
- Adding plant sterols and stanols found naturally in plants or in fortified foods like certain margarines, which can reduce LDL cholesterol
- Limiting dietary cholesterol by reducing consumption of egg yolks and organ meats
- Including omega-3 fatty acids from fish, flaxseeds, and walnuts to help raise HDL (good) cholesterol
Choosing whole-grain, high-fiber foods is also crucial, as dietary patterns high in these foods have been associated with increased diet quality and decreased risk of cardiovascular disease 1. By following these dietary recommendations and making lifestyle changes, individuals can substantially reduce their risk of developing cardiovascular disease, which remains the leading cause of morbidity and mortality in the United States 1.
From the Research
Dietary Recommendations for Lowering Hypercholesterolemia
To help lower hypercholesterolemia, or high cholesterol, several dietary recommendations can be followed:
- A healthy diet should be rich in vegetables and fruits, whole-grain, high-fiber foods, and fish, and should contain a small amount of saturated and trans fats 2
- Increased dietary fiber intakes are associated with significantly lower prevalence of cardiovascular disease and lower LDL-cholesterol concentration of about 5-10% 2, 3, 4
- Some food ingredients such as plant sterol/stanol, soy protein, and isoflavones may help reduce cholesterol levels 2, 5
- Combining a number of foods and food components in a single dietary portfolio, such as the portfolio diet, may lower LDL-C similarly to statins 5
- Consumption of dietary soluble fibers, such as water-soluble, viscous-forming fibers, can reduce total and low-density lipoprotein cholesterol levels by about 5-10% 3, 4
- Fiber-rich foods, such as whole oats, whole barley, legumes, peas, beans, flax seeds, apples, and citrus foods, can also provide hypocholesterolemic benefits 3
- A Mediterranean diet, which is rich in fruits, vegetables, whole grains, low-fat dairy, and fish or other omega-3 fatty acids, is strongly recommended for lowering CVD and total mortality 6
- Minimizing saturated fats and refined carbohydrates, eliminating trans-fat, and increasing omega-3 fatty acids can also help reduce cardiovascular risk 6