What type of diet is recommended for someone with hypercholesterolemia (high cholesterol)?

Diet Recommendations for High Cholesterol

For individuals with high cholesterol, a diet low in saturated fat and cholesterol, high in soluble fiber, and rich in plant sterols/stanols is strongly recommended to reduce LDL cholesterol levels and cardiovascular risk.

Key Dietary Components

Fats and Cholesterol

• Limit saturated fat intake to less than 7% of total daily calories to effectively reduce LDL cholesterol levels 1
• Reduce dietary cholesterol to less than 200 mg per day 1
• Minimize trans fatty acids consumption, as they raise LDL cholesterol similar to saturated fats 1
• Replace saturated fats with monounsaturated fats (olive oil, canola oil) and polyunsaturated fats (corn oil, sunflower oil), which can lower LDL cholesterol without decreasing HDL cholesterol 1, 2
• Select lean cuts of meat, remove skin from poultry before eating, and limit processed meats high in saturated fat 1

Fiber and Plant Foods

• Increase soluble fiber intake (10-25g/day) from oats, psyllium, pectin, and guar gum, which can reduce LDL cholesterol by approximately 2.2 mg/dL per gram of soluble fiber 1, 3
• Consume a diet rich in vegetables and fruits, which are associated with lower risk of cardiovascular disease 1
• Choose whole grains over refined carbohydrates to avoid potential increases in triglycerides and reductions in HDL cholesterol 1
• Incorporate vegetable-based meat substitutes into meals 1

Plant Stanols/Sterols

• Add plant stanols/sterols (2g/day) to your diet, which can lower LDL cholesterol by up to 15% 1
• Plant stanols/sterols are available in various foods (margarine, orange juice) and supplements 1
• Daily consumption is necessary to maintain cholesterol-lowering effects 1

Dairy and Protein Sources

• Select fat-free or low-fat milk and dairy products 1
• Consider incorporating soy protein into your diet, which may help reduce LDL cholesterol, especially in those with elevated levels 1
• Consume fish rich in omega-3 fatty acids at least twice weekly; for those with hypertriglyceridemia, 2-4g of EPA+DHA per day under physician supervision may be beneficial 1

Special Considerations

For Individuals with Elevated Triglycerides

• Moderate fat and carbohydrate intake rather than following a very low-fat diet 4
• Limit refined carbohydrates and sugars, which can raise triglyceride levels 1, 5
• Include omega-3 fatty acids from fish or supplements to help lower triglycerides 1, 5
• Limit alcohol consumption, as it can aggravate hypertriglyceridemia 1

For Individuals with Metabolic Syndrome

• Focus on modest weight loss, which can improve lipid profiles 1
• Increase physical activity to reduce triglycerides and improve insulin sensitivity 1
• Consider a diet with monounsaturated fats rather than high carbohydrate intake 1

Practical Implementation Tips

• Compare sodium content of similar products and choose those with less salt 1
• Grill, bake, or broil fish, meat, and poultry instead of frying 1
• Consume whole vegetables and fruits rather than juices 1
• If consuming alcohol, limit to no more than 1 drink per day for women and 2 drinks per day for men 1
• Maintain appropriate calorie intake to achieve or maintain healthy weight 1

Common Pitfalls to Avoid

• Replacing saturated fats with refined carbohydrates can worsen lipid profiles by increasing triglycerides and reducing HDL cholesterol 1
• Focusing only on total cholesterol without considering other lipid parameters (LDL, HDL, triglycerides) 6
• Inconsistent use of plant stanols/sterols, which requires daily consumption to maintain effectiveness 1
• Overlooking the importance of weight management and physical activity as part of comprehensive cholesterol management 1

Remember that dietary changes should be part of a comprehensive approach that includes regular physical activity and weight management for optimal cholesterol reduction and cardiovascular risk reduction 1.