What diet is recommended for hyperlipidemia (high cholesterol)?

From the Guidelines

A diet for hyperlipidemia should focus on reducing saturated and trans fats while increasing fiber and heart-healthy foods, as recommended by the American Heart Association 1. To achieve this, it is essential to limit saturated fats to less than 7% of daily calories by reducing red meat, full-fat dairy, and processed foods.

• Eliminate trans fats found in fried foods and some baked goods.
• Instead, consume more monounsaturated and polyunsaturated fats from olive oil, avocados, nuts, and fatty fish like salmon, which contain omega-3 fatty acids that help lower triglycerides 1.
• Increase soluble fiber intake to 10-25 grams daily through foods like oats, beans, fruits, and vegetables, as it binds to cholesterol in the digestive system.
• Add plant sterols and stanols found in fortified foods to help block cholesterol absorption.
• Limit dietary cholesterol to under 200mg daily and reduce added sugars and refined carbohydrates that can raise triglycerides.
• Maintain a healthy weight and moderate alcohol consumption, as excessive alcohol consumption can negatively impact cardiovascular health 1. This diet works by reducing LDL (bad) cholesterol production in the liver, increasing HDL (good) cholesterol, and decreasing triglyceride levels, ultimately lowering cardiovascular disease risk. The most recent and highest quality study 1 supports these recommendations, emphasizing the importance of a balanced diet and lifestyle in managing hyperlipidemia and reducing the risk of cardiovascular disease.

From the Research

Dietary Recommendations for Hyperlipidemia

The recommended diet for hyperlipidemia (high cholesterol) includes:

• Consuming foods high in soluble fiber, such as whole oats, whole barley, legumes, peas, beans, flax seeds, apples, and citrus foods 2
• Eating a diet low in saturated fat (< 4 percent of total calories) and cholesterol (< 25 mg per 1000 kcal) 3
• Increasing intake of polyunsaturated and monounsaturated fats 4
• Fortifying foods with plant stanols or sterols 5, 4
• Adopting a Portfolio, Mediterranean, low-carbohydrate, or low-fat diet 4
• Consuming one or two alcoholic drinks per day 4
• Eating fatty marine fish or taking marine-derived omega-3 fatty acid supplements 4

Key Nutrients and Foods

Key nutrients and foods that can help lower cholesterol levels include:

• Soluble fiber: can lower total and low-density lipoprotein (LDL) cholesterol levels by about 5-10% 3, 2
• Plant sterols/stanols: can lower LDL cholesterol by about 10% for a 2 g/day dose 6, 5
• Nuts: can lower LDL cholesterol by about 8% 5
• Soy protein: can lower LDL cholesterol by about 3-10% 5
• Fish oil: can lower triglyceride by a mean of 0.45 mmol/L for a 3.5 g/day amount 6
• Konjac glucomannan: a type of soluble fiber that is effective in lowering LDL cholesterol 6

Lifestyle Changes

In addition to dietary changes, regular aerobic exercise can also have beneficial effects on lipid levels, particularly if performed for at least 120 minutes per week 4. Brief physician counseling can also have relatively small effects on unselected patients, so efforts should be concentrated on patients who are motivated and ready to make lifestyle changes 4.