What diet is recommended for managing hyperlipidemia (high cholesterol)?

From the Guidelines

A diet for managing hyperlipidemia should focus on reducing saturated and trans fats, increasing soluble fiber intake, and consuming heart-healthy foods, as recommended by the American Heart Association and supported by studies such as 1. To manage hyperlipidemia, it is essential to limit saturated fat to less than 7% of daily calories and avoid trans fats found in processed foods. Instead, consume lean proteins like fish, especially salmon and mackerel rich in omega-3 fatty acids, skinless poultry, and plant proteins such as beans and lentils. Increasing soluble fiber intake to 10-25 grams daily through foods like oats, barley, fruits, vegetables, and legumes helps bind cholesterol in the digestive system. Some key recommendations include:

• Limiting dietary cholesterol to under 200mg daily
• Reducing added sugars and refined carbohydrates to prevent triglyceride elevation
• Choosing whole-grain, high-fiber foods, as suggested by 1 and 1
• Consuming fish, especially oily fish, at least twice a week, as recommended by 1 and 1
• Minimizing intake of partially hydrogenated fats and choosing fat-free or low-fat dairy products, as stated in 1 and 1 The Mediterranean diet pattern is particularly beneficial, emphasizing olive oil, nuts, fruits, vegetables, whole grains, and fish while limiting red meat and processed foods. Portion control and weight management are essential as excess weight contributes to dyslipidemia. These dietary changes work by reducing LDL cholesterol production in the liver, increasing cholesterol excretion, and improving the ratio of good to bad cholesterol, ultimately lowering cardiovascular disease risk, as supported by 1.

From the Research

Dietary Recommendations for Managing Hyperlipidemia

To manage hyperlipidemia, the following dietary recommendations are suggested:

• Reduce saturated fat consumption as much as possible 2
• Replace saturated fats with unsaturated fats, including polyunsaturated fatty acids (PUFAs) and monounsaturated fatty acids (MUFAs) 2, 3, 4
• Limit dietary fat to no more than 30% of total calorie intake 3
• Limit saturated fatty acids to no more than 7% of total calorie intake 3
• Limit polyunsaturated fatty acids to 7-10% of total calorie intake 3
• Increase consumption of complex carbohydrates, dietary fiber (more than 20g/d), and fruits and vegetables 3, 4
• Consider consuming foods fortified with plant stanols or sterols, tree nuts, and fatty marine fish or taking marine-derived omega-3 fatty acid supplements 4

Specific Dietary Approaches

The following dietary approaches may be beneficial for managing hyperlipidemia:

• Portfolio diet 4
• Mediterranean diet 4
• Low-carbohydrate diet 4
• Low-fat diet 4
• Diet enriched with omega-3 fatty acids, such as salmon 5

Effects of Fatty Acids on Lipoproteins

Different fatty acids have varying effects on lipoproteins:

• Saturated fatty acids raise low-density lipoprotein (LDL) cholesterol levels, except for stearic acid 6
• Trans-monounsaturated fatty acids raise LDL cholesterol 6
• Polyunsaturated fatty acids lower LDL cholesterol 6
• Omega-3 fatty acids from fish lower triglyceride levels 6