From the Guidelines
The Mediterranean diet is the most effective diet for decreasing Low-Density Lipoprotein (LDL) levels, as it emphasizes consuming olive oil, nuts, fruits, vegetables, whole grains, legumes, and fish while limiting red meat, processed foods, and added sugars. This diet has been consistently shown to lower LDL cholesterol levels by incorporating plenty of soluble fiber, plant sterols and stanols, and omega-3 fatty acids. According to the most recent guidelines, a healthy plant-based and Mediterranean-based diet can reduce saturated fat and optimize caloric intake to include higher intake of monounsaturated fats, polyunsaturated fats, and complex carbohydrates 1.
The key components of the Mediterranean diet that contribute to its LDL-lowering effects include:
- Soluble fiber, found in oats, beans, and fruits, which binds to cholesterol in the digestive system, preventing its absorption
- Plant sterols and stanols, found in vegetable oils and nuts, which compete with cholesterol for absorption in the intestines
- Omega-3 fatty acids, found in fatty fish like salmon, which have been shown to have cardioprotective effects
- Monounsaturated fats, found in olive oil, which help lower LDL without affecting beneficial HDL cholesterol
The benefits of the Mediterranean diet are supported by a recent Cochrane review of randomized trials, which highlighted a 17% reduction of CVD events in patients with chronic coronary disease by reducing saturated fat intake and altering dietary fats 1. Additionally, the American Heart Association recommends lowering saturated fatty acids to <6% of total caloric intake, which can be achieved through a Mediterranean-style diet 2.
For optimal LDL reduction, it is recommended to:
- Add 25-30 grams of fiber daily
- Consume 2 grams of plant sterols/stanols daily
- Incorporate regular physical activity, such as at least 150 minutes of moderate exercise weekly, to enhance cholesterol-lowering effects 2.
Overall, the Mediterranean diet is a well-established and effective approach to lowering LDL cholesterol levels and reducing the risk of cardiovascular disease.
From the Research
Diet Comparison for LDL Reduction
The most effective diet for decreasing Low-Density Lipoprotein (LDL) levels can be determined by examining the results of various studies.
- The Portfolio-Mediterranean Diet has been shown to reduce LDL levels by 25% in the short term in individuals with hypercholesterolemia 3.
- A dietary portfolio that includes a combination of plant sterols, fibres, nuts, and soy protein can reduce LDL-C levels by 20% to 30% in individuals with hyperlipidaemia 4.
- The Portfolio dietary pattern, which combines recognized cholesterol-lowering foods, has been found to reduce LDL-C by approximately 17% when given on a background of a National Cholesterol Education Program (NCEP) Step II diet 5.
- A diet rich in vegetables, fruits, whole-grain, high-fiber foods, and fish, and low in saturated and trans fats, can also help reduce LDL-cholesterol levels, with increased dietary fiber intakes associated with significantly lower prevalence of cardiovascular disease and lower LDL-cholesterol concentration of about 5-10% 6.
Key Components for LDL Reduction
The key components that contribute to the reduction of LDL levels include:
- Plant sterols, which can reduce LDL-cholesterol levels by 10% 6, 4
- Viscous fibers, which can reduce LDL-cholesterol levels by 5-10% 6, 4
- Soy protein, which can reduce LDL-cholesterol levels by 3-10% 6, 4
- Nuts, which can reduce LDL-cholesterol levels by 8% 6
Study Findings
The studies found that:
- A Portfolio-Mediterranean Diet reduced LDL levels by 44±4 mg/dL in individuals with hypercholesterolemia 3
- A dietary portfolio reduced LDL-C levels by approximately 30% in individuals with hyperlipidaemia 4
- The Portfolio dietary pattern reduced LDL-C by approximately 17% in individuals with hyperlipidemia 5
- A diet rich in vegetables, fruits, whole-grain, high-fiber foods, and fish, and low in saturated and trans fats, can reduce LDL-cholesterol levels by 5-10% 6