What foods can help reduce low-density lipoprotein (LDL) cholesterol levels?

Foods to Reduce Blood Cholesterol

To lower LDL cholesterol through diet, prioritize reducing saturated fat to 5-6% of total calories, completely eliminate trans fats, add 2 grams daily of plant stanols/sterols, and increase soluble fiber to 10-25 grams daily—this combination can reduce LDL cholesterol by approximately 20-30%. 1

Primary Dietary Modifications (Highest Impact)

Reduce Saturated Fat

• Limit saturated fat to 5-6% of total daily calories, which alone can lower LDL by 11-13 mg/dL 1
• Saturated fat is the principal dietary determinant of LDL cholesterol levels 2
• Replace saturated fats with polyunsaturated fats (PUFA), which lowers LDL by 1.8 mg/dL for every 1% of energy replaced 1
• Choose liquid vegetable oils over animal fats, and select fat-free or low-fat dairy products instead of full-fat versions 3

Eliminate Trans Fats Completely

• Avoiding trans fats can lower LDL by 2.0 mg/dL for every 1% of energy replaced with PUFA 1
• Trans fats are found in partially hydrogenated vegetable oils (cookies, crackers, baked goods, commercially prepared fried foods, and some margarines) 2
• Limit trans fat intake to less than 1% of total energy 3

Add Plant Stanols/Sterols

• Consume 2 grams daily of plant stanols/sterols, which can lower LDL by 10-15% (8-29 mg/dL) 1
• These are available in fortified margarines, orange juice, or soft gel capsules 3
• Maximum LDL-lowering effect plateaus at doses above 3 grams per day 4
• Take with meals for optimal absorption 4

Increase Soluble Fiber

• Consume 10-25 grams of soluble fiber daily from oats, beans, barley, psyllium, vegetables, and fruits 1
• Each gram of soluble fiber consumed lowers LDL by approximately 2.2 mg/dL 2, 1
• This provides 5-10% LDL cholesterol reduction overall 3, 5
• Choose whole grains over refined grains for all grain servings 1

Secondary Dietary Interventions

Limit Dietary Cholesterol

• General population should limit dietary cholesterol to <300 mg/day 3
• Individuals with elevated LDL, diabetes, or cardiovascular disease should restrict cholesterol to <200 mg/day 2, 3
• Dietary cholesterol increases LDL levels, though to a lesser extent than saturated fat 2
• Cholesterol-rich foods low in saturated fat (egg yolks, shellfish) have smaller effects on LDL 2

Add Soy Protein

• Consuming 20-50 grams of soy protein daily (containing isoflavones) can reduce LDL by 3-10% 1, 5

Include Nuts

• Regular nut consumption can lower LDL cholesterol by approximately 8% 5
• Nuts provide healthy unsaturated fats and fiber 1

Comprehensive Dietary Pattern Approach

Mediterranean Diet Pattern

• Adopt a dietary pattern rich in vegetables, fruits, whole grains, fish, legumes, nuts, and olive oil while limiting red meat and full-fat dairy 1
• This reduces cardiovascular events by 10% for every 2-point increase in Mediterranean diet adherence score 1
• Emphasize deeply colored vegetables and fruits (spinach, carrots, berries) for higher micronutrient content 1, 3

Practical Food Selection

• Use grilling, baking, or broiling instead of frying 3
• Choose lean cuts of meat and remove poultry skin before eating 3
• Limit processed meats high in saturated fat 3

Critical Implementation Considerations

Avoid Common Pitfalls

• Do not simply reduce total fat without replacing saturated fat with healthier fats, as this can raise triglycerides and lower HDL cholesterol 1, 3
• Avoid very low-fat/high-carbohydrate diets (>60% of energy from carbohydrates) in individuals with elevated triglycerides, as these can worsen lipid profiles 2, 3
• Use moderate-fat diets with monounsaturated fats instead for those with hypertriglyceridemia 3

Weight Management Enhancement

• Even modest weight loss (5-10% of body weight) enhances all lipid-lowering dietary interventions 1, 3
• Weight loss improves dyslipidemia before reaching ideal body weight 3
• Regular aerobic exercise improves insulin sensitivity and reduces triglycerides 1

Timeline and Monitoring

Expected Outcomes

• Evaluate LDL response after 6 weeks of dietary changes 1, 3
• Re-evaluate after another 6 weeks to determine if medication should be considered if goals are not met 1, 3
• Monitor adherence every 4-6 months for long-term success 1, 3
• Expect a total potential LDL reduction of approximately 20-30% with comprehensive dietary intervention combining multiple strategies 1, 6

When to Escalate Treatment

• If therapeutic lifestyle changes fail to achieve LDL goals after 12 weeks, medication should be considered while maintaining dietary modifications 1
• Dietary interventions remain important even when pharmacotherapy is initiated 1