From the Guidelines
To reduce cholesterol, focus on foods rich in soluble fiber, healthy fats, and plant sterols, as recommended by the most recent guidelines 1. The best approach to reducing cholesterol involves a combination of dietary changes that aim to lower LDL (bad) cholesterol and increase HDL (good) cholesterol.
- Foods rich in soluble fiber, such as oatmeal, barley, and other whole grains, contain beta-glucan fiber that helps lower LDL cholesterol 1.
- Legumes like beans, lentils, and chickpeas are excellent choices as they're high in fiber and protein while being low in fat.
- Include fatty fish such as salmon, mackerel, and sardines, which contain omega-3 fatty acids that reduce triglycerides and inflammation 1.
- Nuts, particularly walnuts and almonds, provide healthy fats and fiber that help manage cholesterol levels.
- Avocados contain monounsaturated fats that can lower LDL while raising HDL (good) cholesterol.
- Olive oil is another good source of monounsaturated fats and should replace saturated fats in cooking.
- Fruits like apples, citrus, and berries contain pectin, a type of soluble fiber that helps lower cholesterol.
- Dark leafy greens and cruciferous vegetables provide nutrients and fiber with minimal calories.
- Foods fortified with plant sterols and stanols, such as certain margarines and orange juices, can block cholesterol absorption, with daily intake of up to 2g of plant sterols recommended for optimal benefit 1. It's also important to limit saturated fat intake to 5% to 6% of calories, as recommended by the 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk 1. By following these dietary recommendations, individuals can effectively reduce their cholesterol levels and improve their overall cardiovascular health.
From the Research
Foods for Reducing Cholesterol
The following foods have been identified as beneficial for reducing cholesterol levels:
- Phytosterols: found in plants, these compounds inhibit cholesterol absorption, thereby reducing total- and LDL cholesterol 2, 3, 4
- Omega-3 fatty acids: found in fish oil, these fatty acids have been associated with significant hypotriglyceridemic effects and concurrent modifications of other risk factors associated with cardiovascular disease 2, 3, 4, 5
- Fatty fish: rich in omega-3 fatty acids, these fish can help lower triglycerides and raise HDL-cholesterol 5
- Plant-based diets: diets rich in healthful complex carbohydrates, such as whole grains, fruits, and vegetables, can help reduce CVD risk 5
- Mediterranean diet: this diet, which emphasizes whole grains, fruits, vegetables, low-fat dairy, and fish or other omega-3 fatty acids, has been shown to lower CVD and total mortality 5
Mechanisms of Action
The mechanisms by which these foods reduce cholesterol levels are:
- Inhibition of cholesterol absorption: phytosterols inhibit the absorption of cholesterol in the gut, thereby reducing total- and LDL cholesterol 2, 3, 4
- Reduction of triglycerides: omega-3 fatty acids have been shown to reduce plasma triglyceride concentrations 2, 3, 4, 5
- Modification of other risk factors: omega-3 fatty acids have been shown to modify other risk factors associated with cardiovascular disease, including platelet function and pro-inflammatory mediators 2, 3, 4