What are the best foods for reducing hypercholesterolemia (high cholesterol)?

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 and lifestyle modifications. Key foods to include in your diet are:

• Oatmeal, barley, and other whole grains that contain beta-glucan fiber, which helps lower LDL (bad) cholesterol 1
• Legumes like beans, lentils, and chickpeas, which are high in fiber and protein while being low in fat
• Fatty fish such as salmon, mackerel, and sardines, which provide omega-3 fatty acids that raise HDL (good) cholesterol and lower triglycerides
• Nuts, particularly walnuts and almonds, which contain plant sterols and healthy monounsaturated fats that improve cholesterol profiles
• Avocados, olive oil, and other sources of monounsaturated fats, which help reduce LDL while maintaining HDL levels
• Fruits and vegetables, especially apples, citrus fruits, and berries, which provide pectin and other fibers that bind cholesterol It is also essential 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. Additionally, choosing whole-grain, high-fiber foods, as suggested by the American Heart Association nutrition committee 1, can help increase diet quality and decrease the risk of cardiovascular disease. By combining these dietary changes with regular exercise and maintaining a healthy weight, you can effectively reduce your cholesterol levels and improve your overall health.

From the Research

Foods for Reducing Cholesterol

• A healthy diet should be rich in:
  • Vegetables and fruits
  • Whole-grain, high-fiber foods
  • Fish
  • Small amount of saturated and trans fats 2
• Some food ingredients that may help reduce cholesterol levels:
  • Plant sterol/stanol
  • Soy protein
  • Isoflavones 2
• Increased dietary fiber intakes are associated with:
  • Significantly lower prevalence of cardiovascular disease
  • Lower LDL-cholesterol concentration of about 5-10% 2
• Beneficial effects of specific foods:
  • Phytosterols: inhibit cholesterol absorption, reduce total- and LDL cholesterol 3, 4, 5
  • Omega-3 fatty acids: reduce circulating triglycerides, raise HDL-cholesterol 3, 4, 5
  • Nuts: reduce LDL-cholesterol 2
• Combination of phytosterols and omega-3 fatty acids:
  • Synergistic and complementary lipid-lowering effects in hyperlipidemic individuals 4
  • Potential strategy to promote cardiovascular health 5