TO REDUCE YOUR RISK OF HEART DISEASE AND HIGH BLOOD PRESSURE, ADD THESE 6 FOODS TO YOUR DAILY MEALS—AND AVOID THESE 5
Hypercholesterolemia, or high cholesterol, is a common condition among U.S. adults. Elevated cholesterol can raise the risk of heart disease, stroke, and high blood pressure. However, making sustainable lifestyle changes, using medications when appropriate, and following a heart-healthy, low-cholesterol diet can help lower cholesterol levels and reduce the risk of related health problems.
Key takeaways
- High cholesterol can raise the risk of heart disease, stroke, and high blood pressure. It can often be managed through healthy lifestyle habits, appropriate medication, and dietary changes.
- The Mediterranean and DASH diets are commonly recommended for cholesterol management, with an emphasis on fruits, vegetables, whole grains, and healthier fats.
- Foods that can support a low-cholesterol eating pattern include fiber-rich fruits and vegetables, legumes, oily fish, nuts, healthy fats, and whole grains.
- Limit foods high in red meat, saturated or trans fats, refined sugars, fried foods, and processed foods. Egg yolks may also need to be limited depending on your individual dietary needs.
What is high cholesterol?
There are two primary types of cholesterol found in the blood: low-density lipoprotein (LDL), often described as “bad” cholesterol, and high-density lipoprotein (HDL), commonly known as “good” cholesterol. Total cholesterol reflects the combined levels of LDL, HDL, and triglycerides. A commonly used reference range for total cholesterol is 125–200 mg/dL, although the range can vary between laboratories.
Cardiologist and lipidologist Robert Greenfield, MD, notes that dietary choices and overall eating patterns can affect cholesterol levels.
Managing high cholesterol typically involves choosing foods that support healthier cholesterol levels while limiting foods that may have the opposite effect. Medication, regular exercise, and other lifestyle changes can also be part of a cholesterol-management plan.
The best diets to lower your cholesterol
To help lower cholesterol and support cardiovascular health, focus on a diet built around fiber-rich foods, fruits, vegetables, legumes, healthy fats, and whole grains. Nutritionist Dawn Jackson Blatner, RDN, recommends this type of eating pattern as part of a heart-healthy approach.
Experts commonly recommend two dietary patterns for people looking to improve their cholesterol levels:
Mediterranean-style diet
A Mediterranean-style eating pattern emphasises fruits, vegetables, potatoes, nuts, seeds, and olive oil, with smaller amounts of dairy, eggs, fish, and poultry. Red meat is generally limited or avoided.
For people who are significantly overweight and consume substantial amounts of saturated or trans fats, following a Mediterranean-style diet alongside calorie reduction and regular exercise may help lower cholesterol levels, according to Dr. Greenfield.
DASH diet
Another heart healthy diet to consider is the DASH (Dietary Approaches to Stop Hypertension) diet, which helps lower high blood pressure and improves cholesterol levels. Dr. Greenfield recommends this program because it emphasizes vegetables, fruits, legumes, and whole grains.
The DASH eating plan also encourages fat-free or low-fat dairy products, beans, fish, nuts, and vegetable oils, but limits fatty cuts of meat, full-fat dairy products, refined and processed carbohydrates like sweets, and tropical oils.
6 foods to eat when following a low-cholesterol diet
With that in mind, here are six foods to include in your low-cholesterol diet.
1. Fruits and vegetables
Make fiber-rich fruits and vegetables a regular part of a low-cholesterol diet. Good options include Brussels sprouts, avocado, spinach, kale, okra, eggplant, carrots, pears, apples, and berries.
2. Legumes
Beans and other legumes provide plenty of fiber and plant-based protein. Good choices include kidney beans, chickpeas, black beans, pinto beans, and lentils.
3. Oily fish
Fish such as salmon, herring, mackerel, and sardines are rich in heart-friendly omega-3 fatty acids. For people who do not eat fish, Dr. Greenfield notes that an omega-3 fish oil supplement containing a substantial amount of EPA may be another option to discuss with a healthcare provider.
4. Healthy fats and nuts
A cholesterol-conscious diet should favour monounsaturated and polyunsaturated fats over saturated fats. Sources include avocados, olives, walnuts, almonds, pecans, flaxseeds, chia seeds, sunflower seeds, and pumpkin seeds.
5. Healthier cooking oils
Choosing unsaturated fats for cooking can also support a heart-healthy diet. Options include olive, canola, avocado, safflower, peanut, soybean, sunflower, sesame, grapeseed, and flaxseed oils. Canola and avocado oils are particularly rich in monounsaturated fats, while oils such as flaxseed and safflower provide polyunsaturated fats.
6. Whole grains and oat bran
Oat bran contains soluble fiber called beta-glucan, which may help reduce cholesterol levels. Other whole grains, including brown rice, bulgur, quinoa, and steel-cut oats, can also be incorporated into a cholesterol-friendly diet.
Of the two main types of dietary fiber—soluble and insoluble—soluble fiber is particularly helpful for cholesterol management. It can bind some cholesterol in the digestive tract and help the body eliminate it, which may contribute to lower LDL cholesterol levels.
5 foods to avoid in a low-cholesterol diet
A low-cholesterol eating pattern should limit saturated fats, trans fats, and added sugars, including sweeteners such as high-fructose corn syrup. The following foods and drinks are generally best to avoid or consume in smaller amounts when managing high cholesterol:
1. Red meats and processed meats
2. Fried foods and highly processed foods
Limit fried foods, fast food, and highly processed foods, particularly items such as deep-fried foods, chips, deli meats, bacon, and hot dogs. Reducing these foods may help support healthier LDL cholesterol levels.
3. Saturated and trans fats
Foods high in saturated and trans fats should be limited when trying to lower cholesterol. The American Heart Association recommends keeping saturated fat below 6% of daily calories for people who need to reduce cholesterol.
Trans fats can be found in foods such as margarine, baked goods, non-dairy coffee creamers, and fried foods. Since saturated fats are common in many foods, checking nutrition labels can help identify and limit them.
Although lard contains less saturated fat and more monounsaturated fat than butter, healthier oils such as olive oil are still preferable when possible.
4. Added sugars
Highly processed and refined sugars found in soda, desserts, cakes, pastries, and packaged foods can contribute to a less heart-healthy diet. Foods containing ingredients such as high-fructose corn syrup are best limited.
High consumption of refined carbohydrates may also contribute to higher triglyceride levels.
5. Egg yolks
Eggs can be included in a balanced diet, but people managing high cholesterol may choose egg whites more often than yolks. Egg yolks contain cholesterol, fat, and calories, while egg whites provide protein without the cholesterol found in the yolk.
Is fasting good for high cholesterol?
Intermittent fasting involves alternating between periods of eating and fasting. The schedule can vary depending on a person’s goals and preferences. For example, the 16/8 method involves fasting for 16 hours each day and eating within an 8-hour window, while the eat-stop-eat approach involves a 24-hour fast once or twice a week.
Research published in Frontiers in Nutrition suggests that intermittent fasting may support cardiovascular health by improving lipid profiles. In particular, the study found that fasting may increase HDL cholesterol, often referred to as “good” or protective cholesterol.
Other ways to lower cholesterol
A heart-healthy, low-cholesterol diet can help manage cholesterol levels, but dietary changes may not always be enough on their own. Other approaches that may be used to help lower cholesterol include:
- Regular physical activity
- Weight loss, when appropriate
- Cholesterol-lowering medications
Regular exercise
Increasing physical activity may help improve cholesterol levels. Research suggests that regular exercise can raise HDL (“good”) cholesterol and may help counter increases in LDL cholesterol. Beyond cholesterol management, staying physically active also provides a range of broader health benefits.
Losing weight
Cholesterol-lowering medications
Dietary changes and regular exercise can help manage cholesterol, but they may not be enough for everyone. Genetics can also play a significant role in cholesterol levels, and some people may need prescription treatment.
Statins are commonly prescribed to help lower cholesterol. Examples include:
- Lipitor (atorvastatin)
- Lescol (fluvastatin)
- Mevacor (lovastatin)
- Pravachol (pravastatin)
- Crestor (rosuvastatin)
If statins do not provide enough cholesterol reduction, a healthcare provider may consider PCSK9 inhibitors, which are injectable medications administered once or twice a month. Examples include Praluent (alirocumab) and Repatha (evolocumab).
The appropriate medication depends on factors such as cholesterol levels, cardiovascular risk, medical history, and how a person responds to treatment.
When to see your doctor
If high cholesterol runs in your family, consider discussing your cholesterol levels with a healthcare provider. Elevated LDL cholesterol can increase the risk of heart disease.
Some people have familial hypercholesterolemia (FH), an inherited condition that makes it harder for the body to remove LDL cholesterol from the bloodstream. As a result, LDL levels can remain unusually high.
Source: SingleCare