The primary goal of this diet is to lower your levels of low-density lipoprotein (LDL), or bad, cholesterol. This diet may also raise your levels of high-density lipoprotein (HDL), or good cholesterol. Having too much LDL cholesterol, and/or not enough HDL cholesterol can lead to a condition known as atherosclerosis, which causes plaque to build up in your arteries. Plaque buildup narrows and hardens your arteries, increasing your risk of having a heart attack or stroke.
Cholesterol level is one factor considered when determining your overall risk of having a heart attack, heart disease, or stroke. Other factors that are considered include:
A cholesterol-lowering diet may be recommended if you are at high risk for heart disease or stroke. The goal of this diet is to lower bad cholesterol and increase good cholesterol.
Diet is just one of the factors that affect the level of cholesterol in the body. Adjusting certain elements in your diet may help to lower your blood cholesterol levels.
Fat is an essential nutrient with many responsibilities, including transporting the fat soluble vitamins A, D, E, and K; protecting vital organs, and providing a sense of fullness after meals. Fat can be broken down into 4 main types:
Fats that increase LDL levels and should be avoided or limited:
Found in margarine and vegetable shortening, shelf stable snack foods, and fried foods, it increases total blood cholesterol, especially LDL levels.
Hydrogenated or trans fat
Found in margarine and vegetable shortening, it increases total blood cholesterol, including LDL levels. It also decreases HDL levels.
Fats that improve cholesterol profile and should be eaten in moderation:
Found in oils such as olive and canola, it can decrease total cholesterol level while keeping levels of HDL high.
Found in oils such as safflower, sunflower, soybean, corn, and sesame, it can decrease total cholesterol.
Less than 5-6% of calories should come from saturated fat on a cholesterol-lowering diet. Trans fat intake should be kept as low as possible with a goal to eliminate them completely.
On an 2,000 calorie diet, this translates into less than 13 grams of saturated fat per day. The majority of fats you eat should be mono- and polyunsaturated fats.
Dietary cholesterol is found only in animal products. Although dietary cholesterol can increase LDL cholesterol, it does not affect it nearly as much as saturated or trans fats. On a cholesterol-lowering diet, you should eat as little dietary cholesterol as possible while eating a healthful diet.
Eating a diet high in soluble fiber can help lower your LDL cholesterol. There are 2 main types of fiber: soluble and insoluble. While both are very important to health, only soluble fiber impacts cholesterol levels. When soluble fiber is digested, it dissolves into a gel-like substance that helps block the absorption of fat and cholesterol into the bloodstream.
Soluble fiber is found in foods such as oatmeal, oat bran, barley, soy products, legumes, apples, and strawberries. On a cholesterol-lowering diet, you should consume at least 5-10 grams of soluble fiber per day, and ideally 10-25 grams.
Stanols and sterols are substances found in certain plants. Plant stanols and sterols can lower LDL cholesterol levels in a similar way to soluble fiber, by blocking their absorption from the digestive tract. Certain foods, including margarines and orange juice, are now being fortified with these cholesterol-lowering substances. Research shows that consuming at least 2 grams of plant stanols or sterols a day can reduce LDL cholesterol by more than 10%.
|Food Category||Foods Recommended||Foods to Avoid|
|Meat and beans|
|Fats and oil|
|Snacks, sweets, and condiments|
Try different foods and make changes based on what you like to eat. It may take some time to get comfortable with new changes.
Eat Right—Academy of Nutrition and Dietetics
National Heart, Lung, and Blood Institute
Dietitians of Canada
Heart and Stroke Foundation of Canada
Dietary guidelines for Americans 2015-2020. Choose My Plate—US Department of Agriculture website. Available at: https://www.choosemyplate.gov/2015-2020-dietary-guidelines-answers-your-questions. Updated January 7, 2016. Accessed September 14, 2016.
About cholesterol. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/Cholesterol/AboutCholesterol/About-Cholesterol_UCM_001220_Article.jsp. Updated July 31, 2014. Accessed September 10, 2015.
Dietary guidelines for Americans 2010. US Department of Agriculture and US Department of Health and Human Services. Available at: http://www.health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf. Accessed September 10, 2015.
Dietary interventions for cardiovascular disease prevention. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 21, 2015. Accessed September 10, 2015.
Eckel RH, Jakicic JM, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(25 Suppl 2):S76-S99.
Goff DC Jr. Lloyd-Jones DM, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;63(25 pt B):2935-2959.
Harland JI. Food combinations for cholesterol lowering. Nutr Res Rev. 2012;25(2):249-266.
Hypercholesterolemia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 1, 2015. Accessed September 10, 2015.
Know your fats. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/Cholesterol/PreventionTreatmentofHighCholesterol/Know-Your-Fats_UCM_305628_Article.jsp#.V9ll9DVuMpk. Updated March 28, 2016. Accessed September 14, 2016.
Lowering your cholesterol with TLC. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/public/heart/chol/chol_tlc.pdf. Published December 2005. Accessed September 10, 2015.
What your cholesterol levels mean. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/Cholesterol/AboutCholesterol/What-Your-Cholesterol-Levels-Mean_UCM_305562_Article.jsp. Updated August 21, 2015. Accessed September 10, 2015.
Last reviewed September 2016 by Dianne Scheinberg Rishikof MS, RD, LDN
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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